A. Rights in the
service delivery environment refer to a set of fundamental assurances and
protections which people have when accessing and utilizing services at
DMH-certified providers. These rights are based on such principles as dignity,
respect, autonomy, and non-discrimination and are also often based in
applicable law(s). These rights cover various aspects such as informed consent,
privacy, access to care, quality care, participation in choices and
decision-making, confidentiality, freedom from harm, dignity and respect, and
the opportunity to voice needs and concerns. The aim of these rights is to
ensure that people receiving services at DMH-certified providers have their
rights defined, communicated, supported, and protected and that their
well-being is at the forefront of their care.
DMH-certified agencies are required to outline, communicate,
and implement the rights of people being served at their agencies.
DMH-certified providers must include in the agency's written policies and
procedures the rights of persons served.
There must be written documentation in the person's record
that each person receiving services and/or parent(s)/legal representative(s) is
informed of the person's rights while receiving services, at intake and at
least annually thereafter if the person continues to receive services. The
person receiving services and/or parent(s)/legal representative(s) must also be
given a copy of these rights.
At a minimum, the rights of people served by the agency
provider should address all applicable current laws and should, as appropriate,
include the following rights-driven tenets. These rights are applicable to all
people receiving services except for people who have been civilly committed or
people who are confined to a correctional facility. Within the context of the
rights listed below, people who have been involuntarily civilly committed to
treatment or who are confined to a correctional facility should be afforded all
rights and protections awarded to them, as per applicable current law(s)
pertaining to the civil commitment process and correctional facility
policy.
Rights - Accessibility and Availability
1. The right to service provision regardless
of cultural barriers and/or Limited English Proficiency. Additionally,
information about rights should be provided in a manner that is understandable
to people receiving services who have challenges with vision, hearing,
language, and/or cognition.
2. The
right to access services that support the person to live, work, and participate
in the community to the maximum extent of the person's capability.
3. The right to availability of the
service(s) for which the provider is certified by DMH, based on available
capacity and appropriate eligibility and/or diagnosis.
4. Documents or information vital to the
ability of a person receiving services to access services (e.g., registration
forms, sliding scale fee discount schedule, after-hours coverage, signage) are
available online and in paper format, in languages commonly spoken within the
community served, taking account of literacy levels and the need for
alternative formats. The right to be referred to other agency provider services
and supports in the event the agency provider is unequipped or unable to serve
the person.
Rights - Dignity, Respect, and Autonomy
5. The right to services and choices, along
with service rules and regulations, that support person-centered,
recovery-oriented, and resiliency-based services and supports.
6. The right to request or refuse
treatment/services. This right must not be construed as a mechanism to demand
the provision of treatment or services which are not deemed medically
necessary, or which are otherwise inappropriate.
7. The right to considerate, respectful
treatment from all employees, interns, and volunteers of the agency
provider.
8. The right to involve
or not involve family and/or others is recognized and respected, except as
outlined in applicable law(s).
9.
The right to receive services and supports in a culturally and linguistically
competent and culturally sensitive manner.
Rights - Safe, Harm-Free Service
Provision
Persons receiving services and supports from DMH-certified
providers have the right to safe, harm-free services/supports provision,
including, but not limited to the following:
10. The right not to be subjected to corporal
punishment.
11. The right to be
free from all forms of abuse or harassment.
12. The right to be free from restraints of
any form that are not medically necessary or that are used as a means of
coercion, discipline, convenience, or retaliation by employees. The "Use of
Restraints and Time Out and Seclusion" rule in this chapter should be reviewed
for additional information.
13. The
right to be informed of any hazardous side effects of medication prescribed by
medical personnel.
14. The right to
be free from time out, unless utilized in Crisis Residential Services,
according to the parameters for use of time out outlined in "Use of Restraints
and Time Out and Seclusion" in this chapter and Chapter 19.
15. The right to be free from seclusion
unless utilized in Crisis Residential Services, according to the parameters for
use of seclusion outlined in "Use of Restraints and Time Out and Seclusion" in
this chapter and Chapter 19.
16.
The right to have a family member/representative of the person's choice
notified promptly (within no more than four [4] hours) of admission to a
hospital.
17. The right to receive
care in a safe setting and in an environment that is person-centered and
promotes recovery and resiliency.
18. The right not to be required to do work
for the provider. A person receiving services cannot be required to do work
which would otherwise require payment to agency provider employees. For work
done, wages must be in accordance with local, state, and federal requirements
(such as the provision of Peer Support Services by a Certified Peer Support
Specialist Professional), or the agency provider must have a policy that the
people do not work for the agency provider.
Rights - Non-discrimination and Advocacy
19. The right to voice opinions,
recommendations, and to file a written grievance which will result in agency
provider review and response without retribution.
20. The right to non-discrimination, as
outlined in federal laws pertaining to non-discrimination
protections.
21. The right to have
reasonable access to the clergy, spiritual advisors/advocates, and/or other
advocates, based on the person's choice.
22. The right to access legal counsel and the
ability to retain all Constitutional rights, except as restricted by due
process and resulting court order.
23. The right to enjoy the privileges of all
applicable federal and state laws pertaining to services/supports participation
and the receipt of services and supports.
Rights - Informed Consent, Participation, and Decision
Making
24. The right of the
person being served to review their records, except as restricted by law, and
the right to access information contained in the record within a reasonable
time frame, except as restricted by law. (A reasonable time frame is within
five [5] business days; if it takes longer, the reason for the delay must be
communicated and documented in the service record). Additionally, any such
restriction, as is allowed for by law, should be documented in the service
record by the appropriately licensed professional, according to the applicable
scope of practice.
25. The right to
participate in and receive a copy of the individual plan, except as may be
restricted by law, which must be documented in the service record by the
appropriately licensed professional, according to the applicable scope of
practice.
26. The person's right to
make informed decisions regarding their care and services, including being
informed of their health status (when applicable), and being involved in
care/service planning and treatment.
27. The right to engage in planning,
development, delivery, and the evaluation of the services a person is
receiving, and the right to be involved in the service planning and to make
choices about their everyday life, including daily routines and schedules, to
the maximum extent possible.
Rights - Privacy and Confidentiality
28. The right to all privacy and
confidentiality protections afforded by applicable laws. These include, but are
not limited to, the requirements of the Health Insurance Portability and
Accountability Act (HIPAA).
29. The
provider should address in the agency's rights policies and procedures concepts
pertaining to the following: the right to have visitors of the person's
choosing, to the greatest extent possible, including that visitation rights
cannot be withheld as punishment or in any other manner that unreasonably
infringes on the person's stated rights; and, the right to private
communication (phone, mail, email, etc.) without hindrance, unless clinically
contraindicated.
