(a) A person
admitted to the hospital for the purposes of receiving mental health services
shall be accorded the following:
(i) The
right to appropriate treatment and related services in a setting and under
conditions that:
PAT-5.2
(Addendum)
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(A) Are
most supportive of the persons personal liberty; and Patient Bill of Rights
Page Administrative Policies and Procedures 29 Jun 90
(B) Restrict such liberty only to the extent
necessarily consistent with the persons treatment needs, applicable
requirements of law, and applicable judicial orders.
(ii) The right to an individualized, written
treatment or service plan developed pursuant to and in compliance with
W.S.
25-10-113, including:
(A) The right to treatment based on such
plan;
(B) The right to periodic
review and reassessment of treatment and related service needs as required by
W.S. W.S.
25-10-116; and
(C) The right to appropriate revision of the
plan. Appropriate revision includes any revision necessary to provide a
description of mental health services that may be needed after the person is
discharged from the hospital or its program(s).
(iii) The right to ongoing participation, in
a manner appropriate to the persons capabilities, in the planning of mental
health services to be provided the person. This right of participation includes
the right to participate in the development and periodic revision of the plan
described in subsection (ii).
(A) In
connection with such participation, the right to be provided with a reasonable
explanation, in terms and language appropriate to a persons condition and
ability to understand, of:
(I) The persons
general mental condition and, if the program or the hospital has provided a
physical examination, the persons general physical condition.
(II) The objectives of treatment:
(III) The nature, duration, and significance
of possible adverse effects of recommended treatments.
(IV) The reasons why a particular treatment
is considered appropriate.
(V) Any
appropriate and available alternative treatments, services, and types of
providers of mental health services, including the right of the patient to seek
an opinion of an outside mental health professional (at the patient's own
expense).
(iv) The right not to receive a mode or
course of treatment established pursuant to the treatment plan, in the absence
of the persons informed, voluntary, written consent to such mode or course of
treatment, except treatment:
(A) During an
emergency situation if such treatment is pursuant to or documented
contemporaneously by the written order of a responsible mental health
professional; or
(B) As permitted
under applicable law in the case of a person committed by a court to the
hospital or its treatment program(s).
(v) The right not to participate in
experimentation in the absence of the persons informed, voluntary, written
consent.
(A) The right to appropriate
protections in connection with such participation. Appropriate protections
include the right to a reasonable explanation of the procedure to be followed,
the benefits to be expected, the relative advantages of alternative treatments,
and the potential discomforts and risks.
(B) The right and opportunity to revoke
consent to such participation.
(vi) The right to freedom from restraint,
seclusion, or other similar interventions which may be administered solely for
purposes of discipline, staff convenience, or as a substitute for a less
restrictive therapeutic treatment program.
(A) In the event of an emergency situation,
in which it is likely that patient's could harm themselves or others, and in
which less restrictive means of restraint are not feasible, patient's may be
physically restrained or placed in isolation only on a qualified mental health
professionals written order which explains the rationale for such
action.
(B) Restraint or seclusion
during an emergency situation shall not be ordered by a medical doctor who is
also not a qualified mental health professional.
(vii) The right to humane treatment
environment that affords a person reasonable protection from harm and
appropriate privacy with regard to personal needs.
(A) A humane treatment environment includes
the right to be free from any physical, verbal, sexual, financial, or
psychological abuse, exploitation, or punishment.
(B) Personal privacy and dignity shall be
protected.
(viii) The
right to confidentiality of the persons records, in accordance with W.S. W.S.
W.S.
25-10-122.
(ix) The right to access, upon request, to
the persons own mental health care records, except the person may be refused
access to:
(A) Information in the records
provided by a third party under assurance that such information will remain
confidential; and
(B) Specific
material in the records if the mental health professional responsible for the
mental health services concerned has made a determination in writing that
access would be detrimental to the persons health. However, such material may
be made available to a similarly licensed health professional selected by the
person, and the health professional selected may, in the exercise of
professional judgment, provide the person with access to any or all parts of
the specific material or otherwise disclose the information contained in the
material to the person.
(x) The right, in the case of a person
admitted on a residential or inpatient care basis:
(A) To converse with others
privately;
(B) To have convenient
and reasonable access to the telephone and to send and receive uncensored and
unopened mail; and
(C) To see
visitors during regularly scheduled hours.
(I) However, if a mental health professional
treating the person determines that denial of access to a particular person is
necessary for treatment purposes, the mental health professional may, for a
specific, limited, and reasonable period of time, deny access if the mental
health professional has ordered the denial in writing and the order has been
incorporated in the treatment plan for the person. A order denying access shall
include the reasons for denial.
(II) Any denial of access to a particular
person shall be reviewed by a qualified mental health professional at regular
intervals not to exceed seven (7) days.
(xi) Right of access to:
(A) A protection service within the hospital
through the Human Rights Committee;
(B) A protection system established by the
State of Wyoming through the state patient advocate;
(C) The system established under the
Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. SS
10801 et seq.), to protect and advocate the rights of mentally ill individuals.
This right of access includes opportunities and facilities for private
communication.
(xii) The
right to be informed promptly at the time of admission and periodically
thereafter, of the right described in this section.
(A) Such information shall be in language and
terms appropriate to the persons condition and ability to understand.
