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1 | AN ACT concerning health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Mental Health and Developmental | ||||||||||||||||||||||||||
5 | Disabilities Code is amended by changing Sections 2-108 and | ||||||||||||||||||||||||||
6 | 2-109 as follows:
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7 | (405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)
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8 | Sec. 2-108. Use of restraint. Restraint may be used only as | ||||||||||||||||||||||||||
9 | a therapeutic
measure to prevent a recipient from causing | ||||||||||||||||||||||||||
10 | physical harm to himself or
physical abuse to others. Restraint | ||||||||||||||||||||||||||
11 | may only be applied by a person who has
been trained in the | ||||||||||||||||||||||||||
12 | application of the particular type of restraint to be
utilized. | ||||||||||||||||||||||||||
13 | In no event shall restraint be utilized to punish or discipline | ||||||||||||||||||||||||||
14 | a
recipient, nor is restraint to be used as a convenience for | ||||||||||||||||||||||||||
15 | the staff.
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16 | (a) Except as provided in this Section, restraint shall be | ||||||||||||||||||||||||||
17 | employed only
upon the written order of a physician, clinical | ||||||||||||||||||||||||||
18 | psychologist, clinical social
worker, clinical professional | ||||||||||||||||||||||||||
19 | counselor, or registered nurse with supervisory | ||||||||||||||||||||||||||
20 | responsibilities. No restraint
shall be ordered unless the | ||||||||||||||||||||||||||
21 | physician, clinical psychologist, clinical social
worker, | ||||||||||||||||||||||||||
22 | clinical professional counselor, or registered nurse with | ||||||||||||||||||||||||||
23 | supervisory responsibilities, after personally
observing and |
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1 | examining the recipient, is clinically satisfied that the use | ||||||
2 | of
restraint is justified to prevent the recipient from causing | ||||||
3 | physical harm to
himself or others. In no event may restraint | ||||||
4 | continue for longer than 2 hours
unless within that time period | ||||||
5 | a nurse with supervisory responsibilities or a
physician | ||||||
6 | confirms, in writing, following a personal examination of the
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7 | recipient, that the restraint does not pose an undue risk to | ||||||
8 | the recipient's
health in light of the recipient's physical or | ||||||
9 | medical condition. The order
shall state the events leading up | ||||||
10 | to the need for restraint and the purposes
for which restraint | ||||||
11 | is employed. The order shall also state the length of time
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12 | restraint is to be employed and the clinical justification for | ||||||
13 | that length of
time. No order for restraint shall be valid for | ||||||
14 | more than 16 hours. If
further restraint is required, a new | ||||||
15 | order must be issued pursuant to the
requirements provided in | ||||||
16 | this Section.
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17 | (b) In the event there is an emergency requiring the | ||||||
18 | immediate use
of restraint, it may be ordered temporarily by a | ||||||
19 | qualified person only
where a physician, clinical | ||||||
20 | psychologist, clinical social worker, clinical professional | ||||||
21 | counselor, or
registered nurse with supervisory | ||||||
22 | responsibilities is not immediately
available. In that event, | ||||||
23 | an order by a nurse, clinical psychologist, clinical
social | ||||||
24 | worker, clinical professional counselor, or physician shall be | ||||||
25 | obtained pursuant to the requirements of
this Section as | ||||||
26 | quickly as possible, and the recipient shall be examined by a
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1 | physician or supervisory nurse within 2 hours after the initial | ||||||
2 | employment of
the emergency restraint. Whoever orders | ||||||
3 | restraint in emergency situations shall
document its necessity | ||||||
4 | and place that documentation in the recipient's record.
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5 | (c) The person who orders restraint shall inform the | ||||||
6 | facility director or
his designee in writing of the use of | ||||||
7 | restraint within 24 hours.
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8 | (d) The facility director shall review all restraint orders | ||||||
9 | daily and shall
inquire into the reasons for the orders for | ||||||
10 | restraint by any person who
routinely orders them.
