Florida Senate - 2013                                    SB 1170
       By Senator Flores
       37-00326A-13                                          20131170__
    1                        A bill to be entitled                      
    2         An act relating to the use, prevention, and reduction
    3         of seclusion and restraint on students with
    4         disabilities in public schools; amending s. 1003.573,
    5         F.S.; providing definitions; providing legislative
    6         findings and intent; requiring that manual physical
    7         restraint be used only in an emergency when there is
    8         an imminent risk of serious injury or death to the
    9         student or others; providing restrictions on the use
   10         of manual physical restraint; prohibiting the use of
   11         manual physical restraint by school personnel who are
   12         not certified to use district-approved methods for
   13         applying restraint techniques; prohibiting specified
   14         techniques; requiring that each school medically
   15         evaluate a student after the student is manually
   16         physically restrained; prohibiting school personnel
   17         from placing a student in seclusion; providing
   18         requirements for the use of time-out; requiring that a
   19         school district report its training and certification
   20         procedures to the Department of Education; requiring
   21         that school personnel be trained and certified in the
   22         use of manual physical restraint; requiring that a
   23         school review a student’s functional behavior
   24         assessment and positive behavioral intervention plan
   25         under certain circumstances; requiring that parents be
   26         notified of a school district’s policies regarding the
   27         use of manual physical restraint; requiring that each
   28         school send a redacted copy of any incident report or
   29         other documentation to Disability Rights Florida;
   30         requiring that the department make available on its
   31         website data of incidents of manual physical restraint
   32         by a specified date; requiring that each school
   33         district develop policies and procedures addressing
   34         the allowable use of manual physical restraint,
   35         personnel authorized to use such restraint, training
   36         procedures, analysis of data trends, and the reduction
   37         of the use of manual physical restraint; requiring
   38         that any revisions to a school district’s policies and
   39         procedures be filed with the bureau chief of the
   40         Bureau of Exceptional Education and Student Services
   41         by a specified date; providing an effective date.
   43  Be It Enacted by the Legislature of the State of Florida:
   45         Section 1. Section 1003.573, Florida Statutes, is amended
   46  to read:
   47         1003.573 Use, prevention, and reduction of seclusion and
   48  restraint on students with disabilities in public schools Use of
   49  restraint and seclusion on students with disabilities.—
   50         (1) DEFINITIONS.—As used in this section, the term:
   51         (a) “Department” means the Department of Education.
   52         (b) “Imminent risk of serious injury or death” means the
   53  impending risk of a significant injury, such as a laceration,
   54  bone fracture, substantial hematoma, or other injury to internal
   55  organs, or death.
   56         (c) “Manual physical restraint” means the 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.
   60         (d) “Mechanical restraint” means the use of a physical
   61  device that restricts a student’s movement or restricts the
   62  normal function of a student’s body. The term includes the use
   63  of straps, belts, tie-downs, calming blankets, and chairs with
   64  straps; however, the term does not include the use of:
   65         1. Medical protective equipment;
   66         2. Physical equipment or orthopedic appliances, surgical
   67  dressings or bandages, or supportive body bands or other
   68  restraints necessary for ongoing medical treatment in the
   69  educational setting;
   70         3. Devices used to support functional body position or
   71  proper balance, or to prevent a person from falling out of a bed
   72  or a wheelchair, except when such device is used for any purpose
   73  other than supporting a body position or proper balance, such as
   74  coercion, discipline, convenience, or retaliation, to prevent
   75  imminent risk of serious injury or death of the student or
   76  others, or for any other behavior-management reason; or
   77         4. Equipment used for safety during transportation, such as
   78  seatbelts or wheelchair tie-downs.
   79         (e) “Medical protective equipment” means health-related
   80  protective devices prescribed by a physician or dentist for use
   81  as student protection in response to an existing medical
   82  condition.
   83         (f) “Seclusion” means removing a student from an
   84  educational environment, involuntarily confining the student in
   85  a room or area, and preventing the student from leaving the room
   86  or area if achieved by locking the door or otherwise physically
   87  blocking the student’s way, threatening physical force or other
   88  consequences, or using physical force. The term does not include
   89  the use of time-out.
