Training for Client Rights Officers

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Training for Client Rights Officers

• Greta Hochstetler, MA, PC
• Sandra Szczygiel, MS, PCC - S

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Client Rights Officers - Clark County Agencies

• Bill Otto, Catholic Charities (325-8715)
• Patty Preston, Elderly United (324-9000)
• Marilyn Aldridge, Family Service Agency
  (325-5564)
• Dan Barksdale, McKinley Hall (328-5300)
• Vicki Wartner, Mental Health Services (629-3046)
• Carolyn Joyner, Oesterlen (399-6101)
• Susan Loudenback, Project Woman (328-5308)
• Mike Kessler, Rocking Horse Center (324-1111
  x135)
• Michele Cox, Womens Recovery Center (352-2906)

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Client Rights Officers Greene County Agencies

• Harmony Desmond, Family Violence Prevention
  Center (376-8526 x18)
• Dr. Tim Callahan, Greene County Educational
  Service Center (767-1303 x127)
• Melissa McFarland, Greene Leaf Therapeutic
  Community (562-5084)
• Rhonda Baer, Housing Solutions (376-7810)
• Helen Burdsall, Integrated Youth Services
  (427-3837 x212)
• Jason Roush, TCN Behavioral Health (376-8771)

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Client Rights Officers Madison County Agencies

• Vicki Wartner, Mental Health Alcohol Drug
  Services of Madison County (937-629-3046)

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A Historical Perspective of Conditions
Treatment of Persons with Mental Illness and/or
Addictions
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Middle ages through the 18th Century - mental
illness viewed as demon possession
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Trephining
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Middle ages through the 18th Century Middle Ages
alcohol is viewed as positive, even therapeutic
or heavenly
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Mid 19th Century - Crazy people shunned
locked away
Bedlam
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Belgian Cage
Rotary chair
11
Mid 19th Century Morality Model of dipsomania
(alcoholism)
King Alcohol
The evils of spirits
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Keeley League
Beginning of the Temperance Movement
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Early 20th Century -
Freud, Jung Dream interpretation Mental
Health Consumers begin to be treated better
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(No Transcript)
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Psychosurgery
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Ice Baths and Water Boarding
Early Electroshock
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Lining up for a walk
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Early 20th Century major changes in dealing
with alcoholism
Alcoholics Anonymous starts 1939
1904 News Article
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Early Outpatient Clinic
Antabuse 1948
Methadone 1937
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Mid 20th Century mental health treatment
changes significantly due to the start of
psychiatric medications
1950s - Thorazine
1950s 1960s - Long Hospitalizations / ECT
Sitting Motionless
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Transactional Analysis Rational Emotive
Therapy De-institutionalization
Straight Jacket
Seclusion Room
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Addiction treatment expands -
Long term inpatient care
Phoenix House begins 1967
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Early 1990s - 2nd Generation Anti-psychotics
New medications to treat addictions 1995 -
Naltrexone (Revia) 1993 - Levomethadyl
Acetate (LAAM)
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Mid-Late 1990s - Managed Care
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Early 2000s Declining dollars for mental
health and addictions treatment
Returning veterans
Homelessness
Criminalization of mental illness
More demand
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Medications for the treatment of addictions
continue to be developed -
Buprenorphine Naloxone (Suboxone) - 2002
Acamprosate calcium (Campral) - 2004
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Client Rights

• Client Rights for individuals served by an ODMH
  agency
• Client Rights for individuals served by an ODADAS
  agency

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Client Rights

• Rights grouped into five major categories
• Dignity Respect
• Informed Choice Treatment
• Freedom
• Personal Liberties
• Freely Exercise All Rights

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The Right to Dignity Respect

• Dignity, respect, autonomy, privacy (MH-1,
  AOD-1)
• Service in a humane setting with the greatest
  possible freedom
• (MH-2, AOD-2)

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The Right to Informed Choice Treatment

