Florida Senate - 2010 SB 2616 By Senator Siplin 19-01690-10 20102616__ 1 A bill to be entitled 2 An act relating to students with disabilities in 3 public schools; creating s. 1003.573, F.S.; providing 4 definitions; providing legislative findings and 5 intent; requiring that manual physical restraint, 6 mechanical restraint, and seclusion be used in an 7 emergency or as part of a comprehensive behavior 8 intervention plan developed by a certified behavior 9 analyst and approved by an individual education plan 10 team under certain circumstances; providing 11 restrictions on the use of manual physical restraint, 12 mechanical restraint, and seclusion; prohibiting the 13 use of manual physical restraint, mechanical 14 restraint, and seclusion by school personnel who are 15 not certified or trained to use district-approved 16 methods for applying restraint techniques; prohibiting 17 specified techniques; requiring that the school 18 medically evaluate a student during or shortly after 19 the student is manually physically restrained; 20 prohibiting school personnel from placing a student in 21 seclusion; requiring reporting of training and 22 certification procedures to the Department of 23 Education; requiring that school personnel be trained 24 and certified in the use of manual physical restraint 25 or receive competency-based training in the use of 26 mechanical restraint and seclusion; requiring student 27 followup in certain circumstances; requiring 28 notification to parents of a school district’s 29 policies regarding emergency procedures; requiring 30 that a school prepare an emergency procedure report 31 after each occasion of student restraint; specifying 32 the contents of such report; requiring certain 33 reporting and monitoring; requiring the development 34 and revision of school district policies and 35 procedures; providing an effective date. 36 37 Be It Enacted by the Legislature of the State of Florida: 38 39 Section 1. Section 1003.573, Florida Statutes, is created 40 to read: 41 1003.573 Use, monitoring, and reduction of unnecessary 42 seclusion and restraint on students with disabilities in public 43 schools.— 44 (1) DEFINITIONS.—As used in this section, the term: 45 (a) “Behavior protective equipment” means protective 46 devices attached to the student’s body which prevents injury but 47 does not restrict normal physical movement when ordered by a 48 certified behavior analyst. 49 (b) “Department” means the Department of Education. 50 (c) “Imminent risk of injury to student or others or 51 significant disruption or damage to the environment” means a 52 high probability of injury, such as a laceration, bone fracture, 53 hematoma, or bruise, or other injury to internal organs, or a 54 high probability of disruption or damage to property which is 55 likely to lead to endangerment of the safety of others. 56 (d) “Manual physical restraint” means use of physical 57 restraint techniques that involve physical force applied by a 58 teacher or other staff member to restrict the movement of all or 59 part of a student’s body for purposes of protecting the student. 60 (e) “Mechanical restraint” means a physical device used to 61 restrict a student’s movement or restrict the normal function of 62 a student’s body for purposes of protecting the student. This 63 term includes, but is not limited to, belts, vests, helmets, 64 padded mittens, tie-downs, wraps and chairs with straps, 65 seatbelts, and trays. This term does not include: 66 1. Medical protective equipment; 67 2. Physical equipment or orthopedic appliances, surgical 68 dressings or bandages, or supportive body bands or other 69 restraints necessary for medical treatment that is ongoing in 70 the educational setting; 71 3. Devices used to support functional body position or 72 proper balance, or prevent a person from falling out of a bed or 73 a wheelchair, except that these exceptions to the definition of 74 mechanical restraint do not apply to any device when it is used 75 for any purpose other than supporting a body position or proper 76 balance, such as when used as coercion, discipline, convenience, 77 or retaliation, to prevent imminent risk of serious injury or 78 death of the student or others, or for any other behavior 79 management reason; or 80 4. Equipment used for safety during transportation, such as 81 seatbelts or wheelchair tie-downs. 82 (f) “Medical protective equipment” means health-related 83 protective devices prescribed by a physician or dentist for use 84 as student protection in response to an existing medical 85 condition. 86 (g) “Seclusion” means removing a student from an 87 educational environment, involuntarily confining the student in 88 a room, and preventing the student from leaving the room if 89 achieved by locking the door or otherwise physically blocking 90 the student’s way, threatening physical force or other 91 consequences, or using physical force. This term does not 92 include the use of time-out or time-out from positive 93 reinforcement. 94 (h) “Student” means a student with a disability. 95 (i) “Time-out” or “time-out from positive reinforcement” 96 means a procedure in which access to varied sources of 97 reinforcement is removed or reduced for a particular time period 98 contingent on a response. The opportunity to receive 99 reinforcement is contingently removed for a specified time. 100 Either a student is contingently removed from the reinforcing 101 environment or the reinforcing environment is contingently 102 removed for some stipulated duration. 