   90         (g) “Student” means a student with a disability.
   91         (h) “Time-out” means a procedure in which access to varied
   92  sources of reinforcement is removed or reduced for a particular
   93  time period contingent on a response. The opportunity to receive
   94  reinforcement is contingently removed for a specified time.
   95  Either a student is contingently removed from the reinforcing
   96  environment or the reinforcing environment is contingently
   97  removed for some stipulated duration. A time-out setting may not
   98  be locked and the exit may not be blocked. Physical force or
   99  threats may not be used to place a student in time-out.
  101         (a) The Legislature finds that public schools have a
  102  responsibility to ensure that each student is treated with
  103  respect and dignity in a trauma-informed environment that
  104  provides for the physical safety and security of students and
  105  others.
  106         (b) The Legislature finds that students, educators, and
  107  families are concerned about the use of seclusion and restraint,
  108  particularly when used on students in special education
  109  programs. Seclusion and restraint refer to safety procedures in
  110  which a student is isolated from others or physically held in
  111  response to serious problem behavior that places the student or
  112  others at risk of injury or harm. There is concern that these
  113  procedures are prone to misapplication and abuse and place a
  114  student at an equal or greater risk than the risk of the
  115  student’s problem behavior. Particular concerns include:
  116         1. Seclusion or restraint is inappropriately selected and
  117  implemented as treatment or behavioral intervention rather than
  118  as a safety procedure;
  119         2. Seclusion or restraint is inappropriately used for
  120  behaviors, such as noncompliance, threats, or disruption, which
  121  do not place the student or others at risk of injury or harm;
  122         3. Students, peers, or staff may be injured or physically
  123  harmed during attempts to conduct seclusion or restraint;
  124         4. Risk of injury or harm is increased because seclusion or
  125  restraint is implemented by staff who are not adequately
  126  trained;
  127         5. The use of seclusion or restraint may inadvertently
  128  result in reinforcing or strengthening the problem behavior; and
  129         6. Seclusion or restraint is implemented independent of
  130  comprehensive, function-based behavioral intervention plans.
  132  Moreover, there are concerns about the inadequate documentation
  133  of seclusion or restraint procedures, the failure to notify
  134  parents when seclusion or restraint is applied, and the failure
  135  to use data to analyze and address the cause of the
  136  precipitating behavior.
  137         (c) The Legislature finds that the majority of problem
  138  behaviors that are currently used to justify seclusion or
  139  restraint could be prevented with early identification and
  140  intensive early intervention. The need for seclusion or
  141  restraint is, in part, a result of insufficient investment in
  142  prevention efforts. The Legislature further finds that the use
  143  of seclusion or restraint may produce trauma in students. For
  144  such students, who are already experiencing trauma, the use may
  145  cause retraumatization. Left unaddressed, the lasting effects of
  146  childhood trauma place a heavy burden on individuals, families,
  147  and communities. Research has shown that trauma significantly
  148  increases the risk of mental health problems, difficulties with
  149  social relationships and behavior, physical illness, and poor
  150  school performance.
  151         (d) The Legislature intends that students be free from the
  152  abusive and unnecessary use of seclusion or restraint in the
  153  public schools. The Legislature further intends to prevent, and
  154  achieve an ongoing reduction of, the use of manual physical
  155  restraint in the public schools and, specifically, to prohibit
  156  the use of seclusion, prone and supine restraint, and mechanical
  157  restraint on students. The Legislature also intends that manual
  158  physical restraint be used only when an imminent risk of serious
  159  injury or death exists; that manual physical restraint not be
  160  employed as punishment, for the convenience of staff, or as a
  161  substitute for a positive behavior-support plan; and that, when
  162  used, persons applying manual physical restraint impose the
  163  least possible restrictions and discontinue the restraint as
  164  soon as the threat of imminent risk of serious injury or death
  165  ceases.
  166         (3) MANUAL PHYSICAL RESTRAINT.—Manual physical restraint
  167  shall be used only in an emergency when there is an imminent
  168  risk of serious injury or death to the student or others.
  169         (a) Manual physical restraint shall be used only for the
  170  period needed in order to eliminate the imminent risk of serious
  171  injury or death to the student or others.
