Full Text of HB3899 96th General Assembly
HB3899 96TH GENERAL ASSEMBLY
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96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010 HB3899
Introduced 2/26/2009, by Rep. Linda Chapa LaVia SYNOPSIS AS INTRODUCED: |
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405 ILCS 5/2-108 |
from Ch. 91 1/2, par. 2-108 |
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Amends the Mental Health and Developmental Disabilities Code. Provides that restraint may be used only as an emergency measure of last resort (instead of only as a therapeutic measure) to prevent a recipient of mental health services from causing physical harm to himself or physical abuse to others. Provides that a patient shall be placed in a position that allows airway access and does not compromise respiration. Provides that a face-down or prone position shall not be used on children and adolescents. Provides that a face-down or prone position shall not be used on adults unless: (1) there is a documented specified patient preference and no psychological or medical contraindications to its use; or (2) there is an overriding psychological or medical justification for its use, which shall be documented. Effective immediately.
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| FISCAL NOTE ACT MAY APPLY | |
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A BILL FOR
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HB3899 |
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LRB096 04203 DRJ 14247 b |
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| AN ACT concerning mental health.
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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 Mental Health and Developmental | 5 |
| Disabilities Code is amended by changing Section 2-108 as | 6 |
| follows:
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| (405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)
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| Sec. 2-108. Use of restraint. Restraint may be used only as | 9 |
| an emergency a therapeutic
measure of last resort to prevent a | 10 |
| recipient from causing physical harm to himself or
physical | 11 |
| abuse to others. Restraint may only be applied by a person who | 12 |
| has
been 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 restraint | 15 |
| to be used as a convenience for the staff.
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| (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, or registered nurse with | 19 |
| supervisory responsibilities. No restraint
shall be ordered | 20 |
| unless the physician, clinical psychologist, clinical social
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| worker, or registered nurse with supervisory responsibilities, | 22 |
| after personally
observing and examining the recipient, is | 23 |
| clinically satisfied that the use of
restraint is justified to |
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HB3899 |
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LRB096 04203 DRJ 14247 b |
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| prevent the recipient from causing physical harm to
himself or | 2 |
| others. In no event may restraint continue for longer than 2 | 3 |
| hours
unless within that time period a nurse with supervisory | 4 |
| responsibilities or a
physician confirms, in writing, | 5 |
| following a personal examination of the
recipient, that the | 6 |
| restraint does not pose an undue risk to the recipient's
health | 7 |
| in light of the recipient's physical or medical condition. The | 8 |
| order
shall state the events leading up to the need for | 9 |
| restraint and the purposes
for which restraint is employed. The | 10 |
| order shall also state the length of time
restraint is to be | 11 |
| employed and the clinical justification for that length of
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| time. No order for restraint shall be valid for more than 16 | 13 |
| hours. If
further restraint is required, a new order must be | 14 |
| issued pursuant to the
requirements provided in this Section.
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| (b) In the event there is an emergency requiring the | 16 |
| immediate use
of restraint, it may be ordered temporarily by a | 17 |
| qualified person only
where a physician, clinical | 18 |
| psychologist, clinical social worker, or
registered nurse with | 19 |
| supervisory responsibilities is not immediately
available. In | 20 |
| that event, an order by a nurse, clinical psychologist, | 21 |
| clinical
social worker, or physician shall be obtained pursuant | 22 |
| to the requirements of
this Section as quickly as possible, and | 23 |
| the recipient shall be examined by a
physician or supervisory | 24 |
| nurse within 2 hours after the initial employment of
the | 25 |
| emergency restraint. Whoever orders restraint in emergency | 26 |
| situations shall
document its necessity and place that |
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HB3899 |
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LRB096 04203 DRJ 14247 b |
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| documentation in the recipient's record.
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| (c) The person who orders restraint shall inform the | 3 |
| facility director or
his designee in writing of the use of | 4 |
| restraint within 24 hours.
