Florida Senate - 2012                                     SB 144
       
       
       
       By Senator Flores
       
       
       
       
       38-00163-12                                            2012144__
    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 the Advocacy Center for Persons
   30         with Disabilities, Inc.; requiring that the department
   31         make available on its website data of incidents of
   32         manual physical restraint by a specified date;
   33         requiring that each school district develop policies
   34         and procedures addressing the allowable use of manual
   35         physical restraint, personnel authorized to use such
   36         restraint, training procedures, analysis of data
   37         trends, and the reduction of the use of manual
   38         physical restraint; requiring that any revisions to a
   39         school district’s policies and procedures be filed
   40         with the bureau chief of the Bureau of Exceptional
   41         Education and Student Services by a specified date;
   42         providing an effective date.
   43  
   44  Be It Enacted by the Legislature of the State of Florida:
   45  
   46         Section 1. Section 1003.573, Florida Statutes, is amended
   47  to read:
   48         1003.573 Use, prevention, and reduction of seclusion and
   49  restraint on students with disabilities in public schools Use of
   50  restraint and seclusion on students with disabilities.—
   51         (1) DEFINITIONS.—As used in this section, the term:
   52         (a) “Department” means the Department of Education.
   53         (b) “Imminent risk of serious injury or death” means the
   54  impending risk of a significant injury, such as a laceration,
   55  bone fracture, substantial hematoma, or other injury to internal
   56  organs, or death.
   57         (c) “Manual physical restraint” means the use of physical
   58  restraint techniques that involve physical force applied by a
   59  teacher or other staff member to restrict the movement of all or
   60  part of a student’s body.
   61         (d) “Mechanical restraint” means the use of a physical
   62  device that restricts a student’s movement or restricts the
   63  normal function of a student’s body. The term includes the use
   64  of straps, belts, tie-downs, calming blankets, and chairs with
   65  straps; however, the term does not include the use of:
   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 ongoing medical treatment in the
   70  educational setting;
   71         3. Devices used to support functional body position or
   72  proper balance, or to prevent a person from falling out of a bed
   73  or a wheelchair, except when such device is used for any purpose
   74  other than supporting a body position or proper balance, such as
   75  coercion, discipline, convenience, or retaliation, to prevent
   76  imminent risk of serious injury or death of the student or
   77  others, or for any other behavior-management reason; or
   78         4. Equipment used for safety during transportation, such as
   79  seatbelts or wheelchair tie-downs.
   80         (e) “Medical protective equipment” means health-related
   81  protective devices prescribed by a physician or dentist for use
   82  as student protection in response to an existing medical
   83  condition.
   84         (f) “Seclusion” means removing a student from an
   85  educational environment, involuntarily confining the student in
   86  a room or area, and preventing the student from leaving the room
   87  or area if achieved by locking the door or otherwise physically
   88  blocking the student’s way, threatening physical force or other
   89  consequences, or using physical force. The term does not include
   90  the use of time-out.
   91         (g) “Student” means a student with a disability.
   92         (h) “Time-out” means a procedure in which access to varied
   93  sources of reinforcement is removed or reduced for a particular
   94  time period contingent on a response. The opportunity to receive
   95  reinforcement is contingently removed for a specified time.
   96  Either a student is contingently removed from the reinforcing
   97  environment or the reinforcing environment is contingently
   98  removed for some stipulated duration. A time-out setting may not
   99  be locked and the exit may not be blocked. Physical force or
  100  threats may not be used to place a student in time-out.
  101         (2) LEGISLATIVE FINDINGS AND INTENT.—
  102         (a) The Legislature finds that public schools have a
  103  responsibility to ensure that each student is treated with
  104  respect and dignity in a trauma-informed environment that
  105  provides for the physical safety and security of students and
  106  others.
