97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5524

 

Introduced 2/15/2012, by Rep. Daniel Biss

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Use of Physical Restraint and Seclusion on Students Act. Provides that all covered entities (defined as an educational setting receiving public funds from the State Board of Education, including, but not limited to, public schools, public regional programs, charter schools, private schools, special purpose private schools, career and technical education schools, and public pre-kindergarten) shall have local policies regarding the use of physical restraint and seclusion. Sets forth provisions concerning a local complaint procedure, providing overview and awareness information to staff, and notice to parents. Provides that seclusion and physical restraint may be used only as an emergency intervention when the behavior of a student presents imminent risk of injury or harm to the student or others, and only after other less intrusive interventions have failed or been deemed inappropriate; sets forth requirements and prohibitions. Provides for notification of an incident, documentation and an incident report, a response to the use of physical restraint or seclusion, cumulative reporting, a complaint process, and staff training.


LRB097 19404 NHT 64657 b

FISCAL NOTE ACT MAY APPLY
STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

 

 

A BILL FOR

 

HB5524LRB097 19404 NHT 64657 b

1    AN ACT concerning education.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Use of
5Physical Restraint and Seclusion on Students Act.
 
6    Section 5. Definitions. For the purposes of this Act:
7    "Aversive procedure" means the use of a substance or
8stimulus, intended to modify behavior, that would cause
9physical or emotional trauma to a student, even when the
10substance or stimulus appears to be pleasant or neutral to
11others. Such substances and stimuli include, but are not
12limited to, infliction of bodily pain (e.g. hitting, pinching,
13slapping), water spray, noxious fumes, extreme physical
14exercise, costumes, or signs.
15    "Behavior intervention plan" or "BIP" means a
16comprehensive plan for managing problem behavior by changing or
17removing contextual factors that trigger or maintain it and by
18strengthening replacement skills.
19    "Chemical restraint" means the use of medication,
20including those administered pro re nata (as needed), given
21involuntarily to control student behavior.
22    "Covered entity" means any educational setting receiving
23public funds from the State Board of Education, including, but

 

 

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1not limited to public schools, public regional programs,
2charter schools, private schools, special purpose private
3schools, career and technical education schools, and public
4pre-kindergarten.
5    "De-escalation" means the use of behavior management
6techniques intended to cause a situation involving problem
7behavior of a student to become more controlled, calm, and less
8dangerous, thus reducing the risk for injury or harm.
9    "Dangerous behavior" means behavior that presents an
10imminent risk of injury or harm to a student or others.
11    "Emergency" means a sudden, urgent occurrence, usually
12unexpected but sometimes anticipated, that requires immediate
13action.
14    "Functional behavioral assessment" or "FBA" means a
15school-based process that includes the parent and, as
16appropriate, the child to determine why a child engages in
17challenging behaviors and how the behavior relates to the
18child's environment. The term includes direct assessments,
19indirect assessments, and data analysis designed to assist the
20team to identify and define the problem behavior in concrete
21terms, identify the contextual factors (including affective
22and cognitive factors) that contribute to the behavior, and
23formulate a hypothesis regarding the general conditions under
24which a behavior usually occurs and the probable consequences
25that maintain the behavior. Formal documentation of the
26assessment by appropriately qualified individuals becomes part

 

 

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1of the child's educational record.
2    "Imminent risk of injury or harm" means a situation in
3which a student has the means to cause harm or injury to
4himself or herself or others and such injury or harm is likely
5to occur at any moment such that a reasonable and prudent
6person would take steps instantly to protect the student and
7others against the risk of such injury or harm.
8    "Individualized education plan" or "IEP" is a term used
9under special education law to reference the written document
10that states goals, objectives and services for students
11receiving special education.
12    "Individual health plan" or "IHP" means a plan of action
13for a student with special health care needs, actual and
14potential. It is an adaptation of the nursing care plans
15commonly used in health care institutions.
16    "Mechanical restraint" means any item worn by or placed on
17the student to limit behavior or movement and which cannot be
18removed by the student.
19    "Parent" means a parent with legal custody of a minor
20child, except that the parent of a child with disabilities
21means a parent as defined in the federal Individuals with
22Disabilities Education Act.
23    "Physical restraint" means an intervention that restricts
24a student's freedom of movement or normal access to his or her
25body and includes the forcible moving of a student against the
26student's will. Physical restraint does not include the