• Information of current condition suggested
  services (MH-3, AOD-3,4)
• Accept or reject any service (MH-4, AOD-5)

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The Right to Informed Choice Treatment

• Receive a current, written individualized
  treatment plan
• (MH-5, AOD-6)
• Active informed participation in treatment plan
  (MH-6, AOD-6)

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The Right to Informed Choice Treatment

• Participation in any service, even if other
  services are refused (MH-9)
• Advance notice if any services are to be
  discontinued (MH-15, AOD-13)
• Clear explanation of denial of any service
  (MH-16, AOD-14)

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The Right to Freedom

• Unnecessary medication (MH-7, AOD-7)
• Unnecessary restraint seclusion
• (MH-8, AOD-7)
• Unusual or dangerous treatment
• (MH-10, AOD-8)

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The Right to Freedom

• Intrusion of one-way mirrors, photographs,
  audio/visual recorders, television, movies
  (MH-11, AOD-9)

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The Right to Personal Liberties

• Consultation with treatment specialist or legal
  counsel at own expense (MH-12, AOD-10)
• Confidentiality (MH-13, AOD-11)

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The Right to Personal Liberties

• Read get copies of psychiatric, medical, or
  other treatment records
• (MH-14, AOD-12)
• Non-discrimination (MH-17, AOD-15)
• Know the cost of services (MH-18, AOD-16)

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The Right to Freely Exercise All Rights

• Fully informed of all rights (MH-19, AOD-17)
• Exercise any all rights without being
  threatened or punished (MH-20, AOD-18)

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The Right to Freely Exercise All Rights

• File a grievance (MH-21, AOD-19)
• Have oral written instructions for filing a
  grievance (MH-22, AOD-20)

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Differences between ODMH ODADAS Rights

• Participation in any service, even if other
  services are refused. (Not ODADAS)

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Complaint vs. Grievance

• Grievance any concern communicated by a person
  regarding a perceived violation of any of the 22
  Client Rights outlined in Ohio Revised Code and
  Ohio Administrative Code that apply to consumers
  receiving public community mental health
  services. (ODMH)
• Complaint any concern communicated by a person
  regarding issues other than the 22 Client Rights.
  (ODMH)

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Grievance Process

• Agencies must have a written Grievance
  Procedure, which provides the following
• Assistance in filing the grievance, if needed.
• Investigation of the grievance on behalf of the
  griever.

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• Provision of agency representation for the
  griever at the agency hearing, if desired.
• Specification of the name, title, location, hours
  of availability, and telephone number of the
  Client Rights Officer (CRO).

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• Assurance of an explanation to the griever of the
  grievance process from the original filing of the
  grievance to the final resolution, that includes
  reasonable opportunity for the griever to be
  heard by an impartial decision-maker. (ODMH)
• Specification of time lines for resolving the
  grievance not to exceed 20 working days from the
  date of filing the grievance.

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• Specification that written notification and
  explanation of the resolution will be provided to
  the client, or to the griever if other than the
  client, with the clients permission. (ODMH)
• Provision of the opportunity to file a grievance
  within a reasonable period of time from the date
  a grievance occurred.
• (ODMH)

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• A statement regarding the option of the griever
  to initiate a complaint with any or all of
  several outside entities. The relevant addresses
  and telephone numbers shall be included.
  (Handout)
• Provision for providing, upon request, all
  relevant information about the grievance to one
  or more of the organizations. (ODMH)

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• Provision to provide alternative arrangements for
  situations in which the CRO is the subject of the
  grievance. (ODMH)
• Assurance of the prompt accessibility of the CRO.
  (ODMH)
• Assurance that the grievance is in writing, dated
  and signed by the client.
• (ODADAS)

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• Assurance that the grievance include the date,
  approximate time, description of the incident and
  individuals involved. (ODADAS)
• Provision that a written receipt be provided to
  the grievant within 3 working days. The receipt
  must include date grievance was received, summary
  of the grievance, overview of the grievance
  investigation process, timetable for completion
  of the investigation and notification of
  resolution, treatment provider contact name,
  address and telephone number. (ODADAS)

