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.