 

 

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1temporary touching or holding of the hand, wrist, arm,
2shoulder, hip, or back for the purpose of moving a student
3voluntarily.
4    "Positive alternatives" means a set of instructional and
5environmental supports to teach students pro-social
6alternatives to problem behaviors with high rates of positive
7feedback.
8    "School day" means a day in which a school or program is in
9operation as an instructional day or a teacher in-service day.
10    "Seclusion" means the involuntary confinement of a student
11alone in a room or area from which the student is physically
12prevented from leaving. Seclusion is not timeout.
13    "Section 504 plan" refers to a written plan of
14modifications and accommodations under Section 504 of the
15federal Rehabilitation Act of 1973 and the Americans with
16Disabilities Act of 1990.
17    "Serious bodily injury" means any bodily injury that
18involves the following:
19        (1) a substantial risk of death;
20        (2) extreme physical pain;
21        (3) protracted and obvious disfigurement; or
22        (4) protracted loss or impairment of the function of a
23    bodily member, organ, or mental faculty.
24    "State-approved training program" means a nationally
25recognized, evidenced-based, training program approved by this
26State that includes the components outlined in Section 50 of

 

 

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1this Act.
2    "Student" means a child or adult aged 3 to 20 years
3enrolled in a school or a program that is a covered entity as
4defined in this Section.
5    "Timeout" means an intervention where a student requests or
6complies with an adult request for a break. Timeout is not
7seclusion.
8    "Transitional hold" means a brief physical restraint of an
9individual, which may be on the ground, for the purpose of
10quickly and effectively gaining physical control of an
11individual who has met the criteria for physical restraint,
12with the intent to transition that individual to a safer,
13standing position as quickly as possible.
 
14    Section 10. Local policy; notice to parents.
15    (a) All covered entities shall have local policies,
16consistent with this Act, regarding the use of physical
17restraint and seclusion. Covered entities must also have a
18procedure available by which parents may submit a complaint
19regarding the use of physical restraint or seclusion on their
20child, based upon which the covered entity shall investigate
21the circumstances surrounding the incident complained of, make
22written findings, and, where appropriate, determine to take
23corrective action.
24    Covered entities shall revise existing policies or develop
25policies consistent with this Act within 90 calendar days of

 

 

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1the effective date of this Act.
2    (b) Annually, each covered entity shall provide overview
3and awareness information to all staff, including contracted
4providers, regarding the contents of this Act and any local
5policies or procedures related to the use of physical restraint
6and seclusion.
7    Each covered entity shall provide an annual notice
8informing parents of students enrolled at the covered entity of
9this Act and any local policies or procedures related to the
10use of physical restraint and seclusion, including the local
11complaint process.
 
12    Section 15. Seclusion.
13    (a) Seclusion may be used only as an emergency intervention
14when the behavior of a student presents imminent risk of injury
15or harm to the student or others, and only after other less
16intrusive interventions have failed or been deemed
17inappropriate.
18    Seclusion must be implemented by staff certified in a
19State-approved training program to the extent possible. If, due
20to the nature of the emergency, untrained staff have intervened
21and initiated a seclusion, trained personnel must be summoned
22to the scene and assume control of the situation as rapidly as
23possible.
24    (b) Seclusion may not be used for punitive purposes or
25staff convenience or to control challenging behavior.