  172         (b) The degree of force applied during manual physical
  173  restraint must be only that degree of force necessary to protect
  174  the student or others from bodily injury.
  175         (c) Manual physical restraint shall be used only by school
  176  personnel who are qualified and certified to use the district
  177  approved methods for the appropriate application of specific
  178  restraint techniques. School personnel who have received
  179  training that is not associated with their employment with the
  180  school district, such as a former law enforcement officer who is
  181  now a teacher, shall be certified in the specific district
  182  approved techniques and may not apply techniques or procedures
  183  acquired elsewhere.
  184         (d) School personnel may not manually physically restrain a
  185  student except when an imminent risk of serious injury or death
  186  to the student or others exists.
  187         (e) School personnel may not use any of the following
  188  manual physical restraint techniques on a student:
  189         1. Prone and supine restraint.
  190         2. Pain inducement to obtain compliance.
  191         3. Bone locks.
  192         4. Hyperextension of joints.
  193         5. Peer restraint.
  194         6. Mechanical restraint.
  195         7. Pressure or weight on the chest, lungs, sternum,
  196  diaphragm, back, or abdomen, causing chest compression.
  197         8. Straddling or sitting on any part of the body or any
  198  maneuver that places pressure, weight, or leverage on the neck
  199  or throat, on any artery, or on the back of the student’s head
  200  or neck or that otherwise obstructs or restricts the circulation
  201  of blood or obstructs an airway.
  202         9. Any type of choking, including hand chokes, and any type
  203  of neck or head hold.
  204         10. Any technique that involves pushing anything on or into
  205  the student’s mouth, nose, eyes, or any part of the face or that
  206  involves covering the face or body with anything, including soft
  207  objects such as pillows or washcloths.
  208         11. Any maneuver that involves punching, hitting, poking,
  209  pinching, or shoving.
  210         12. Any type of mat or blanket restraint.
  211         13. Water or lemon sprays.
  212         (f) The school shall ensure that a student is medically
  213  evaluated by a physician, nurse, or other qualified medical
  214  professional as soon as possible after the student has been
  215  manually physically restrained by school personnel.
  216         (4) SECLUSION; TIME-OUT.—
  217         (a) School personnel may not place a student in seclusion.
  218         (b) School personnel may place a student in time-out if the
  219  following conditions are met:
  220         1. The time-out is part of a positive behavioral
  221  intervention plan developed for that student from a functional
  222  behavioral assessment and referenced in the student’s individual
  223  education plan.
  224         2. There is documentation that the time-out was preceded by
  225  the use of other positive behavioral supports that were not
  226  effective.
  227         3. The time-out takes place in a classroom or in another
  228  environment where class educational activities are taking place.
  229         4. The student is not physically prevented from leaving the
  230  time-out area.
  231         5. The student is observed on a constant basis by an adult
  232  for the duration of the time-out.
  233         6. The time-out area and process are free of any action
  234  that is likely to embarrass or humiliate the student.
  235         (c) Time-out may not be used for a period that exceeds 1
  236  minute for each year of a student’s age and time-out must end
  237  immediately when the student is calm enough to return to his or
  238  her seat.
  239         (d) Time-out may not be used as a punishment or negative
  240  consequence of a student’s behavior.
  242         (a) Each school district shall report its training and
  243  certification procedures to the department by publishing the
  244  procedures in the district’s special policies and procedures
  245  manual.
  246         (b) Training for initial certification in the use of manual
  247  physical restraint must include:
  248         1. Procedures for deescalating problem behaviors before the
  249  problems increase to a level or intensity necessitating physical
  250  intervention.
  251         2. Information regarding the risks associated with manual
  252  physical restraint and procedures for assessing individual
  253  situations and students in order to determine if the use of
  254  manual physical restraint is appropriate and sufficiently safe.
  255         3. The actual use of specific techniques that range from
  256  the least to most restrictive, with ample opportunity for
  257  trainees to demonstrate proficiency in the use of such
  258  techniques.
  259         4. Techniques for implementing manual physical restraint
  260  with multiple staff members working as a team.
