Amended in Senate July 16, 2015

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 BillNo. 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 seclusion and restraint.

LEGISLATIVE COUNSEL’S DIGEST

AB 918, as amended, Mark Stone. Seclusion and restraint: developmental services: health facilities.

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.

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, incidents of physical and chemical restraint. Existing law requires a regional center that receives information from a special incident report regarding the use of physical or chemical restraint, 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 and other specified facilities 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 services, long-term health care facilities,begin insert as defined,end insert and acute psychiatricbegin delete hospitalsend deletebegin insert hospitals, as defined,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:

P2    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) The President’s New Freedom Commission on Mental Health
4(2003) reported that the use of behavioral restraint and seclusion
5poses significant risks for adults and children, including serious
6injury or death, retraumatizing people with a history of trauma or
7abuse, loss of dignity, and other psychological harm.

8(b) Although California currently requires the tracking and
9public reporting of the use of seclusion and restraint in state
10developmental centers and collects data regarding the use of
11restraint through the department’s special incident reporting system,
12the data concerning the use of restraint in community residential
13and other long-term care facilities and acute psychiatric hospitals
P3    1serving individuals with developmental disabilities is not publicly
2reported.

3(c) One of the best methods to achieve the goal of a reduction
4in the use of restraint is to ensure consistent data collection and
5analysis and public access to this data.

6(d) It is the intent of the Legislature in enacting this act to ensure
7that data regarding the use of restraint in community residential
8and other long-term care facilities and acute psychiatric hospitals
9is publicly available as a means of ensuring quality services to
10individuals with developmental disabilities and a reduction in the
11use of restraint.

12

SEC. 2.  

Section 4436.5 is added to the Welfare and Institutions
13Code
, to read:

14

4436.5.  

(a) For the purposes of this section, the following
15definitions apply:

16(1) “Physical restraint” means any behavioral or mechanical
17restraint as defined in Section 1180.1 of the Health and Safety
18Code.

19(2) “Chemical restraint” means a drug that is used to control
20behavior and that is used in a manner not required to treat the
21patient’s medical conditions.

22(3) “Long-term health care facility” means a facility, as defined
23in Section 1418 of the Health and Safetybegin delete Code.end deletebegin insert Code, that is
24required to report to a regional center pursuant to Section 54327
25of Title 17 of the California Code of Regulations.end insert

26(4) “Acute psychiatric hospital” means abegin delete facilityend deletebegin insert facility,end insert as
27defined in subdivision (b) of Section 1250 of the Health and Safety
28Code, including an institution for mentalbegin delete disease.end deletebegin insert disease, that is
29a regional center vendor.end insert

begin insert

30(5) “Regional center vendor” means an agency, individual, or
31service provider that a regional center has approved to provide
32vendored or contracted services or supports pursuant to paragraph
33(3) of subdivision (a) of Section 4648.

end insert

34(b) The department shall ensure the consistent, timely, and
35public reporting of data it receives from regional centers pursuant
36to Section 54327 of Title 17 of the California Code of Regulations
37regarding the use of physical restraint, chemical restraint, or both,
38by all regional center vendors who provide residential services or
39supported living services pursuant to Section 4689, and by
P4    1long-term health care facilities and acute psychiatric hospitals
2serving individuals with developmental disabilities.

3(c) The department shall publish quarterly on its Internet Web
4site the following data, segregated by individual regional center
5vendor that provides residential services or supported living
6services and each individual long-term health care facility and
7acute psychiatric hospital that serves persons with developmental
8disabilities:

9(1) The number of incidents of physical restraint.

10(2) The number of incidents of chemical restraint.

11

SEC. 3.  

Section 4659.2 is added to the Welfare and Institutions
12Code
, to read:

13

4659.2.  

(a) For the purposes of this section, the following
14definitions apply:

15(1) “Physical restraint” means any behavioral or mechanical
16restraint, as defined in Section 1180.1 of the Health and Safety
17Code.

18(2) “Chemical restraint” means a drug that is used to control
19behavior and that is used in a manner not required to treat the
20patient’s medical conditions.

21(3) “Seclusion” means involuntary confinement of a person
22alone in a room or an area as defined in subdivision (e) of Section
231180.1 of the Health and Safety Code.

24(4) “Long-term health care facility” means a facility, as defined
25in Section 1418 of the Health and Safetybegin delete Code.end deletebegin insert Code, that is
26required to report to a regional center pursuant to Section 54327
27of Title 17 of the California Code of Regulations.end insert

28(5) “Acute psychiatric hospital” means abegin delete facilityend deletebegin insert facility,end insert as
29defined in subdivision (b) of Section 1250 of the Health and Safety
30Code, including an institution for mentalbegin delete disease.end deletebegin insert disease, that is
31a regional center vendor.end insert

begin insert

32(6) “Regional center vendor” means an agency, individual, or
33service provider that a regional center has approved to provide
34vendored or contracted services or supports pursuant to paragraph
35(3) of subdivision (a) of Section 4648.

end insert

36(b) All regional center vendors that provide residential services
37or supported living services, long-term health care facilities, and
38acute psychiatric hospitals shall report each death or serious injury
39of a person occurring during, or related to, the use of seclusion,
40physical restraint, or chemical restraint, or any combination thereof,
P5    1to the agency designated pursuant to subdivision (i) of Section
24900 no later than the close of the business day following the death
3or serious injury. The report shall include the encrypted identifier
4of the person involved, and the name, street address, and telephone
5number of the facility.



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