(REPRINTED WITH ADOPTED AMENDMENTS)

 

Senate Bill No. 116–Committee on Human
Resources and Facilities

 

(On Behalf of Department of Human Resources—Mental
Health and Developmental Services)

 

February 13, 2001

____________

 

Referred to Committee on Human Resources and Facilities

 

SUMMARY—Revises provisions governing use of restraints and interventions on persons with disabilities. (BDR 39‑346)

 

FISCAL NOTE:                     Effect on Local Government: No.

                                    Effect on the State: No.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to persons with disabilities; prescribing the circumstances under which a secure facility for mentally disordered offenders may use mechanical restraint on clients who have disabilities; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1. Chapter 433 of NRS is hereby amended by adding thereto a

1-2  new section to read as follows:

1-3    1.  Except as otherwise provided in subsection 3, mechanical restraint

1-4  may be used on a person with a disability who is a client of a forensic

1-5  facility only if:

1-6    (a) An emergency exists that necessitates the use of the mechanical

1-7  restraint;

1-8    (b) The client’s behavior presents an imminent threat of causing

1-9  physical injury to himself or to others or causing severe property damage

1-10  and less restrictive measures have failed to modify the client’s behavior;

1-11    (c) The client is in the care of the facility but not on the premises of

1-12  the facility and mechanical restraint is necessary to ensure security; or

1-13    (d) The client is in the process of being transported to another

1-14  location and mechanical restraint is necessary to ensure security.

1-15    2.  If mechanical restraint is used pursuant to subsection 1, the

1-16  forensic facility shall ensure that:

2-1    (a) The mechanical restraint is applied by a member of the staff of the

2-2  facility who is trained and qualified to apply mechanical restraint;

2-3    (b) A member of the staff of the facility continuously monitors the

2-4  client during the time that mechanical restraint is used on the client;

2-5    (c) The record of the client contains a notation that indicates the time

2-6  period during which the restraint was used and the circumstances

2-7  warranting the restraint; and

2-8    (d) The mechanical restraint is used only for the period that is

2-9  necessary.

2-10    3.  Mechanical restraint may be used on a person with a disability

2-11  who is a client of a forensic facility, and the provisions of subsections 1

2-12  and 2 do not apply if the mechanical restraint is used to:

2-13    (a) Treat the medical needs of a client;

2-14    (b) Protect a client who is known to be at risk of injury to himself

2-15  because he lacks coordination or suffers from frequent loss of

2-16  consciousness;

2-17    (c) Provide proper body alignment to a client; or

2-18    (d) Position a client who has physical disabilities in a manner

2-19  prescribed in the client’s plan of services.

2-20    4.  If mechanical restraint is used in an emergency on a person with a

2-21  disability who is a client of a forensic facility, the use of the procedure

2-22  must be reported as a denial of rights pursuant to NRS 433.534,

2-23  regardless of whether the use of the procedure is authorized by statute.

2-24  The report must be made not later than 1 working day after the

2-25  procedure is used.

2-26    5.  As used in this section, “forensic facility” means a secure facility

2-27  of the division for mentally disordered offenders and defendants who are

2-28  ordered to the facility pursuant to chapter 178 of NRS.

2-29    Sec. 2.  NRS 433.545 is hereby amended to read as follows:

2-30    433.545  As used in NRS 433.545 to 433.551, inclusive, and section 1

2-31  of this act, unless the context otherwise requires, the words and terms

2-32  defined in NRS 433.5453 to 433.548, inclusive,have the meanings

2-33  ascribed to them in those sections.

2-34    Sec. 3.  NRS 433.547 is hereby amended to read as follows:

2-35    433.547  “Mechanical restraint” means the use of devices, including,

2-36  without limitation, mittens, straps , [and] restraint chairs , handcuffs, belly

2-37  chains and four-point restraints to limit a person’s movement or hold a

2-38  person immobile.

2-39    Sec. 4.  NRS 433.549 is hereby amended to read as follows:

2-40    433.549  A person employed by a facility or any other person shall not:

2-41    1.  Except as otherwise provided in NRS 433.5493, use physical

2-42  restraint on a person with a disability who is a client.

2-43    2.  Except as otherwise provided in NRS 433.5496 [,] and section 1 of

2-44  this act, use mechanical restraint on a person with a disability who is a

2-45  client.

2-46    3.  Except as otherwise provided in NRS 433.5503, use chemical

2-47  restraint on a person with a disability who is a client.

 

 

3-1    Sec. 5.  NRS 433.5496 is hereby amended to read as follows:

3-2    433.5496  1.  Except as otherwise provided in [subsection 2,]

3-3  subsections 2 and 4, mechanical restraint may be used on a person with a

3-4  disability who is a client only if:

3-5    (a) An emergency exists that necessitates the use of mechanical

3-6  restraint;

3-7    (b) A medical order authorizing the use of mechanical restraint is

3-8  obtained from the client’s treating physician before the application of the

3-9  mechanical restraint or not later than 15 minutes after the application of the

3-10  mechanical restraint;

3-11    (c) The physician who signed the order required pursuant to paragraph

3-12  (b) or the attending physician examines the client not later than 1 working

3-13  day immediately after the application of the mechanical restraint;

3-14    (d) The mechanical restraint is applied by a member of the staff of the

3-15  facility who is trained and qualified to apply mechanical restraint;

3-16    (e) The client is given the opportunity to move and exercise the parts of

3-17  his body that are restrained at least 10 minutes per every 60 minutes of

3-18  restraint;

3-19    (f) A member of the staff of the facility lessens or discontinues the

3-20  restraint every 15 minutes to determine whether the client will stop or

3-21  control his inappropriate behavior without the use of the restraint;

3-22    (g) The record of the client contains a notation that includes the time of

3-23  day that the restraint was lessened or discontinued pursuant to paragraph

3-24  (f), the response of the client and the response of the member of the staff of

3-25  the facility who applied the mechanical restraint;

3-26    (h) A member of the staff of the facility continuously monitors the

3-27  client during the time that mechanical restraint is used on the client; and

3-28    (i) The mechanical restraint is used only for the period that is necessary

3-29  to contain the behavior of the client so that the client is no longer an

3-30  immediate threat of causing physical injury to himself or others or causing

3-31  severe property damage.

3-32    2.  Mechanical restraint may be used on a person with a disability who

3-33  is a client and the provisions of subsection 1 do not apply if the mechanical

3-34  restraint is used to:

3-35    (a) Treat the medical needs of a client;

3-36    (b) Protect a client who is known to be at risk of injury to himself

3-37  because he lacks coordination or suffers from frequent loss of

3-38  consciousness;

3-39    (c) Provide proper body alignment to a client; or

3-40    (d) Position a client who has physical disabilities in a manner prescribed

3-41  in the client’s plan of services.

3-42    3.  If mechanical restraint is used on a person with a disability who is a

3-43  client in an emergency, the use of the procedure must be reported as a

3-44  denial of rights pursuant to NRS 433.534, regardless of whether the use of

3-45  the procedure is authorized by statute. The report must be made not later

3-46  than 1 working day after the procedure is used.

3-47    4.  The provisions of this section do not apply to a forensic facility, as

3-48  that term is defined in subsection 5 of section 1 of this act.

 

4-1    Sec. 6.  This act becomes effective upon passage and approval.

 

4-2  H