 

 

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1    Seclusion may not be used to prevent property destruction
2or disruption of the environment in the absence of imminent
3risk of injury or harm.
4    Seclusion may not be used as a therapeutic or educational
5intervention.
6    Seclusion may not take place in a locked room.
7    (c) At least one adult must be physically present to
8monitor a student in seclusion at all times. Students must be
9continuously monitored until the student no longer presents
10imminent risk of injury or harm to himself or herself or
11others.
12    In the event of an injury to the student or staff, the
13local policy for emergency response must be initiated.
14    (d) The staff involved in the use of seclusion shall
15continually assess for signs that the student is no longer
16presenting imminent risk of injury or harm to himself or
17herself or others, and the emergency intervention must be
18discontinued as soon as possible.
19    Time must be recorded consistent with the requirements of
20this Act and local policy.
21    The covered entity may request assistance from parents at
22any time during the incident.
23    If attempts to release from seclusion have been
24unsuccessful and a student is still presenting behaviors that
25create an imminent risk of injury or harm to himself or herself
26or others, then the covered entity may request assistance from

 

 

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1outside sources such as caregivers, case managers, crisis
2intervention teams, local emergency medical service personnel,
3or other community resources.
4    If seclusion continues for more than 10 minutes, an
5administrator or his or her designee shall determine whether
6continued seclusion is warranted and shall continue to monitor
7the status of the seclusion every 10 minutes until the
8seclusion is terminated.
9    (e) Seclusion can be achieved in any part of a school
10building with adequate light, heat, and ventilation and of
11normal room height. If a specific room is designated as a
12seclusion room, it must be a minimum of 60 square feet with
13adequate light, heat, and ventilation, be of normal room
14height, and be free of hazardous material and objects with
15which a student could self-inflict bodily injury.
 
16    Section 20. Physical restraint.
17    (a) Physical restraint may be used only as an emergency
18intervention when the behavior of a student presents imminent
19risk of injury or harm to the student or others, and only after
20other less intrusive interventions have failed or been deemed
21inappropriate.
22    Physical restraint must be implemented by staff certified
23in a State-approved training program to the extent possible.
24If, due to the nature of the emergency, untrained staff have
25intervened and initiated a physical restraint, trained

 

 

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1personnel must be summoned to the scene and assume control of
2the situation as rapidly as possible.
3    Physical restraint may be used to move a student only if
4the need for movement outweighs the risks involved in such
5movement.
6    If a student is demonstrating imminent risk while on the
7ground or if during the process of physical restraint the
8student directs the restraint to the ground, staff shall make
9attempts to disengage or utilize a transitional hold to move
10the student back to a safer restraint position.
11    Protective equipment or devices that are part of a
12treatment plan as prescribed by a licensed health care provider
13are not prohibited by this Act.
14    (b) Physical restraint may not be used for punitive
15purposes or staff convenience or to control challenging
16behavior.
17    Physical restraint may not be used to prevent property
18destruction or disruption of the environment in the absence of
19imminent risk of injury.
20    No physical restraint may be used that restricts the free
21movement of the diaphragm or chest or that restricts the airway
22so as to interrupt the normal breathing or speech
23(restraint-related positional asphyxia) of a student.
24    No physical restraint may be used that involves taking the
25student to the floor and forcibly holding him or her in a
26prone, supine, seated, or side position.

 

 

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1    No physical restraint may be used that relies on pain for
2control, including, but not limited to, joint hyperextension,
3excessive force, take-down (supported or unsupported), the use
4of any physical structure (e.g. wall, railing, or post),
5punching, and hitting.
6    Physical restraint may not be used as a therapeutic or
7educational intervention.
8    Aversive procedures and mechanical and chemical restraints
9may not be used under any circumstances. However, prescribed
10assistive devices are not considered mechanical restraints
11when used as prescribed. Their use must be supervised by
12qualified and trained individuals in accordance with
13professional standards. Prescribed medications administered by
14a health care provider consistent with a student's health care
15plan are permitted.
16    (c) At least 2 adults must be present at all times when
17physical restraint is used, except when, for safety reasons,
18waiting for a second adult is precluded.
19    A student in physical restraint must be continuously
20monitored by an adult not directly involved in the restraint
21until the student no longer presents imminent risk of injury or
22harm to himself or herself or others.
23    In the event of an injury, local policy must be followed.
24    (d) The staff involved in the use of physical restraint
25must continually assess for signs that the student is no longer
26presenting imminent risk of injury or harm to himself or

