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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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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 |