103 (2) LEGISLATIVE FINDINGS AND INTENT.— 104 (a) The Legislature finds that public schools have a 105 responsibility to ensure that each student is treated with 106 respect and dignity in a trauma-informed environment that 107 provides for the physical safety and security of students and 108 others. 109 (b) The Legislature finds that students, educators, and 110 families are concerned about the use of seclusion and restraint, 111 particularly when used on students in special education 112 programs. Seclusion and restraint refer to safety procedures in 113 which a student is isolated from others or physically held in 114 response to serious problem behavior that places the student or 115 others at risk of injury or harm. Concern exists that these 116 procedures are prone to misapplication and abuse, placing a 117 student at an equal or greater risk than the risk of the 118 student’s problem behavior. Concerns include the following: 119 seclusion or restraint is inappropriately selected and 120 implemented as treatment or behavioral intervention rather than 121 as a safety procedure; seclusion or restraint is inappropriately 122 used for behaviors, such as noncompliance, threats, or 123 disruption, which do not place the student or others at risk of 124 injury or harm; students, peers, or staff may be injured or 125 physically harmed during attempts to conduct seclusion or 126 restraint; risk of injury or harm is increased because seclusion 127 or restraint is implemented by staff who are not adequately 128 trained; use of seclusion or restraint may inadvertently result 129 in reinforcing or strengthening the problem behavior; and 130 seclusion or restraint is implemented independent of 131 comprehensive, function-based behavioral intervention plans. 132 Moreover, there are concerns about inadequate documentation of 133 seclusion or restraint procedures, failure to notify parents 134 when seclusion or restraint is applied, and failure to use data 135 to analyze and address the cause of the precipitating behavior. 136 (c) The Legislature finds that the majority of problem 137 behaviors that are currently used to justify seclusion or 138 restraint could be prevented with early identification and 139 intensive early intervention. The need for seclusion or 140 restraint may, in part, be a result of insufficient investment 141 in prevention efforts. 142 (d) The Legislature further finds that the inappropriate 143 use of seclusion or restraint may produce trauma in students. 144 For such students who are already experiencing trauma, the use 145 may cause retraumatization. Left unaddressed, the lasting 146 effects of childhood trauma place a heavy burden on individuals, 147 families, and communities. Research has shown that trauma 148 significantly increases the risk of mental health problems, 149 difficulties with social relationships and behavior, physical 150 illness, and poor school performance. 151 (e) The Legislature intends that students be free from 152 abusive or unnecessary applications of seclusion or restraint in 153 the public schools. 154 (f) The Legislature intends to achieve an ongoing reduction 155 and elimination of the inappropriate use of manual physical 156 restraint in the public schools and, specifically, to prohibit 157 the use of inappropriate seclusion, prone and supine restraint, 158 and mechanical restraint on students. Further, the Legislature 159 intends that students in public schools be provided with 160 educational environments that minimize the need for such 161 procedures by providing quality educational programming in 162 positive environments. 163 (g) The Legislature also intends that manual physical 164 restraint, mechanical restraint, and seclusion shall be used 165 only when an imminent risk of serious injury to a student or 166 others or significant disruption or damage to the environment 167 exists, or as part of a comprehensive behavior intervention plan 168 developed by a certified behavior analyst and approved by an 169 individual education plan (IEP) team; that manual physical 170 restraint shall not be employed as punishment, for the 171 convenience of staff, or as a substitute for a positive 172 behavior-support plan; or as a substitute for functional 173 behavior assessment and comprehensive behavior support plan; and 174 that, when used, persons applying manual physical restraint 175 shall impose the least possible restrictions and shall 176 discontinue the restraint as soon as the threat of imminent risk 177 of serious injury ceases or programmatic requirements are met. 178 Use of manual physical restraint, mechanical restraint, and 179 seclusion may also be used under rare conditions when a 180 certified behavior analyst deems it necessary for behaviors that 181 are not immediately associated with imminent harm but are highly 182 likely to quickly lead to injury without appropriate 183 intervention. 184 (3) MANUAL PHYSICAL RESTRAINT.—Manual physical restraint 185 shall be used in an emergency when there is a risk of serious 186 injury to the student or others or significant disruption or 187 damage to the environment, or as part of a comprehensive 188 behavior intervention plan developed by a certified behavior 189 analyst and approved by an IEP team. 190 (a) Manual physical restraint shall be used only for the 191 period needed in order to eliminate the risk of serious injury 192 to the student or others as programmatic requirements are met. 193 (b) The degree of force applied during manual physical 194 restraint must be only that degree of force necessary to protect 195 the student or others from bodily injury. 