 

 

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1herself or others, and the emergency intervention must be
2discontinued as soon as possible or at the first sign of
3distress.
4    Time must be recorded consistent with the requirements of
5this Act and local policy.
6    The covered entity may request assistance from parents at
7any time during the incident.
8    If attempts to release from physical restraint have been
9unsuccessful and a student is still presenting behaviors that
10create an imminent risk of injury or harm to himself or herself
11or others, then the covered entity may request assistance from
12outside sources such as caregivers, case managers, crisis
13intervention teams, local emergency medical service personnel,
14or other community resources.
15    If physical restraint continues for more than 10 minutes,
16an administrator or his or her designee shall determine whether
17continued physical restraint is warranted and shall continue to
18monitor the status of the physical restraint every 10 minutes
19until the physical restraint is terminated.
20    (e) Those restraints used by law enforcement officers or
21school resource officers employed by a police department in the
22course of their professional duties are not subject to this
23Act.
 
24    Section 25. Notification of incident.
25    (a) After each incident of physical restraint or seclusion,

 

 

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1a staff member involved shall do the following:
2        (1) report to the administrator or his or her designee,
3    by oral notification, as soon as possible after each
4    incident, but in no event later than the end of the school
5    day of its occurrence; and
6        (2) if the student is receiving his or her education in
7    an out-of-district placement through a tuition agreement
8    or other agreement, report the incident to the entity
9    responsible for the student's education, by phone, within
10    24 hours.
11    (b) An administrator or his or her designee shall notify
12the parent that physical restraint or seclusion and any related
13first aid have occurred as soon as practical, but within the
14school day in which the incident occurred, utilizing all
15available phone numbers and other appropriate means. If the
16parent is unavailable, a phone message must be left for the
17parent to contact the school as soon as possible. If a parent
18does not have access to a phone, the entity must use whatever
19contact information is available for emergencies. The parent
20must be informed that written documentation will be provided to
21him or her within 7 calendar days.
22    If a restraint or seclusion has occurred outside the school
23day, notification of the restraint or seclusion and any related
24first aid must occur as soon as possible in compliance with the
25entity's procedures for emergency situations.
26    (c) If serious bodily injury or death of a student occurs

 

 

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1during the implementation of restraint or seclusion, the
2following apply:
3        (1) oral notification of the incident must follow local
4    health and safety procedures as outlined by the covered
5    entity's policies and procedures; and
6        (2) the administrator or his or her designee shall
7    notify the State Board of Education within 24 hours or the
8    next business day.
 
9    Section 30. Documentation; incident report.
10    (a) Each use of physical restraint or seclusion must be
11documented in an incident report. The incident report must be
12completed and provided to an administrator or his or her
13designee as soon as practicable after the incident and in all
14cases within 2 school days. At a minimum, the incident report
15must include the following:
16        (1) Student name.
17        (2) Age, gender, grade.
18        (3) Location of the incident.
19        (4) Date of incident.
20        (5) Date of report.
21        (6) Person completing the report.
22        (7) Beginning and ending time of each physical
23    restraint or seclusion.
24        (8) Total time of incident.
25        (9) Description of prior events and circumstances.