  261         5. Techniques for assisting a student to reenter the
  262  instructional environment and again engage in learning.
  263         6. Instruction in the district’s documentation and
  264  reporting requirements.
  265         7. Procedures to identify and deal with possible medical
  266  emergencies arising during the use of manual physical restraint.
  267         8. Cardiopulmonary resuscitation.
  268         (c) School districts shall provide refresher certification
  269  training courses in manual physical restraint techniques at
  270  least annually to all staff members who have successfully
  271  completed the initial certification program. The district must
  272  identify those persons to be certified and maintain a record
  273  that includes the name and position of the person certified, the
  274  date of the most recent certification, an indication of whether
  275  it was an initial certification or a refresher certification,
  276  and whether the individual successfully completed the
  277  certification and achieved proficiency.
  278         (d) School district policies regarding the use of manual
  279  physical restraint must address whether it is appropriate for an
  280  employee working in specific settings, such as a school bus
  281  driver, school bus aide, job coach, employment specialist, or
  282  cafeteria worker, to be certified in manual physical restraint
  283  techniques. In the case of school resource officers or others
  284  who may be employed by other agencies when working in a school,
  285  administrators shall review each agency’s specific policies to
  286  be aware of techniques that may be used.
  287         (6) STUDENT-CENTERED FOLLOWUP.—If a student is manually
  288  physically restrained more than twice during a school year, the
  289  school shall review the student’s functional behavioral
  290  assessment and positive behavioral intervention plan.
  291         (7)(1) DOCUMENTATION AND REPORTING.—
  292         (a) At the beginning of each school year, a school district
  293  shall provide a copy of its policies on all emergency
  294  procedures, including its policies on the use of manual physical
  295  restraint, to each student’s parent or guardian. The student’s
  296  parent or guardian must sign a form indicating that he or she
  297  has read and received the district’s policies, which the
  298  student’s school shall retain on file.
  299         (b)(a) A school shall prepare an incident report within 24
  300  hours after a student is released from a restraint or seclusion.
  301  If the student’s release occurs on a day before the school
  302  closes for the weekend, a holiday, or another reason, the
  303  incident report must be completed by the end of the school day
  304  on the day the school reopens.
  305         (c)(b) The following must be included in the incident
  306  report:
  307         1. The name of the student restrained or secluded.
  308         2. The age, grade, ethnicity, and disability of the student
  309  restrained or secluded.
  310         3. The date and time of the event and the duration of the
  311  restraint or seclusion.
  312         4. The location at which the restraint or seclusion
  313  occurred.
  314         5. A description of the type of restraint used in terms
  315  established by the Department of Education.
  316         6. The name of the person using or assisting in the
  317  restraint or seclusion of the student.
  318         7. The name of any nonstudent who was present to witness
  319  the restraint or seclusion.
  320         8. A description of the incident, including:
  321         a. The context in which the restraint or seclusion
  322  occurred.
  323         b. The student’s behavior leading up to and precipitating
  324  the decision to use manual or physical restraint or seclusion,
  325  including an indication as to why there was an imminent risk of
  326  serious injury or death to the student or others.
  327         c. The specific positive behavioral strategies used to
  328  prevent and deescalate the behavior.
  329         d. What occurred with the student immediately after the
  330  termination of the restraint or seclusion.
  331         e. Any injuries, visible marks, or possible medical
  332  emergencies that may have occurred during the restraint or
  333  seclusion, documented according to district policies.
  334         f. The results of the medical evaluation and a copy of any
  335  report by the medical professionals conducting the evaluation,
  336  if available. If the medical report is not available within 24
  337  hours, the district must submit the medical report separately as
  338  soon as it is available.
  339         g.f. Evidence of steps taken to notify the student’s parent
  340  or guardian.
  341         (d)(c) A school shall notify the parent or guardian of a
  342  student each time manual or physical restraint or seclusion is
  343  used. Such notification must be in writing and provided before
  344  the end of the school day on which the restraint or seclusion
  345  occurs. Reasonable efforts must also be taken to notify the
  346  parent or guardian by telephone or computer e-mail, or both, and
  347  these efforts must be documented. The school shall obtain, and
  348  keep in its records, the parent’s or guardian’s signed
  349  acknowledgment that he or she was notified of his or her child’s
  350  restraint or seclusion.
