Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. SB 144
                                Barcode 695260                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: FAV            .                                
                  02/16/2012           .                                

       The Committee on Children, Families, and Elder Affairs (Detert)
       recommended the following:
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 1003.573, Florida Statutes, is amended
    6  to read:
    7         1003.573 Use, prevention, and reduction of seclusion and
    8  restraint on students with disabilities in public schools Use of
    9  restraint and seclusion on students with disabilities.—
   10         (1) DEFINITIONS.—As used in this section, the term:
   11         (a) “Department” means the Department of Education.
   12         (b) “Imminent risk of serious injury or death” means the
   13  impending risk of a significant injury, such as a laceration,
   14  bone fracture, substantial hematoma, or other injury to internal
   15  organs, or death.
   16         (c) “Manual physical restraint” means the use of physical
   17  restraint techniques that involve physical force applied by
   18  school personnel to restrict the movement of all or part of a
   19  student’s body.
   20         (d) “Mechanical restraint” means the use of a physical
   21  device that restricts a student’s movement or restricts the
   22  normal function of a student’s body. The term includes the use
   23  of straps, belts, tie-downs, calming blankets, and chairs with
   24  straps; however, the term does not include the use of:
   25         1. Medical protective equipment;
   26         2. Physical equipment or orthopedic appliances, surgical
   27  dressings or bandages, or supportive body bands or other
   28  restraints necessary for ongoing medical treatment in the
   29  educational setting;
   30         3. Devices used to support functional body position or
   31  proper balance, or to prevent a person from falling out of a bed
   32  or a wheelchair, except when such device is used for any purpose
   33  other than supporting a body position or proper balance, such as
   34  coercion, discipline, convenience, or retaliation, to prevent
   35  imminent risk of serious injury or death of the student or
   36  others, or for any other behavior-management reason; or
   37         4. Equipment used for safety during transportation, such as
   38  seatbelts or wheelchair tie-downs.
   39         (e) “Medical protective equipment” means health-related
   40  protective devices prescribed by a physician or dentist for use
   41  as student protection in response to an existing medical
   42  condition.
   43         (f) “Seclusion” means the involuntary confinement of a
   44  student alone in a room or area from which the student is
   45  prevented from leaving. The term does not include the use of
   46  time-out.
   47         (g) “Student” means a student with a disability.
   48         (h) “Time-out” means a procedure in which access to varied
   49  sources of reinforcement is removed or reduced for a particular
   50  time period contingent on a response. The opportunity to receive
   51  reinforcement is contingently removed for a specified time.
   52  Either a student is contingently removed from the reinforcing
   53  environment or the reinforcing environment is contingently
   54  removed for some stipulated duration. A time-out setting may not
   55  be locked and the exit may not be blocked. Physical force or
   56  threats may not be used to place a student in time-out.
   58         (a) The Legislature finds that public schools have a
   59  responsibility to ensure that each student is treated with
   60  respect and dignity in a trauma-informed environment that
   61  provides for the physical safety and security of students and
   62  others.
   63         (b) The Legislature finds that students, educators, and
   64  families are concerned about the use of seclusion and restraint,
   65  particularly when used on students in special education
   66  programs. Seclusion and restraint refer to safety procedures in
   67  which a student is isolated from others or physically held in
   68  response to serious problem behavior that places the student or
   69  others at risk of injury or harm. There is concern that these
   70  procedures are prone to misapplication and abuse and place a
   71  student at an equal or greater risk than the risk of the
   72  student’s problem behavior. Particular concerns include:
   73         1. Seclusion or restraint is inappropriately selected and
   74  implemented as treatment or behavioral intervention rather than
   75  as a safety procedure;
   76         2. Seclusion or restraint is inappropriately used for
   77  behaviors, such as noncompliance, threats, or disruption, which
   78  do not place the student or others at risk of injury or harm;
   79         3. Students, peers, or staff may be injured or physically
   80  harmed during attempts to conduct seclusion or restraint;
   81         4. Risk of injury or harm is increased because seclusion or
   82  restraint is implemented by staff who are not adequately
   83  trained;
   84         5. The use of seclusion or restraint may inadvertently
   85  result in reinforcing or strengthening the problem behavior; and
   86         6. Seclusion or restraint is implemented independent of
   87  comprehensive, function-based behavioral intervention plans.