196 (c) Manual physical restraint shall be used only by school 197 personnel who are qualified and trained or certified to use the 198 district-approved methods for the appropriate application of 199 specific restraint techniques. School personnel who have 200 received training not associated with their employment with the 201 school district, such as a former law enforcement officer who is 202 now a teacher, shall be certified or trained in the specific 203 district-approved techniques and may not apply techniques or 204 procedures acquired elsewhere. 205 (d) School personnel may not manually physically restrain a 206 student except when there exists an imminent risk of serious 207 injury to the student or others or when included as part of a 208 comprehensive behavior intervention plan composed by a certified 209 behavior analyst. 210 (e) School personnel may not under any circumstances use 211 any of the following manual physical restraint techniques on a 212 student: 213 1. Pain inducement to obtain compliance. 214 2. Bone locks. 215 3. Hyperextension of joints. 216 4. Peer restraint. 217 5. Pressure or weight on the chest, lungs, sternum, 218 diaphragm, back, or abdomen, causing chest compression. 219 6. Straddling or sitting on any part of the body or any 220 maneuver that places pressure, weight, or leverage on the neck 221 or throat, on any artery, or on the back of the student’s head 222 or neck or that otherwise obstructs or restricts the circulation 223 of blood or obstructs an airway. 224 7. Any type of choking, including hand chokes, and any type 225 of neck or head hold. 226 8. Any technique that involves pushing on or into the 227 student’s mouth, nose, eyes, or any part of the face that is not 228 part of an approved crisis intervention technique. 229 9. Covering the student’s mouth, nose, or body with 230 anything, including soft objects such as pillows or washcloths. 231 10. Any maneuver that involves punching, hitting, poking, 232 pinching, or shoving. 233 11. Lemon sprays. 234 (f) The school shall have a student medically evaluated by 235 staff trained to monitor physical condition during and as soon 236 as possible after the student has been manually physically 237 restrained by school personnel. 238 (4) SECLUSION.— 239 (a) Seclusion shall be used in an emergency where there is 240 a risk of serious injury to the student or others or significant 241 disruption or damage to the environment, or as part of a 242 comprehensive behavior intervention plan developed by a 243 certified behavior analyst and approved by an IEP team; and 244 manual restraint is highly likely to lead to injury to the 245 student as determined by an individual consideration. 246 (b) School personnel may place a student in seclusion if 247 the following conditions are met: 248 1. There is documentation that the seclusion was preceded 249 by other emergency interventions that were not able to be 250 implemented safely. 251 2. The student is observed on a constant basis by an adult 252 for the duration of the seclusion. 253 3. The seclusion area and process is free of any action 254 that is likely to embarrass or humiliate the student. 255 4. The seclusion must end immediately when the student is 256 calm enough to return to his or her educational environment. If 257 seclusion exceeds a duration of 30 minutes, a designated 258 district administrator or a certified behavior analyst shall be 259 notified for guidance on how to proceed. 260 5. Seclusion may not be used as a punishment or negative 261 consequence of a student’s behavior. 262 (5) TRAINING AND CERTIFICATION.— 263 (a) Each school district shall report its training and 264 certification procedures to the department by publishing the 265 procedures in the district’s special policies and procedures 266 manual. 267 (b) Initial training for certification in the use of manual 268 physical restraint must include: 269 1. Procedures for deescalating problem behaviors before 270 they increase to a level or intensity necessitating physical 271 intervention. 272 2. Information regarding the risks associated with manual 273 physical restraint and procedures for assessing individual 274 situations and students in order to determine if the use of 275 manual physical restraint is appropriate and sufficiently safe. 276 3. The actual use of specific techniques that range from 277 the least to most restrictive, with ample opportunity for 278 trainees to demonstrate proficiency in their use. 279 4. Techniques for implementing manual physical restraint, 280 with multiple staff members working as a team. 281 5. Techniques for assisting a student to reenter the 282 instructional environment and again engage in learning. 283 6. Instruction in the district’s documentation and 284 reporting requirements. 285 7. Procedures to identify and deal with possible medical 286 emergencies arising during the use of manual physical restraint. 287 (c) Each school shall maintain adequate personnel certified 288 in cardiopulmonary resuscitation (CPR). 