  351         (e)(d) A school shall also provide the parent or guardian
  352  with the completed incident report in writing by mail within 3
  353  school days after a student was manually or physically
  354  restrained or secluded. The school shall obtain, and keep in its
  355  records, the parent’s or guardian’s signed acknowledgment that
  356  he or she received a copy of the incident report.
  357         (8)(2) MONITORING.—
  358         (a) Monitoring of The use of manual or physical restraint
  359  or seclusion on students shall be monitored occur at the
  360  classroom, building, district, and state levels.
  361         (b) Any documentation prepared by a school pursuant to as
  362  required in subsection (7) (1) shall be provided to the school
  363  principal, the district director of Exceptional Student
  364  Education, and the bureau chief of the Bureau of Exceptional
  365  Education and Student Services electronically each week month
  366  that the school is in session.
  367         (c) Each week that a school is in session, the school shall
  368  send a redacted copy of any incident report and other
  369  documentation prepared pursuant to subsection (7) to Disability
  370  Rights Florida.
  371         (d)(c) The department shall maintain aggregate data of
  372  incidents of manual or physical restraint and seclusion and
  373  disaggregate the data for analysis by county, school, student
  374  exceptionality, and other variables, including the type and
  375  method of restraint or seclusion used. This information shall be
  376  updated monthly and made available to the public through the
  377  department’s website no later than January 31, 2014.
  378         (e)(d) The department shall establish standards for
  379  documenting, reporting, and monitoring the use of manual or
  380  physical restraint or mechanical restraint, and occurrences of
  381  seclusion. These standards shall be provided to school districts
  382  by October 1, 2011.
  384         (a) Each school district shall develop policies and
  385  procedures that are consistent with this section and that govern
  386  the following:
  387         1. Allowable use of manual physical restraint on students.
  388         2. Personnel authorized to use manual physical restraint.
  389         3. Training procedures.
  390         4.1. Incident-reporting procedures.
  391         5.2. Data collection and monitoring, including when, where,
  392  and why students are restrained or secluded; the frequency of
  393  occurrences of such restraint or seclusion; and the prone or
  394  mechanical restraint that is most used.
  395         6.3. Monitoring and reporting of data collected.
  396         7.4. Training programs relating to manual or physical
  397  restraint and seclusion.
  398         8.5. The district’s plan for selecting personnel to be
  399  trained.
  400         9.6. The district’s plan for reducing the use of restraint
  401  and seclusion particularly in settings in which it occurs
  402  frequently or with students who are restrained repeatedly, and
  403  for reducing the use of prone restraint and mechanical
  404  restraint. The plan must include a goal for reducing the use of
  405  restraint and seclusion and must include activities, skills, and
  406  resources needed to achieve that goal. Activities may include,
  407  but are not limited to:
  408         a. Additional training in positive behavioral support and
  409  crisis management;
  410         b. Parental involvement;
  411         c. Data review;
  412         d. Updates of students’ functional behavioral analysis and
  413  positive behavior intervention plans;
  414         e. Additional student evaluations;
  415         f. Debriefing with staff;
  416         g. Use of schoolwide positive behavior support; and
  417         h. Changes to the school environment.
  418         10. Analysis of data to determine trends.
  419         11. Ongoing reduction of the use of manual physical
  420  restraint.
  421         (b) Any revisions that a school district makes to its to
  422  the district’s policies and procedures, which are must be
  423  prepared as part of the school district’s its special policies
  424  and procedures, must be filed with the bureau chief of the
  425  Bureau of Exceptional Education and Student Services no later
  426  than January 31, 2012.
  427         (4) PROHIBITED RESTRAINT.—School personnel may not use a
  428  mechanical restraint or a manual or physical restraint that
  429  restricts a student’s breathing.
  430         (5) SECLUSION.—School personnel may not close, lock, or
  431  physically block a student in a room that is unlit and does not
  432  meet the rules of the State Fire Marshal for seclusion time-out
  433  rooms.
  434         Section 2. This act shall take effect July 1, 2013.