Bill > A1012

Introduced Session

This bill restricts the use of physical and mechanical restraints on persons with developmental disabilities by providing that, except in limited circumstances, physical and mechanical restraints may be used in emergency situations only. Under current law, in addition to emergency use, such restraints may be used as planned interventions as part of approved behavior modification plans, and as a result of inclusion in these plans, the unusual incident reporting requirements of the Division of Developmental Disabilities in the Department of Human Services do not apply. The bill also excludes aversive techniques as planned interventions. Specifically, under the provisions of the bill, a person receiving services for persons with developmental disabilities at a public or private facility or from a public or private agency that provides services for persons with developmental disabilities, would not be subjected to physical restraint unless: 1) an emergency exists that necessitates the use of physical restraint; 2) the physical restraint is used only for the period that is necessary to contain the behavior of the person so that the person no longer poses an immediate threat of causing serious physical injury to himself or others, except that this period may not exceed one hour; 3) a medical order authorizing the use of physical restraint is obtained from the person's treating physician before the application of physical restraint or not later than 15 minutes after the application; 4) the physician who signed the order or the attending physician examines the person not later than one working day after the application of physical restraint; and 5) the use of force in the application of the physical restraint does not exceed the force that is reasonable and necessary under the circumstances precipitating the use of physical restraint. The limited circumstances under which the above provisions would not apply are when physical restraint is applied for the following reasons: to assist a person in completing a task if the person does not resist the application of physical restraint or if the restraint is minimal in intensity and duration; to escort or carry a person to safety if the person is in danger in his present location; or to enable a health care professional to treat the medical needs of the person. With regard to mechanical restraints, a person receiving services for persons with developmental disabilities at a facility or from a public or private agency would not be subjected to mechanical restraint unless: 1) an emergency exists that necessitates the use of mechanical restraint; 2) a medical order authorizing the use of mechanical restraint is obtained from the person's treating physician before the application of the mechanical restraint or not later than 15 minutes after the application of the mechanical restraint; 3) the physician who signed the order or the attending physician examines the person not later than one working day after the application of mechanical restraint; 4) the mechanical restraint is applied by staff trained in the use and application of the particular restraint; 5) the person is given the opportunity to move and exercise the parts of his body that are restrained at least 10 minutes for every 60 minutes of restraint; 6) a member of the staff lessens or discontinues the mechanical restraint every 15 minutes to determine whether the person will stop or control dangerous behavior without the use of the restraint; 7) the record of the person contains a notation that includes the time of day that the mechanical restraint was lessened or discontinued, the response of the person to the lessening or discontinuation of the restraint, and the action taken by the member of the staff to lessen or discontinue the mechanical restraint, as appropriate; 8) a member of the staff continuously monitors the person during the time that mechanical restraint is used on the person; and 9) the mechanical restraint is used only for the period that is necessary to contain the behavior of the person so that the person no longer poses an immediate threat of causing serious physical injury to himself or others. The limited circumstances under which the above provisions would not apply are when mechanical restraint is applied for the following reasons: to enable a health care professional to treat the medical needs of the person; to protect a person who is known to be at risk of injury to himself because he lacks coordination or suffers from frequent loss of consciousness; to provide proper body alignment of a person; or to position a person who has physical disabilities in a manner described in the person's individual habilitation plan. In these circumstances, however, a medical order authorizing the use of mechanical restraint for any of these purposes would first need to be obtained. For both physical and mechanical restraints, the bill provides that within one working day of the use of the restraint, the use is to be reported as an unusual incident, in accordance with the Division of Developmental Disabilities' policy for reporting unusual incidents, which would include reporting these incidents to the person's parent or legal guardian, to an unusual incident report coordinator in the division, and to the Office of Operations Support, or its successor, in the Department of Human Services. The bill also provides that, as a condition of licensure, a private facility or agency that provides services for persons with traumatic brain injury may not use aversive techniques on persons with traumatic brain injury, and may not use physical or mechanical restraints unless that use is in accordance with the procedures outlined in the bill. In addition, the bill includes a provision requiring staff training in positive approaches to behavior and completion of a course in understanding the legal and ethical responsibilities of staff. The bill also requires the department to develop and maintain a web site for statistical information about the number of unusual incidents occurring at public or private facilities or agencies, as well as any reports or findings from any State monitoring agencies. The bill defines "emergency" as a situation in which immediate intervention is necessary to protect the physical safety of a person receiving services at a facility or from a public or private agency, or to protect the safety of others from an immediate threat of serious physical injury. The bill amends N.J.S.A.30:6D-5 to exclude "substantial property damage" as a basis for using chemical restraint in emergency situations, and it amends N.J.S.A.30:6D-11 to provide that individual habilitation plans may not include aversive techniques or physical or mechanical restraint as planned interventions, but may provide for the use of physical or mechanical restraint in accordance with the limited circumstances described above. This bill is based on Nevada and Pennsylvania law and is intended to reduce the use of physical and mechanical restraints and eliminate the use of aversive techniques in the State in order to address the tragic situation that occurred at a State-licensed facility in Haddonfield, where a teenage boy with autism, named Matthew, was improperly restrained and left unattended.

AI Summary

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Michele Matsikoudis (R)*,  Nancy Muñoz (R)*, 

Introduced, Referred to Assembly Health Committee (on 01/09/2024)

Official Document