Senate Bill 1043—Manual Restraints in Short-Term Residential Therapeutic Programs
Implementation of California’s Accountability in Children’s Treatment Act
Background
Manual restraints involve the use of hands-on or other physically applied techniques to temporarily limit a child’s movement. These techniques may include forced escorts and holding (also known as behavioral restraints), containment techniques, and protective separation (also known as seclusion), and are intended to help maintain a safe environment for all children and staff. The use of manual restraints is strictly regulated by state licensing standards specified in Short-Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS), Article 10 Emergency Interventions, Sections 87095.00 through 87095.68.
Manual restraints may be used as part of a facility’s trauma-informed emergency intervention plan when a child’s behavior poses a serious risk of injury to themselves or others, provided the STRTP has a Department of Social Services (DSS) approved manual restraint plan in place, as specified in STRTP ILS Section 87095.22(f). In addition, manual restraints may only be used as a last resort, after staff have attempted multiple de-escalation strategies that were not effective and the child continues to pose an imminent danger of injuring themselves or others.
STRTPs must ensure that staff are properly trained, that each incident is documented, and that required notifications are made to DSS and to a child’s authorized representative, attorney, if applicable, and for Indian children, the tribal representative. These safeguards are in place to ensure manual restraints are used appropriately, safely, and only when necessary.
Senate Bill (SB) 1043
In 2024, SB 1043 (Grove, Chapter 628) was signed into law, adding Health and Safety Code (HSC) 1180.55 to create the Accountability in Children’s Treatment Act. This law was enacted to increase transparency around the use of manual restraints in STRTP facilities. The law requires DSS to publicly post data and information about the use of manual restraints in STRTPs. Making this information available online allows families, the public, and policy makers to better understand how these practices are used and the circumstances in which they occur.
By making this data publicly accessible, the law promotes continuous oversight of STRTPs and supports STRTPs in upholding safe, high-quality therapeutic environments to children in out-of-home care.
Manual Restraint Data in STRTPs
MRIRS portal collection is scheduled to begin April 1, 2026.
The data will be published in 2026 upon completion of the internal review process to ensure client confidentiality and compliance with state quality and accuracy standards, in accordance with SB 1043 requirements.
STRTP Manual Restraint Incident Reporting System (MRIRS)
STRTP MRIRS is the new online portal for manual restraint incident reporting in STRTPs. Effective April 1, 2026, the online portal will serve as the reporting system for STRTP licensees, who are required to submit an incident report for each use of manual restraints to Community Care Licensing Division (CCLD), as specified in STRTP ILS Sections 87061(i) and 87095.61.
STRTP MRIRS cannot be used to submit any other type of incident report by a STRTP as it is exclusively designed for the reporting of manual restraints.
STRTP MRIRS does not replace the requirement to notify CCLD by the next working day following the manual restraint, as specified in STRTP ILS Section 87095.61(a). STRTPs should maintain their current practice for this notification.