Compilation of Rules and Regulations of the State of Georgia
Department 82 - DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Chapter 82-5 - PATIENT'S RIGHT
Subject 82-5-1 - PATIENT'S RIGHT
Rule 82-5-1-.03 - Treatment
Universal Citation: GA Rules and Regs r 82-5-1-.03
Current through Rules and Regulations filed through September 23, 2024
(1) Appropriateness.
(a) General. Each individual shall receive care and treatment that is suited to the individual's needs in the least restrictive environment available offering appropriate care and treatment.
(b) Individual Service Plans.
1. The examination of individuals shall be governed as follows:
(i) For individuals being treated pursuant to O.C.G.A. Chapters 37-7 and 37-3, each individual shall be assessed by the staff as soon as possible after admission, but within the time limits contained within O.C.G.A. Chapters 37-7 and 37-3, or 48 hours, whichever comes first;
(ii) Admissions to facilities may no longer take place under O.C.G.A. Chapter 37-4.
2. The development of an individualized service plan shall be governed as follows:
(i) For persons being treated in a hospital pursuant to O.C.G.A. Chapters 37-7 and 37-3, staff shall develop an individualized service plan for each individual as soon after the initial assessment as practicable, but within the time limits contained within O.C.G.A. Chapters 37-7 and 37-3 or 10 days, whichever comes first;
(ii) Admissions to facilities may no longer take place under O.C.G.A. Chapter 37-4.
3. Each individualized service plan shall be reviewed at regular intervals to determine the individual's progress toward the stated goals and objectives of the plan and to determine whether the plan should be modified because of the individual's present condition. These reviews should be based upon relevant progress notes in the individual's clinical record and upon other related information. Information from the individual and other sources, including family members, should be obtained and utilized where feasible. Reviews should be conducted as required by applicable standards such as those required by Medicare, Medicaid, and the Joint Commission.
(c) Physical Restraints, and Seclusion.
1. Seclusion may not be used with individuals who are served by a DBHDD ICF/IID facility. Use of physical restraints in a DBHDD ICF/IID must comply with the requirements of the State Operations Manual of the Centers for Medicare and Medicaid Services, Appendix J; relevant federal regulations; and O.C.G.A. §
37-4-124.
2. Other use of seclusion or restraint under these regulations shall only be accomplished in a manner that complies with the requirements of the State Operations Manual of the Centers for Medicare and Medicaid Services, Appendix A; relevant federal regulations; O.C.G.A. §
37-3-165; and O.C.G.A. §
37-7-165.
3. "Time-out" means a situation in which an individual is placed in a room from which egress is prevented. This definition applies only for an individual admitted pursuant to Chapter 37-4. A time-out is permitted only if all of the following conditions are met:
(i) the placement is a part of an approved systematic time-out (emergency placement of an individual into a time-out room is not allowed under these regulations); and
(ii) the individual is under the direct, constant visual supervision of designated staff; and
(iii) the door to the room is held shut by staff, or by a mechanism requiring constant physical pressure from a staff member to keep the mechanism engaged.
4. The Department shall establish and maintain policies that set forth the manner in which Department staff will comply with these requirements.
(2) Participation of Individual.
(a) Access to information. Each individual and the individual's guardian (if applicable and not prohibited by law), or in the case of a minor individual the individual and the individual's parent(s) (unless prohibited by law), shall:
1. have the right to review the individual's own medical records subject to conditions in §
82-5-1-.06(3) of these regulations, the right to be told their diagnosis, and the right to be consulted and informed about the treatment recommendation and any risk involved;
2. have the right to be fully informed about the individual's medication, including its side effects and available treatment alternatives; such disclosures shall be made unless the disclosure to the individual is determined by the chief medical officer, the Regional Hospital Administrator, or the individual's treating physician to be detrimental to the individual's physical or mental health and unless a notation to that effect is made part of the individual's record; and
3. have the right to be so informed about matters related to the individual's treatment or habilitation, as required or allowed under these regulations, to the fullest extent possible in a manner that is commensurate with the individual's, guardian's, and/or parent's abilities of comprehension and understanding; such information shall not be withheld from a guardian or parent of a minor child in cases in which disclosure is to be made to that person.
(b) Consent to Medical Treatment and Involuntary Administration of Psychotropic Medication. The Department shall recognize the personal physical integrity of all individuals and their rights to consent to or refuse medical treatment.
