2014 -- H 7993

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LC005194

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO HEALTH AND SAFETY - FREEDOM FROM LIFE-THREATENING

PHYSICAL RESTRAINT ACT

     Introduced By: Representatives Gallison, Canario, Naughton, Azzinaro, and Kazarian

     Date Introduced: March 27, 2014

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

amended by adding thereto the following chapter:

CHAPTER 17.27

FREEDOM FROM LIFE-THREATENING PHYSICAL RESTRAINT ACT

     23-17.27-1. Short title.-- This chapter shall be known and may be cited as the "Freedom

from Life-Threatening Physical Restraint Act."

     23-17.27-2. Fundamental purpose.-- This chapter is enacted to protect and promote the

right of each person who is served by a covered facility to be free from life-threatening physical

restraint.

     23-17.27-3. Definitions.-- For the purposes of this chapter:

     (1) "Service provider" means any person employed or contracted by a covered facility to

provide support or care, residential support, education, healthcare, treatment, or direct

supervision.

     (2) "Covered facility" means any agency, organization, or public or private entity,

regardless of the state agency under whose authority its license or certification is established, that

provides support or care, residential support, education, healthcare, treatment, or direct

supervision. "covered facility" does not include any law enforcement department, the department

of corrections, the training school for youth, or the forensic unit at the Eleanor Slater hospital.

     (3) "Life-threatening physical restraint" means any physical restraint or hold on a person

that may cause death, including prone restraint or any restraint that is contraindicated by a

person's physical or mental health.

     23-17.27-4. Use of restraints.-- No service provider of any covered facility may use a

life-threatening physical restraint, at any time.

     23-17.27-5. Recording and data collection.-- (a) Any use of restraint on a person must

be documented. This documentation must be maintained by the covered facility and shall be

submitted electronically to the licensing agency within four (4) days of the use of a restraint. The

following information must be included:

     (1) The name of the person restrained;

     (2) The name of the covered facility;

     (3) The names of the staff participating in the restraint;

     (4) The names of other staff present (including medical professionals);

     (5) The date and time of the restraint;

     (6) The length of time of the restraint;

     (7) The location of the restraint:

     (8) The nature of the emergency and what steps were taken to prevent the emergency

from arising if there were indications that such an emergency was likely to arise;

     (9) The attempts of de-escalation and positive behavioral supports utilized;

     (10) If, when, and how the family or advocate was contacted;

     (11) Who attended the debriefing and when the debriefing occurred; and

     (12) The outcome of the debriefing.

     (b) If the use of restraint results in serious physical injury or death to the person, the

covered facility shall immediately contact emergency rescue responders and report the incident to

law enforcement. The covered facility shall then report the incident to the director of the state

agency that has jurisdiction or supervisory control over the covered facility. The director shall

report any incidence of serious injury or death to the attorney general, and if a child, to the child

advocate.

     23-17.27-6. Training and policies.-- Each covered facility shall:

     (1) Develop policies and procedures that establish monitoring, documentation, reporting

and internal review of the use of restraint in accordance with this chapter;

     (2) Require nationally recognized training of all service providers in the

reduction/elimination of restraint and seclusion. The training shall be approved by the director of

the state agency that has supervisory control over the covered facility. The training shall include,

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but not be limited to:

     (i) Leadership towards organizational change;

     (ii) Use of data to inform practice;

     (iii) Workforce development;

     (iv) Use of prevention tools, including positive behavior interventions and de-escalation;

     (v) Inclusion of individuals, families, and advocates; and

     (vi) Debriefing techniques and outcomes.

     (3) Make the policies and procedures required under subdivision (1) available to the

director of the state agency that has jurisdiction or supervisory control over the covered facility.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - FREEDOM FROM LIFE-THREATENING

PHYSICAL RESTRAINT ACT

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     This act would prevent service providers at covered facilities from using life-threatening

physical restraint at any time upon persons serviced by the agency. If any restraint is used the act

would require incident reports, medical care and law enforcement involvement as well as

development of policies and procedures and staff training.

     This act would take effect upon passage.

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