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       Florida Senate - 2010                                    SB 2118
       By Senator Gardiner
       9-00283-10                                            20102118__
    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; creating s. 1003.573,
    5         F.S.; providing definitions; providing legislative
    6         findings and intent; providing that manual physical
    7         restraint shall be used only in an emergency when
    8         there is an imminent risk of serious injury or death
    9         to the student or others; providing restrictions on
   10         the use of manual physical restraint; prohibiting the
   11         use of manual physical restraint by school personnel
   12         who are not certified to use district-approved methods
   13         for applying restraint techniques; prohibiting
   14         specified techniques; requiring the school to
   15         medically evaluate a student as soon as possible after
   16         the student is manually physically restrained;
   17         prohibiting school personnel from placing a student in
   18         seclusion; providing requirements for use of time-out;
   19         requiring reporting of 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 student
   23         followup in certain circumstances; requiring
   24         notification to parents of school district policies
   25         regarding emergency procedures; requiring the school
   26         to prepare an incident report after each occasion of
   27         student restraint and specifying contents of report;
   28         requiring certain reporting and monitoring; requiring
   29         the development and revision of school district
   30         policies and procedures; providing an effective date.
   32  Be It Enacted by the Legislature of the State of Florida:
   34         Section 1. Section 1003.573, Florida Statutes, is created
   35  to read:
   36         1003.573 Use, prevention, and reduction of seclusion and
   37  restraint on students with disabilities in public schools.—
   38         (1) DEFINITIONS.—As used in this section, the term:
   39         (a) “Department” means the Department of Education.
   40         (b) “Imminent risk of serious injury or death” means the
   41  impending risk of a significant injury, such as a laceration,
   42  bone fracture, substantial hematoma, or other injury to internal
   43  organs, or death.
   44         (c) “Manual physical restraint” means use of physical
   45  restraint techniques that involve physical force applied by a
   46  teacher or other staff member to restrict the movement of all or
   47  part of a student’s body.
   48         (d) “Mechanical restraint” means a physical device used to
   49  restrict a student’s movement or restrict the normal function of
   50  a student’s body. Objects that fall within the term “mechanical
   51  restraint” include straps, belts, tie-downs, calming blankets,
   52  and chairs with straps. The term does not include:
   53         1. Medical protective equipment;
   54         2. Physical equipment or orthopedic appliances, surgical
   55  dressings or bandages, or supportive body bands or other
   56  restraints necessary for medical treatment that is ongoing in
   57  the educational setting;
   58         3. Devices used to support functional body position or
   59  proper balance, or prevent a person from falling out of a bed or
   60  a wheelchair, except that these exceptions to the definition of
   61  mechanical restraint do not apply to any device when it is used
   62  for any purpose other than supporting a body position or proper
   63  balance, such as when used as coercion, discipline, convenience,
   64  or retaliation, to prevent imminent risk of serious injury or
   65  death of the student or others, or for any other behavior
   66  management reason; or
   67         4. Equipment used for safety during transportation, such as
   68  seatbelts or wheelchair tie-downs.
   69         (e) “Medical protective equipment” means health-related
   70  protective devices prescribed by a physician or dentist for use
   71  as student protection in response to an existing medical
   72  condition.
   73         (f) “Seclusion” means removing a student from an
   74  educational environment, involuntarily confining the student in
   75  a room or area, and preventing the student from leaving the room
   76  or area if achieved by locking the door or otherwise physically
   77  blocking the student’s way, threatening physical force or other
   78  consequences, or using physical force. The term does not include
   79  the use of time-out.
   80         (g) “Student” means a student with a disability.
   81         (h) “Time-out” means a procedure in which access to varied
   82  sources of reinforcement is removed or reduced for a particular
   83  time period contingent on a response. The opportunity to receive
   84  reinforcement is contingently removed for a specified time.
   85  Either a student is contingently removed from the reinforcing
   86  environment or the reinforcing environment is contingently
   87  removed for some stipulated duration. A time-out setting may not
   88  be locked and the exit may not be blocked. Physical force or
   89  threats may not be used to place a student in time-out.
   91         (a) The Legislature finds that public schools have a
   92  responsibility to ensure that each student is treated with
   93  respect and dignity in a trauma-informed environment that
   94  provides for the physical safety and security of students and
   95  others.
