Illinois General Assembly - Full Text of HR0088
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Full Text of HR0088  102nd General Assembly




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2    WHEREAS, The Illinois Department of Children and Family
3Services, Illinois Department of Human Services, the Illinois
4Department of Public Health, the Illinois Department of Mental
5Health, the Illinois Department of Juvenile Justice, and the
6Illinois State Board of Education promulgate rules and
7procedures to govern the use of restraint and seclusion with
8children and adolescents in social services, medical, and
9educational settings; and
10    WHEREAS, Manual restraint is defined as anytime an adult
11staff member, responsible for the care of a child or an
12adolescent, manually holds a child to prevent the child's free
13movement or normal access to the child's body; and
14    WHEREAS, Seclusion is defined as the involuntary
15confinement of a child in a room or an area from which the
16child is physically prevented from leaving; and
17    WHEREAS, Numerous sources document the harmful physical
18outcomes associated with manual restraint, including
19dehydration, choking, loss of strength or mobility,
20incontinence, and injuries, including bruises, rug burns,
21broken bones, and cardiopulmonary complications, or death; and



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1    WHEREAS, Children and adolescents who experience restraint
2express negative social-emotional consequences, including
3fear, rage, anxiety, a lack of understanding about why they
4were restrained, profound alienation from adult staff
5responsible for their care, re-traumatization from their own
6restraint, and vicarious traumatization from witnessing the
7restraint of their peers; and
8    WHEREAS, Adult staff, responsible for the care of children
9and adolescents, who implement restraints may be exposed to
10biological material, such as saliva or blood, without
11appropriate protective equipment or may sustain injuries,
12including scrapes, bruises, sprains, scratches, bites, or
13broken bones; and
14    WHEREAS, Children and adolescents placed in seclusion have
15experienced a wide variety of self-inflicted injuries, such as
16cutting, pounding, head banging, and suicide; and
17    WHEREAS, High frequency of restraint and seclusion
18episodes are associated with turbulent workplace environments,
19uncertainty, lost productivity, low morale, and potentially
20detrimental influences on the quality of care delivered; and
21    WHEREAS, The United Nations Committee on the Rights of the
22Child has stated that restraint and seclusion may violate



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1children's rights, including their right to be free from
2cruel, inhuman, or degrading treatment or punishment, their
3right to respect for bodily integrity, and their right not to
4be deprived of their liberty; and
5    WHEREAS, Over the last two decades, national
6organizations, including the Substance Abuse and Mental Health
7Services Administration, the Child Welfare League of America,
8the Federation of Families for Children's Mental Health, and
9the National Association of State Mental Health Program
10Directors, began supporting programs to prevent and reduce the
11use of restraint and seclusion; and
12    WHEREAS, The U.S. Department of Education warned on
13multiple occasions that secluding students can be dangerous
14and that there is no evidence it is effective in reducing
15problematic behaviors among children and adolescents; and
16    WHEREAS, The Statewide Youth Advisory Board for the
17Department of Children and Family Services, which provides the
18Department and General Assembly with the perspective of
19youth-in-care, voted that reforming use of restraints was a
20top policy priority; and
21    WHEREAS, The National Association of State Mental Health
22Program Directors' position statement on restraint and



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1seclusion illustrates that practices should only be
2administered in the least restrictive method and should never
3be used for purposes of punishment, discipline, or
4convenience; and
5    WHEREAS, The U.S. Department of Education found Illinois
6had the highest number of state-level seclusion totals within
7schools across the country; and
8    WHEREAS, Research has shown that children and adolescents
9often see seclusion as a form of punishment and can be
10traumatized by the practice; and
11    WHEREAS, The use of restraint and seclusion are based on
12the staff assumption that controlling children and adolescents
13by force will reduce dangerous behaviors and maintain
14community safety, although academic research shows that such
15coercive interventions can maintain and intensify the very
16behaviors staff are trying to control; and
17    WHEREAS, Research shows that inexperienced or inadequately
18trained staff are involved in more restraint and seclusion
19incidents than experienced staff in child welfare, mental
20health, juvenile justice, and educational settings; and
21    WHEREAS, Strategies to reduce restraint and elimination



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1may include leadership in organizational culture change, using
2data to inform practice, workforce development, inclusion of
3family and peers, specific reduction interventions, and
4rigorous debriefing; and
5    WHEREAS, Service providers may select from various
6available training curricula, supported by data and academic
7research, to implement organizational change and focus on the
8reduction of restraint and seclusion; and
9    WHEREAS, Research by the Substance Abuse and Mental Health
10Service Administration deemed one training curriculum, the Six
11Core Strategies, an evidence-based intervention after an
12eight-state evaluation; and
13    WHEREAS, Restraint and seclusion reduction training
14curricula include trauma-informed principles as foundational
15components; and
16    WHEREAS, When Massachusetts developed and implemented a
17statewide initiative to reduce or eliminate the use of
18seclusion and restraint among children and adolescents for
19psychiatric facility workers, the number of workers'
20compensation claims decreased by 29 percent, and the amount of
21compensation paid decreased by 98 percent; and



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1    WHEREAS, A shared vision across child and adolescent
2serving organizations, which is grounded in academic research
3and data, will help unite professionals under the common goal
4of restraint and seclusion reduction; therefore, be it
7we urge policy decisions of State agencies and the Illinois
8General Assembly to align with the goal of preventing,
9reducing, and ultimately eliminating, the use of restraint and
10seclusion with children and adolescents; and be it further
11    RESOLVED, That it is the overarching policy of the State
12of Illinois that restraint and seclusion should only be used
13as a last resort to protect a youth from harming themselves or
14others and should never be used for punishment, discipline, or
15convenience; and be it further
16    RESOLVED, That until use of restraint and seclusion is
17ultimately eliminated, State agencies who employ restraint and
18seclusion, as well as contractors to those agencies, must
19ensure that only staff members with certified training who are
20experienced in restraint and seclusion employ these methods to
21reduce incidents of harm; and be it further
22    RESOLVED, That we urge all administrative staff of the



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1State of Illinois who promulgate rules and procedures that
2govern the use of restraint and seclusion with children and
3adolescents, including the Office of the Governor, the State
4Board of Education, the Department of Human Services, the
5Department of Children and Family Services, the Department of
6Public Health, and the Department of Juvenile Justice, to
7operate under the shared vision that restraint and seclusion
8are behavior management interventions of last resort and work
9towards their reduction.