 

 

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1        (10) Less restrictive interventions tried prior to the
2    use of physical restraint or seclusion. If none used, an
3    explanation as to why.
4        (11) The student behavior that justified the use of
5    physical restraint or seclusion.
6        (12) A detailed description of the physical restraint
7    or seclusion used.
8        (13) The staff person or persons involved, their role
9    in the use of physical restraint or seclusion and their
10    certification in an approved training program.
11        (14) Description of the incident, including the
12    resolution and process of return to the program, if
13    appropriate.
14        (15) Whether the student has an IEP, 504 plan, behavior
15    plan, IHP, or other plan.
16        (16) If a student or staff sustained bodily injury, the
17    date and time of nurse or response personnel notification
18    and the treatment administered, if any.
19        (17) Date, time, and method of parent notification.
20        (18) Date and time of staff debriefing.
21    (b) A copy of the incident report must be provided, within
227 calendar days of the incident to the following:
23        (1) the parent; and
24        (2) if the student is receiving his or her education in
25    an out-of-district placement through a tuition agreement
26    or other agreement, the entity responsible for the

 

 

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1    student's education.
 
2    Section 35. Response to the use of physical restraint or
3seclusion.
4    (a) Following each incident of physical restraint or
5seclusion, the covered entity shall ensure that, within 2
6school days, an administrator or his or her designee reviews
7the incident with all staff persons who implemented the use of
8physical restraint or seclusion to discuss the following:
9        (1) whether the use of restraint or seclusion was
10    implemented in compliance with this Act and local policies;
11    and
12        (2) how to prevent or reduce the future need for
13    physical restraint or seclusion.
14    (b) Following each incident of physical restraint or
15seclusion, the covered entity shall ensure that, as soon as
16possible, but no later than 2 school days after the incident or
17upon the return to school, an administrator or his or her
18designee shall review the incident with the student involved to
19discuss the following:
20        (1) details of the incident in an effort to assist the
21    student and staff in identifying patterns of behaviors,
22    triggers, or antecedents; and
23        (2) alternative positive behaviors or coping skills
24    the student can opt for in future incidents.
25    (c) When physical restraint or seclusion has resulted in

 

 

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1serious bodily injury to a student or staff member requiring
2emergency medical treatment, the debriefing must take place as
3soon as possible, but no later than the next school day.
4    (d) Following the debriefing, a written plan for response
5and de-escalation must be developed (or, if a plan already
6exists, the plan must be revised) and implemented for the
7student.
8    (e) After the third incident of physical restraint or
9seclusion in a school year of a student who has been found
10eligible for special education or has a Section 504 plan, the
11student's IEP or Section 504 team shall meet within 10 school
12days after the third incident to discuss the incident and
13consider the need to conduct an FBA or develop a BIP or amend
14an existing one.
15    (f) For students not described in subsection (e) of this
16Section, a team shall meet within 10 school days after the
17third incident to discuss the incidents.
18    The team shall consist of the parent, an administrator or
19his or her designee, a teacher for the student, a staff member
20involved in the incident (if not the teacher or administrator
21already invited), and other appropriate staff members.
22    The team shall consider the appropriateness of a referral
23to special education and, regardless of whether a referral to
24special education is to be made, the need to conduct an FBA, or
25develop a BIP.
26    (g) Nothing in this Section is meant to prevent the

 

 

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1completion of an FBA or BIP for any student who might benefit
2from these measures, but who has had fewer than 3 restraints or
3seclusions.
4    (h) The covered entity shall make reasonable, documented
5efforts to encourage parent participation in the meetings
6required in subsections (e) and (f) of this Section and to
7schedule them at times convenient for parents to attend.
8    A covered entity may not seek written permission from a
9parent to provide restraint and seclusion to a student, nor may
10a parent waive their right to notification of an incident of
11restraint or seclusion.
 