   96         (b) The Legislature finds that students, educators, and
   97  families are concerned about the use of seclusion and restraint,
   98  particularly when used on students in special education
   99  programs. Seclusion and restraint refer to safety procedures in
  100  which a student is isolated from others or physically held in
  101  response to serious problem behavior that places the student or
  102  others at risk of injury or harm. Concern exists that these
  103  procedures are prone to misapplication and abuse, placing a
  104  student at an equal or greater risk than the risk of the
  105  student’s problem behavior. Concerns include the following:
  106  seclusion or restraint is inappropriately selected and
  107  implemented as treatment or behavioral intervention rather than
  108  as a safety procedure; seclusion or restraint is inappropriately
  109  used for behaviors, such as noncompliance, threats, or
  110  disruption, which do not place the student or others at risk of
  111  injury or harm; students, peers, or staff may be injured or
  112  physically harmed during attempts to conduct seclusion or
  113  restraint; risk of injury or harm is increased because seclusion
  114  or restraint is implemented by staff who are not adequately
  115  trained; use of seclusion or restraint may inadvertently result
  116  in reinforcing or strengthening the problem behavior; and
  117  seclusion or restraint is implemented independent of
  118  comprehensive, function-based behavioral intervention plans.
  119  Moreover, there are concerns about inadequate documentation of
  120  seclusion or restraint procedures, failure to notify parents
  121  when seclusion or restraint is applied, and failure to use data
  122  to analyze and address the cause of the precipitating behavior.
  123         (c) The Legislature finds that the majority of problem
  124  behaviors that are currently used to justify seclusion or
  125  restraint could be prevented with early identification and
  126  intensive early intervention. The need for seclusion or
  127  restraint is, in part, a result of insufficient investment in
  128  prevention efforts.
  129         (d) The Legislature further finds that the use of seclusion
  130  or restraint may produce trauma in students. For such students,
  131  who are already experiencing trauma, the use may cause
  132  retraumatization. Left unaddressed, the lasting effects of
  133  childhood trauma place a heavy burden on individuals, families,
  134  and communities. Research has shown that trauma significantly
  135  increases the risk of mental health problems, difficulties with
  136  social relationships and behavior, physical illness, and poor
  137  school performance.
  138         (e) The Legislature intends that students be free from the
  139  abusive and unnecessary use of seclusion or restraint in the
  140  public schools.
  141         (f) The Legislature intends to prevent and achieve an
  142  ongoing reduction of the use of manual physical restraint in the
  143  public schools and, specifically, to prohibit the use of
  144  seclusion, prone and supine restraint, and mechanical restraint
  145  on students.
  146         (g) The Legislature also intends that manual physical
  147  restraint shall be used only when an imminent risk of serious
  148  injury or death exists; that manual physical restraint shall not
  149  be employed as punishment, for the convenience of staff, or as a
  150  substitute for a positive behavior-support plan; and that, when
  151  used, persons applying manual physical restraint shall impose
  152  the least possible restrictions and shall discontinue the
  153  restraint as soon as the threat of imminent risk of serious
  154  injury or death ceases.
  155         (3) MANUAL PHYSICAL RESTRAINT.—Manual physical restraint
  156  shall be used only in an emergency when there is an imminent
  157  risk of serious injury or death to the student or others.
  158         (a) Manual physical restraint shall be used only for the
  159  period needed in order to eliminate the imminent risk of serious
  160  injury or death to the student or others.
  161         (b) The degree of force applied during manual physical
  162  restraint must be only that degree of force necessary to protect
  163  the student or others from bodily injury.
  164         (c) Manual physical restraint shall be used only by school
  165  personnel who are qualified and certified to use the district
  166  approved methods for the appropriate application of specific
  167  restraint techniques. School personnel who have received
  168  training not associated with their employment with the school
  169  district, such as a former law enforcement officer who is now a
  170  teacher, shall be certified in the specific district-approved
  171  techniques and may not apply techniques or procedures acquired
  172  elsewhere.
  173         (d) School personnel may not manually physically restrain a
  174  student except when there exists an imminent risk of serious
  175  injury or death to the student or others.
  176         (e) School personnel may not under any circumstances use
  177  any of the following manual physical restraint techniques on a
  178  student:
  179         1. Prone and supine restraint.
  180         2. Pain inducement to obtain compliance.
  181         3. Bone locks.
  182         4. Hyperextension of joints.
  183         5. Peer restraint.
  184         6. Mechanical restraint.
  185         7. Pressure or weight on the chest, lungs, sternum,
  186  diaphragm, back, or abdomen, causing chest compression.
