Those were just some of the legislature’s health and safety measures reported on by C-HIT during the year. The session, which ended last week, was largely dominated by budget and transportation issues.

Under the bills approved:

• Any prescriber supplying more than a 72-hour supply of a controlled substance must first review the patient’s record in a statewide database. In addition, practitioners must review the patient’s record at least every 90 days if prescribing for prolonged treatment. Doctors, advanced registered nurses, dentists and physician assistants are required to participate in continuing education on prescribing controlled substances and pain management.

The legislation, introduced by Gov. Dannel P. Malloy, aims to reduce occurrences of prescription drug addiction and overdoses tied to opioids and other substances. It also makes naloxone, a drug that treats overdoses, more widely available.

“Not only do we need to eliminate a lifetime of permanent punishment with our drug laws by giving people a second chance, but we also need to prevent addiction in the first place,” Malloy said in a statement. “By ensuring that health care professionals prescribing treatment are utilizing patient history data to help them make smart decisions, we’ll curb potential abuse.”

• The use of restraints and seclusion in schools to discipline children would be restricted to only emergencies, and for only 15 minutes in most cases. The measure also requires school staff to meet when a child is restrained or secluded four or more times in a 20-day span.

In each of the last three years, the state Department of Education has reported about 30,000 incidents of restraints or seclusion, with autistic students the most frequently subjected to the practices.

The state Office of the Child Advocate pushed for a policy change, saying that restraint and seclusion can be “traumatizing and ineffective for both students and staff.” In testimony, the child advocate’s office said that restraint and seclusion are harmful to children when used inappropriately, increase rather than decrease the likelihood of staff injury, and are less effective than therapeutic behavior interventions.

• Additional funding will be allocated for Emergency Mobile Psychiatric Services (EMPS), the statewide crisis intervention program for youth.

The current $9.4 million budget for EMPS will increase by $4.46 million in the next two years. The expansion funds include $1.91 million in the first year and $2.55 million during the second year, according to the state Office of Policy and Management. Last fiscal year, EMPS provided 12,376 instances of care – up 11.4 percent from the previous fiscal year.

Some advocates were concerned that demand for services would soon exceed the program’s capacity.

• The use of shackles on juveniles appearing in court will be limited. The change, originally proposed in bills introduced by Rep. Bruce Morris and Rep. Toni Walker of New Haven, was prompted by concerns that juveniles appearing in court were often shackled unless their attorneys asked that they not be. Legislation ultimately passed as part of a juvenile justice omnibus bill spearheaded by Walker.

Juveniles in court will be restrained – with handcuffs, leg irons and belly chains – only when a judge deems it necessary due to potential flight risk or other factors, said Marisa Mascolo Halm, director of the TeamChild Juvenile Justice Project at the Hartford-based Center for Children’s Advocacy.

“There’s a presumption of guilt if a child is coming into the courtroom with shackles on,” Halm said. Also, many juveniles in court have experienced trauma and being restrained can have “extremely negative” psychological impacts on them and inhibit them from communicating with their lawyers, she said.

“(The legislation) was something that folks really cared about and the juvenile justice community really cared about,” she said. “We feel like we accomplished a lot.”

• The Department of Veterans’ Affairs would be required to reach out to female veterans and make them aware of federal and state services that are available to them. It also requires the state to consider establishing programs for female veterans, but not funding is attached to the legislation.

A bill to increase the minimum assets to $50,000 that a spouse living in community can keep in order for his or her partner to be eligible for Medicaid nursing home care failed to get out of committee this year. The proposal to increase the minimum from $23,844 to $50,000, was introduced by Sen. Kevin Kelly of Monroe. It was lauded by advocates for the elderly, who said it would help spouses to afford to live independently, but opposed by the state Department of Social Services because it would increase Medicaid costs.

C-HIT writer Magaly Olivero contributed to this story.

The proposals are in response to advocates’ concerns that juveniles are often shackled when they appear in court unless their attorneys ask that the restraints, which can include handcuffs, leg irons and belly chains, be removed.

Morris, who chairs the General Assembly’s Black and Puerto Rican Caucus, said shackling is demeaning and can damage a child’s sense of self-worth. “It says, ‘I don’t trust you enough that you will honor the dignity of a court. You’re unmanageable,’” he said. “Is that a message we want to send? I say no.”

Photo Courtesy of Flordia public defender

Juvenile in leg chains.

Under current policy, juveniles are normally shackled when being transported from detention centers to the courthouse, and whether or not the restraints stay on in the courtroom depends on an assessment of the child’s behavior in detention. But advocates say the policy is not followed consistently.

