Sec. 46a-151. Life-threatening physical restraint prohibited.
Secs. 46a-155 to 46a-169. Reserved
Sec. 46a-150. Definitions. For purposes of this section and sections 46a-151 to 46a-154, inclusive:
(1) “Provider of care or supervision of a person at risk” and “provider” mean a person who provides direct care or supervision of a person at risk.
(2) “Assistant provider of care or supervision of a person at risk” and “assistant” mean a person assigned to provide, or who may be called upon in an emergency to provide, assistance or security to a provider of care or supervision of a person at risk.
(3) “Person at risk” means a person receiving care or supervision in an institution or facility operated by, licensed or authorized to operate by or operating pursuant to a contract with the Departments of Public Health, Developmental Services, Children and Families, or Mental Health and Addiction Services. The term does not include a person in the custody of the Commissioner of Correction, or a resident or patient of a nursing home subject to federal regulations concerning restraint of residents or patients.
(4) “Life-threatening physical restraint” means any physical restraint or hold of a person that restricts the flow of air into a person's lungs, whether by chest compression or any other means.
(5) “Physical restraint” means any mechanical or personal restriction that immobilizes or reduces the free movement of a person's arms, legs or head. The term does not include: (A) Briefly holding a person in order to calm or comfort the person; (B) restraint involving the minimum contact necessary to safely escort a person from one area to another; (C) medical devices, including, but not limited to, supports prescribed by a health care provider to achieve proper body position or balance; (D) helmets or other protective gear used to protect a person from injuries due to a fall; or (E) helmets, mitts and similar devices used to prevent self injury when the device is part of a documented treatment plan and is the least restrictive means available to prevent such self-injury.
(6) “Psychopharmacologic agent” means any medication that affects the central nervous system, influencing thinking, emotion or behavior.
(7) “Seclusion” means the confinement of a person in a room, whether alone or with staff supervision, in a manner that prevents the person from leaving, except that in the case of seclusion at Long Lane School, the term does not include the placing of a single child or youth in a secure room for the purpose of sleeping.
(P.A. 99-210, S. 1, 6; P.A. 07-73, S. 2(a); 07-147, S. 1; P.A. 15-141, S. 2.)
History: P.A. 99-210 effective June 29, 1999; pursuant to P.A. 07-73 “Department of Mental Retardation” was changed editorially by the Revisors to “Department of Developmental Services”, effective October 1, 2007; P.A. 07-147 amended Subdiv. (3) to redefined “person at risk” to include a child requiring special education or awaiting a determination for eligibility for special education in new Subpara. (A), designate existing provisions as new Subpara. (B) and existing Subparas. (A) and (B) as new clauses (i) and (ii), and delete former clause (i) and (ii) designators, and amended Subdiv. (5)(E) to exclude from the definition of “physical restraint” devices that prevent injury if the device is part of an “individualized education program pursuant to section 10-76d”; P.A. 15-141 replaced “provider of care, education or supervision of a person at risk” with “provider of care or supervision of a person at risk” and deleted reference to education in Subdiv. (1), replaced “assistant provider of care, education or supervision of a person at risk” with “assistant provider of care or supervision of a person at risk” and deleted reference to education in Subdiv. (2), redefined “person at risk” in Subdiv. (3), and deleted reference to individualized education program in Subdiv. (5), effective July 1, 2015.
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Sec. 46a-151. Life-threatening physical restraint prohibited. No provider of care or supervision of a person at risk and no assistant provider may use a life-threatening physical restraint on a person at risk. This section shall not be construed as limiting any defense to criminal prosecution for the use of deadly physical force that may be available under sections 53a-18 to 53a-22, inclusive.
(P.A. 99-210, S. 2, 6; P.A. 15-141, S. 3.)
History: P.A. 99-210 effective June 29, 1999; P.A. 15-141 deleted reference to education, effective July 1, 2015.
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Sec. 46a-152. Physical restraint, seclusion and use of psychopharmacologic agents restricted. Notification of parent or guardian of physical restraint or seclusion of child required. Monitoring and documentation required. (a) No provider or assistant may use involuntary physical restraint on a person at risk except (1) as an emergency intervention to prevent immediate or imminent injury to the person at risk or to others, provided the restraint is not used for discipline or convenience and is not used as a substitute for a less restrictive alternative, (2) as necessary and appropriate, as determined on an individual basis by the person's treatment team and consistent with sections 17a-540 to 17a-550, inclusive, for the transportation of a person under the jurisdiction of the Whiting Forensic Hospital of the Department of Mental Health and Addiction Services.
(b) No provider or assistant may involuntarily place a person at risk in seclusion except as an emergency intervention to prevent immediate or imminent injury to the person or to others, provided the seclusion is not used for discipline or convenience and is not used as a substitute for a less restrictive alternative.