  187         8. Straddling or sitting on any part of the body or any
  188  maneuver that places pressure, weight, or leverage on the neck
  189  or throat, on any artery, or on the back of the student’s head
  190  or neck or that otherwise obstructs or restricts the circulation
  191  of blood or obstructs an airway.
  192         9. Any type of choking, including hand chokes, and any type
  193  of neck or head hold.
  194         10. Any technique that involves pushing on or into the
  195  student’s mouth, nose, eyes, or any part of the face or involves
  196  covering the face or body with anything, including soft objects
  197  such as pillows or washcloths.
  198         11. Any maneuver that involves punching, hitting, poking,
  199  pinching, or shoving.
  200         12. Any type of mat or blanket restraint.
  201         13. Water or lemon sprays.
  202         (f) The school shall have a student medically evaluated by
  203  a physician, nurse, or other qualified medical professional as
  204  soon as possible after the student has been manually physically
  205  restrained by school personnel.
  206         (4) SECLUSION; TIME-OUT.—
  207         (a) School personnel may not place a student in seclusion.
  208         (b) School personnel may place a student in time-out if the
  209  following conditions are met:
  210         1. The time-out is part of a positive behavioral
  211  intervention plan developed for that student from a functional
  212  behavioral assessment and referenced in the student’s individual
  213  education plan.
  214         2. There is documentation that the time-out was preceded by
  215  other interventions that used positive behavioral supports that
  216  were not effective.
  217         3. The time-out takes place in a classroom or in another
  218  environment where class educational activities are taking place.
  219         4. The student is not physically prevented from leaving the
  220  time-out area.
  221         5. The student is observed on a constant basis by an adult
  222  for the duration of the time-out.
  223         6. The time-out area and process is free of any action that
  224  is likely to embarrass or humiliate the student.
  225         (c) Time-out may not be used for a period that exceeds 1
  226  minute for each year of a student’s age, and time-out must end
  227  immediately when the student is calm enough to return to his or
  228  her seat.
  229         (d) Time-out may not be used as a punishment or negative
  230  consequence of a student’s behavior.
  232         (a) Each school district shall report its training and
  233  certification procedures to the department by publishing the
  234  procedures in the district’s special policies and procedures
  235  manual.
  236         (b) Training for initial certification in the use of manual
  237  physical restraint must include:
  238         1. Procedures for deescalating problem behaviors before
  239  they increase to a level or intensity necessitating physical
  240  intervention.
  241         2. Information regarding the risks associated with manual
  242  physical restraint and procedures for assessing individual
  243  situations and students in order to determine if the use of
  244  manual physical restraint is appropriate and sufficiently safe.
  245         3. The actual use of specific techniques that range from
  246  the least to most restrictive, with ample opportunity for
  247  trainees to demonstrate proficiency in their use.
  248         4. Techniques for implementing manual physical restraint
  249  with multiple staff members working as a team.
  250         5. Techniques for assisting a student to reenter the
  251  instructional environment and again engage in learning.
  252         6. Instruction in the district’s documentation and
  253  reporting requirements.
  254         7. Procedures to identify and deal with possible medical
  255  emergencies arising during the use of manual physical restraint.
  256         8. Cardiopulmonary resuscitation (CPR).
  257         (c) School districts shall provide refresher certification
  258  in manual physical restraint techniques at least annually to all
  259  staff members who have successfully completed the initial
  260  certification program. The district must identify those persons
  261  to be certified and maintain a record that includes the name and
  262  position of the person certified, the date of the most recent
  263  certification, an indication of whether it was an initial
  264  certification or a refresher certification, and whether the
  265  individual successfully completed the certification and achieved
  266  proficiency.
  267         (d) School district policies regarding the use of manual
  268  physical restraint shall address whether it is appropriate for
  269  an employee working in specific settings, such as a school bus
  270  driver, school bus aide, job coach, employment specialist, or
  271  cafeteria worker, to be certified in manual physical restraint
  272  techniques. In the case of school resource officers or others
  273  who may be employed by other agencies when working in a school,
  274  administrators shall review each agency’s specific policies to
  275  be aware of techniques that might be used.
  276         (6) STUDENT-CENTERED FOLLOWUP.—If a student is manually
  277  physically restrained more than twice in a school year, the
  278  student’s functional behavioral assessment and positive
  279  behavioral intervention plan must be reviewed.