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| (d) The facility director shall review all restraint orders | 6 |
| daily and shall
inquire into the reasons for the orders for | 7 |
| restraint by any person who
routinely orders them.
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| (e) Restraint may be employed during all or part of one 24 | 9 |
| hour
period, the period commencing with the initial application | 10 |
| of the
restraint. However, once restraint has been employed | 11 |
| during one 24 hour
period, it shall not be used again on the | 12 |
| same recipient during the next
48 hours without the prior | 13 |
| written authorization of the facility director.
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| (f) Restraint shall be employed in a humane and therapeutic | 15 |
| manner and
the person being restrained shall be observed by a | 16 |
| qualified person as often
as is clinically appropriate but in | 17 |
| no event less than once every 15 minutes.
The qualified person | 18 |
| shall maintain a record of the observations.
Specifically, | 19 |
| unless there is an immediate danger that the recipient
will | 20 |
| physically harm himself or others, restraint shall be loosely
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| applied to permit freedom of movement. Further, the recipient | 22 |
| shall be
permitted to have regular meals and toilet privileges | 23 |
| free from the
restraint, except when freedom of action may | 24 |
| result in physical harm to
the recipient or others.
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| (f-5) A patient shall be placed in a position that allows | 26 |
| airway access and does not compromise respiration. A face-down |
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HB3899 |
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LRB096 04203 DRJ 14247 b |
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| or prone position shall not be used on children and | 2 |
| adolescents. A face-down or prone position shall not be used on | 3 |
| adults unless: (1) there is a documented specified patient | 4 |
| preference and no psychological or medical contraindications | 5 |
| to its use; or (2) there is an overriding psychological or | 6 |
| medical justification for its use, which shall be documented. | 7 |
| (g) Every facility that employs restraint shall provide | 8 |
| training in the
safe and humane application of each type of | 9 |
| restraint employed.
The facility shall not authorize the use of | 10 |
| any type of restraint by an
employee who has not received | 11 |
| training in the safe and humane application
of that type of | 12 |
| restraint. Each facility in which restraint is used shall
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| maintain records detailing which employees have been trained | 14 |
| and are
authorized to apply restraint, the date of the training | 15 |
| and the type of
restraint that the employee was trained to use.
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| (h) Whenever restraint is imposed upon any recipient whose | 17 |
| primary mode
of communication is sign language, the recipient | 18 |
| shall be permitted to have
his hands free from restraint for | 19 |
| brief periods each hour, except
when freedom may result in | 20 |
| physical harm to the recipient or others.
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| (i) A recipient who is restrained may only be secluded at | 22 |
| the same time
pursuant to an explicit written authorization as | 23 |
| provided in Section 2-109
of this Code. Whenever a recipient is | 24 |
| restrained, a member of the facility
staff shall remain with | 25 |
| the recipient at all times unless the recipient has
been | 26 |
| secluded. A recipient who is restrained and secluded shall be
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LRB096 04203 DRJ 14247 b |
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| observed by a qualified person as often as is clinically | 2 |
| appropriate but in
no event less than every 15 minutes.
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| (j) Whenever restraint is used, the recipient shall be | 4 |
| advised of his
right, pursuant to Sections 2-200 and 2-201 of | 5 |
| this Code, to have any
person of his choosing, including the | 6 |
| Guardianship and Advocacy Commission
or the agency designated | 7 |
| pursuant to the Protection and Advocacy for
Developmentally | 8 |
| Disabled Persons Act notified of the restraint. A recipient
who | 9 |
| is under guardianship may request that any person of his | 10 |
| choosing be
notified of the restraint whether or not the | 11 |
| guardian approves of the notice.
Whenever the Guardianship and | 12 |
| Advocacy Commission is notified that a recipient
has been | 13 |
| restrained, it shall contact that recipient to determine the
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| circumstances of the restraint and whether further action is | 15 |
| warranted.
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| (Source: P.A. 92-651, eff. 7-11-02.)
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| Section 99. Effective date. This Act takes effect upon | 18 |
| becoming law.
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