   89         Moreover, there are concerns about the inadequate
   90  documentation of seclusion or restraint procedures, the failure
   91  to notify parents when seclusion or restraint is applied, and
   92  the failure to use data to analyze and address the cause of the
   93  precipitating behavior.
   94         (c) The Legislature finds that the majority of problem
   95  behaviors that are currently used to justify seclusion or
   96  restraint could be prevented with early identification and
   97  intensive early intervention. The need for seclusion or
   98  restraint is, in part, a result of insufficient investment in
   99  prevention efforts. The Legislature further finds that the use
  100  of seclusion or restraint may produce trauma in students. For
  101  such students, who are already experiencing trauma, the use may
  102  cause retraumatization. Left unaddressed, the lasting effects of
  103  childhood trauma place a heavy burden on individuals, families,
  104  and communities. Research has shown that trauma significantly
  105  increases the risk of mental health problems, difficulties with
  106  social relationships and behavior, physical illness, and poor
  107  school performance.
  108         (d) The Legislature intends that students be free from the
  109  abusive and unnecessary use of seclusion or restraint in the
  110  public schools. The Legislature further intends to prevent, and
  111  achieve an ongoing reduction of, the use of manual physical
  112  restraint in the public schools and, specifically, to prohibit
  113  the use of seclusion, prone and supine restraint, and mechanical
  114  restraint on students. The Legislature also intends that manual
  115  physical restraint be used only when an imminent risk of serious
  116  injury or death exists; that manual physical restraint not be
  117  employed as punishment, for the convenience of staff, or as a
  118  substitute for a positive behavior-support plan; and that, when
  119  used, persons applying manual physical restraint impose the
  120  least possible restrictions and discontinue the restraint as
  121  soon as the threat of imminent risk of serious injury or death
  122  ceases.
  123         (3) MANUAL PHYSICAL RESTRAINT.—Manual physical restraint
  124  shall be used only in an emergency when there is an imminent
  125  risk of serious injury or death to the student or others.
  126         (a) Manual physical restraint shall be used only for the
  127  period needed in order to eliminate the imminent risk of serious
  128  injury or death to the student or others.
  129         (b) The degree of force applied during manual physical
  130  restraint must be only that degree of force necessary to protect
  131  the student or others from bodily injury.
  132         (c) Manual physical restraint shall be used only by school
  133  personnel who are qualified and certified to use the district
  134  approved methods for the appropriate application of specific
  135  restraint techniques. School personnel who have received
  136  training that is not associated with their employment with the
  137  school district, such as a former law enforcement officer who is
  138  now a teacher, shall be certified in the specific district
  139  approved techniques and may not apply techniques or procedures
  140  acquired elsewhere.
  141         (d) School personnel may not manually physically restrain a
  142  student except when an imminent risk of serious injury or death
  143  to the student or others exists.
  144         (e) School personnel may not use any of the following
  145  manual physical restraint techniques on a student:
  146         1. Prone and supine restraint.
  147         2. Pain inducement to obtain compliance.
  148         3. Bone locks.
  149         4. Hyperextension of joints.
  150         5. Peer restraint.
  151         6. Mechanical restraint.
  152         7. Pressure or weight on the chest, lungs, sternum,
  153  diaphragm, back, or abdomen, causing chest compression. This
  154  provision does not prohibit the use of cardiopulmonary
  155  resuscitation.
  156         8. Straddling or sitting on any part of the body or any
  157  maneuver that places pressure, weight, or leverage on the neck
  158  or throat, on any artery, or on the back of the student’s head
  159  or neck or that otherwise obstructs or restricts the circulation
  160  of blood or obstructs an airway.
  161         9. Any type of choking, including hand chokes, and any type
  162  of neck or head hold.
  163         10. Any technique that involves pushing anything on or into
  164  the student’s mouth, nose, eyes, or any part of the face or that
  165  involves covering the face or body with anything, including soft
  166  objects such as pillows or washcloths.
  167         11. Any maneuver that involves punching, hitting, poking,
  168  pinching, or shoving.