(B) Such information shall include patient's
right under the Fair Labor Standards Act, 42 U.S.C. SS 201 et seq., which
includes:
(I) The right to refuse to perform
services for the hospital;
(II) The
right to have the need or desire to work documented in the patient's individual
treatment plan in the event the patient chooses to perform services;
(III) The individual treatment plan shall
specify the nature of the services and whether the services are voluntary or
performed for compensation;
(IV)
The agreement to perform services may be terminated at any time.
(xiii) The right to
assert grievances with respect to infringement of the rights described in these
rules, including the right to have such grievances considered in a fair, timely
and impartial grievance procedure provided for by the hospital, in accordance
with Section 5(a) (iii) of these rules.
(xiv) The right to exercise the rights
described in this section without reprisal, including reprisal in the form of
denial of any appropriate, available treatment.
(xv) The right to referral, as appropriate,
to other providers of mental health services upon discharge.
(b) The rights described
in these rules shall be in addition to and not in derogation of any other
statutory or constitutional rights.
(i) The
right to confidentiality of and access to records described in provisions
designated (a)(viii) and (a)(ix) shall remain applicable to records pertaining
to a person after the persons discharge from the hospital or program(s), with
the following exception: Records and reports which are made under the
Hospitalization of Mentally Ill Persons Act (W.S. W.S.
W.S.
25-10-101 through
25-10-404) , and directly or
indirectly identify a patient, former patient, or person for whom an
application for hospitalization has been filed, may be provided without the
persons consent, if the records and reports as provided:
(A) By and between a mental health center,
the State Hospital and hospitals designated under W.S.
W.S.
25-10-104; and
(B) Only for the purpose of facilitating
referral treatment, admission, readmission or transfer of the patient under the
Hospitalization of Mentally Ill Persons Act.
(c) No otherwise eligible person will be
denied admission to the hospital or its program(s) for mental health services
as a reprisal for the exercise of the rights described in these rules.
(i) Nothing in these rules shall:
(A) Obligate an individual mental health or
health professional to administer treatment contrary to the professionals
clinical judgement;
(B) Prevent the
hospital or any of its programs from discharging any person for whom the
provision of appropriate treatment, consistent with the clinical judgement of
the mental health professional primarily responsible for the persons treatment,
is or has become impossible as a result of the person's refusal to consent to
the treatment.
(C) Require the
hospital or any of its programs to admit any person who, while admitted on
prior occasions to such program or facility, has repeatedly frustrated the
purposes of admission by withholding consent to proposed treatment;
or
(D) Obligate the hospital or any
of its programs to provide treatment services to any person who is admitted to
such program or facility solely for diagnostic or evaluative
purposes.
(ii) In order
to assist a person admitted to a program or facility in the exercise or
protection of the persons rights, the persons attorney or legal representative
shall have reasonable access to:
(A) The
person;
(B) The areas of the
hospital or its program(s) where such person has received treatment, resided,
or had access; and
(C) Pursuant to
the written authorization of the person, the records and information pertaining
to such persons diagnosis, treatment, and related services described in
paragraph (a)(ix).
(iii)
The hospital and each of its programs shall post a notice listing and
describing the rights described in this section of all persons admitted to the
hospital or any of its program.
(A) The
notice shall be in language and terms appropriate to the ability of the persons
to whom the notice is addressed to understand.
(B) Each notice should conform to the format
and content for such notices, and shall be posted in appropriate
locations.
(d) When a person is adjudicated by a court
of competent jurisdiction as being incompetent to exercise the rights or
provide the authorization described in paragraphs (i), (ii) or (iii) of this
subsection, such rights may be exercised or such authorization provided by the
individual appointed by the court as the persons guardian for the purpose of:
(i) Exercising the right to consent to
treatment or experimentation described in the provisions designated as (a)(iv)
and (a)(v) of this section;
(ii)
Exercising the right to confidentiality of or access to records described in
provisions designated as (a)(viii) or (a)(ix) of this section;
(iii) Providing authorization as described in
subparagraph (c)(ii)(C) of this section; or
(iv) Avoiding conflicts of
interest.
(e) The
following shall apply with respect to minors:
(i) A minors parent or legal guardian may, on
behalf of the minor:
(A) Exercise the right
to consent to treatment to experimentation described in the provisions
designated as (a)(iv) and (a)(v) of this section;
(B) Exercise the right to confidentiality of
or access to records described in provisions designated as (a)(viii) or (a)(ix)
of this section; or
(C) Provide
authorization as described in the provision designated as (c)(ii)(C) of this
section.
(ii)
Notwithstanding provision (e)(i) above, a minor, and not the minors parent or
legal guardian, may exercise the rights contained in these rules and provide
any necessary authorization to exercise the rights, in the following cases:
(A) The minors parent or legal guardian
cannot with reasonable diligence be located and the minors need for treatment
is sufficiently urgent to require immediate attention;
(B) The minor was living apart from the
parent or guardian and managing his own affairs regardless of his source of
income, at the time of admission or commitment;
(C) The minor is or was legally
married;
(D) The minor is in the
active military service of the United States;
(E) The minor is emancipated under W.S. W.S.
W.S.
14-1-201 through
14-1-206.