MO SB828

Repeals and replaces section 630.175, RSMo, governing use of restraint, isolation, and seclusion in mental health facilities and residential programs operated or licensed by the department.

Allows advanced practice registered nurses (APRNs) in collaborative practice with a physician to authorize restraint, isolation, or seclusion when immediately necessary to protect health and safety, with physician review required within specified time limits.

Requires physician in-person review of APRN restraint orders within 4 hours for patients under 18, within 8 hours for patients 18 and older, and when cumulative restraint exceeds 4 hours in 24 hours for minors or 8 hours in 24 hours for adults.

All uses of physical or chemical restraint, isolation, or seclusion must be documented in the clinical record with signature of the facility head, attending physician, or attending APRN.

Excludes security escort devices used during transport and extraordinary disaster safety measures from the definition of physical restraint, though such devices require authorization for civil detainees and are presumed necessary for those committed under criminal statutes unless determined otherwise.