  169         12. Any type of mat or blanket restraint.
  170         13. Water or lemon sprays.
  171         (f) The school shall ensure that a student is medically
  172  evaluated by a physician, nurse, or other qualified medical
  173  professional as soon as possible after the student has been
  174  manually physically restrained by school personnel.
  175         (4) SECLUSION; TIME-OUT.—
  176         (a) School personnel may not place a student in seclusion.
  177         (b) School personnel may place a student in time-out if the
  178  following conditions are met:
  179         1. The time-out is part of a positive behavioral
  180  intervention plan developed for that student from a functional
  181  behavioral assessment and referenced in the student’s individual
  182  education plan.
  183         2. There is documentation that the time-out was preceded by
  184  the use of other positive behavioral supports that were not
  185  effective.
  186         3. The time-out takes place in a classroom or in another
  187  environment where class educational activities are taking place.
  188         4. The student is not physically prevented from leaving the
  189  time-out area.
  190         5. The student is observed on a constant basis by an adult
  191  for the duration of the time-out.
  192         (c) Time-out may not be used for a period that exceeds 1
  193  minute for each year of a student’s age and time-out must end
  194  immediately when the student is calm enough to return to his or
  195  her seat.
  196         (d) Time-out may not be used as a punishment or negative
  197  consequence of a student’s behavior.
  199         (a) Each school district shall report its training and
  200  certification procedures to the department by publishing the
  201  procedures in the district’s special policies and procedures
  202  manual.
  203         (b) Training for initial certification in the use of manual
  204  physical restraint must include:
  205         1. Procedures for deescalating problem behaviors before the
  206  problems increase to a level or intensity necessitating physical
  207  intervention.
  208         2. Information regarding the risks associated with manual
  209  physical restraint and procedures for assessing individual
  210  situations and students in order to determine if the use of
  211  manual physical restraint is appropriate and sufficiently safe.
  212         3. The actual use of specific techniques that range from
  213  the least to most restrictive, with ample opportunity for
  214  trainees to demonstrate proficiency in the use of such
  215  techniques.
  216         4. Techniques for implementing manual physical restraint
  217  with multiple school personnel working as a team.
  218         5. Techniques for assisting a student to reenter the
  219  instructional environment and again engage in learning.
  220         6. Instruction in the district’s documentation and
  221  reporting requirements.
  222         7. Procedures to identify and deal with possible medical
  223  emergencies arising during the use of manual physical restraint.
  224         8. Cardiopulmonary resuscitation.
  225         (c) School districts shall provide refresher certification
  226  training courses in manual physical restraint techniques at
  227  least annually to all school personnel who have successfully
  228  completed the initial certification program. The district must
  229  identify those persons to be certified and maintain a record
  230  that includes the name and position of the person certified, the
  231  date of the most recent certification, an indication of whether
  232  it was an initial certification or a refresher certification,
  233  and whether the individual successfully completed the
  234  certification and achieved proficiency.
  235         (d) School district policies regarding the use of manual
  236  physical restraint must address whether it is appropriate for an
  237  employee working in specific settings, such as a school bus
  238  driver, school bus aide, job coach, employment specialist, or
  239  cafeteria worker, to be certified in manual physical restraint
  240  techniques. In the case of school resource officers or others
  241  who may be employed by other agencies when working in a school,
  242  administrators shall review each agency’s specific policies to
  243  be aware of techniques that may be used.
  244         (6) STUDENT-CENTERED FOLLOWUP.—If a student is manually
  245  physically restrained more than twice during a school year, the
  246  school shall review the student’s functional behavioral
  247  assessment and positive behavioral intervention plan.
  248         (7)(1) DOCUMENTATION AND REPORTING.—
  249         (a) At the beginning of each school year, a school district
  250  shall provide a copy of its policies on all emergency
  251  procedures, including its policies on the use of manual physical
  252  restraint, to each student’s parent or guardian. The student’s
  253  parent or guardian must sign a form indicating that he or she
  254  has read and received the district’s policies, which the
  255  student’s school shall retain on file.
  256         (b)(a) A school shall prepare an incident report within 24
  257  hours after a student is released from a restraint or seclusion.
