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

 

HB5631LRB103 35846 RLC 65931 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Mental Health and Developmental
5Disabilities Code is amended by changing Section 2-108 and by
6adding 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
9restraint, as defined in Section 1-125, the use of which may
10lead to the death or severe injury of the person being
11restrained.
 
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
14prohibited. Restraint, other than lethal restraint, may be
15used only as a therapeutic measure to prevent a recipient from
16causing physical harm to himself or physical abuse to others.
17Restraint, other than lethal restraint, may only be applied by
18a person who has been trained in the application of the
19particular type of restraint to be utilized. In no event shall
20restraint be utilized to punish or discipline a recipient, nor
21is restraint to be used as a convenience for the staff.
22    (a) Except as provided in this Section, restraint, other

 

 

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1than lethal restraint, shall be employed only upon the written
2order of a physician, clinical psychologist, clinical social
3worker, clinical professional counselor, advanced practice
4psychiatric nurse, or registered nurse with supervisory
5responsibilities. No restraint shall be ordered unless the
6physician, clinical psychologist, clinical social worker,
7clinical professional counselor, advanced practice psychiatric
8nurse, or registered nurse with supervisory responsibilities,
9after personally observing and examining the recipient, is
10clinically satisfied that the use of restraint is justified to
11prevent the recipient from causing physical harm to himself or
12others. In no event may restraint continue for longer than 2
13hours unless within that time period a nurse with supervisory
14responsibilities, advanced practice psychiatric nurse, or a
15physician confirms, in writing, following a personal
16examination of the recipient, that the restraint does not pose
17an undue risk to the recipient's health in light of the
18recipient's physical or medical condition. The order shall
19state the events leading up to the need for restraint and the
20purposes for which restraint is employed. The order shall also
21state the length of time restraint is to be employed and the
22clinical justification for that length of time. No order for
23restraint shall be valid for more than 16 hours. If further
24restraint is required, a new order must be issued pursuant to
25the requirements provided in this Section.
26    (b) In the event there is an emergency requiring the

 

 

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1immediate use of restraint, other than lethal restraint, it
2may be ordered temporarily by a qualified person only where a
3physician, clinical psychologist, clinical social worker,
4clinical professional counselor, advanced practice psychiatric
5nurse, or registered nurse with supervisory responsibilities
6is not immediately available. In that event, an order by a
7nurse, clinical psychologist, clinical social worker, clinical
8professional counselor, advanced practice psychiatric nurse,
9or physician shall be obtained pursuant to the requirements of
10this Section as quickly as possible, and the recipient shall
11be examined by a physician or supervisory nurse within 2 hours
12after the initial employment of the emergency restraint.
13Whoever orders restraint in emergency situations shall
14document its necessity and place that documentation in the
15recipient's record.
16    (c) The person who orders restraint shall inform the
17facility director or his designee in writing of the use of
18restraint within 24 hours.
19    (d) The facility director shall review all restraint
20orders daily and shall inquire into the reasons for the orders
21for restraint by any person who routinely orders them.
22    (e) Restraint, other than lethal restraint, may be
23employed during all or part of one 24 hour period, the period
24commencing with the initial application of the restraint.
25However, once restraint has been employed during one 24 hour
26period, it shall not be used again on the same recipient during

 

 

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1the next 48 hours without the prior written authorization of
2the facility director.
3    (f) Restraint, other than lethal restraint, shall be
4employed in a humane and therapeutic manner and the person
5being restrained shall be observed by a qualified person as
6often as is clinically appropriate but in no event less than
7once every 15 minutes. The qualified person shall maintain a
8record of the observations. Specifically, unless there is an
9immediate danger that the recipient will physically harm
10himself or others, restraint shall be loosely applied to
11permit freedom of movement. Further, the recipient shall be
12permitted to have regular meals and toilet privileges free
13from the restraint, except when freedom of action may result
14in physical harm to the recipient or others.
15    (g) Every facility that employs restraint shall provide
16training in the safe and humane application of each type of
17restraint employed. The facility shall not authorize the use
18of any type of restraint by an employee who has not received
19training in the safe and humane application of that type of
20restraint. Each facility in which restraint is used shall
21maintain records detailing which employees have been trained
22and are authorized to apply restraint, the date of the
23training and the type of restraint that the employee was
24trained to use.
25    (h) Whenever restraint is imposed upon any recipient whose
26primary mode of communication is sign language, the recipient

 

 

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1shall be permitted to have his hands free from restraint for
2brief periods each hour, except when freedom may result in
3physical harm to the recipient or others.
4    (i) A recipient who is restrained may only be secluded at
5the same time pursuant to an explicit written authorization as
6provided in Section 2-109 of this Code. Whenever a recipient
7is restrained, a member of the facility staff shall remain
8with the recipient at all times unless the recipient has been
9secluded. A recipient who is restrained and secluded shall be
10observed by a qualified person as often as is clinically
11appropriate but in no event less than every 15 minutes.
12    (j) Whenever restraint is used, the recipient shall be
13advised of his right, pursuant to Sections 2-200 and 2-201 of
14this Code, to have any person of his choosing, including the
15Guardianship and Advocacy Commission or the agency designated
16pursuant to the Protection and Advocacy for Persons with
17Developmental Disabilities Act notified of the restraint. A
18recipient who is under guardianship may request that any
19person of his choosing be notified of the restraint whether or
20not the guardian approves of the notice. Whenever the
21Guardianship and Advocacy Commission is notified that a
22recipient has been restrained, it shall contact that recipient
23to determine the circumstances of the restraint and whether
24further action is warranted.
25    (k) Lethal restraint may not be used as a therapeutic
26measure to prevent a recipient from causing physical harm to

 

 

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1himself or physical abuse to others or for any other purpose.
2(Source: P.A. 101-587, eff. 1-1-20.)