Public Act 098-0137
 
HB1005 EnrolledLRB098 05627 RLC 35665 b


  
    AN ACT concerning health.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  
 
 
    Section 5. The Mental Health and Developmental 
Disabilities Code is amended  by changing Sections 2-108 and 
2-109 as follows:
 



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



    Sec. 2-108. Use of restraint. Restraint may be used only as 
a therapeutic
measure to prevent a recipient from causing 
physical harm to himself or
physical abuse to others. Restraint 
may only be applied by a person who has
been trained in the 
application of the particular type of restraint to be
utilized. 
In no event shall restraint be utilized  to punish or discipline 
a
recipient, nor is restraint to be used as a convenience for 
the staff.

    (a) Except as provided in this Section, restraint shall be 
employed only
upon the written order of a physician, clinical 
psychologist, clinical social
worker, clinical professional 
counselor, or registered nurse with supervisory 
responsibilities.  No restraint
shall be ordered unless the 
physician, clinical psychologist, clinical social
worker, 
clinical professional counselor, or registered nurse with 
supervisory responsibilities, after personally
observing and 
examining the recipient, is clinically satisfied that the use 
of
restraint is justified to prevent the recipient from causing 
physical harm to
himself or others. In no event may restraint 
continue for longer than 2 hours
unless within that time period 
a nurse with supervisory responsibilities or a
physician 
confirms, in writing, following a personal examination of the

recipient, that the restraint does not pose an undue risk to 
the recipient's
health in light of the recipient's physical or 
medical condition.  The order
shall state the events leading up 
to the need for restraint and the purposes
for which restraint 
is employed.  The order shall also state the length of time

restraint is to be employed and the clinical justification for 
that length of
time.  No order for restraint shall be valid for 
more than 16 hours.  If
further restraint is required, a new 
order must be issued pursuant to the
requirements provided in 
this Section.

    (b) In the event there is an emergency requiring the 
immediate use
of restraint, it may be ordered temporarily by a 
qualified person only
where a physician, clinical 
psychologist, clinical social worker, clinical professional 
counselor, or
registered nurse with supervisory 
responsibilities is not immediately
available.  In that event, 
an order by a nurse, clinical psychologist, clinical
social 
worker, clinical professional counselor, or physician shall be 
obtained pursuant to the requirements of
this Section as 
quickly as possible, and the recipient shall be examined by a

physician or supervisory nurse within 2 hours after the initial 
employment of
the emergency restraint. Whoever orders 
restraint in emergency situations shall
document its necessity 
and place that documentation in the recipient's record.

    (c) The person who orders restraint shall inform the 
facility director or
his designee in writing of the use of 
restraint within 24 hours.

    (d) The facility director shall review all restraint orders 
daily and shall
inquire into the reasons for the orders for 
restraint by any person who
routinely orders them.

    (e) Restraint may be employed during all or part of one 24 
hour
period, the period commencing with the initial application 
of the
restraint.  However, once restraint has been employed 
during one 24 hour
period, it shall not be used again on the 
same recipient during the next
48 hours without the prior 
written authorization of the facility director.

    (f) Restraint shall be employed in a humane and therapeutic 
manner and
the person being restrained shall be observed by a 
qualified person as often
as is clinically appropriate but in 
no event less than once every 15 minutes.
The qualified person 
shall maintain a record of the observations.
Specifically, 
unless there is an immediate danger that the recipient
will 
physically harm himself or others, restraint shall be loosely

applied to permit freedom of movement.  Further, the recipient 
shall be
permitted to have regular meals and toilet privileges 
free from the
restraint, except when freedom of action may 
result in physical harm to
the recipient or others.

    (g) Every facility that employs restraint shall provide 
training in the
safe and humane application of each type of 
restraint employed.
The facility shall not authorize the use of 
any type of restraint by an
employee who has not received 
training in the safe and humane application
of that type of 
restraint.  Each facility in which restraint is used shall

maintain records detailing which employees have been trained 
and are
authorized to apply restraint, the date of the training 
and the type of
restraint that the employee was trained to use.

    (h) Whenever restraint is imposed upon any recipient whose 
primary mode
of communication is sign language, the recipient 
shall be permitted to have
his hands free from restraint for 
brief periods each hour, except
when freedom may result in 
physical harm to the recipient or others.