  281         (a) The school district’s policy regarding the use of
  282  manual physical restraint must be thoroughly explained to
  283  parents annually. At the beginning of each school year, the
  284  district shall provide parents with a copy of the district’s
  285  policies on all emergency procedures, including the use of
  286  manual physical restraint. A parent should indicate receipt of
  287  the district policies by his or her signature, which should be
  288  retained on file by the student’s school.
  289         (b) A school shall prepare an incident report within 24
  290  hours after a student is released from a restraint. If the
  291  student’s release occurs on a day before the school closes for
  292  the weekend, a holiday, or another reason, the incident report
  293  must be completed by the end of the school day on the day the
  294  school reopens.
  295         (c) The following must be included in the incident report:
  296         1. The name of the student restrained.
  297         2. The date and time of the event and the duration of the
  298  restraint.
  299         3. The location at which the restraint occurred.
  300         4. The type of restraint used.
  301         5. The name of the person using or assisting the restraint
  302  of the student.
  303         6. The name of any nonstudent who was present to witness
  304  the restraint.
  305         7. A description of the incident, including:
  306         a. The context in which the restraint occurred.
  307         b. The student’s behavior leading up to and precipitating
  308  the decision to use manual physical restraint, including an
  309  indication as to why there was an imminent risk of serious
  310  injury or death to the student or others.
  311         c. The specific positive behavioral strategies used to
  312  prevent and deescalate the behavior.
  313         d. What occurred with the student immediately after the
  314  termination of the restraint.
  315         e. Any injuries, visible marks, or possible medical
  316  emergencies that may have occurred during the restraint,
  317  documented according to district policies.
  318         f. The results of the medical evaluation and a copy of any
  319  report by the medical professionals conducting the evaluation if
  320  available. If the medical report is not available within 24
  321  hours, the district must submit the medical report separately as
  322  soon as it is available.
  323         g. Evidence of steps taken to notify the parent.
  324         (d) A school shall notify the parent of a student each time
  325  manual physical restraint is used. Such notification must be in
  326  writing and provided before the end of the school day on which
  327  the restraint occurs. Reasonable efforts must also be taken to
  328  notify the parent by telephone or computer e-mail, or both, and
  329  these efforts must be documented. The school shall obtain, and
  330  keep in its records, the parent’s signed acknowledgement that he
  331  or she was notified of his or her child’s restraint.
  332         (e) A school shall also provide the parent with the
  333  completed incident report in writing by mail within 3 school
  334  days after a student was manually physically restrained. The
  335  school shall obtain, and keep in its records, the parent’s
  336  signed acknowledgement that he or she received a copy of the
  337  incident report.
  338         (8) MONITORING.—
  339         (a) Monitoring of the use of manual physical restraint on
  340  students shall occur at the classroom, building, district, and
  341  state levels.
  342         (b) Documentation prepared as required in subsection (7)
  343  shall be provided to the school principal, the district
  344  Exceptional Student Education (ESE) director, and the bureau
  345  chief of the Bureau of Exceptional Education and Student
  346  Services each week that the school is in session.
  347         (c) A school shall send to the Advocacy Center for Persons
  348  with Disabilities, Inc., a redacted copy of any incident report
  349  and other documentation prepared as required in subsection (7)
  350  each week that the school is in session.
  351         (d) The department shall maintain aggregate data of
  352  incidents of manual physical restraint and disaggregate the data
  353  for analysis by county, school, student exceptionality, and
  354  other variables. This information shall be updated monthly and
  355  made available to the public through the department’s website no
  356  later than January 31, 2011.
  357         (9) DISTRICT POLICIES AND PROCEDURES.—School districts
  358  shall develop policies and procedures consistent with this
  359  section and governing the following:
  360         (a) Allowable use of manual physical restraint on students.
  361         (b) Personnel authorized to use manual physical restraint.
  362         (c) Training procedures.
  363         (d) Incident-reporting procedures.
  364         (e) Data collection.
  365         (f) Monitoring and reporting of data collected.
  366         (g) Analysis of data to determine trends.
  367         (h) Ongoing reduction of the use of manual physical
  368  restraint.
  370  Policy and procedure revisions pursuant to this section, which
  371  must be prepared as part of the district’s special policies and
  372  procedures, must be filed with the bureau chief of the Bureau of
  373  Exceptional Education and Student Services no later than January
  374  31, 2011.
  375         Section 2. This act shall take effect July 1, 2010.

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