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       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.
   37  Be It Enacted by the Legislature of the State of Florida:
   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.
  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.
  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.
  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.
  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.

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