  107         (b) The Legislature finds that students, educators, and
  108  families are concerned about the use of seclusion and restraint,
  109  particularly when used on students in special education
  110  programs. Seclusion and restraint refer to safety procedures in
  111  which a student is isolated from others or physically held in
  112  response to serious problem behavior that places the student or
  113  others at risk of injury or harm. There is concern that these
  114  procedures are prone to misapplication and abuse and place a
  115  student at an equal or greater risk than the risk of the
  116  student’s problem behavior. Particular concerns include:
  117         1. Seclusion or restraint is inappropriately selected and
  118  implemented as treatment or behavioral intervention rather than
  119  as a safety procedure;
  120         2. Seclusion or restraint is inappropriately used for
  121  behaviors, such as noncompliance, threats, or disruption, which
  122  do not place the student or others at risk of injury or harm;
  123         3. Students, peers, or staff may be injured or physically
  124  harmed during attempts to conduct seclusion or restraint;
  125         4. Risk of injury or harm is increased because seclusion or
  126  restraint is implemented by staff who are not adequately
  127  trained;
  128         5. The use of seclusion or restraint may inadvertently
  129  result in reinforcing or strengthening the problem behavior; and
  130         6. Seclusion or restraint is implemented independent of
  131  comprehensive, function-based behavioral intervention plans.
  132  
  133  Moreover, there are concerns about the inadequate documentation
  134  of seclusion or restraint procedures, the failure to notify
  135  parents when seclusion or restraint is applied, and the failure
  136  to use data to analyze and address the cause of the
  137  precipitating behavior.
  138         (c) The Legislature finds that the majority of problem
  139  behaviors that are currently used to justify seclusion or
  140  restraint could be prevented with early identification and
  141  intensive early intervention. The need for seclusion or
  142  restraint is, in part, a result of insufficient investment in
  143  prevention efforts. The Legislature further finds that the use
  144  of seclusion or restraint may produce trauma in students. For
  145  such students, who are already experiencing trauma, the use may
  146  cause retraumatization. Left unaddressed, the lasting effects of
  147  childhood trauma place a heavy burden on individuals, families,
  148  and communities. Research has shown that trauma significantly
  149  increases the risk of mental health problems, difficulties with
  150  social relationships and behavior, physical illness, and poor
  151  school performance.
  152         (d) The Legislature intends that students be free from the
  153  abusive and unnecessary use of seclusion or restraint in the
  154  public schools. The Legislature further intends to prevent, and
  155  achieve an ongoing reduction of, the use of manual physical
  156  restraint in the public schools and, specifically, to prohibit
  157  the use of seclusion, prone and supine restraint, and mechanical
  158  restraint on students. The Legislature also intends that manual
  159  physical restraint be used only when an imminent risk of serious
  160  injury or death exists; that manual physical restraint not be
  161  employed as punishment, for the convenience of staff, or as a
  162  substitute for a positive behavior-support plan; and that, when
  163  used, persons applying manual physical restraint impose the
  164  least possible restrictions and discontinue the restraint as
  165  soon as the threat of imminent risk of serious injury or death
  166  ceases.
  167         (3) MANUAL PHYSICAL RESTRAINT.—Manual physical restraint
  168  shall be used only in an emergency when there is an imminent
  169  risk of serious injury or death to the student or others.
  170         (a) Manual physical restraint shall be used only for the
  171  period needed in order to eliminate the imminent risk of serious
  172  injury or death to the student or others.
  173         (b) The degree of force applied during manual physical
  174  restraint must be only that degree of force necessary to protect
  175  the student or others from bodily injury.
  176         (c) Manual physical restraint shall be used only by school
  177  personnel who are qualified and certified to use the district
  178  approved methods for the appropriate application of specific
  179  restraint techniques. School personnel who have received
  180  training that is not associated with their employment with the
  181  school district, such as a former law enforcement officer who is
  182  now a teacher, shall be certified in the specific district
  183  approved techniques and may not apply techniques or procedures
  184  acquired elsewhere.
  185         (d) School personnel may not manually physically restrain a
  186  student except when an imminent risk of serious injury or death
  187  to the student or others exists.
