Illinois-2023-HB5631-Introduced

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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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 Section 2-108 and by

6 adding Section 1-116.1 as follows:

7 (405 ILCS 5/1-116.1 new)

8 Sec. 1-116.1. Lethal restraint. "Lethal restraint" means a

9 restraint, as defined in Section 1-125, the use of which may

10 lead to the death or severe injury of the person being

11 restrained.

12 (405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)

13 Sec. 2-108. Use of restraint; use of lethal restraint

14 prohibited. Restraint, other than lethal restraint, may be

15 used only as a therapeutic measure to prevent a recipient from

16 causing physical harm to himself or physical abuse to others.

17 Restraint, other than lethal restraint, may only be applied by

18 a person who has been trained in the application of the

19 particular type of restraint to be utilized. In no event shall

20 restraint be utilized to punish or discipline a recipient, nor

21 is restraint to be used as a convenience for the staff.

22 (a) Except as provided in this Section, restraint, other

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1 than lethal restraint, shall be employed only upon the written

2 order of a physician, clinical psychologist, clinical social

3 worker, clinical professional counselor, advanced practice

4 psychiatric nurse, or registered nurse with supervisory

5 responsibilities. No restraint shall be ordered unless the

6 physician, clinical psychologist, clinical social worker,

7 clinical professional counselor, advanced practice psychiatric

8 nurse, or registered nurse with supervisory responsibilities,

9 after personally observing and examining the recipient, is

10 clinically satisfied that the use of restraint is justified to

11 prevent the recipient from causing physical harm to himself or

12 others. In no event may restraint continue for longer than 2

13 hours unless within that time period a nurse with supervisory

14 responsibilities, advanced practice psychiatric nurse, or a

15 physician confirms, in writing, following a personal

16 examination of the recipient, that the restraint does not pose

17 an undue risk to the recipient's health in light of the

18 recipient's physical or medical condition. The order shall

19 state the events leading up to the need for restraint and the

20 purposes for which restraint is employed. The order shall also

21 state the length of time restraint is to be employed and the

22 clinical justification for that length of time. No order for

23 restraint shall be valid for more than 16 hours. If further

24 restraint is required, a new order must be issued pursuant to

25 the requirements provided in this Section.

26 (b) In the event there is an emergency requiring the

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1 immediate use of restraint, other than lethal restraint, ~~it~~

2 may be ordered temporarily by a qualified person only where a

3 physician, clinical psychologist, clinical social worker,

4 clinical professional counselor, advanced practice psychiatric

5 nurse, or registered nurse with supervisory responsibilities

6 is not immediately available. In that event, an order by a

7 nurse, clinical psychologist, clinical social worker, clinical

8 professional counselor, advanced practice psychiatric nurse,

9 or physician shall be obtained pursuant to the requirements of

10 this Section as quickly as possible, and the recipient shall

11 be examined by a physician or supervisory nurse within 2 hours

12 after the initial employment of the emergency restraint.

13 Whoever orders restraint in emergency situations shall

14 document its necessity and place that documentation in the

15 recipient's record.

16 (c) The person who orders restraint shall inform the

17 facility director or his designee in writing of the use of

18 restraint within 24 hours.

19 (d) The facility director shall review all restraint

20 orders daily and shall inquire into the reasons for the orders

21 for restraint by any person who routinely orders them.

22 (e) Restraint, other than lethal restraint, may be

23 employed during all or part of one 24 hour period, the period

24 commencing with the initial application of the restraint.

25 However, once restraint has been employed during one 24 hour

26 period, it shall not be used again on the same recipient during

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1 the next 48 hours without the prior written authorization of

2 the facility director.

3 (f) Restraint, other than lethal restraint, shall be

4 employed in a humane and therapeutic manner and the person

5 being restrained shall be observed by a qualified person as

6 often as is clinically appropriate but in no event less than

7 once every 15 minutes. The qualified person shall maintain a

8 record of the observations. Specifically, unless there is an

9 immediate danger that the recipient will physically harm

10 himself or others, restraint shall be loosely applied to

11 permit freedom of movement. Further, the recipient shall be

12 permitted to have regular meals and toilet privileges free

13 from the restraint, except when freedom of action may result

14 in physical harm to the recipient or others.

15 (g) Every facility that employs restraint shall provide

16 training in the safe and humane application of each type of

17 restraint employed. The facility shall not authorize the use

18 of any type of restraint by an employee who has not received

19 training in the safe and humane application of that type of

20 restraint. Each facility in which restraint is used shall

21 maintain records detailing which employees have been trained

22 and are authorized to apply restraint, the date of the

23 training and the type of restraint that the employee was

24 trained to use.

25 (h) Whenever restraint is imposed upon any recipient whose

26 primary mode of communication is sign language, the recipient

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1 shall be permitted to have his hands free from restraint for

2 brief periods each hour, except when freedom may result in

3 physical harm to the recipient or others.

4 (i) A recipient who is restrained may only be secluded at

5 the same time pursuant to an explicit written authorization as

6 provided in Section 2-109 of this Code. Whenever a recipient

7 is restrained, a member of the facility staff shall remain

8 with the recipient at all times unless the recipient has been

9 secluded. A recipient who is restrained and secluded shall be

10 observed by a qualified person as often as is clinically

11 appropriate but in no event less than every 15 minutes.

12 (j) Whenever restraint is used, the recipient shall be

13 advised of his right, pursuant to Sections 2-200 and 2-201 of

14 this Code, to have any person of his choosing, including the

15 Guardianship and Advocacy Commission or the agency designated

16 pursuant to the Protection and Advocacy for Persons with

17 Developmental Disabilities Act notified of the restraint. A

18 recipient who is under guardianship may request that any

19 person of his choosing be notified of the restraint whether or

20 not the guardian approves of the notice. Whenever the

21 Guardianship and Advocacy Commission is notified that a

22 recipient has been restrained, it shall contact that recipient

23 to determine the circumstances of the restraint and whether

24 further action is warranted.

25 (k) Lethal restraint may not be used as a therapeutic

26 measure to prevent a recipient from causing physical harm to

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