Accu Reference Medical Lab has acknowledged it ran the blood collection sites without obtaining a necessary written certificate of approval from the state, according to a consent order released by the state Department of Public Health. Operating the centers prior to that regulatory approval violates state law.

The facilities, which in some cases operated illegally for nearly a year, have been shut down since DPH issued an interim cease and desist order to the company in October.

Konstantin Bas, the licensee for Accu Reference, signed the DPH consent order, agreeing to its contents.

Prior to shutting down in October, blood collection sites had operated in Manchester since December 2013, South Windsor since November 2013, Enfield since March 2014 and West Hartford since May 2014.

Originally, in its October cease and desist order, DPH named only two sites – the Manchester and South Windsor labs – as operating without approvals.

In addition to the four blood collection sites, the company has a clinical laboratory at 580 Burnside Ave. in East Hartford that is licensed by the state. Accu Reference had been running the blood draw sites under its clinical laboratory license, according to DPH, but further written consent was needed.

According to the consent order, Accu Reference submitted a “plan of correction” to DPH in January, which DPH officials approved. The company has withdrawn all pending applications for blood draw facilities and has no pending applications for clinical laboratory licenses in Connecticut, according to the order.

Company officials paid the $25,000 fine to DPH at the time the consent order was signed.

Luz Bagley, director of business operations, released a statement saying the company voluntarily entered into the consent order and has fully cooperated with DPH.

“Accu Reference continues to operate in Connecticut, and the consent order does not limit our ability to expand our operations,” the statement said. “We will work with the Department of Public Health to ensure that all required certifications are in place before Accu Reference opens any future blood collection sites.”

Accu Reference is based in Linden, N.J. It operates blood draw locations in Connecticut, New Jersey, New York, Virginia, Massachusetts and Rhode Island. It conducts various lab tests, including blood, urine and genetic.

The report from the state Department of Education shows that autism was the primary disability among special education students subject to “emergency” restraint or seclusion, with 40.4 percent of all such incidents involving a child with autism. Autism also accounted for nearly half of all cases in which children were put in seclusion as part of their individualized education plans, or IEPs.

Jordan Harrison Graphic

The report shows a slight decline from the previous year in the overall number of students restrained or secluded, and a drop in reports of injuries – from 840 in 2011-12, to 378 last year. But the number of serious injuries rose from eight to 10, and more than 900 reported episodes of seclusion or restraint lasted more than an hour.

“This is just so disheartening,” said Shannon Knall of Simsbury, policy chair of the Connecticut chapter of Autism Speaks, an advocacy group. She blamed the high incidence of children being restrained and secluded on “a tremendous lack of training” of teachers and school staff in alternative interventions.

“The numbers of children with autism are skyrocketing, and I think our school districts are just overwhelmed,” she said. “The people on the front lines need training and tools” in alternative behavior management. “If you only give someone a hammer and a nail, that’s all they’re going to use.”

This is the second year that the state Department of Education has compiled data on restraints and seclusions submitted by schools. While the education department has no specific strategy to reduce those practices, the report says that the “continued examination” of the data will inform “technical assistance and trainings” that promote the use of positive interventions and reduce reliance on restraint and seclusion.

The release of the report comes as a coalition of eight state agencies, including the Office of the Child Advocate and Office of Protection and Advocacy for Persons with Disabilities, begins a public education campaign to reduce the unnecessary use of restraints and seclusion in schools. The education department is a partner in that effort.

Sarah Eagan, the state’s child advocate, said the new report illustrates that the use of physical restraint and seclusion is still common in schools, especially among young children with developmental disabilities. About half of all the 2012-13 incidents involved special education students in grades five and below, with about 180 incidents involving children in kindergarten and pre-K.

“What this highlights is that ultimately, the practices are widespread,” Eagan said. “What we have to remember is that the use of restraints and seclusion [for behavior management] has no research to support it. We’re really going to have to support schools and teachers with resources and tools so they can find a better way” to de-escalate problem behaviors.

A seclusion room for children with emotional/behavioral problems.

Connecticut state law allows for the use of restraints and seclusion in emergencies that pose imminent danger to a student or others. It also allows for special education students to be put in seclusion if their IEPs provide for such measures – a provision that some child advocates say is overly broad.

Schools reported that the majority of restraints and seclusions – 71 percent — were in response to emergency risk of harm, with the remaining 7,741 seclusions done in accordance with an IEP. In many cases, individual children were restrained and secluded multiple times throughout the year. Forty students were physically restrained or secluded more than 100 times — and 11 of them were subject to those practices 300 to 900 times during the year, the report shows.

Eagan noted that the U.S. Department of Education issued a “resource document” to schools in 2012 that discourages the use of physical restraints or seclusion except in extreme situations where a child’s behavior poses imminent danger of serious harm to self or others. But there is no federal law restricting the practices.

Data in the new state report shows the majority of restraints and seclusions lasted 20 minutes or less. However, 30 emergency restraints and 119 seclusions lasted more than two hours.

Farm Hill Elementary School

Reporting by individual school districts and programs varied widely, with some smaller programs reporting hundreds of incidents, and some large districts reporting a handful. Hartford schools reported no incidents, Bridgeport reported 28, and New Haven reported 54.

Education department officials said they were following up with districts that reported very low numbers.

Eagan said that, on the flip side, some programs may be diligently reporting “every time they put hands on a student,” boosting their numbers.

Among districts reporting the highest number of restraints and seclusions were: East Hartford, with 1,644 cases involving 165 special education students; Darien, with 895 incidents involving 10 students; Vernon, with 357 incidents involving 24 students; and Windsor, with 298 incidents involving 19 students.

High numbers were reported by many state-approved private special education programs and regional education centers, including: CREC, with 3,860 cases involving 89 students; Benhaven School in Wallingford, which serves children with autism, with 2,162 incidents involving 30 students; and the Connecticut Center for Child Development in Milford, which also specializes in autism, with 3,183 cases involving 35 students.

The co-chairs of the legislature’s Committee on Children, Sen. Dante Bartolomeo and Rep. Diana Urban, both expressed concerns about the unnecessary use of restraints and seclusion at a recent forum on the issue convened by the Office of the Child Advocate and the Office of Protection and Advocacy. Last year, leaders of those two agencies called for an end to the use of restraints and seclusion as behavioral interventions in schools, as they investigated the controversial use of “scream rooms” at the Farm Hill Elementary School in Middletown.

The report indicates that black and Hispanic children are more likely to be restrained and secluded than white students. Fifty-seven percent of students who were restrained or secluded were members of minority groups, while the majority of special education students statewide are white.

Read the full report below.