  258  If the student’s release occurs on a day before the school
  259  closes for the weekend, a holiday, or another reason, the
  260  incident report must be completed by the end of the school day
  261  on the day the school reopens.
  262         (c)(b) The following must be included in the incident
  263  report:
  264         1. The name of the student restrained or secluded.
  265         2. The age, grade, ethnicity, and disability of the student
  266  restrained or secluded.
  267         3. The date and time of the event and the duration of the
  268  restraint or seclusion.
  269         4. The location at which the restraint or seclusion
  270  occurred.
  271         5. A description of the type of restraint used in terms
  272  established by the Department of Education.
  273         6. The name of the person using or assisting in the
  274  restraint or seclusion of the student.
  275         7. The name of any nonstudent who was present to witness
  276  the restraint or seclusion.
  277         8. A description of the incident, including:
  278         a. The context in which the restraint or seclusion
  279  occurred.
  280         b. The student’s behavior leading up to and precipitating
  281  the decision to use manual or physical restraint or seclusion,
  282  including an indication as to why there was an imminent risk of
  283  serious injury or death to the student or others.
  284         c. The specific positive behavioral strategies used to
  285  prevent and deescalate the behavior.
  286         d. What occurred with the student immediately after the
  287  termination of the restraint or seclusion.
  288         e. Any injuries, visible marks, or possible medical
  289  emergencies that may have occurred during the restraint or
  290  seclusion, documented according to district policies.
  291         f. The results of the medical evaluation and a copy of any
  292  report by the medical professionals conducting the evaluation,
  293  if available. If the medical report is not available within 24
  294  hours, the district must submit the medical report separately as
  295  soon as it is available.
  296         g.f. Evidence of steps taken to notify the student’s parent
  297  or guardian.
  298         (d)(c) A school shall notify the parent or guardian of a
  299  student each time manual or physical restraint or seclusion is
  300  used. Such notification must be in writing and provided before
  301  the end of the school day on which the restraint or seclusion
  302  occurs. Reasonable efforts must also be taken to notify the
  303  parent or guardian by telephone or computer e-mail, or both, and
  304  these efforts must be documented. The school shall obtain, and
  305  keep in its records, the parent’s or guardian’s signed
  306  acknowledgment that he or she was notified of his or her child’s
  307  restraint or seclusion.
  308         (e)(d) A school shall also provide the parent or guardian
  309  with the completed incident report in writing by mail within 3
  310  school days after a student was manually or physically
  311  restrained or secluded. The school shall obtain, and keep in its
  312  records, the parent’s or guardian’s signed acknowledgment that
  313  he or she received a copy of the incident report.
  314         (8)(2) MONITORING.—
  315         (a) Monitoring of The use of manual or physical restraint
  316  or seclusion on students shall be monitored occur at the
  317  classroom, building, district, and state levels.
  318         (b) Any documentation prepared by a school pursuant to as
  319  required in subsection (7) (1) shall be provided to the school
  320  principal, the district director of Exceptional Student
  321  Education, and the bureau chief of the Bureau of Exceptional
  322  Education and Student Services electronically each week month
  323  that the school is in session.
  324         (c) Four times during the school year, the school shall
  325  send a redacted copy of any incident report and other
  326  documentation prepared pursuant to subsection (7) to Disability
  327  Rights Florida.
  328         (d)(c) The department shall maintain aggregate data of
  329  incidents of manual or physical restraint and seclusion and
  330  disaggregate the data for analysis by county, school, student
  331  exceptionality, and other variables, including the type and
  332  method of restraint or seclusion used. This information shall be
  333  updated monthly and made available to the public through the
  334  department’s website no later than January 31, 2013.
  335         (e)(d) The department shall establish standards for
  336  documenting, reporting, and monitoring the use of manual or
  337  physical restraint or mechanical restraint, and occurrences of
  338  seclusion. These standards shall be provided to school districts
  339  by October 1, 2011.
  341         (a) Each school district shall develop policies and
  342  procedures that are consistent with this section and that govern
  343  the following:
  344         1. Allowable use of manual physical restraint on students.
  345         2. Personnel authorized to use manual physical restraint.
  346         3. Training procedures.
  347         4.1. Incident-reporting procedures.