289 (d) School districts shall provide refresher certification 290 or training in manual physical restraint techniques at least 291 annually to all staff members who have successfully completed 292 the initial certification or training program. The district must 293 identify those persons to be certified or trained. The school 294 district or the company providing the training must maintain a 295 record that includes the name and position of the person 296 certified or trained, the date of the most recent certification 297 or training, an indication of whether it was an initial 298 certification or training or a refresher certification or 299 training, and whether the individual successfully completed the 300 certification or training and achieved proficiency. If a company 301 keeps the records, the information must be made readily 302 available to the school district. 303 (e) School district policies regarding the use of manual 304 physical restraint shall address whether it is appropriate for 305 an employee working in specific settings, such as a school bus 306 driver, school bus aide, job coach, employment specialist, or 307 cafeteria worker, to be certified or trained in manual physical 308 restraint techniques. In the case of school resource officers or 309 others who may be employed by other agencies when working in a 310 school, administrators shall review each agency’s specific 311 policies to be aware of techniques that might be used. 312 (6) STUDENT-CENTERED FOLLOWUP.—If a student is manually 313 physically restrained more than six times in a school year, the 314 student’s functional behavioral assessment and positive 315 behavioral intervention plan must be reviewed. 316 (7) DOCUMENTATION AND REPORTING.— 317 (a) The school district’s policy regarding the use of 318 manual physical restraint must be thoroughly explained to 319 parents annually. At the beginning of each school year, the 320 district shall provide parents with a copy of the district’s 321 policies on all emergency procedures, including the use of 322 manual physical restraint. A parent shall indicate receipt of 323 the district policies by his or her signature, which shall be 324 retained on file by the student’s school. 325 (b) A school shall prepare an emergency procedure report 326 within 24 hours after a student is released from a restraint. If 327 the student’s release occurs on a day before the school closes 328 for the weekend, a holiday, or another reason, the incident 329 report must be completed by the end of the school day on the day 330 the school reopens. 331 (c) The following must be included in the incident report: 332 1. The name of the student restrained. 333 2. The date and time of the event and the duration of the 334 restraint. 335 3. The location at which the restraint occurred. 336 4. The type of restraint used. 337 5. The name of the person using or assisting the restraint 338 of the student. 339 6. The name of any nonstudent who was present to witness 340 the restraint. 341 7. A description of the incident, including: 342 a. The context in which the restraint occurred. 343 b. The student’s behavior leading up to and precipitating 344 the decision to use manual physical restraint, including an 345 indication as to why there was a risk of serious injury to the 346 student or others. 347 c. The specific positive behavioral strategies used to 348 prevent and deescalate the behavior. 349 d. What occurred with the student immediately after the 350 termination of the restraint. 351 e. Any injuries, visible marks, or possible medical 352 emergencies that may have occurred during the restraint, 353 documented according to district policies. 354 f. Evidence of steps taken to notify the parent. 355 (d) A school shall notify the parent of a student each time 356 manual physical restraint is used. Such notification must be 357 attempted before the end of the school day on which the 358 restraint occurs. Reasonable efforts must be taken to notify the 359 parent by telephone or computer e-mail, or both, and these 360 efforts must be documented. 361 (8) MONITORING.— 362 (a) Monitoring of the use of manual physical restraint, 363 mechanical restraint, and seclusion on students shall occur at 364 the student, classroom, building, district, and state levels. 365 (b) Documentation prepared as required in subsection (7) 366 shall be provided to the school principal, the district 367 Exceptional Student Education director, and the bureau chief of 368 the Bureau of Exceptional Education and Student Services each 369 week that the school is in session. 370 (c) The department shall maintain aggregate data of 371 incidents of manual physical restraint and disaggregate the data 372 for analysis by county, school, student exceptionality, and 373 other variables. 374 (9) DISTRICT POLICIES AND PROCEDURES.—School districts 375 shall develop policies and procedures consistent with this 376 section and governing the following: 377 (a) Allowable use of manual physical restraint, mechanical 378 restraint, seclusion on students. 379 (b) Personnel authorized to use manual physical restraint. 380 (c) Training procedures. 381 (d) Incident-reporting procedures. 382 (e) Data collection. 383 (f) Monitoring and reporting of data collected. 384 (g) Analysis of data to determine trends. 385 (h) Ongoing reduction of the use of manual physical 386 restraint. 387 388 Policy and procedure revisions pursuant to this section, which 389 must be prepared as part of the district’s special policies and 390 procedures, must be filed with the bureau chief of the Bureau of 391 Exceptional Education and Student Services no later than January 392 31, 2011. 393 Section 2. This act shall take effect July 1, 2010.