Amended in Assembly May 28, 2015

Amended in Assembly April 6, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 918

Introduced by Assembly Member Mark Stone

February 26, 2015

An act to add begin delete Section 1180.7 to the Health and Safety Code, relating to health and care facilities. end delete begin insert Sections 4436.5 and 4659.2 to the Welfare and Institutions Code, relating to developmental services. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 918, as amended, Mark Stone. begin delete Health and care facilities: seclusion and behavioral restraints. end delete begin insert Developmental services: reporting: seclusion and restraint. end insert

Existing law requires the Secretary of California Health and Human Services to develop technical assistance and training programs to support the efforts of community care facilities, group homes, skilled nursing facilities, intermediate care facilities, and mental health rehabilitation centers, among others, to reduce or eliminate the use of seclusion and behavioral restraints in these facilities. Existing law requires specified entities within the California health and Human Services Agency to take steps to establish a system of mandatory, consistent, timely, and publicly accessible data collection regarding the use of seclusion and behavioral restraints in state hospitals operated by the State Department of State Hospitals, facilities operated by the State Department of Developmental Services, and other specified facilities that utilize seclusion or behavioral restraints.

begin delete

The bill would require, on or before January 1, 2017, the secretary to take steps to establish a system of mandatory, consistent, timely, and publicly accessible data collection regarding the use of seclusion and behavioral restraints in additional facilities, including adult residential facilities, that utilize seclusion or behavioral restraints. The bill would require these facilities to report to the protection and advocacy agency designated by the Governor each death or serious injury of a person occurring during, or related to, the use of seclusion or behavioral restraints.

end delete begin insert

Under existing law, the Lanterman Developmental Disabilities Services Act, the State Department of Developmental Services contracts with regional centers to provide services and supports to individuals with developmental disabilities. Existing law requires all vendors and long-term health care facilities, as defined, to report special incidents to a regional center, including, among other things, physical or chemical restraint, or both. Existing law requires a regional center that receives information from a special incident report regarding the use of physical or chemical restraint, or both, to report that information to the department, as specified.

end insert begin insert

This bill would require the department to ensure the consistent, timely, and public reporting of data it receives from regional centers regarding the use of physical or chemical restraint and to publish that information on its Internet Web site.

end insert begin insert

This bill would also require regional center vendors that provide residential services or supported living services and long-term health care facilities to report each death or serious injury of a person occurring during, or related to, the use of seclusion, physical restraint, or chemical restraint, as specified.

end insert begin insert

This bill would make related findings and declarations.

end insert

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert The Legislature finds and declares all of the
following: end insert

begin insert

(a) The President’s New Freedom Commission on Mental Health
(2003) reported that the use of behavioral restraint and seclusion
poses significant risks for adults and children, including serious
injury or death, retraumatizing people with a history of trauma or
abuse, loss of dignity, and other psychological harm.

end insert begin insert

(b) Although California currently requires the tracking and
public reporting of the use of seclusion and restraint in state
developmental centers and collects data regarding the use of
restraint through the department’s special incident reporting
system, the data concerning the use of restraint in community
residential and other long-term care facilities serving individuals
with developmental disabilities is not publicly reported.

end insert begin insert

(c) One of the best methods to achieve the goal of a reduction
in the use of restraint is to ensure consistent data collection and
analysis and public access to this data.

end insert begin insert

(d) It is the intent of the Legislature in enacting this act to ensure
that data regarding the use of restraint in community residential
and other long-term care facilities is publicly available as a means
of ensuring quality services to individuals with developmental
disabilities and a reduction in the use of restraint.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 4436.5 is added to the end insert begin insert Welfare and Institutions
Code end insert begin insert , to read: end insert

begin insert

begin insert 4436.5. end insert   

(a) For the purposes of this section, the following
definitions apply:

(1) “Physical restraint” means any behavioral or mechanical
restraint as defined in Section 1180.1 of the Health and Safety
Code.

(2) “Chemical restraint” means a drug that is used to control
behavior and that is used in a manner not required to treat the
patient’s medical conditions.

(3) “Long-term health care facility” means a facility, as defined
in Section 1418 of the Health and Safety Code, or an acute
psychiatric hospital, as defined in subdivision (b) of Section 1250
of the Health and Safety Code, including an institution for mental
disease.

(b) The department shall ensure the consistent, timely, and
public reporting of data it receives from regional centers pursuant
to Section 54327 of Title 17 of the California Code of Regulations
regarding the use of physical restraint, chemical restraint, or both,
by all regional center vendors who provide residential services or
supported living services pursuant to Section 4689, and by
long-term health care facilities serving individuals with
developmental disabilities.

(c) The department shall publish quarterly on its Internet Web
site of the following data, segregated by individual regional center
vendor that provides residential services or supported living
services and individual long-term health care facility that serves
persons with developmental disabilities:

(1) The number of incidents of physical restraint.

(2) The number of incidents of chemical restraint.

end insert

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 4659.2 is added to the end insert begin insert Welfare and Institutions
Code end insert begin insert , to read: end insert

begin insert

begin insert 4659.2. end insert   

(a) For the purposes of this section, the following
definitions apply:

(1) “Physical restraint” means any behavioral or mechanical
restraint, as defined in Section 1180.1 of the Health and Safety
Code.

(2) “Chemical restraint” means a drug that is used to control
behavior and that is used in a manner not required to treat the
patient’s medical conditions.

(3) “Seclusion” means involuntary confinement of a person
alone in a room or an area as defined in subdivision (e) of Section
1180.1 of the Health and Safety Code.

(4) “Long-term health care facility” means a facility, as defined
in Section 1418 of the Health and Safety Code, or an acute
psychiatric hospital, as defined in subdivision (b) of Section 1250
of the Health and Safety Code, including an institution for mental
disease.

(b) All regional center vendors that provide residential services
or supported living services and long-term health care facilities
shall report each death or serious injury of a person occurring
during, or related to, the use of seclusion, physical restraint, or
chemical restraint, or any combination thereof, to the agency
designated pursuant to subdivision (i) of Section 4900 no later
than the close of the business day following the death or serious
injury. The report shall include the encrypted identifier of the
person involved, and the name, street address, and telephone
number of the facility.

end insert

begin delete

SECTION 1.  

Section 1180.7 is added to the Health and Safety
Code, to read:

1180.7.  

(a) This section shall apply to intermediate care
facilities, intermediate care facilities/developmentally
disabled-nursing, intermediate care facilities for the
developmentally disabled, intermediate care
facilities/developmentally disabled-habilitative, group homes, adult
residential facilities, and mental health rehabilitation centers.

(b) (1) Notwithstanding subdivision (d) of Section 1180.3, on
or before January 1, 2017, the secretary or his or her designee shall
take steps to establish a system of mandatory, consistent, timely,
and publicly accessible data collection regarding the use of
seclusion and behavioral restraints in all facilities described in
subdivision (a) that utilize seclusion and behavioral restraints.

(2) Data collected pursuant to this subdivision shall include all
of the data described in paragraph (3) of subdivision (d) of Section
1180.2.

(c) A facility described in subdivision (a) shall report each death
or serious injury of a person occurring during, or related to, the
use of seclusion or behavioral restraints. This report shall be made
to the agency designated in subdivision (i) of Section 4900 of the
Welfare and Institutions Code no later than the close of the business
day following the death or injury. The report shall include the
encrypted identifier of the person involved, and the name, street
address, and telephone number of the facility.

end delete

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CORRECTIONS:

Text--Page 4.

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