  188         (e) School personnel may not use any of the following
  189  manual physical restraint techniques on a student:
  190         1. Prone and supine restraint.
  191         2. Pain inducement to obtain compliance.
  192         3. Bone locks.
  193         4. Hyperextension of joints.
  194         5. Peer restraint.
  195         6. Mechanical restraint.
  196         7. Pressure or weight on the chest, lungs, sternum,
  197  diaphragm, back, or abdomen, causing chest compression.
  198         8. Straddling or sitting on any part of the body or any
  199  maneuver that places pressure, weight, or leverage on the neck
  200  or throat, on any artery, or on the back of the student’s head
  201  or neck or that otherwise obstructs or restricts the circulation
  202  of blood or obstructs an airway.
  203         9. Any type of choking, including hand chokes, and any type
  204  of neck or head hold.
  205         10. Any technique that involves pushing anything on or into
  206  the student’s mouth, nose, eyes, or any part of the face or that
  207  involves covering the face or body with anything, including soft
  208  objects such as pillows or washcloths.
  209         11. Any maneuver that involves punching, hitting, poking,
  210  pinching, or shoving.
  211         12. Any type of mat or blanket restraint.
  212         13. Water or lemon sprays.
  213         (f) The school shall ensure that a student is medically
  214  evaluated by a physician, nurse, or other qualified medical
  215  professional as soon as possible after the student has been
  216  manually physically restrained by school personnel.
  217         (4) SECLUSION; TIME-OUT.—
  218         (a) School personnel may not place a student in seclusion.
  219         (b) School personnel may place a student in time-out if the
  220  following conditions are met:
  221         1. The time-out is part of a positive behavioral
  222  intervention plan developed for that student from a functional
  223  behavioral assessment and referenced in the student’s individual
  224  education plan.
  225         2. There is documentation that the time-out was preceded by
  226  the use of other positive behavioral supports that were not
  227  effective.
  228         3. The time-out takes place in a classroom or in another
  229  environment where class educational activities are taking place.
  230         4. The student is not physically prevented from leaving the
  231  time-out area.
  232         5. The student is observed on a constant basis by an adult
  233  for the duration of the time-out.
  234         6. The time-out area and process are free of any action
  235  that is likely to embarrass or humiliate the student.
  236         (c) Time-out may not be used for a period that exceeds 1
  237  minute for each year of a student’s age and time-out must end
  238  immediately when the student is calm enough to return to his or
  239  her seat.
  240         (d) Time-out may not be used as a punishment or negative
  241  consequence of a student’s behavior.
  242         (5) TRAINING AND CERTIFICATION.—
  243         (a) Each school district shall report its training and
  244  certification procedures to the department by publishing the
  245  procedures in the district’s special policies and procedures
  246  manual.
  247         (b) Training for initial certification in the use of manual
  248  physical restraint must include:
  249         1. Procedures for deescalating problem behaviors before the
  250  problems increase to a level or intensity necessitating physical
  251  intervention.
  252         2. Information regarding the risks associated with manual
  253  physical restraint and procedures for assessing individual
  254  situations and students in order to determine if the use of
  255  manual physical restraint is appropriate and sufficiently safe.
  256         3. The actual use of specific techniques that range from
  257  the least to most restrictive, with ample opportunity for
  258  trainees to demonstrate proficiency in the use of such
  259  techniques.
  260         4. Techniques for implementing manual physical restraint
  261  with multiple staff members working as a team.
  262         5. Techniques for assisting a student to reenter the
  263  instructional environment and again engage in learning.
  264         6. Instruction in the district’s documentation and
  265  reporting requirements.
  266         7. Procedures to identify and deal with possible medical
  267  emergencies arising during the use of manual physical restraint.
  268         8. Cardiopulmonary resuscitation.