(c) No provider or assistant may use a psychopharmacologic agent on a person at risk without that person's consent except (1) as an emergency intervention to prevent immediate or imminent injury to the person or to others, or (2) as an integral part of the person's established medical or behavioral support plan, as developed consistent with section 17a-543 or, if no such plan has been developed, as part of a licensed practitioner's initial orders. The use of psychopharmacologic agents, alone or in combination, may be used only in doses that are therapeutically appropriate and not as a substitute for other appropriate treatment.
(d) Any use of physical restraint or seclusion on a person at risk shall be documented in the person's medical record. The documentation shall include (1) in the case of emergency use, the nature of the emergency and what other steps, including attempts at verbal deescalation, were taken to prevent the emergency from arising if there were indications that such an emergency was likely to arise, and (2) a detailed description of the nature of the restraint or seclusion, its duration and its effect on the person's established medical or behavioral support plan.
(e) Any person at risk who is physically restrained shall be continually monitored by a provider or assistant. Any person at risk who is involuntarily placed in seclusion shall be frequently monitored by a provider or assistant. Each person so restrained or in seclusion shall be regularly evaluated by a provider or assistant for indications of physical distress. The provider or assistant conducting the evaluation shall enter each evaluation in the person's medical record. For purposes of this subsection, “monitor” means (1) direct observation, or (2) observation by way of video monitoring within physical proximity sufficient to provide aid as may be needed.
(f) Nothing in this section shall be construed as limiting any rights a person may have under sections 17a-540 to 17a-550, inclusive, section 17a-566 or section 54-56d.
(g) Nothing in this section shall be construed as limiting the justified use of physical force by a local, state or federal law enforcement official or an employee of the Board of Pardons and Paroles or the Department of Correction responsible for the supervision of persons released on parole while in the performance of such official's or employee's duties.
(h) (1) Nothing in this section shall be construed as prohibiting the use of mechanical physical restraint in transporting any person (A) who is receiving services from the Department of Mental Health and Addiction Services pursuant to sections 17a-513 to 17a-517, inclusive, 17a-566 to 17a-567, inclusive, 17a-582 to 17a-603, inclusive, or 54-56d, or (B) who is committed to the department by a court of competent jurisdiction and has a pending criminal charge for which bail or a bond has not been posted, from a department facility to another location and, if applicable, back to such facility. Any such use of mechanical physical restraint shall be determined on an individualized basis by the head of the facility, or by a designee of the head of the facility, to be necessary and appropriate to protect the public safety.
(2) Any use of mechanical physical restraint under this subsection shall be documented in the medical record of the person who is transported. Such documentation shall include, but not be limited to, (A) the reason for the use of such restraint, including the risk of flight, the risk to public safety and the person's clinical condition, and (B) a detailed description of the nature of such restraint and its duration. If the use of any such restraint results in serious physical injury or death to such person, the head of the facility shall report such injury or death to the Commissioner of Mental Health and Addiction Services. The commissioner, upon receiving any such report, shall inform the executive director of the nonprofit entity designated by the Governor in accordance with section 46a-10b to serve as the Connecticut protection and advocacy system, as required by the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 USC 15041 et seq., as amended from time to time, and any regulations promulgated thereunder and as required by the Protection and Advocacy for Individuals with Mental Illness Act, 42 USC 10801 et seq., as amended from time to time, and any regulations promulgated thereunder, of such injury or death.
(P.A. 99-210, S. 3; P.A. 00-55; P.A. 04-257, S. 117; P.A. 05-108, S. 4; P.A. 07-147, S. 2; P.A. 15-141, S. 4; P.A. 17-96, S. 36; P.A. 18-86, S. 51.)
History: P.A. 00-55 added new Subsec. (h) re use of mechanical physical restraint in transporting persons receiving services from or committed to the Department of Mental Health and Addiction Services; P.A. 04-257 amended Subsec. (g) to replace “an employee of the Board of Parole” with “an employee of the Department of Correction responsible for the supervision of persons released on parole”, effective June 14, 2004; P.A. 05-108 amended Subsec. (g) to include “an employee of the Board of Pardons and Paroles” responsible for the supervision of persons released on parole, effective June 7, 2005; P.A. 07-147 amended Subsec. (b) to require each local or regional board of education, institution or facility providing special education for a child to notify the parent or guardian of each incident of physical restraint or seclusion of the child and substituted “individualized education program” for “individual education plan”; P.A. 15-141 amended Subsec. (b) by deleting former Subdiv. (2) re individualized education program and making a conforming change, and amended Subsecs. (c) to (e) by deleting “or educational”, effective July 1, 2015; P.A. 17-96 amended Subsec. (h)(2) to replace reference to director of Office of Protection and Advocacy for Persons with Disabilities with reference to executive director of nonprofit entity designated to serve as Connecticut protection and advocacy system and add provision re requirements under certain acts and regulations, effective July 1, 2017; P.A. 18-86 replaced “Whiting Forensic Division” with “Whiting Forensic Hospital”, effective June 4, 2018.
