Bill Text: IL HB5631 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Mental Health and Developmental Disabilities Code. Prohibits the use of a lethal restraint as a therapeutic measure to prevent a recipient from causing physical harm to himself or physical abuse to others or for any other purpose. Defines "lethal restraint" as a restraint the use of which may lead to the death or severe injury of the person being restrained.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2024-04-05 - Rule 19(a) / Re-referred to Rules Committee [HB5631 Detail]

Download: Illinois-2023-HB5631-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB5631 Introduced 2/9/2024, by Rep. Anne Stava-Murray SYNOPSIS AS INTRODUCED:
405 ILCS 5/1-116.1 new
405 ILCS 5/2-108 from Ch. 91 1/2, par. 2-108
Amends the Mental Health and Developmental Disabilities Code. Prohibits the use of a lethal restraint as a therapeutic measure to prevent a recipient from causing physical harm to himself or physical abuse to others or for any other purpose. Defines "lethal restraint" as a restraint the use of which may lead to the death or severe injury of the person being restrained.
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A BILL FOR
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AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Mental Health and Developmental
Disabilities Code is amended by changing Section 2-108 and by
adding Section 1-116.1 as follows:
(405 ILCS 5/1-116.1 new)
Sec. 1-116.1. Lethal restraint. "Lethal restraint" means a
restraint, as defined in Section 1-125, the use of which may
lead to the death or severe injury of the person being
restrained.
(405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)
Sec. 2-108. Use of restraint; use of lethal restraint
prohibited. Restraint, other than lethal restraint, may be
used only as a therapeutic measure to prevent a recipient from
causing physical harm to himself or physical abuse to others.
Restraint, other than lethal restraint, may only be applied by
a person who has been trained in the application of the
particular type of restraint to be utilized. In no event shall
restraint be utilized to punish or discipline a recipient, nor
is restraint to be used as a convenience for the staff.
(a) Except as provided in this Section, restraint, other

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than lethal restraint, shall be employed only upon the written
order of a physician, clinical psychologist, clinical social
worker, clinical professional counselor, advanced practice
psychiatric nurse, or registered nurse with supervisory
responsibilities. No restraint shall be ordered unless the
physician, clinical psychologist, clinical social worker,
clinical professional counselor, advanced practice psychiatric
nurse, or registered nurse with supervisory responsibilities,
after personally observing and examining the recipient, is
clinically satisfied that the use of restraint is justified to
prevent the recipient from causing physical harm to himself or
others. In no event may restraint continue for longer than 2
hours unless within that time period a nurse with supervisory
responsibilities, advanced practice psychiatric nurse, or a
physician confirms, in writing, following a personal
examination of the recipient, that the restraint does not pose
an undue risk to the recipient's health in light of the
recipient's physical or medical condition. The order shall
state the events leading up to the need for restraint and the
purposes for which restraint is employed. The order shall also
state the length of time restraint is to be employed and the
clinical justification for that length of time. No order for
restraint shall be valid for more than 16 hours. If further
restraint is required, a new order must be issued pursuant to
the requirements provided in this Section.
(b) In the event there is an emergency requiring the

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immediate use of restraint, other than lethal restraint, it
may be ordered temporarily by a qualified person only where a
physician, clinical psychologist, clinical social worker,
clinical professional counselor, advanced practice psychiatric
nurse, or registered nurse with supervisory responsibilities
is not immediately available. In that event, an order by a
nurse, clinical psychologist, clinical social worker, clinical
professional counselor, advanced practice psychiatric nurse,
or physician shall be obtained pursuant to the requirements of
this Section as quickly as possible, and the recipient shall
be examined by a physician or supervisory nurse within 2 hours
after the initial employment of the emergency restraint.
Whoever orders restraint in emergency situations shall
document its necessity and place that documentation in the
recipient's record.
(c) The person who orders restraint shall inform the
facility director or his designee in writing of the use of
restraint within 24 hours.
(d) The facility director shall review all restraint
orders daily and shall inquire into the reasons for the orders
for restraint by any person who routinely orders them.
(e) Restraint, other than lethal restraint, may be
employed during all or part of one 24 hour period, the period
commencing with the initial application of the restraint.
However, once restraint has been employed during one 24 hour
period, it shall not be used again on the same recipient during

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the next 48 hours without the prior written authorization of
the facility director.
(f) Restraint, other than lethal restraint, shall be
employed in a humane and therapeutic manner and the person
being restrained shall be observed by a qualified person as
often as is clinically appropriate but in no event less than
once every 15 minutes. The qualified person shall maintain a
record of the observations. Specifically, unless there is an
immediate danger that the recipient will physically harm
himself or others, restraint shall be loosely applied to
permit freedom of movement. Further, the recipient shall be
permitted to have regular meals and toilet privileges free
from the restraint, except when freedom of action may result
in physical harm to the recipient or others.
(g) Every facility that employs restraint shall provide
training in the safe and humane application of each type of
restraint employed. The facility shall not authorize the use
of any type of restraint by an employee who has not received
training in the safe and humane application of that type of
restraint. Each facility in which restraint is used shall
maintain records detailing which employees have been trained
and are authorized to apply restraint, the date of the
training and the type of restraint that the employee was
trained to use.
(h) Whenever restraint is imposed upon any recipient whose
primary mode of communication is sign language, the recipient

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shall be permitted to have his hands free from restraint for
brief periods each hour, except when freedom may result in
physical harm to the recipient or others.
(i) A recipient who is restrained may only be secluded at
the same time pursuant to an explicit written authorization as
provided in Section 2-109 of this Code. Whenever a recipient
is restrained, a member of the facility staff shall remain
with the recipient at all times unless the recipient has been
secluded. A recipient who is restrained and secluded shall be
observed by a qualified person as often as is clinically
appropriate but in no event less than every 15 minutes.
(j) Whenever restraint is used, the recipient shall be
advised of his right, pursuant to Sections 2-200 and 2-201 of
this Code, to have any person of his choosing, including the
Guardianship and Advocacy Commission or the agency designated
pursuant to the Protection and Advocacy for Persons with
Developmental Disabilities Act notified of the restraint. A
recipient who is under guardianship may request that any
person of his choosing be notified of the restraint whether or
not the guardian approves of the notice. Whenever the
Guardianship and Advocacy Commission is notified that a
recipient has been restrained, it shall contact that recipient
to determine the circumstances of the restraint and whether
further action is warranted.
(k) Lethal restraint may not be used as a therapeutic
measure to prevent a recipient from causing physical harm to

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