  269         (c) School districts shall provide refresher certification
  270  training courses in manual physical restraint techniques at
  271  least annually to all staff members who have successfully
  272  completed the initial certification program. The district must
  273  identify those persons to be certified and maintain a record
  274  that includes the name and position of the person certified, the
  275  date of the most recent certification, an indication of whether
  276  it was an initial certification or a refresher certification,
  277  and whether the individual successfully completed the
  278  certification and achieved proficiency.
  279         (d) School district policies regarding the use of manual
  280  physical restraint must address whether it is appropriate for an
  281  employee working in specific settings, such as a school bus
  282  driver, school bus aide, job coach, employment specialist, or
  283  cafeteria worker, to be certified in manual physical restraint
  284  techniques. In the case of school resource officers or others
  285  who may be employed by other agencies when working in a school,
  286  administrators shall review each agency’s specific policies to
  287  be aware of techniques that may be used.
  288         (6) STUDENT-CENTERED FOLLOWUP.—If a student is manually
  289  physically restrained more than twice during a school year, the
  290  school shall review the student’s functional behavioral
  291  assessment and positive behavioral intervention plan.
  292         (7)(1) DOCUMENTATION AND REPORTING.—
  293         (a) At the beginning of each school year, a school district
  294  shall provide a copy of its policies on all emergency
  295  procedures, including its policies on the use of manual physical
  296  restraint, to each student’s parent or guardian. The student’s
  297  parent or guardian must sign a form indicating that he or she
  298  has read and received the district’s policies, which the
  299  student’s school shall retain on file.
  300         (b)(a) A school shall prepare an incident report within 24
  301  hours after a student is released from a restraint or seclusion.
  302  If the student’s release occurs on a day before the school
  303  closes for the weekend, a holiday, or another reason, the
  304  incident report must be completed by the end of the school day
  305  on the day the school reopens.
  306         (c)(b) The following must be included in the incident
  307  report:
  308         1. The name of the student restrained or secluded.
  309         2. The age, grade, ethnicity, and disability of the student
  310  restrained or secluded.
  311         3. The date and time of the event and the duration of the
  312  restraint or seclusion.
  313         4. The location at which the restraint or seclusion
  314  occurred.
  315         5. A description of the type of restraint used in terms
  316  established by the Department of Education.
  317         6. The name of the person using or assisting in the
  318  restraint or seclusion of the student.
  319         7. The name of any nonstudent who was present to witness
  320  the restraint or seclusion.
  321         8. A description of the incident, including:
  322         a. The context in which the restraint or seclusion
  323  occurred.
  324         b. The student’s behavior leading up to and precipitating
  325  the decision to use manual or physical restraint or seclusion,
  326  including an indication as to why there was an imminent risk of
  327  serious injury or death to the student or others.
  328         c. The specific positive behavioral strategies used to
  329  prevent and deescalate the behavior.
  330         d. What occurred with the student immediately after the
  331  termination of the restraint or seclusion.
  332         e. Any injuries, visible marks, or possible medical
  333  emergencies that may have occurred during the restraint or
  334  seclusion, documented according to district policies.
  335         f. The results of the medical evaluation and a copy of any
  336  report by the medical professionals conducting the evaluation,
  337  if available. If the medical report is not available within 24
  338  hours, the district must submit the medical report separately as
  339  soon as it is available.
  340         g.f. Evidence of steps taken to notify the student’s parent
  341  or guardian.
  342         (d)(c) A school shall notify the parent or guardian of a
  343  student each time manual or physical restraint or seclusion is
  344  used. Such notification must be in writing and provided before
  345  the end of the school day on which the restraint or seclusion
  346  occurs. Reasonable efforts must also be taken to notify the
  347  parent or guardian by telephone or computer e-mail, or both, and
  348  these efforts must be documented. The school shall obtain, and
  349  keep in its records, the parent’s or guardian’s signed
  350  acknowledgment that he or she was notified of his or her child’s
  351  restraint or seclusion.
  352         (e)(d) A school shall also provide the parent or guardian
  353  with the completed incident report in writing by mail within 3
  354  school days after a student was manually or physically
  355  restrained or secluded. The school shall obtain, and keep in its
  356  records, the parent’s or guardian’s signed acknowledgment that
  357  he or she received a copy of the incident report.
