Full Text of HB4089 94th General Assembly
HB4089 94TH GENERAL ASSEMBLY
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94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006 HB4089
Introduced 7/7/2005, by Rep. Robert F. Flider SYNOPSIS AS INTRODUCED: |
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210 ILCS 45/2-106 |
from Ch. 111 1/2, par. 4152-106 |
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Amens the Nursing Home Care Act. In provisions concerning the use of restraints on nursing home residents, provides that a restraint may be used only under the supervision of a licensed health professional and only for a strictly defined period (instead of only for specific periods). Provides that in no case may a restraint be used for more than 2 hours. Requires continued assessment of a resident's condition to treat any ill effects resulting from the use of a restraint. Sets forth procedures to be used when applying a restraint. Requires that a nursing home adopt a clear, written instructional policy on the use of restraints and make the policy available to residents and their guardians or other authorized representatives. Requires a nursing home to keep records concerning the use of restraints.
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A BILL FOR
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HB4089 |
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LRB094 12843 DRJ 47689 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Nursing Home Care Act is amended by changing | 5 |
| Section 2-106 as follows: | 6 |
| (210 ILCS 45/2-106) (from Ch. 111 1/2, par. 4152-106)
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| Sec. 2-106. Restraints and confinements.
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| (a) For purposes of this Act, (i) a physical restraint is | 9 |
| any
manual method or physical or
mechanical device, material, | 10 |
| or equipment attached or adjacent to a
resident's body that the | 11 |
| resident cannot remove easily and
restricts
freedom of movement | 12 |
| or normal access to one's
body. Devices used for
positioning, | 13 |
| including but not limited to bed rails,
gait belts, and | 14 |
| cushions, shall not be considered to be restraints for
purposes | 15 |
| of this Section;
(ii) a chemical restraint
is
any drug used for | 16 |
| discipline or convenience and not required to treat medical
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| symptoms. The Department shall by rule, designate certain | 18 |
| devices as
restraints,
including at least all those devices | 19 |
| which have been determined
to be restraints by the United | 20 |
| States Department of Health and Human Services
in
interpretive | 21 |
| guidelines issued for the purposes of administering Titles 18 | 22 |
| and
19 of the Social Security Acts.
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| (b) Neither restraints nor confinements shall be employed
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| for the purpose of punishment or for the convenience of any | 25 |
| facility personnel.
No restraints or confinements shall be | 26 |
| employed except as ordered
by a physician who documents the | 27 |
| need for such restraints or confinements
in the
resident's | 28 |
| clinical record. Each facility licensed under this Act must | 29 |
| have
a written policy to address the use of restraints and | 30 |
| seclusion. The
Department shall establish by rule the | 31 |
| provisions that the policy must include,
which, to the extent | 32 |
| practicable, should be consistent with the requirements
for |
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LRB094 12843 DRJ 47689 b |
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| participation in the federal Medicare program. Each policy | 2 |
| shall include
periodic review of the use of restraints.
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| (c) A restraint may be used only with the informed consent | 4 |
| of the
resident, the resident's guardian, or other authorized | 5 |
| representative. A
restraint may be used only under the | 6 |
| supervision of a licensed health professional and only for a | 7 |
| strictly defined period
specific periods , if it is the
least | 8 |
| restrictive means necessary to attain and maintain the | 9 |
| resident's highest
practicable physical, mental or | 10 |
| psychosocial well-being, including brief
periods of time to | 11 |
| provide necessary life-saving treatment. A restraint may be
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| used only after consultation with appropriate health | 13 |
| professionals, such as
occupational or physical therapists, | 14 |
| and a trial of less restrictive measures
has led to the | 15 |
| determination that the use of less restrictive measures
would | 16 |
| not attain or maintain the resident's highest practicable | 17 |
| physical,
mental or psychosocial well-being.
However, if the | 18 |
| resident needs emergency care, restraints may be used for brief
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| periods to
permit medical treatment to proceed unless the | 20 |
| facility has notice that the
resident has previously made a | 21 |
| valid refusal of the treatment in
question.
The use of the | 22 |
| restraint shall be discontinued as soon as feasible. In no | 23 |
| case, however, may a restraint be used for more than 2 hours, | 24 |
| or less if necessary, to allow for normal body functioning. | 25 |
| Following the use of a restraint, there must be continued | 26 |
| assessment of the resident's condition to treat any ill effects | 27 |
| resulting from the use of the restraint.
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| (d) A restraint may be applied only by a person trained in | 29 |
| the application
of the particular type of restraint.
The health | 30 |
| professional must apply and adjust the restraint so that it is | 31 |
| comfortable for the resident. The health professional must also | 32 |
| do all of the following: | 33 |
| (1) Follow the manufacturer's directions to select the | 34 |
| type of restraint recommended for the resident's | 35 |
| condition. | 36 |
| (2) Use the correct size restraint for the resident's |
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| weight. | 2 |
| (3) Note the "front" and "back" of the restraint and | 3 |
| apply the restraint correctly. | 4 |
| (4) Tie knots that can be released quickly. | 5 |
| (5) Secure a bed restraint to the bed springs or frame, | 6 |
| never to the mattress or bed rails. | 7 |
| (6) In the case of a bed restraint used with an | 8 |
| adjustable bed, secure the restraint to the parts of the | 9 |
| bed that move with the resident.
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| (e) Whenever a period of use of a restraint is initiated, | 11 |
| the resident shall
be advised of his or her right to have a | 12 |
| person or organization of his or
her
choosing,
including the | 13 |
| Guardianship and Advocacy Commission, notified of the use of | 14 |
| the
restraint. The facility shall display a notice of this | 15 |
| right, and of other instructions concerning the use of | 16 |
| restraints, in a highly visible location within the facility. | 17 |
| The notice shall be in English and in any other language spoken | 18 |
| by a resident of the facility who does not speak English. A | 19 |
| recipient
who is under guardianship may request that a person | 20 |
| or organization of his or
her choosing be notified of the | 21 |
| restraint, whether or not the guardian
approves the notice.
If | 22 |
| the resident so chooses, the facility shall make the | 23 |
| notification
within 24 hours, including any information
about
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| the period of time that the restraint is to be used.
Whenever | 25 |
| the Guardianship and Advocacy Commission is notified that a | 26 |
| resident
has been restrained, it shall contact the resident to | 27 |
| determine the
circumstances of the restraint and whether | 28 |
| further action is warranted.
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| The facility shall adopt a clear, written instructional | 30 |
| policy on the use of restraints and shall make copies of the | 31 |
| policy available to residents of the facility and their | 32 |
| guardians or other authorized representatives.
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| (f) Whenever a restraint is used on a resident whose | 34 |
| primary mode of
communication is sign language, the resident | 35 |
| shall be permitted to have his or
her
hands free from restraint | 36 |
| for brief periods each hour, except when this freedom
may
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| result in physical harm to the resident or others.
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| (f-5) The facility shall keep well-documented records of | 3 |
| all circumstances resulting in the use of a restraint on a | 4 |
| patient, including why, how, where, and for how long the | 5 |
| restraint was used.
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| (g) The requirements of this Section are intended to | 7 |
| control in any conflict
with the requirements of Sections
1-126 | 8 |
| and 2-108 of the Mental Health and Developmental Disabilities | 9 |
| Code.
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| (Source: P.A. 93-636, eff. 6-1-04 .)
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