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• Provision to post the Grievance Procedure in a
  conspicuous place. (ODMH)
• Provision to distribute a copy of the written
  Grievance Procedure to each applicant and client,
  upon request. (ODMH)
• Provision for the CRO to take all necessary steps
  to assure compliance with the Grievance
  Procedure. (ODMH)

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• Assurance that every agency staff person
  (including administrative and support staff) has
  a clearly understood responsibility to
  immediately advise any client, or applicant, or
  any other person who is articulating a concern,
  complaint, or grievance, about the name and
  availability of the agencys CRO and the
  complainants right to file a grievance. (ODMH)

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• The Mental Health and Recovery Board of Clark,
  Greene and Madison Counties has responsibilities
  regarding Client Rights and the grievance
  process, as well
• Assurance of prompt accessibility of the Boards
  CRO. (ODMH)
• Assurance that the utilization of outside persons
  is clearly explained to grievers.

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• Assurance that each agency CRO is keeping records
  of grievances, including the subject matter and
  the resolution. (ODMH)
• Annual review of the implementation of the Client
  Rights Policy and Grievance Procedure for each of
  its contract agencies.(ODMH)
• Annual receipt from each contract agencys CROs
  summary of the number of grievances, type and
  resolution. (ODMH)

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• Maintenance of records of grievances it receives,
  including the subject and resolution. (ODMH)
• Assurance of the availability of records for
  review by ODMH upon request. (Not ODADAS)
• Annual summarization of its records to include
  number of grievances, types, and resolution.
  (ODMH)

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• The Client Rights Officers
• for the Board
• Greta Hochstetler 937-322-0648 ext. 103,
• Greta_at_mhrb.org
• Sandy Szczygiel 937-3220648 ext. 112,
• Sandra_at_mhrb.org

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The Ohio Department of Mental Health (ODMH) has
responsibilities regarding Client Rights and the
grievance process, as well

• ODMH periodically reviews the implementation of
  Client Rights Policy and Grievance Procedure in
  each board area.

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• ODMH receives from each Board the annual
  summaries provided by the agencies to the Board
  and the Boards own annual summary.
• ODMH prepares and distributes an annual report of
  grievance summaries.

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• Clients are Free
• to Voice Concerns at any Level

A G E N C Y
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The Role of the Client Rights Officer (CRO)

• Person designated with responsibility for
  assuring compliance with the Client Rights and
  Grievance Procedure Rule (OAC 51222-1-02)
  (ODMH)

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The name, title, location, hours of availability,
and telephone number of the CRO with a statement
of her/his responsibility to accept and oversee
the process of any grievance filed by a client
(or other person or agency on behalf of a client)
must be posted. (ODMH)
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• Must assure that staff will explain any and all
  aspects of Client Rights and the Grievance
  Procedure upon request.
• Must assure a copy of the Client Rights Policy
  is distributed to each applicant or client at the
  intake or the next subsequent appointment in
  writing and orally. Must assure that the agency
  specifies how distribution shall be accomplished.

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• Must assure that in a crisis or emergency
  situation, the client (or applicant) shall be
  verbally advised of at least the immediate
  pertinent rights, such as the right to consent to
  or refuse the offered treatment and the
  consequences of that agreement or refusal.
  Written copy and full verbal explanation of the
  Client Rights Policy may be delayed to a
  subsequent meeting. (ODMH)

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• Must assure that clients or recipients of the
  type of mental health services specified as
  community services (information referral,
  consultation, mental health education,
  prevention, training) may have a copy and
  explanation of the Client Rights Policy upon
  request. (ODMH)

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• Must assure that a copy of the Client Rights
  Policy is posted in a conspicuous location in
  each building operated by the agency. (ODMH)
• Must assure that every staff person, including
  administrative and support staff, is familiar
  with all specific Client Rights and the Grievance
  Procedure.

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Case Examples