SCS/HCS/HB 1779 - Under current law, physical or chemical restraints, isolation, or seclusion cannot be used on patients, residents or clients of a mental health facility or mental health program unless it is determined by the head of the facility or the attending licensed physician that it is necessary to protect the health and safety of the individual or others and that it provides the least restrictive environment. This act allows such orders to also be made by an advanced practice registered nurse (APRN) in a collaborative practice arrangement with the attending licensed physician for certain patients in facilities or programs that only provide psychiatric care and in dedicated psychiatric units. If the APRN orders the use of restraints, isolation or seclusion, it shall be reviewed in person by the attending licensed physician if the episode of restraint extends beyond 4 hours duration for a person under 18 years of age, or beyond 8 hours duration for a person 18 years of age or older, or for any total length of restraint lasting more than four hours duration in a 24 hour period in the case of a person under 18 years of age, or beyond eight hours duration in the case of a person over 18 years of age in a 24 hour period.
Depending on the circumstances under which an individual has been committed to the facility, security escort devices may be used when such individuals are transported outside a mental health facility based on the determination of the head of the facility or the attending licensed physician. This act allows such determinations to also be made by the attending advanced practice registered nurse in a collaborative practice arrangement with the attending licensed physician.
All orders made by the APRN under this act shall be reviewed in person by the attending licensed physician of the facility within 24 hours or the next regular working day of the order being issued, and such review shall be documented in the clinical record of the patient, resident, or client. The APRN shall also document the use of the restraint, isolation or seclusion.
Restraint or seclusion shall not be used in habilitation centers or community programs that serve persons with developmental disabilities that are operated or funded by the Division of Developmental Disabilities unless such procedure is part of an emergency intervention system approved by the Division and is identified in such person's individual support plan.
ADRIANE CROUSE