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11 | (e) Restraint may be employed during all or part of one 24 | ||||||
12 | hour
period, the period commencing with the initial application | ||||||
13 | of the
restraint. However, once restraint has been employed | ||||||
14 | during one 24 hour
period, it shall not be used again on the | ||||||
15 | same recipient during the next
48 hours without the prior | ||||||
16 | written authorization of the facility director.
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17 | (f) Restraint shall be employed in a humane and therapeutic | ||||||
18 | manner and
the person being restrained shall be observed by a | ||||||
19 | qualified person as often
as is clinically appropriate but in | ||||||
20 | no event less than once every 15 minutes.
The qualified person | ||||||
21 | shall maintain a record of the observations.
Specifically, | ||||||
22 | unless there is an immediate danger that the recipient
will | ||||||
23 | physically harm himself or others, restraint shall be loosely
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24 | applied to permit freedom of movement. Further, the recipient | ||||||
25 | shall be
permitted to have regular meals and toilet privileges | ||||||
26 | free from the
restraint, except when freedom of action may |
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1 | result in physical harm to
the recipient or others.
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2 | (g) Every facility that employs restraint shall provide | ||||||
3 | training in the
safe and humane application of each type of | ||||||
4 | restraint employed.
The facility shall not authorize the use of | ||||||
5 | any type of restraint by an
employee who has not received | ||||||
6 | training in the safe and humane application
of that type of | ||||||
7 | restraint. Each facility in which restraint is used shall
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8 | maintain records detailing which employees have been trained | ||||||
9 | and are
authorized to apply restraint, the date of the training | ||||||
10 | and the type of
restraint that the employee was trained to use.
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11 | (h) Whenever restraint is imposed upon any recipient whose | ||||||
12 | primary mode
of communication is sign language, the recipient | ||||||
13 | shall be permitted to have
his hands free from restraint for | ||||||
14 | brief periods each hour, except
when freedom may result in | ||||||
15 | physical harm to the recipient or others.
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16 | (i) A recipient who is restrained may only be secluded at | ||||||
17 | the same time
pursuant to an explicit written authorization as | ||||||
18 | provided in Section 2-109
of this Code. Whenever a recipient is | ||||||
19 | restrained, a member of the facility
staff shall remain with | ||||||
20 | the recipient at all times unless the recipient has
been | ||||||
21 | secluded. A recipient who is restrained and secluded shall be
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22 | observed by a qualified person as often as is clinically | ||||||
23 | appropriate but in
no event less than every 15 minutes.
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24 | (j) Whenever restraint is used, the recipient shall be | ||||||
25 | advised of his
right, pursuant to Sections 2-200 and 2-201 of | ||||||
26 | this Code, to have any
person of his choosing, including the |
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1 | Guardianship and Advocacy Commission
or the agency designated | ||||||
2 | pursuant to the Protection and Advocacy for
Developmentally | ||||||
3 | Disabled Persons Act notified of the restraint. A recipient
who | ||||||
4 | is under guardianship may request that any person of his | ||||||
5 | choosing be
notified of the restraint whether or not the | ||||||
6 | guardian approves of the notice.
Whenever the Guardianship and | ||||||
7 | Advocacy Commission is notified that a recipient
has been | ||||||
8 | restrained, it shall contact that recipient to determine the
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9 | circumstances of the restraint and whether further action is | ||||||
10 | warranted.
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11 | (Source: P.A. 92-651, eff. 7-11-02.)
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12 | (405 ILCS 5/2-109) (from Ch. 91 1/2, par. 2-109)
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13 | Sec. 2-109. Seclusion. Seclusion may be used only as a | ||||||
14 | therapeutic
measure to prevent a recipient from causing | ||||||
15 | physical harm to himself or
physical abuse
to others. In no | ||||||
16 | event shall seclusion be utilized to punish or discipline
a | ||||||
17 | recipient, nor is seclusion to be used as a convenience for the | ||||||
18 | staff.
