Recipient Rights Training

1. Recipient Rights Training General Staff Orientation Darlene J. LoPresto, Rnc, BSN Office of Recipient Rights

2. Educational Objectives Increase knowledge in the following areas: • Where do Rights come from? • Basic Rights • Rights Office purpose • Contacting the Rights Office

3. Where Do Recipient Rights Come From? • The United States Constitution • Federal Statutes • State Constitution • State Statutes • Mental Health Code • Administrative Rules • Case Law • Contractual Requirements

4. Recipient’s Personal & Treatment Rights • Voting • Treatment suited to condition • Freedom of movement • Individualized person centered planning • To receive services in safe, sanitary, and humane environment • To be free from abuse and neglect • To be treated with dignity and respect • Confidentiality

5. Recipient’s Personal & Treatment Rights continued: • To send and receive mail • To know what things are restricted and limitations • To have their own property • To include persons of their choice in treatment planning • To review their record

6. Recipient Privileges • Driving • Watching TV • Smoking

7. Responsibilities of the ORR What does the Recipient Rights Office Do? • Consultation • Site reviews • Training/Education • Complaint investigation/resolution • Policy development & review • Notify BHU Director of inappropriate practices • Complies and submits required reports to the State

8. MHC 330.1722 • A recipient of mental health services shall not be subjected to abuse or neglect. • The department shall ensure that appropriate action is taken against those who have engaged in abuse or neglect. • A recipient of mental health services who is abused or neglected has a right to pursue injunctive and other appropriate civil relief.

9. Definition of Abuse • Abuse, Class I: A nonaccidental act or provocation of another to act by an employee, volunteer, or agent of a provider that caused or contributed to the death, or sexual abuse of, or serious physical harm to a recipient. • Abuse, Class II: A) A nonaccidental act or provocation of another to act by an employee, volunteer, or agent of a provider that caused or contributed to nonserious physical harm to a recipient. B) The use of unreasonable force on a recipient by an employee, volunteer, or agent of a provider with or without apparent harm, C) Any action or provocation of another to act by an employee, volunteer, or agent of a provider that causes or contributes to emotional harm to a recipient, D) An action taken on behalf of a recipient by a provider who assumes the recipient is incompetent, despite the fact that a guardian has not been appointed, that results in substantial economic, material, or emotional harm to the recipient. E) Exploitation of a recipient by an employee, volunteer, or agent of a provider.

10. Definition of Abuse cont. • Abuse, Class III: The use of language or other means of communication by an employee, volunteer, or agent of a provider to degrade, threaten, or sexually harass a recipient.

11. Definitions of Neglect • Neglect, Class I: means either: • Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by law and/or rules, policies, guidelines, written directives, procedures, or individual plan of service and causes or contributes to the death, or sexual abuse of, or serious physical harm to a recipient. B) The failure to report apparent or suspected abuse Class I of neglect Class I of a recipient.

12. Definitions of Neglect • Neglect, Class II: means either : • Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by laws, rules, policies, guidelines, written directives, procedures, or individual plan of service and that cause or contribute to non serious physical harm or emotional harm to a recipient. B) The failure to report apparent or suspected abuse Class II or neglect Class II of a recipient.

13. Definitions of Neglect • Neglect, Class III: means either: • Acts of commission or omission by an employee, volunteer, or agent of a provider that result from noncompliance with a standard of care or treatment required by law and/or rules, policies, guidelines, written directives, procedures, or individual plan of service that either placed or could have placed a recipient at risk of physical harm or sexual abuse. B) The failure to report apparent or suspected abuse Class III or neglect Class III of a recipient.

14. Why Report? • A person employed by Hillsdale Community Health Center who has reasonable cause to suspect abuse or neglect of a patient shall immediately contact the Office of Recipient Rights at (517) 437-1725 (this line is confidential). • As an employee, reporting of the above is mandatory under several Michigan laws.

15. Decreasing Complaints • Smile: No whining after exiting your car. If you feel cranky tell someone. It often makes you feel lees so. • Decrease response time: Tell people when you will get back to them and then follow through. • Answer all questions as if it were the first time: No one needs to be told that they have asked that questions 5 minutes ago- this is humiliating. • Do not send people away from the desk without explanation. • Look people in the eye when speaking with them- this builds trust. • Advocate for your patients! • Remember: every patient deserves to be treated with dignity and respect.

16. Terms to Know • Confidentiality: recipients have the right to have their medical chart private • Civil Rights: this is guaranteed to all US citizens. Recipients have the right to religious expression, to vote, and not to be discriminated against. • Sexual Harassment: includes sexual advances, gestures, or requests for sexual favors by staff towards recipients. • Dignity & Respect: Do not be rude, sarcastic, or impolite to recipients. • Informed consent: this is obtained from the recipient in order to release information, provide treatment, and administer psychotropic medication.

17. Terms to Know • Preponderance of Evidence: this is based upon an idea of greater weight of credibility of the evidence in determining if it is more likely that something occurred than not. This exists to substantiate any allegation in a complaint investigation. • Mental Health Code: this is the chapter of law outlining recipient rights and appeals. It was compiled in 1974 and revised in 1996 then effective in 2005. A copy is available on the unit for all staff. • Failure to Report: Avoid this by reporting any incident that compromises safety or well being of a recipient through abuse or neglect. • Unreasonable Force: this is physical management or force that is applied by staff towards a recipient were the is no immediate risk of physical harm to self or others. We must use physical management techniques, plan of service, and least restrictive measures.

18. Conclusion • Questions/Comments? • Contact number: 437-1725 • ORR Contact Name: Darlene LoPresto