16.50-Patients_Rights.doc

PATIENTS' RIGHTS

POLICY NO. 16.50

Colorado Mental Health Institute at Pueblo

POLICY MANUAL

SECTION - PATIENTS' RIGHTS

POLICY NO.16.50 16.50

Effective Date: 5/8/13

TITLE:

PATIENTS' RIGHTS

REF NAME \* MERGEFORMAT PATIENTS' RIGHTS

This replaces policy 16.50, dated 2/1/11.

I.

macrobutton update PURPOSE/DEFINITION It is the policy of CMHIP to provide care and treatment that is skillfully and humanely delivered, with respect for the patients’ dignity and privacy and in compliance with constitutional, civil and statutory rights, and that all staff are advised of patients’ rights and are provided the guidance to assist staff in upholding these rights.

The purpose of this policy is to describe the rights of patients at CMHIP.

II.

ACCOUNTABILITY

Individuals responsible for implementing this policy are staff in the Office of Patient and Consumer Relations, and all CMHIP staff. All staff is responsible for protecting and advocating for the rights of patients.

III.

PROCEDURE

A. Patients’ Rights

1.

TREATMENT: CMHIP believes that when a patient participates in treatment planning decisions and understands the treatment options he/she has, a patient will achieve better results. The physician will explain procedures and medications that will be offered, including benefits, risks, potential side effects, and alternatives to this treatment. A patient has the right to participate in planning where he/she will live, and where he/she may get treatment after discharge from CMHIP, when possible. A patient has the right to be given the names and the professional status of the staff members responsible for his/her care. Patients have the right to be informed that CMHIP is a teaching hospital and provides intern opportunities for a number of disciplines.

2.

NO DISCRIMINATION: A patient has the right to treatment that is not based on or influenced by age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression. CMHIP does not discriminate on the basis of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression. The ban on discriminatory practices extends to a patient’s visitors. The patient has the right to choose who may or may not visit him/her. If there is a restriction on visitation for clinical or other reasonable reasons, those reasons must be clearly explained to the patient (or personal representative). CMHIP will ensure that all visitors enjoy full and equal visitation privileges consistent with patient preferences.

3.

ATTORNEY: A patient has the right to retain an attorney and to consult with an attorney at any time. If a patient is here involuntarily for emergency evaluation and treatment, the court has appointed an attorney. If a patient is here involuntarily under a short-term or long-term certification for treatment, the court will appoint an attorney to advise and represent him/her in mental health proceedings, unless the court finds that the patient is able to engage an attorney at his/her own expense.

4.

REFUSAL OF TREATMENT: A patient has the right to refuse medication unless, due to mental illness, he/she poses an imminent danger to self or others, is gravely disabled or the court has ordered medications. A patient has the right to refuse any test, medical procedure or treatment unless his/her ability to make decisions is impaired or a life-threatening condition exists. A patient has the right to express his/her medical wishes through an Advance Directive. Within reasonable guidelines, CMHIP will honor a patient’s Advance Directive. (See CMHIP policies 6.25, Involuntary Psychiatric Medications and 8.50, Advance Directives.)

5.

INVOLUNTARY MEDICATION COURT PROCEEDINGS (See CMHIP policy 6.25, Involuntary Psychiatric Medications): Medication is a fundamental aspect of good psychiatric care. A patient shall expect to be educated about why medication is being prescribed for him/her, what symptoms are expected to change with medication, and potential side effects.

A physician may order involuntary medication on an emergency basis, without a hearing. If the emergency medications will continue beyond 72 hours, the physician will initiate an affidavit to request a court hearing for court ordered medication.

At the court hearing, the patient has the right to appear before a judge to present his/her case and voice objections to involuntary medication, with representation by an attorney at the hearing, if so desired.

6.