“What I’ve heard from the public defenders is that unless they ask to have the shackles taken off, most of the time they don’t come off,” said Christine Rapillo, director of delinquency defense and child protection for the Connecticut Office of the Chief Public Defender, who supervises public defenders for juveniles.

“The legislation would essentially create a presumption that a child would not be shackled in a courtroom unless the court made an affirmative ruling,” said Marisa Halm, director of TeamChild Juvenile Justice Project at the Center for Children’s Advocacy.

But Judge Bernadette Conway, the chief administrative judge for juvenile matters for the state, said that in her experience presiding in juvenile court, previously in Middletown and now in New Haven, the policy is followed consistently. She said she had not heard of any cases in which juveniles remained shackled if the risk assessment did not warrant it.

“The marshals seem to have an understanding of the policy and it appears that the policy is being followed,” she said. “If it’s not being carried out, we need to correct that.”

“It has not come to our attention that standard operating procedure is shackled unless the lawyers request,” said Stephen Grant, the executive director of court support services for the judicial branch. The shackling policy has been modified significantly in recent years in response to concerns from advocates and public defenders, he said. According to data provided by the state, the proportion of juveniles fully restrained in court — with leg irons, handcuffs and belly chains — has declined significantly from 84 percent in 2012 to 23 percent in 2013. Over the same period, however, the number restrained with only leg irons increased from 14 percent to 52 percent, which means that 75 percent of juveniles were still restrained with at least leg irons.

Source: Court Support Services, Judicial Branch, State of Connecticut.

Social workers at the detention centers are responsible for screening children for risk of escape or dangerous behavior. “We did not want solely a custodial person—whose frame of reference is security—to make that decision,” but to have the assessment informed by social science, Grant said. “We’re very sensitive to not further traumatizing a kid whose life is in chaos. It’s a balance.”

Julian Ford, a professor of psychiatry and director of the Center for Trauma Recovery and Juvenile Justice at the University of Connecticut Health Center, said restraints can be especially traumatizing to juvenile offenders.

“Shackling is not only public embarrassment and physical restraint. It literally picks away at the youths’ ability to control their own bodies,” Ford said. “It reinforces the idea that they are viewed by society and the community as people who are bad and need to be restrained.”

That belief can be self-fulfilling, leading youths to view laws and social customs as irrelevant to them, he said. “Since children are still developing a self-concept and sense of their identity, shackling can change how they view themselves … It reinforces their own views of themselves as bad people.”

In addition, many juveniles have witnessed violence or suffered abuse, and shackling can reactivate traumatic memories, leading to anxiety, hostility and behavior problems.

“You’re unnecessarily causing trauma to the child,” Rapillo said. “We’re dealing with kids. It’s supposed to be a more rehabilitative system. It’s a place where you’re holding people accountable, but doing it in a way that’s going to turn them into productive citizens.”

The U.S. Supreme Court has ruled that shackling defendants in view of a jury violates the person’s presumption of innocence, among other rights, but in Connecticut juvenile cases are decided by judges, not juries. “When that child is appearing in front of the judge time and time again in shackles,” Rapillo said, “the argument is that it has the same impact on the presumption of innocence as an adult defendant appearing in front of a jury in shackles.”

In recent years, several states have changed their laws and policies to restrict shackling to cases where there has been a specific finding that restraints are warranted. In 2006, Miami-Dade County in Florida changed its policy after a successful challenge by public defenders. “Since then, more than 20,000 detained children have appeared before the court unbound, in proceedings that respected their dignity and fostered the goal of rehabilitation. In that time, no child has harmed anyone or escaped from court,” wrote public defender Carlos Martinez in “Unchain the Children: Five years later in Florida,” a report issued in 2011.

The practice can also threaten the confidentiality of juvenile court if the shackled children are visible in public. In the Danbury courthouse, because of the layout of the building, juveniles are brought through a public area on their way to the courtroom, said Sharon Elias, supervisory assistant public defender in juvenile court for Waterbury, Torrington and Danbury. “They are walking through public areas shackled,” she said. “When I first saw it, I was shocked.”

Morris, who is director of human relations at Norwalk public schools, said that in his experience, incentives for positive behavior work better for young people than punishment for bad behavior. Shackling is counterproductive to the mission of the juvenile court system, which is to correct bad behavior, he said.

“If I am going to get you on the right track, I have to demonstrate that I have hope and faith that you can change,” he said. However, “if your expectations of children are low, then they behave as such.”

To view Rep. Morris’ bill click here.

To view Rep. Walker’s bill click here.