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19 | (a) Seclusion shall be employed only upon the written order | ||||||
20 | of a
physician, clinical psychologist, clinical social worker, | ||||||
21 | clinical professional counselor, or registered
nurse with | ||||||
22 | supervisory responsibilities. No seclusion shall be ordered
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23 | unless the physician, clinical psychologist, clinical social | ||||||
24 | worker, clinical professional counselor, or
registered nurse | ||||||
25 | with supervisory responsibilities, after personally
observing |
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1 | and examining the recipient, is clinically satisfied that the | ||||||
2 | use
of seclusion is justified to prevent the recipient from | ||||||
3 | causing physical
harm to himself or others. In no event may | ||||||
4 | seclusion continue for longer
than 2 hours unless within that | ||||||
5 | time
period a nurse with supervisory responsibilities or a | ||||||
6 | physician confirms in
writing, following a personal | ||||||
7 | examination of the recipient, that the
seclusion does not pose | ||||||
8 | an undue risk to the recipient's health in light of
the | ||||||
9 | recipient's physical or medical condition. The order
shall | ||||||
10 | state the events leading up to the need for seclusion and the
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11 | purposes for which seclusion is employed. The order shall also
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12 | state the length of time seclusion is to be employed and the | ||||||
13 | clinical
justification for the length of time. No order for | ||||||
14 | seclusion shall be
valid for more than 16 hours. If further | ||||||
15 | seclusion is required, a new
order must be issued pursuant to | ||||||
16 | the requirements
provided in this Section.
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17 | (b) The person who orders seclusion shall inform the | ||||||
18 | facility
director or his designee in writing of the use of | ||||||
19 | seclusion within 24
hours.
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20 | (c) The facility director shall review all seclusion orders | ||||||
21 | daily and
shall inquire into the reasons for the orders for | ||||||
22 | seclusion by any
person who routinely orders them.
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23 | (d) Seclusion may be employed during all or part of one 16 | ||||||
24 | hour
period, that period commencing with the initial | ||||||
25 | application of the
seclusion. However, once seclusion has been | ||||||
26 | employed during one 16 hour
period, it shall not be used again |
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1 | on the same recipient during the next
48 hours without the | ||||||
2 | prior written authorization of the facility director.
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3 | (e) The person who ordered the seclusion shall assign a | ||||||
4 | qualified
person to observe the recipient at all times.
A | ||||||
5 | recipient who is restrained and secluded shall be observed by a | ||||||
6 | qualified
person as often as is clinically appropriate but in | ||||||
7 | no event less than once
every 15 minutes.
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8 | (f) Safety precautions shall be followed to prevent | ||||||
9 | injuries to the
recipient in the seclusion room. Seclusion | ||||||
10 | rooms shall be adequately
lighted, heated, and furnished. If a | ||||||
11 | door is locked, someone with a key
shall be in constant | ||||||
12 | attendance nearby.
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13 | (g) Whenever seclusion is used, the recipient shall be | ||||||
14 | advised of his
right, pursuant to Sections 2-200 and 2-201 of | ||||||
15 | this Code, to have any
person of his choosing, including the | ||||||
16 | Guardianship and Advocacy Commission
notified of the | ||||||
17 | seclusion. A person who is under guardianship may request
that | ||||||
18 | any person of his choosing be notified of the seclusion whether | ||||||
19 | or not
the guardian approves of the notice. Whenever the | ||||||
20 | Guardianship and
Advocacy Commission is notified that a | ||||||
21 | recipient has been secluded, it shall
contact that recipient to | ||||||
22 | determine the circumstances of the seclusion and
whether | ||||||
23 | further action is warranted.
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24 | (Source: P.A. 86-1013; 86-1402; 87-124; 87-530; 87-895.)
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25 | Section 99. Effective date. This Act takes effect upon | ||||||
26 | becoming law.
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