Client Rights

PURPOSE:

To provide clients with written documentation regarding their rights with respect to HIPAA, freedom from abuse, financial or other exploitation, retaliation, humiliation, and neglect.  To provide information to persons served in sufficient time to facilitate their decision making, their own records, informed consent or refusal and expression of choice regarding:

• Service delivery
• Release of Information
• Concurrent Services
• Composition of service delivery team
• Involvement in research projects

To provide clients access or referral to legal entities for appropriate representation, self-help support services and advocacy support services. a designated Client Rights Officer for the investigation and resolution of alleged infringement of rights.

To adhere to research guidelines and ethics when persons served are involved, investigation and resolution of alleged infringement of rights and other legal rights.

POLICY:

Each client shall be communicated with in a manner that is meaningful to the person served prior to the beginning of services and annually for persons served longer than one year.  This shall be available at all times for which the facility is open, for review and clarification.  Each client will be oriented to the program services and activities, expectations, hours of operation, access to after-hour services, code of ethics, and any requirements for follow-up for mandated persons served regardless of his/her discharge outcome.  Each client shall read and sign a statement delineating his/her rights prior to the initiation of treatment, and understand the ramifications around his/her treatment and give written consent.

PROCEDURES:

1. Upon entry to McKinley Hall for evaluation, assessment and/or treatment, each new client is informed of his/her rights that include the following:
   1. The right to be informed of the rights described in this rule prior to consent to proceed with services, and the right to request a written copy of these rights;
   2. The right to receive information in language and terms appropriate for the person’s understanding; and
   3. The right to be fully informed of the cost of services.
   4. The right to be treated with consideration, respect for personal dignity, autonomy, and privacy,
   5. The right to receive humane services;
   6. The right to participate in any appropriate and available service that is consistent with an individual treatment plan, regardless of the refusal of any other service, unless that service is a necessity for clear treatment reasons and requires the person’s participation;
   7. The right to reasonable assistance, in the least restrictive setting; and
   8. The right to reasonable protection from physical, sexual and emotional abuse, inhumane treatment, assault, or battery by any other person.
   9. The right to a current treatment plan that addresses the needs and responsibilities of an individual that specifies the provision of appropriate and adequate services, as available, either directly or by referral
   10. The right to actively participate in periodic treatment plan reviews with the staff including services necessary upon discharge.
   11. The right to give full informed consent to any service including medication prior to commencement and the right to decline services including medication absent an emergency;
   12. The right to be advised of and refuse observation by techniques such as one-way vision mirrors, tape recorders, televisions, movies, or photographs, or other audio and visual technology. This right does not prohibit an agency from using closed-circuit monitoring to observe seclusion rooms or common areas, which does not include bathrooms
   13. The right to decline any hazardous procedures.
   14. The right to be free from restraint or seclusion unless there is imminent risk of physical harm to self or others.
   15. The right to reasonable privacy and freedom from excessive intrusion by visitors, guests and non-agency surveyors, contractors, construction crews or others.
   16. The right to confidentiality unless a release or exchange of information is authorized and the right to request to restrict treatment information being shared; and
   17. The right to be informed of the circumstances under which an agency is authorized or intends to release, or has released, confidential information without written consent for the purposes of continuity of care.
   18. The right to have the grievance procedure explained orally and in writing, the right to file a grievance, with assistance if requested; and the right to have a grievance reviewed through a grievance process, including the right to appeal a decision.
   19. The right to receive services and participate in activities free of discrimination on the basis of of race, ethnicity, age, color, religion, gender, national origin, sexual orientation, physical or mental handicap, developmental disability, genetic information, human immunodeficiency virus status, or in any manner prohibited by local, state or federal laws.
   20. The right to exercise rights without reprisal in any form including the ability to continue services with uncompromised access. No right extends so far as to supersede health and safety considerations.
   21. The right to have the opportunity to consult with independent specialists or legal counsel, at one’s own expense.
   22. No agency employee may be a person’s guardian or representative if the person is currently receiving services from said facility.
   23. The right to have access to one’s own psychiatric, medical or other treatment records, unless access to particular identified items of information is specifically restricted for that individual client for clear treatment reasons in the client’s treatment plan. If access is restricted, the treatment plan shall also include a goal to remove the restriction.
   24. The right to be informed in advance of the reason (s) for discontinuance of service provision, and to be involved in planning for the consequences of that event.
   25. The right to receive an explanation of the reasons for denial of service.
2. The client, at entry, receives a copy of the Client Rights Policy and Procedures, a copy of the Clients Right and Confidentiality Regulations, program rules, events, or attitudes that may lead to the loss of privileges, which is also reviewed orally.
3. The client will be given education regarding advanced directives (if in residential treatment).
4. The client will be given information regarding transition criteria and procedures.
5. An explanation of the risks and benefits of treatment is discussed with the client.
6. After discussion of the risks and benefits and the contents of the Client Consent Form the clients are asked to sign the form, indicating that it has been explained to them and agree to the evaluation, assessment, and/or treatment at McKinley Hall.
7. The client’s right to refuse treatment is reaffirmed and the client is made aware of the implications and potential consequences for refusing or withdrawing from treatment.
8. The client is informed that an effort to develop alternative approaches in a collaborative manner should occur if deemed necessary.
9. In an emergency situation the client or applicant will be verbally advised of his/her right to consent or refuse the offered treatment and the consequences of that agreement or refusal
10. Clients receiving McKinley Hall’s information and referral services, consultation services and community support services will receive a copy and explanation of the Clients Rights Policy upon request.
11. All staff, including administrative, clinical and support staff shall be fully knowledgeable about the Client Rights policy and Grievance procedure. Client rights training for staff will be conducted and documented by the Client Rights Officer at time of hire.  Updates will be provided in general staff meetings.
12. The program will regularly evaluate the restriction of services.
13. An annual review of formal complaints, grievances, and appeals is conducted to determine trends, and areas needing performance improvement.

Additional specific rights, or clarifying wording of rights noted above, are listed below:

1. The right to be informed of the counseling approaches used at McKinley Hall which are most often psycho-educational in nature, based upon a cognitive behavioral theory that is demonstrated to work well. McKinley Hall also stresses the use of AA, NA, and other 12 step groups; the social support offered there works well in conjunction with CBT. Any other approaches used will be described prior to use.
2. The right to be informed that McKinley Hall is certified to operate as an integrated mental health alcohol and drug addiction program (Outpatient #1039; Women’s Outpatient Program # 2578; Men’s Residential #3271). The Ohio Department of Mental Health and Addiction Services (OhioMHAS) standards apply.
3. The right to receive treatment by staff credentialed for the services they offer. Each client will receive a list of the staff and their credentials, and be assured that each therapist is supervised by a credentialed supervising counselor.
4. The right to know that information about one’s case may be exchanged amongst staff as needed for clinical care decision making and supervision.
5. The right to receive treatment by staff whose care is directed by codes of professional ethics that guide service delivery decisions, in addition to statutory rules. Each client will be provided with a copy of the McKinley Hall Code of Organizational Ethics.
6. The right to know that McKinley Hall’s non-discriminatory policy (noted above section (s)) extends specifically to the following as well, to include: creed, sexual orientation, physical or mental handicap, developmental disability, inability to pay, and AIDS related complex.
7. The right to receive a copy of the agency’s policy on client’s rights.
8. The right of freedom from: abuse, financial or other exploitation, retaliations, humiliation, or neglect.
9. The right to a guarantee that the agency will adhere to research guidelines and ethics if a client is involved in such research.