048-1 Wyo. Code R. § 1-4

Current through April 27, 2019
Section 1-4 - Patient's Bill of Rights

(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:

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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.

048-1 Wyo. Code R. § 1-4