Amended in Senate June 25, 2015

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 Sections 4436.5 and 4659.2 to the Welfare and Institutions Code, relating to begin delete developmental services. end delete begin insert seclusion and restraint. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 918, as amended, Mark Stone. begin delete Developmental services: reporting: seclusion and restraint. end delete begin insert Seclusion and restraint: developmental services: health facilities. 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 begin delete health end delete begin insert Health end insert 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.

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, begin insert incidents of end insert physical begin delete or end delete begin insert and end insert chemical restraint begin delete , or both end delete . Existing law requires a regional center that receives information from a special incident report regarding the use of physical or chemical restraint, begin delete or both, end delete to report that information to the department, as specified.

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

This bill would also require regional center vendors that provide residential services or supported living begin delete services and end delete begin insert services, end insert long-term health care begin delete facilities end delete begin insert facilities, and acute psychiatric hospitals end insert 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.

This bill would make related findings and declarations.

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

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

SECTION 1.  

The Legislature finds and declares all of the
following:

(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.

(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 begin insert and acute psychiatric hospitals end insert
serving individuals with developmental disabilities is not publicly
reported.

(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.

(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 begin insert and acute psychiatric hospitals end insert
is publicly available as a means of ensuring quality services to
individuals with developmental disabilities and a reduction in the
use of restraint.

SEC. 2.  

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

4436.5.  

(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 begin delete 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. end delete begin insert Code. end insert

begin insert

(4) “Acute psychiatric hospital” means a facility as defined in
subdivision (b) of Section 1250 of the Health and Safety Code,
including an institution for mental disease.

end insert

(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 begin insert and acute psychiatric hospitals end insert
serving individuals with developmental disabilities.

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

(1) The number of incidents of physical restraint.

(2) The number of incidents of chemical restraint.

SEC. 3.  

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

4659.2.  

(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 begin delete 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. end delete begin insert Code. end insert

begin insert

(5) “Acute psychiatric hospital” means a facility as defined in
subdivision (b) of Section 1250 of the Health and Safety Code,
including an institution for mental disease.

end insert

(b) All regional center vendors that provide residential services
or supported living begin delete services and end delete begin insert services, end insert long-term health care
begin delete facilities end delete begin insert facilities, and acute psychiatric hospitals end insert 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.