093_HB2310

 
                                     LRB093 07857 DRJ 08046 b

 1        AN ACT in relation to 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  Section  2-108  as
 6    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
 9    only as a therapeutic measure to  prevent  a  recipient  from
10    causing physical harm to himself or physical abuse to others.
11    Restraint  may  only  be  applied  by  a  person who has been
12    trained  in  the  application  of  the  particular  type   of
13    restraint  to  be  utilized.  In  no event shall restraint be
14    utilized   to  punish  or  discipline  a  recipient,  nor  is
15    restraint to be used as a convenience for the staff.
16        (a)  Except as provided in this Section, restraint  shall
17    be  employed  only  upon  the  written  order of a physician,
18    clinical  psychologist,  clinical  social  worker,   clinical
19    professional  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
24    examining the recipient, is clinically satisfied that the use
25    of restraint is  justified  to  prevent  the  recipient  from
26    causing  physical  harm to himself or others. In no event may
27    restraint continue for longer than 2 hours unless within that
28    time period a nurse with supervisory  responsibilities  or  a
29    physician   confirms,   in   writing,  following  a  personal
30    examination of the recipient, that  the  restraint  does  not
31    pose  an undue risk to the recipient's health in light of the
 
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 1    recipient's physical or medical condition.  The  order  shall
 2    state the events leading up to the need for restraint and the
 3    purposes  for  which  restraint is employed.  The order shall
 4    also state the length of time restraint is to be employed and
 5    the clinical justification for that length of time.  No order
 6    for restraint shall be valid for  more  than  16  hours.   If
 7    further  restraint  is  required,  a new order must be issued
 8    pursuant to the requirements provided in this Section.
 9        (b)  In the event there is  an  emergency  requiring  the
10    immediate  use of restraint, it may be ordered temporarily by
11    a  qualified  person  only  where   a   physician,   clinical
12    psychologist,  clinical  social worker, clinical professional
13    counselor,   or    registered    nurse    with    supervisory
14    responsibilities  is  not  immediately  available.   In  that
15    event,  an  order by a nurse, clinical psychologist, clinical
16    social worker, clinical professional counselor, or  physician
17    shall  be  obtained  pursuant  to  the  requirements  of this
18    Section as quickly as possible, and the  recipient  shall  be
19    examined  by  a physician or supervisory nurse within 2 hours
20    after the initial  employment  of  the  emergency  restraint.
21    Whoever   orders  restraint  in  emergency  situations  shall
22    document its necessity and place that  documentation  in  the
23    recipient's record.
24        (c)  The  person  who  orders  restraint shall inform the
25    facility director or his designee in writing of  the  use  of
26    restraint within 24 hours.
27        (d)  The  facility  director  shall  review all restraint
28    orders daily and shall  inquire  into  the  reasons  for  the
29    orders for restraint by any person who routinely orders them.
30        (e)  Restraint  may be employed during all or part of one
31    24 hour  period,  the  period  commencing  with  the  initial
32    application  of  the  restraint.  However, once restraint has
33    been employed during one 24 hour period, it shall not be used
34    again on the same recipient during the next 48 hours  without
 
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 1    the prior written authorization of the facility director.
 2        (f)  Restraint   shall   be  employed  in  a  humane  and
 3    therapeutic manner and the person being restrained  shall  be
 4    observed  by  a  qualified  person  as often as is clinically
 5    appropriate but in no event less than once every 15  minutes.
 6    The   qualified   person  shall  maintain  a  record  of  the
 7    observations. Specifically,  unless  there  is  an  immediate
 8    danger  that  the  recipient  will physically harm himself or
 9    others, restraint shall be loosely applied to permit  freedom
10    of  movement.   Further,  the recipient shall be permitted to
11    have regular  meals  and  toilet  privileges  free  from  the
12    restraint,  except  when  freedom  of  action  may  result in
13    physical harm to the recipient or others.
14        (g)  Every facility that employs restraint shall  provide
15    training  in  the safe and humane application of each type of
16    restraint employed. The facility shall not authorize the  use
17    of  any type of restraint by an employee who has not received
18    training in the safe and humane application of that  type  of
19    restraint.   Each  facility  in which restraint is used shall
20    maintain records detailing which employees have been  trained
21    and  are  authorized  to  apply  restraint,  the  date of the
22    training and the type of  restraint  that  the  employee  was
23    trained to use.
24        (h)  Whenever  restraint  is  imposed  upon any recipient
25    whose primary mode of communication  is  sign  language,  the
26    recipient  shall  be  permitted  to  have his hands free from
27    restraint for brief periods each hour,  except  when  freedom
28    may result in physical harm to the recipient or others.
29        (i)  A  recipient  who is restrained may only be secluded
30    at  the  same  time   pursuant   to   an   explicit   written
31    authorization  as  provided  in  Section  2-109 of this Code.
32    Whenever a recipient is restrained, a member of the  facility
33    staff shall remain with the recipient at all times unless the
34    recipient  has  been secluded.  A recipient who is restrained
 
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 1    and secluded shall be observed by a qualified person as often
 2    as is clinically appropriate but in no event less than  every
 3    15 minutes.
 4        (j)  Whenever  restraint  is used, the recipient shall be
 5    advised of his right, pursuant to Sections 2-200 and 2-201 of
 6    this Code, to have any person of his choosing, including  the
 7    Guardianship and Advocacy Commission or the agency designated
 8    pursuant  to  the Protection and Advocacy for Developmentally
 9    Disabled Persons Act  notified of the restraint.  A recipient
10    who is under guardianship may request that any person of  his
11    choosing  be  notified  of  the  restraint whether or not the
12    guardian approves of the notice.  Whenever  the  Guardianship
13    and Advocacy Commission is notified that a recipient has been
14    restrained,  it shall contact that recipient to determine the
15    circumstances of the restraint and whether further action  is
16    warranted.
17    (Source: P.A. 92-651, eff. 7-11-02.)

18        Section  99.  Effective date.  This Act takes effect upon
19    becoming law.