  348         5.2. Data collection and monitoring, including when, where,
  349  and why students are restrained or secluded; the frequency of
  350  occurrences of such restraint or seclusion; and the prone or
  351  mechanical restraint that is most used.
  352         6.3. Monitoring and reporting of data collected.
  353         7.4. Training programs relating to manual or physical
  354  restraint and seclusion.
  355         8.5. The district’s plan for selecting personnel to be
  356  trained.
  357         9.6. The district’s plan for reducing the use of restraint
  358  and seclusion particularly in settings in which it occurs
  359  frequently or with students who are restrained repeatedly, and
  360  for reducing the use of prone restraint and mechanical
  361  restraint. The plan must include a goal for reducing the use of
  362  restraint and seclusion and must include activities, skills, and
  363  resources needed to achieve that goal. Activities may include,
  364  but are not limited to:
  365         a. Additional training in positive behavioral support and
  366  crisis management;
  367         b. Parental involvement;
  368         c. Data review;
  369         d. Updates of students’ functional behavioral analysis and
  370  positive behavior intervention plans;
  371         e. Additional student evaluations;
  372         f. Debriefing with staff;
  373         g. Use of schoolwide positive behavior support; and
  374         h. Changes to the school environment.
  375         10. Analysis of data to determine trends.
  376         11. Ongoing reduction of the use of manual physical
  377  restraint.
  378         (b) Any revisions that a school district makes to its to
  379  the district’s policies and procedures, which are must be
  380  prepared as part of the school district’s its special policies
  381  and procedures, must be filed with the bureau chief of the
  382  Bureau of Exceptional Education and Student Services no later
  383  than January 31, 2012.
  384         (4) PROHIBITED RESTRAINT.—School personnel may not use a
  385  mechanical restraint or a manual or physical restraint that
  386  restricts a student’s breathing.
  387         (5) SECLUSION.—School personnel may not close, lock, or
  388  physically block a student in a room that is unlit and does not
  389  meet the rules of the State Fire Marshal for seclusion time-out
  390  rooms.
  391         Section 2. This act shall take effect July 1, 2012.
  394  ================= T I T L E  A M E N D M E N T ================
  395         And the title is amended as follows:
  396         Delete everything before the enacting clause
  397  and insert:
  398                        A bill to be entitled                      
  399         An act relating to ; providing an effective date.
  400         An act relating to the use, prevention, and reduction
  401         of seclusion and restraint on students with
  402         disabilities in public schools; amending s. 1003.573,
  403         F.S.; providing definitions; providing legislative
  404         findings and intent; requiring that manual physical
  405         restraint be used only in an emergency when there is
  406         an imminent risk of serious injury or death to the
  407         student or others; providing restrictions on the use
  408         of manual physical restraint; prohibiting the use of
  409         manual physical restraint by school personnel who are
  410         not certified to use district-approved methods for
  411         applying restraint techniques; prohibiting specified
  412         techniques; requiring that each school medically
  413         evaluate a student after the student is manually
  414         physically restrained; prohibiting school personnel
  415         from placing a student in seclusion; providing
  416         requirements for the use of time-out; requiring that a
  417         school district report its training and certification
  418         procedures to the Department of Education; requiring
  419         that school personnel be trained and certified in the
  420         use of manual physical restraint; requiring that a
  421         school review a student’s functional behavior
  422         assessment and positive behavioral intervention plan
  423         under certain circumstances; requiring that parents be
  424         notified of a school district’s policies regarding the
  425         use of manual physical restraint; requiring that each
  426         school send a redacted copy of any incident report or
  427         other documentation to Disability Rights Florida;
  428         requiring that the department make available on its
  429         website data of incidents of manual physical restraint
  430         by a specified date; requiring that each school
  431         district develop policies and procedures addressing
  432         the allowable use of manual physical restraint,
  433         personnel authorized to use such restraint, training
  434         procedures, analysis of data trends, and the reduction
  435         of the use of manual physical restraint; requiring
  436         that any revisions to a school district’s policies and
  437         procedures be filed with the bureau chief of the
  438         Bureau of Exceptional Education and Student Services
  439         by a specified date; providing an effective date.