    (i) A recipient who is restrained may only be secluded at 
the same time
pursuant to an explicit written authorization as 
provided in Section 2-109
of this Code.  Whenever a recipient is 
restrained, a member of the facility
staff shall remain with 
the recipient at all times unless the recipient has
been 
secluded.  A recipient who is restrained and secluded shall be

observed by a qualified person as often as is clinically 
appropriate but in
no event less than every 15 minutes.

    (j) Whenever restraint is used, the recipient shall be 
advised of his
right, pursuant to Sections 2-200 and 2-201 of 
this Code, to have any
person of his choosing, including the 
Guardianship and Advocacy Commission
or the agency designated 
pursuant to the Protection and Advocacy for
Developmentally 
Disabled Persons Act  notified of the restraint.  A recipient
who 
is under guardianship may request that any person of his 
choosing be
notified of the restraint whether or not the 
guardian approves of the notice.
Whenever the Guardianship and 
Advocacy Commission is notified that a recipient
has been 
restrained, it shall contact that recipient to determine the

circumstances of the restraint and whether further action is 
warranted.

(Source: P.A. 92-651, eff. 7-11-02.)

 



    (405 ILCS 5/2-109)  (from Ch. 91 1/2, par. 2-109)



    Sec. 2-109. Seclusion. Seclusion may be used only as a 
therapeutic
measure to prevent a recipient from causing 
physical harm to himself or
physical abuse
to others. In no 
event shall seclusion be utilized  to punish or discipline
a 
recipient, nor is seclusion to be used as a convenience for the 
staff.

    (a) Seclusion shall be employed only upon the written order 
of a
physician, clinical psychologist, clinical social worker, 
clinical professional counselor, or registered
nurse with 
supervisory responsibilities. No seclusion shall be ordered

unless the physician, clinical psychologist, clinical social 
worker, clinical professional counselor, or
registered nurse 
with supervisory responsibilities, after personally
observing 
and examining the recipient, is clinically satisfied that the 
use
of seclusion is justified to prevent the recipient from 
causing physical
harm to himself or others.  In no event may 
seclusion continue for longer
than 2 hours unless within that 
time
period a nurse with supervisory responsibilities or a 
physician confirms in
writing, following a personal 
examination of the recipient, that the
seclusion does not pose 
an undue risk to the recipient's health in light of
the 
recipient's physical or medical condition.  The order
shall 
state the events leading up to the need for seclusion and the

purposes for which seclusion is employed.  The order shall also

state the length of time seclusion is to be employed and the 
clinical
justification for the length of time.  No order for 
seclusion shall be
valid for more than 16 hours.  If further 
seclusion is required, a new
order must be issued pursuant to 
the requirements
provided in this Section.

    (b) The person who orders seclusion shall inform the 
facility
director or his designee in writing of the use of 
seclusion within 24
hours.

    (c) The facility director shall review all seclusion orders 
daily and
shall inquire into the reasons for the orders for 
seclusion by any
person who routinely orders them.

    (d) Seclusion may be employed during all or part of one 16 
hour
period, that period commencing with the initial 
application of the
seclusion. However,  once seclusion has been 
employed during one 16 hour
period, it shall not be used again 
on the same recipient during the next
48 hours without the 
prior written authorization of the facility director.

    (e) The person who ordered the seclusion shall assign a 
qualified
person to observe the recipient at all times.
A 
recipient who is restrained and secluded shall be observed by a 
qualified
person as often as is clinically appropriate but in 
no event less than once
every 15 minutes.

    (f) Safety precautions shall be followed to prevent 
injuries to the
recipient in the seclusion room.  Seclusion 
rooms shall be adequately
lighted, heated, and furnished.  If a 
door is locked, someone with a key
shall be in constant 
attendance nearby.

    (g) Whenever seclusion is used, the recipient shall be 
advised of his
right, pursuant to Sections 2-200 and 2-201 of 
this Code, to have any
person of his choosing, including the 
Guardianship and Advocacy Commission
notified of the 
seclusion.  A person who is under guardianship may request
that 
any person of his choosing be notified of the seclusion whether 
or not
the guardian approves of the notice.  Whenever the 
Guardianship and
Advocacy Commission is notified that a 
recipient has been secluded, it shall
contact that recipient to 
determine the circumstances of the seclusion and
whether 
further action is warranted.

(Source: P.A. 86-1013; 86-1402; 87-124; 87-530; 87-895.)

 
 
    Section 99. Effective date. This Act takes effect upon 
becoming law.