1. No treatment of any kind shall be administered by the Department to an individual if that individual refuses the treatment prior to the treatment, except that:
(i) Psychotropic medication may be administered without the consent of the individual or other person where a physician determines that refusal would be unsafe to the individual or others. If the individual continues to refuse medication after such initial emergency treatment, a concurring opinion from a second physician must be obtained before medication can be continued without the individual's consent. Additionally:
(I) All psychotropic medications shall be used solely for the purposes of providing effective treatment and protecting the safety of the individual and other persons and shall not be used as punishment or for the convenience of staff; and
(II) The Department shall establish and maintain policies that set forth the manner in which Department staff may administer psychotropic medication in compliance with state and federal law in cases where and individual does not consent to administration of such medication.
(ii) For an adult individual who has been judicially determined to be incompetent to give consent or make decisions of a similar nature, consent for treatment shall be obtained from the individual's guardian with capacity to make such decisions, provided the individual does not refuse to consent to medical treatment; however, nothing in this subsection should be construed as to abridge any rights of an individual 18 years of age or over to refuse to consent to medical treatment as to his own person. If the individual is a minor, consent shall be obtained from the minor's parent or guardian.
(iii) In the absence of a guardian of an adult, if there is a determination in the medical record by a licensed physician after the physician has personally examined an adult that the adult lacks sufficient understanding or capacity to make significant responsible decisions regarding his or her medical treatment or the ability to communicate by any means such decisions, consent shall be obtained from a surrogate who is authorized under Georgia law to consent to such treatment.
(iv) When treatment is being provided by an outside provider, the responsibility for determining capacity of the individual to consent, and subsequently obtaining consent, lies with the outside provider.
(v) When the treatment for which consent is sought is not standard psychiatric treatment, the consent obtained from the persons listed in this section shall not be sufficient to authorize the treatment unless court approval is also obtained after a hearing. Standard psychiatric treatment shall not include insulin coma or psychosurgery.
(vi) In cases of grave emergency where the medical staff of the facility determines that immediate surgical or other intervention is necessary to prevent serious physical consequences or death, and where delay in obtaining consent would create a grave danger to the physical health of the individual as determined by at least two physicians, then essential surgery or other intervention may be administered without the consent of the individual or other person. In such cases, a record of the determination of the physicians shall be entered into the medical records of the individual and this will be the prior consent for such surgery or other intervention. Such consent shall be valid notwithstanding the type of admission of the individual, and it shall also be valid whether the individual has been adjudicated incapacitated pursuant to O.C.G.A Title 29. Actual notice of any action taken pursuant to this section shall be given to the individual and the spouse, next of kin, attorney, guardian, or representative of the individual as soon as practicable.
(3) Participation of Representative.
(a) Two representatives shall be appointed for each individual whose rights are the subject of these regulations. If two representatives cannot be located, a guardian ad litem shall be requested from the Court by the relevant facility. Appointments shall be made in accordance with Rule .07 of this Chapter.
(b) The Department shall establish and maintain policies that set forth the rights and responsibilities of representatives and of individuals with regard to their representatives in a manner that complies with O.C.G.A. Title 37, Chapters 3, 4, and 7.
(4) Private Physician.
(a) If an individual is able to secure the services of a private physician who is not on the medical staff of the facility, the individual shall have the right to have that physician visit the individual at the inpatient facility. The individual or the individual's guardian, parent, or other surrogate, if applicable, shall sign a written form indicating the name, telephone, and address of the private physician and requesting that the physician be allowed to make such visits. Thereafter, the private physician shall be allowed to visit the individual at the inpatient facility at any reasonable time, and subject only to other reasonable regulations. The staff shall require the private physician to produce proper identification and proof of current certification as a physician upon the initial visit and thereafter as necessary. The private physician shall be provided a private area in which to examine and consult with the individual. Upon the individual's written authorization, the private physician shall be allowed to examine the individual's clinical record.
(b) As such an examination by a private clinician is required by law, a private clinician who examines an individual in a facility of the Department under this provision is not required to be credentialed by the facility where the examination takes place.
O.C.G.A. §§ 37-1-23, 37-1-40, 37-1-41, 37-3-2, 37-4-3, 37-7-2, 37-3-43, 37-7-43, 37-3-85, 37-4-44, 37-7-85, 37-4-124, 37-3-165, 37-7-165, 37-3-162, 37-4-122, 37-7-162, 37-3-167, 37-4-126, 37-7-167, 37-3-163, 37-4-123, 37-7-163, 31-9-1 et seq., 37-3-147, 37-4-107, 37-7-147.
Disclaimer: These regulations may not be the most recent version. Georgia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