12    Section 40. Cumulative reporting.
13    (a) A cumulative report by building must be made to the
14superintendent or chief administrator on a quarterly and annual
15basis and must include the following:
16        (1) the aggregate number of physical restraint
17    incidents;
18        (2) the aggregate number of students placed in physical
19    restraint;
20        (3) the aggregate number of seclusion incidents;
21        (4) the aggregate number of students placed in
22    seclusion;
23        (5) the aggregate number of serious bodily injuries to
24    students related to the use of restraint and seclusions;
25    and

 

 

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1        (6) the aggregate number of serious bodily injuries to
2    staff related to physical restraint and seclusion.
3    The superintendent or chief administrator shall review
4cumulative reports received as set forth in this subsection (a)
5and identify those areas that can be addressed to reduce the
6future use of physical restraint and seclusion. These
7cumulative reports may be requested by the State Board
8Education at any time.
9    (b) Each covered entity shall submit to the State Board of
10Education an annual report of the incidence of physical
11restraint and seclusion, which must include the following:
12        (1) the aggregate number of physical restraint
13    incidents;
14        (2) the aggregate number of students placed in physical
15    restraint;
16        (3) the aggregate number of seclusion incidents;
17        (4) the aggregate number of students placed in
18    seclusion;
19        (5) the aggregate number of serious bodily injuries to
20    students related to physical restraint and seclusion; and
21        (6) the aggregate number of serious bodily injuries to
22    staff related to physical restraint and seclusion.
 
23    Section 45. Complaint process.
24    (a) Parent complaints related to restraint and seclusion
25must be submitted to the covered entity in accordance with

 

 

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1local policy and procedure.
2    (b) Any parent who is dissatisfied with the result of the
3local complaint process may file a complaint with the State
4Board of Education, which complaint is not considered an appeal
5of that local process. The State Board shall review the results
6of the local complaint process and may initiate its own
7investigation of the complaint, and the State Board shall issue
8to the complaining parent and the covered entity a written
9report with specific findings within 60 days after receiving
10the complaint. If a violation is found, the State Board shall
11develop a corrective action plan by which the entity will
12achieve compliance.
 
13    Section 50. Staff training; approved programs. The State
14Board of Education shall maintain a directory of nationally
15recognized, evidence-based, training programs approved for use
16on its Internet website. These training programs must require
17participants to demonstrate physical and written competency to
18achieve certification and must include instruction in at least
19the following core components:
20        (1) The use of non-physical interventions for
21    responding to potentially dangerous behaviors, including
22    de-escalation and the use of positive alternatives.
23        (2) Identification of dangerous behaviors that may
24    indicate the need for physical restraint or seclusion and
25    methods for evaluating the risk of harm to determine

 

 

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1    whether such interventions are warranted.
2        (3) Instruction and simulated experience in
3    administering safe physical restraint techniques across a
4    range of increasingly restrictive interventions, including
5    the safe movement of a student, and in recognizing and
6    avoiding positions involving a high risk of
7    restraint-related positional asphyxia (restricting a
8    student's ability to breathe).
9        (4) The effects of physical restraint and seclusion on
10    a student, including monitoring physical and psychological
11    signs of distress and when to obtain medical assistance in
12    compliance with the covered entity's procedures for
13    emergency interventions.
14        (5) The risks and realities of physical restraint and
15    seclusion.
16        (6) A review of the process of student and staff
17    debriefing.
18    Each covered entity shall provide all staff with training
19in the use of non-physical interventions for responding to
20potentially dangerous behaviors, including de-escalation and
21the use of positive alternatives and the process for student
22and staff debriefing. Each covered entity shall ensure that a
23sufficient number of staff have additional training in the
24identification of dangerous behaviors that may indicate the
25need for physical restraint, how to safely administer physical
26restraint techniques across a range of increasingly

 

 

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1restrictive interventions, including the safe movement of a
2student, recognizing and understanding the risks of the use of
3physical restraint and seclusion, including monitoring for
4signs of physical and psychological distress, and when to
5obtain medical assistance in compliance with the covered
6entity's procedures for emergency interventions. This training
7shall occur at the time of hire and shall be formally refreshed
8annually.