COURT PROCEEDINGS REGARDING DISCHARGE FROM HOSPITAL: Discharge proceedings for patients under commitments vary depending on the type of commitment. (a) If a patient is hospitalized at CMHIP under a short-term or long-term certification under Title 27, Article 65, C.R.S., the patient has the right to review of his/her certification or treatment by a judge or jury. A patient may ask the court to appoint an independent psychiatrist or psychologist to examine him/her and to testify at his/her hearing. (b) If a patient has been found not guilty by reason of insanity or impaired mental condition, the patient has the right to petition the court for release six months following the patient’s commitment, and annually thereafter. A patient may ask the court to appoint an independent psychiatrist or psychologist to examine him/her and to testify at his/her hearing. (c) If a patient has been found incompetent to proceed in a criminal case, he/she has the right to have his/her case reviewed every three months. (d) If a patient has been committed to the hospital for a sanity or competency evaluation, he/she will usually be returned to jail, or bond status, after the evaluation is complete. More information about patient’s rights regarding discharge is available from the patient’s attorney or from the Patients’ Legal Access Attorney, at extension 4378. There is no charge to a patient for assistance from CMHIP’s Patient Representative(s) or the Patients' Legal Access Attorney.

7.

CONFIDENTIALITY: A patient has the right to confidentiality of his/her treatment records, except as required by law. When a patient is admitted to CMHIP, he/she receives a written advisement regarding confidentiality rights under the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996. For additional information, patients may call the HIPAA Privacy Liaison at extension 4343. It is a violation of state criminal law for staff or patients to release any information about another patient's condition or treatment to anyone, unless the patient has authorized, in writing, the disclosure. See Section 18-4-412, C.R.S.

8.

VOTING: Those patients who are eligible to vote in elections have the right to vote by absentee ballot. Staff will assist patients with understanding and using the absentee voting process.

9.

ACCESS TO MEDICAL RECORDS: A patient has the right to review his/her medical records at reasonable times unless the physician determines that in doing so would present a risk of harm to himself/herself or others. A patient has the right to appeal the physician’s decision for this denial. (See CMHIP HIPAA Policy 14.46, Authorizations for Disclosure or CMHIP Policy14.41, Privacy Rights of Patients.)

10.

DAY-TO-DAY LIVING: If a patient is receiving care and treatment under any provision of the Colorado Care and Treatment of Persons with Mental Illness Act (Title 27, Article 65, C.R.S.), he/she has the statutory rights listed below. Even if a patient is not receiving care and treatment under the Care and Treatment Act, these provisions are applied to patients by CMHIP, regardless whether they have statutory rights. All patients will be treated according to the following rights or standards, and are entitled to receive help from the Patient Representatives to make sure they receive these benefits.

a.

TELEPHONES: A patient has the right to readily access telephones, both to make and receive calls in privacy.

b.

LETTERS: A patient has the right to receive and send sealed letters. No incoming or outgoing letters shall be opened, delayed, held or censored by the personnel of the facility. For the safety of the patient and staff, all incoming mail and packages are opened in the presence of a staff person, to prevent the introduction of dangerous or restricted items (“contraband”).

c.

WRITING MATERIALS: A patient has the right to access letter writing materials, including postage. A reasonable amount of postage and stationary will be provided to him/her. Staff are available to help patients write, prepare, or mail correspondence.

d.

VISITORS: Visitors are welcome. A patient has a right to frequent and convenient opportunities to meet with visitors. A patient may meet with his/her clergy, attorney, or physician at any time, but to expedite these visits, the visitor should notify staff prior to the visit. All units have certain regular days and times for visits. Staff will work with patients to schedule visits at times more convenient for their visitors. If staff cancels a scheduled family visit, they will document in the progress notes the reason for the cancellation.

e.

CLOTHING AND POSSESSIONS: A patient has the right to wear his/her own clothes, to keep and use his/her own possessions, and to keep and spend a reasonable sum of his/her own money. Personal items may be limited due to space, or for clinical or security reasons.

f. RESTRICTIONS: The statutory rights listed above concerning clothing, telephone use, visitation, personal items, and mail may be restricted for good cause by a psychiatrist providing treatment, but the patient must be given an explanation as to why the right is restricted. Restricted rights shall be evaluated for therapeutic effectiveness and re-ordered every seven days except in the Hawkins Building when restriction of rights may be based on the safety and security needs of the unit. The order for restriction shall be renewed every 30 days in such cases.

Additionally, rights may be restricted by court order or as otherwise provided by law.

g.

