DHHS, clinicians say SB 501 brings seclusion and restraint law into federal alignment; committee asks about rules and reporting

Sen. Sue Prentiss introduced SB 501 to authorize advanced practice registered nurses (APRNs) and physician associates, in addition to physicians, to order seclusion or restraint during a personal safety emergency in specified mental health facilities. She said the change would amend RSA 135‑C and align state law with federal regulation (42 CFR 482.13).

Rosemary Wyant, an attorney with DHHS and general counsel for New Hampshire Hospital, and Megan Thompson, lead APRN at the New Hampshire Hospital, explained seclusion and restraint are last‑resort interventions used to ensure immediate physical safety. They told the committee that in practice APRNs currently are treating providers but that rule language requires obtaining a physician order; the bill would allow the licensed treating practitioner to order an emergency intervention and would not change established reporting, review and documentation protocols (including daily review and CMS/Joint Commission oversight).

Members asked whether current statute already authorized physician orders or whether rules had implemented that practice; DHHS counsel said much of the operational approach is currently in rule, and the bill would codify and clarify authority in statute to reduce conflicts and align with federal standards. Committee members also discussed safeguards — immediate action by trained staff is permitted, but extended use requires a written order by an authorized licensed practitioner and structured reporting and review.

The public hearing closed with departmental clarifications that the change is focused on designated receiving facilities that admit involuntary patients, and that the department uses APRNs as treating providers at the state hospital. No committee vote was recorded at the hearing.