98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB1005

 

Introduced , by Rep. Robert W. Pritchard

 

SYNOPSIS AS INTRODUCED:
 
405 ILCS 5/2-108  from Ch. 91 1/2, par. 2-108
405 ILCS 5/2-109  from Ch. 91 1/2, par. 2-109

    Amends the Mental Health and Developmental Disabilities Code. Provides that restraints or seclusion may be employed upon a recipient with the written order of a clinical professional counselor. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB1005LRB098 05627 RLC 35665 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Mental Health and Developmental
5Disabilities Code is amended by changing Sections 2-108 and
62-109 as follows:
 
7    (405 ILCS 5/2-108)  (from Ch. 91 1/2, par. 2-108)
8    Sec. 2-108. Use of restraint. Restraint may be used only as
9a therapeutic measure to prevent a recipient from causing
10physical harm to himself or physical abuse to others. Restraint
11may only be applied by a person who has been trained in the
12application of the particular type of restraint to be utilized.
13In no event shall restraint be utilized to punish or discipline
14a recipient, nor is restraint to be used as a convenience for
15the staff.
16    (a) Except as provided in this Section, restraint shall be
17employed only upon the written order of a physician, clinical
18psychologist, clinical social worker, clinical professional
19counselor, or registered nurse with supervisory
20responsibilities. No restraint shall be ordered unless the
21physician, clinical psychologist, clinical social worker,
22clinical professional counselor, or registered nurse with
23supervisory responsibilities, after personally observing and

 

 

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1examining the recipient, is clinically satisfied that the use
2of restraint is justified to prevent the recipient from causing
3physical harm to himself or others. In no event may restraint
4continue for longer than 2 hours unless within that time period
5a nurse with supervisory responsibilities or a physician
6confirms, in writing, following a personal examination of the
7recipient, that the restraint does not pose an undue risk to
8the recipient's health in light of the recipient's physical or
9medical condition. The order shall state the events leading up
10to the need for restraint and the purposes for which restraint
11is employed. The order shall also state the length of time
12restraint is to be employed and the clinical justification for
13that length of time. No order for restraint shall be valid for
14more than 16 hours. If further restraint is required, a new
15order must be issued pursuant to the requirements provided in
16this Section.
17    (b) In the event there is an emergency requiring the
18immediate use of restraint, it may be ordered temporarily by a
19qualified person only where a physician, clinical
20psychologist, clinical social worker, clinical professional
21counselor, or registered nurse with supervisory
22responsibilities is not immediately available. In that event,
23an order by a nurse, clinical psychologist, clinical social
24worker, clinical professional counselor, or physician shall be
25obtained pursuant to the requirements of this Section as
26quickly as possible, and the recipient shall be examined by a

 

 

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1physician or supervisory nurse within 2 hours after the initial
2employment of the emergency restraint. Whoever orders
3restraint in emergency situations shall document its necessity
4and place that documentation in the recipient's record.
5    (c) The person who orders restraint shall inform the
6facility director or his designee in writing of the use of
7restraint within 24 hours.
8    (d) The facility director shall review all restraint orders
9daily and shall inquire into the reasons for the orders for
10restraint by any person who routinely orders them.
11    (e) Restraint may be employed during all or part of one 24
12hour period, the period commencing with the initial application
13of the restraint. However, once restraint has been employed
14during one 24 hour period, it shall not be used again on the
15same recipient during the next 48 hours without the prior
16written authorization of the facility director.
17    (f) Restraint shall be employed in a humane and therapeutic
18manner and the person being restrained shall be observed by a
19qualified person as often as is clinically appropriate but in
20no event less than once every 15 minutes. The qualified person
21shall maintain a record of the observations. Specifically,
22unless there is an immediate danger that the recipient will
23physically harm himself or others, restraint shall be loosely
24applied to permit freedom of movement. Further, the recipient
25shall be permitted to have regular meals and toilet privileges
26free from the restraint, except when freedom of action may

 

 