LEAST RESTRICTIVE ENVIRONMENT: A patient has the right to receive medical and psychiatric care and treatment suited to meet the patient’s individual needs and provided in the least restrictive environment. A patient has the right to be free from physical restraint and not be placed in seclusion against his/her will except in emergency situations or other limited situations allowed by law.

h.

TRANSFER TO OTHER HOSPITALS OR FACILITIES: If a patient is certified under Title 27, Article 65, C.R.S., he/she has the right to 24-hour notice before being transferred to another "27-65" designated facility, unless an emergency exists. A patient also has the right to protest to the court any such transfer, the right to notify whom he/she wishes about the transfer, and the right to have the facility notify up to two persons designated by him/her about the transfer.

i.

FINGERPRINTS: A patient committed under Title 27, Article 65, C.R.S., will not be fingerprinted, unless it is required by other provisions of law.

j.

PHOTOGRAPHS: A patient has the right to refuse to be photographed except for hospital identification purposes and the administrative purposes of the facility. Photographs shall be confidential and shall not be released except by court order, to law enforcement to address commission of a criminal act, or in the case of escape of persons committed as Not Guilty by Reason of Insanity (NGRI)/Impaired Mental Condition (IMC) or persons who have criminal charges pending, which includes Incompetent to Proceed (ITP) patients. In some common areas and seclusion rooms, video-surveillance may be used. Signs are posted to advise patients and staff of this surveillance.

k.

SIGNING IN VOLUNTARILY: A patient has the right to sign in voluntarily, unless reasonable grounds exist to believe he/she will not remain a voluntary patient. Persons under criminal court commitments may not sign in voluntarily.

l.

DUAL LEGAL STATUS: In cases where a patient is committed to CMHIP and is also committed to the custody of another institution, such as a county jail or the Department of Corrections (DOC), CMHIP may impose security procedures that are consistent with the security level of the facility from which the patient was admitted. These security procedures may limit the above rights. Security limitations are available in written form through the unit policies.

11.

GRIEVANCES: Patients are encouraged to discuss their care and treatment, and any difficulties they are having, with their treatment team. A patient also has the right to file a complaint about his/her care or treatment. Grievances or complaints can be submitted to any CMHIP staff person, including treatment unit staff, and to the CMHIP Patient Representative, CDHS Division of Behavioral Health, or the CDHS Client Rights Program Director for allegations of discrimination. Other agencies that accept and act on complaints by patients include the Colorado Department of Public Health and Environment, the Department of Regulatory Agencies, Office of Civil Rights/U.S. Department of Health and Human Services, and The Legal Center for People with Disabilities and Older People. On request from the patient, the treatment team or CMHIP Patient Representative will provide him/her telephone numbers and addresses for contacting these or other agencies. (See CMHIP policy 16.35, Patient Grievance Resolution Process.)

12.

PATIENT RESPONSIBILITIES: Patients are responsible for providing information, asking questions, following instructions, accepting consequences, following rules and regulations, showing respect and consideration, and meeting financial commitments. Patients are informed about their responsibilities verbally, in writing, or both, and through the “For Your Information” (FYI) handbook, which addresses the SpeakUp program.

B.

Patient Notification and Education About Rights

1.

Upon admission, a patient is provided a written list of rights in English or Spanish and the “For Your Information” (FYI) handbook. All patients will be provided an explanation of these rights in a language and by a means that the patient can understand.

2.

Rights will be posted in patient areas on each unit.

3.

The CMHIP Patient Representative's picture shall be posted on all units with information describing how he/she may be contacted.

4.

The right to complain or object to treatment and the procedure for doing so will be clearly posted on each unit.

a.

Grievance forms will be readily available to patients.

b.

If requested to do so by a patient, unit staff will assist in filing a grievance.

c.

The originals of grievance forms, including the resolution efforts made by the unit and CMHIP patient representatives and any review of these resolution efforts by the Superintendent’s Office or Division of Behavioral Health, shall be maintained by the Office of Patient and Consumer Relations for a period of ten years from the date that the patient submitted the grievance.

William J. May

Date

Superintendent