Full Text of HB1005 98th General Assembly
HB1005enr 98TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Mental Health and Developmental | 5 | | Disabilities Code is amended by changing Sections 2-108 and | 6 | | 2-109 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 | 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.
| 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
| 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
| 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.
| 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.
| 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.
| 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.
| 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.
| 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
| 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.
| 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
| 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.
| 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.
| 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
| 22 | | observed by a qualified person as often as is clinically | 23 | | appropriate but in
no event less than every 15 minutes.
| 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
| 9 | | circumstances of the restraint and whether further action is | 10 | | warranted.
| 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 | 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.
| 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
| 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
| 11 | | purposes for which seclusion is employed. The order shall also
| 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.
| 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.
| 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.
| 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.
| 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.
| 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.
| 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.
| 24 | | (Source: P.A. 86-1013; 86-1402; 87-124; 87-530; 87-895.)
| 25 | | Section 99. Effective date. This Act takes effect upon | 26 | | becoming law.
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