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1result in physical harm to the recipient or others.
2    (g) Every facility that employs restraint shall provide
3training in the safe and humane application of each type of
4restraint employed. The facility shall not authorize the use of
5any type of restraint by an employee who has not received
6training in the safe and humane application of that type of
7restraint. Each facility in which restraint is used shall
8maintain records detailing which employees have been trained
9and are authorized to apply restraint, the date of the training
10and the type of restraint that the employee was trained to use.
11    (h) Whenever restraint is imposed upon any recipient whose
12primary mode of communication is sign language, the recipient
13shall be permitted to have his hands free from restraint for
14brief periods each hour, except when freedom may result in
15physical harm to the recipient or others.
16    (i) A recipient who is restrained may only be secluded at
17the same time pursuant to an explicit written authorization as
18provided in Section 2-109 of this Code. Whenever a recipient is
19restrained, a member of the facility staff shall remain with
20the recipient at all times unless the recipient has been
21secluded. A recipient who is restrained and secluded shall be
22observed by a qualified person as often as is clinically
23appropriate but in no event less than every 15 minutes.
24    (j) Whenever restraint is used, the recipient shall be
25advised of his right, pursuant to Sections 2-200 and 2-201 of
26this Code, to have any person of his choosing, including the

 

 

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1Guardianship and Advocacy Commission or the agency designated
2pursuant to the Protection and Advocacy for Developmentally
3Disabled Persons Act notified of the restraint. A recipient who
4is under guardianship may request that any person of his
5choosing be notified of the restraint whether or not the
6guardian approves of the notice. Whenever the Guardianship and
7Advocacy Commission is notified that a recipient has been
8restrained, it shall contact that recipient to determine the
9circumstances of the restraint and whether further action is
10warranted.
11(Source: P.A. 92-651, eff. 7-11-02.)
 
12    (405 ILCS 5/2-109)  (from Ch. 91 1/2, par. 2-109)
13    Sec. 2-109. Seclusion. Seclusion may be used only as a
14therapeutic measure to prevent a recipient from causing
15physical harm to himself or physical abuse to others. In no
16event shall seclusion be utilized to punish or discipline a
17recipient, nor is seclusion to be used as a convenience for the
18staff.
19    (a) Seclusion shall be employed only upon the written order
20of a physician, clinical psychologist, clinical social worker,
21clinical professional counselor, or registered nurse with
22supervisory responsibilities. No seclusion shall be ordered
23unless the physician, clinical psychologist, clinical social
24worker, clinical professional counselor, or registered nurse
25with supervisory responsibilities, after personally observing

 

 

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1and examining the recipient, is clinically satisfied that the
2use of seclusion is justified to prevent the recipient from
3causing physical harm to himself or others. In no event may
4seclusion continue for longer than 2 hours unless within that
5time period a nurse with supervisory responsibilities or a
6physician confirms in writing, following a personal
7examination of the recipient, that the seclusion does not pose
8an undue risk to the recipient's health in light of the
9recipient's physical or medical condition. The order shall
10state the events leading up to the need for seclusion and the
11purposes for which seclusion is employed. The order shall also
12state the length of time seclusion is to be employed and the
13clinical justification for the length of time. No order for
14seclusion shall be valid for more than 16 hours. If further
15seclusion is required, a new order must be issued pursuant to
16the requirements provided in this Section.
17    (b) The person who orders seclusion shall inform the
18facility director or his designee in writing of the use of
19seclusion within 24 hours.
20    (c) The facility director shall review all seclusion orders
21daily and shall inquire into the reasons for the orders for
22seclusion by any person who routinely orders them.
23    (d) Seclusion may be employed during all or part of one 16
24hour period, that period commencing with the initial
25application of the seclusion. However, once seclusion has been
26employed during one 16 hour period, it shall not be used again

 

 

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1on the same recipient during the next 48 hours without the
2prior written authorization of the facility director.
3    (e) The person who ordered the seclusion shall assign a
4qualified person to observe the recipient at all times. A
5recipient who is restrained and secluded shall be observed by a
6qualified person as often as is clinically appropriate but in
7no event less than once every 15 minutes.
8    (f) Safety precautions shall be followed to prevent
9injuries to the recipient in the seclusion room. Seclusion
10rooms shall be adequately lighted, heated, and furnished. If a
11door is locked, someone with a key shall be in constant
12attendance nearby.
13    (g) Whenever seclusion is used, the recipient shall be
14advised of his right, pursuant to Sections 2-200 and 2-201 of
15this Code, to have any person of his choosing, including the
16Guardianship and Advocacy Commission notified of the
17seclusion. A person who is under guardianship may request that
18any person of his choosing be notified of the seclusion whether
19or not the guardian approves of the notice. Whenever the
20Guardianship and Advocacy Commission is notified that a
21recipient has been secluded, it shall contact that recipient to
22determine the circumstances of the seclusion and whether
23further action is warranted.
24(Source: P.A. 86-1013; 86-1402; 87-124; 87-530; 87-895.)
 
25    Section 99. Effective date. This Act takes effect upon
26becoming law.