  358         (8)(2) MONITORING.—
  359         (a) Monitoring of The use of manual or physical restraint
  360  or seclusion on students shall be monitored occur at the
  361  classroom, building, district, and state levels.
  362         (b) Any documentation prepared by a school pursuant to as
  363  required in subsection (7) (1) shall be provided to the school
  364  principal, the district director of Exceptional Student
  365  Education, and the bureau chief of the Bureau of Exceptional
  366  Education and Student Services electronically each week month
  367  that the school is in session.
  368         (c) Each week that a school is in session, the school shall
  369  send a redacted copy of any incident report and other
  370  documentation prepared pursuant to subsection (7) to the
  371  Advocacy Center for Persons with Disabilities, Inc.
  372         (d)(c) The department shall maintain aggregate data of
  373  incidents of manual or physical restraint and seclusion and
  374  disaggregate the data for analysis by county, school, student
  375  exceptionality, and other variables, including the type and
  376  method of restraint or seclusion used. This information shall be
  377  updated monthly and made available to the public through the
  378  department’s website no later than January 31, 2013.
  379         (e)(d) The department shall establish standards for
  380  documenting, reporting, and monitoring the use of manual or
  381  physical restraint or mechanical restraint, and occurrences of
  382  seclusion. These standards shall be provided to school districts
  383  by October 1, 2011.
  384         (9)(3) SCHOOL DISTRICT POLICIES AND PROCEDURES.—
  385         (a) Each school district shall develop policies and
  386  procedures that are consistent with this section and that govern
  387  the following:
  388         1. Allowable use of manual physical restraint on students.
  389         2. Personnel authorized to use manual physical restraint.
  390         3. Training procedures.
  391         4.1. Incident-reporting procedures.
  392         5.2. Data collection and monitoring, including when, where,
  393  and why students are restrained or secluded; the frequency of
  394  occurrences of such restraint or seclusion; and the prone or
  395  mechanical restraint that is most used.
  396         6.3. Monitoring and reporting of data collected.
  397         7.4. Training programs relating to manual or physical
  398  restraint and seclusion.
  399         8.5. The district’s plan for selecting personnel to be
  400  trained.
  401         9.6. The district’s plan for reducing the use of restraint
  402  and seclusion particularly in settings in which it occurs
  403  frequently or with students who are restrained repeatedly, and
  404  for reducing the use of prone restraint and mechanical
  405  restraint. The plan must include a goal for reducing the use of
  406  restraint and seclusion and must include activities, skills, and
  407  resources needed to achieve that goal. Activities may include,
  408  but are not limited to:
  409         a. Additional training in positive behavioral support and
  410  crisis management;
  411         b. Parental involvement;
  412         c. Data review;
  413         d. Updates of students’ functional behavioral analysis and
  414  positive behavior intervention plans;
  415         e. Additional student evaluations;
  416         f. Debriefing with staff;
  417         g. Use of schoolwide positive behavior support; and
  418         h. Changes to the school environment.
  419         10. Analysis of data to determine trends.
  420         11. Ongoing reduction of the use of manual physical
  421  restraint.
  422         (b) Any revisions that a school district makes to its to
  423  the district’s policies and procedures, which are must be
  424  prepared as part of the school district’s its special policies
  425  and procedures, must be filed with the bureau chief of the
  426  Bureau of Exceptional Education and Student Services no later
  427  than January 31, 2012.
  428         (4) PROHIBITED RESTRAINT.—School personnel may not use a
  429  mechanical restraint or a manual or physical restraint that
  430  restricts a student’s breathing.
  431         (5) SECLUSION.—School personnel may not close, lock, or
  432  physically block a student in a room that is unlit and does not
  433  meet the rules of the State Fire Marshal for seclusion time-out
  434  rooms.
  435         Section 2. This act shall take effect July 1, 2012.