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Sec. 46a-153. Recording and annual compilation of use of restraint and seclusion. Review of annual compilation by state agencies. Reports. (a) Each institution or facility that provides direct care or supervision of persons at risk shall (1) record each instance of the use of physical restraint or seclusion on a person at risk and the nature of the emergency that necessitated its use, and (2) include such information in an annual compilation on its use of such restraint and seclusion. The commissioner of the state agency that has jurisdiction or supervisory control over each institution or facility shall review the annual compilation prior to renewing a license for or a contract with such institution or facility.
(b) If the use of such restraint or seclusion results in physical injury to the person, the institution or facility shall report the incident to the commissioner of the state agency that has jurisdiction or supervisory control over the institution or facility. The commissioner receiving a report of such an incident shall report any incidence of serious injury or death to the executive director of the nonprofit entity designated by the Governor in accordance with section 46a-10b to serve as the Connecticut protection and advocacy system, as required by the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 USC 15041 et seq., as amended from time to time, and any regulations promulgated thereunder, and as required by the Protection and Advocacy for Individuals with Mental Illness Act, 42 USC 10801 et seq., as amended from time to time, and any regulations promulgated thereunder, and, if appropriate, to the Child Advocate of the Office of the Child Advocate.
(P.A. 99-210, S. 4; P.A. 07-147, S. 3; P.A. 12-88, S. 1; P.A. 14-122, S. 55; P.A. 15-141, S. 5; P.A. 17-96, S. 37.)
History: P.A. 07-147 made provisions applicable to local or regional boards of education, added provision re report of physical injury incident to State Board of Education and provided that State Board of Education may review annual compilation, may produce annual summary report, and shall report any incidence of serious injury or death to director of Office of Protection and Advocacy for Persons with Disabilities and to Child Advocate; P.A. 12-88 designated existing provision re recording instances of the use of physical restraint or seclusion as Subsec. (a) and amended same to delete “local or regional board of education”, added Subsec. (b) requiring local and regional board of education, institution and facility providing special education for a child to record and compile information re use of physical restraint or seclusion, designated existing provision re review of annual compilations and production of annual summary report by State Board of Education as Subsec. (c) and amended same to require State Board of Education to review such compilations and produce such report to be submitted to General Assembly for inclusion in annual report card, designated existing provisions re use of physical restraint or seclusion resulting in physical injury as Subsec. (d)(1) and (2) and amended Subsec. (d)(1) to require State Board of Education to include incident in report submitted pursuant to Subsec. (c), effective July 1, 2012; P.A. 14-122 made a technical change in Subsec. (c); P.A. 15-141 deleted former Subsec. (b) re record of use of physical restraint or seclusion on child, deleted former Subsec. (c) re State Board of Education review, redesignated existing Subsec. (d) as Subsec. (b) and amended same to delete former Subdiv. (1) re report of local or regional board of education, make a conforming change and delete reference to State Board of Education, effective July 1, 2015; P.A. 17-96 amended Subsec. (b) to replace reference to director of Office of Protection and Advocacy for Persons with Disabilities with reference to executive director of nonprofit entity designated to serve as Connecticut protection and advocacy system and add provision re requirements under certain acts and regulations, effective July 1, 2017.
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Sec. 46a-154. Internal monitoring, training and development of policies and procedures required and subject to state agency inspection. (a) Each institution or facility that provides direct care or supervision of a person at risk shall develop policies and procedures that (1) establish monitoring and internal reporting of the use of physical restraint and seclusion on persons at risk, and (2) require training of all providers and assistant providers of care or supervision of persons at risk in the use of physical restraint and seclusion on persons at risk. Such training shall include, but not be limited to: Verbal defusing or deescalation; prevention strategies; types of physical restraint; the differences between life-threatening physical restraint and other varying levels of physical restraint; the differences between permissible physical restraint and pain compliance techniques; monitoring to prevent harm to a person physically restrained or in seclusion and recording and reporting procedures on the use of restraints and seclusion.
(b) Each institution or facility required to develop policies and procedures under subsection (a) of this section shall make such policies and procedures available upon request to the commissioner of the state agency that has jurisdiction or supervisory control over the institution or facility.
(P.A. 99-210, S. 5; P.A. 15-141, S. 6.)
History: P.A. 15-141 amended Subsec. (a) by deleting “, education”, effective July 1, 2015.
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Secs. 46a-155 to 46a-169. Reserved for future use.
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