DEPARTMENT OF COMMUNITY HEALTH

                   MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

                               RECIPIENT RIGHTS


R  325.14301   Construction; effective date.
  Rule 301. (1) R 325.14302 to  R 325.14306  shall  not  be  construed  to
expand or diminish  other  remedies  at  law  which  are  available  to  a
recipient under the act or the statutory and common law of this state.
  (2) This part shall take effect 120 days following the effective date of
these rules.

  History:  1981 AACS.


R  325.14302   Policy and procedures.
  Rule 302. (1) A program  shall,  by  a  formal  vote  of  the  governing
authority, adopt  official  written  policies  and  procedures  to  assure
compliance with recipient rights  rules  and  procedures.  Copies  of  the
recipient rights policies and procedures and any revisions  thereto  shall
be submitted with the annual licensing renewal  application  or  with  the
initial license application for transmittal to the office recipient rights
coordinator.
  (2) The recipient rights policies and procedures shall  be  reviewed  at
least annually by the governing authority to consider any  revisions  that
might be necessary. Such review and approval shall become a  part  of  the
administrative record of the program.
  (3) The recipient rights policies and procedures shall meet all  of  the
following requirements:
  (a) Require the program director to designate a staff member to function
as the program rights advisor who shall do all of the following:
  (i) Attend training offered by the office  concerning  recipient  rights
procedures.
  (ii) Receive and investigate all recipient rights complaints independent
of interference or reprisal from the program administration.
  (iii)  Communicate  directly  with  the   coordinating   agency   rights
consultant when necessary.
  Where staffing permits, the  program  rights  advisor  shall  not  be  a
provider of counseling services.
  (b) Outline the method of filling recipient requests to review, copy, or
receive a summary  of  recipient  treatment  or  prevention  service  case
records.
  (c) Provide simple mechanisms for notifying recipients of their  rights,
reporting  apparent  rights  violations,  determining  whether   in   fact
violations have occurred, and for ensuring that firm, consistent, and fair
remedial action is taken in the event of a violation of these rules.
  (4) Copies of recipient rights policies and procedures shall be provided
to each member of the program staff. Each  staff  member  of  the  program
shall review the policies and procedures and shall sign a form provided by
the office which indicates that he or she understands, and shall abide by,
the policies and procedures. The form shall be explained to the  staff  by
the program director. A signed copy  shall  be  maintained  in  the  staff
personnel file and a signed copy shall be retained by the staff member.
  (5) A treatment program may choose to  restrict  specific  rights  of  a
recipient based on the  program  policies  and  procedures.  For  example,
program policy may call for restricted access to money or visitors  during
the initial stage of treatment. Such  restrictions  are  permissible  only
under all of the following conditions:
  (a) The written policies and procedures developed by the  program  shall
describe what rights are to be restricted, for what  therapeutic  purpose,
and for what period of time.
  (b) Further individual limitation of rights shall be based on individual
treatment plans which are approved by the program director and  which  are
included in the client's case record. These limitations shall not  be  for
more than 30 days without being renewed in writing  in  the  case  record.
Such documentation shall be written by the program  staff  member  who  is
designated in the  treatment  plan  as  having  major  responsibility  for
implementing the plan and shall be co-signed by the program director.
  (c) The provisions for restrictions and limitations on recipient  rights
outlined in this subrule shall not be construed to  permit  any  abuse  or
neglect as defined in these rules.
  (6) As part of the admission procedure to a program, a  recipient  shall
receive all of the following:
  (a) If incapacitated, receive the procedures described in  this  subrule
as soon as feasible, but not more than 72  hours  after  admission  to  an
approved service program.
  (b) A written description of the rights of recipients of substance abuse
services.
  (c) A written description of any restrictions of  the  rights  based  on
program policy.
  (d) An oral explanation of the rights in language which is understood by
the recipient.
  (e) A form approved by the office which  indicates  that  the  recipient
understands the rights and consents to  specific  restrictions  of  rights
based on program policy. The recipient shall sign this form. One  copy  of
the form shall be provided to the client and 1 copy shall become a part of
the client's record.
  (7) A recipient of prevention services shall be notified of his  or  her
rights by a notation on  any  program  announcement,  brochure,  or  other
written communication that describes the program services to recipients or
to the general  public.  Such  notification  shall  state  the  following:
"Recipients of substance abuse services have rights protected by state and
federal law and promulgated rules. For information, contact  (staff  name,
address, phone) or the Center  for  Substance  Abuse  Services,  Recipient
Rights Coordinator, P.O. Box 30035, 3500 North  Martin  Luther  King,  Jr.
Blvd., Lansing, Michigan 48909."
  (8) When a prevention service maintains case records  that  include  the
recipient's name and information about the recipient's  substance  use  or
abuse, the recipient shall be provided with the  notification  in  subrule
(7) of this rule and a summary of specific rights. Phone callers shall  be
informed that a summary of recipient rights will  be  mailed  to  them  on
request if such records are maintained.
  (9) Rights of recipients shall be displayed on a poster provided by  the
office in a public  area  of  all  licensed  programs.  The  poster  shall
indicate the program rights advisor's name and phone number.
  (10) The administrator of the office, with approval of the  coordinating
agency, shall designate a staff member of a local coordinating  agency  to
act  as  the  coordinating  agency  recipient   rights   consultant.   The
designation shall be renewed annually. The coordinating  agency  recipient
rights consultant shall conduct recipient rights activities  according  to
procedures outlined by the office.

  History:  1981 AACS.


R 325.14303 Recipient rights violations; complaints; procedures; remedies.
  Rule 303. (1) A complaint of a recipient rights violation shall be  made
on a form provided by the office, whether made  by  a  client  or  another
person on behalf of a client or group of clients, and shall be distributed
to the client, the program, the coordinating agency, and the  office.  All
recipient rights  communications  shall  comply  with  state  and  federal
confidentiality rules and regulations.
  (2) When circumstances prevent completion of the procedures outlined  in
subrules  (3)  and  (5)  of  this  rule,  the  rights  advisor  or  rights
consultant, whoever is responsible in the specific subrule, shall submit a
written report to the office rights coordinator stating  the  reasons  for
tardiness and the actions  being  taken  to  expedite  completion  of  the
procedures.
  (3) An initial complaint  of  a  recipient  rights  violation  shall  be
investigated by the program rights advisor.  The  investigation  shall  be
initiated within 10 working days  of  receipt  of  the  complaint  by  the
program rights advisor.
  (4) A written report, including the procedures followed in  the  conduct
of the investigation,  findings,  conclusions,  and  recommended  remedial
actions, if any, to be implemented by  the  program,  shall  be  completed
within 25 working days of receipt of the initial complaint. Copies of  the
report shall be submitted within 5  working  days  of  completion  to  the
complainant, coordinating agency recipient rights consultant, and  to  the
office rights coordinator. This report shall serve as notice of the rights
advisor's final recommendation for resolution of the complaint.
  (5)  Recommended  remedial  action  shall  include   time   limits   for
implementation. The coordinating agency recipient rights consultant  shall
monitor the implementation of remedial actions recommended by the  program
rights  advisor  and  shall  notify  the  office  rights  coordinator   of
situations where time limits appear unreasonably short or  long  or  where
unforeseen  problems  cause  a  delay  in  implementation  of  recommended
remedial actions.
  (6) If a complainant is  not  satisfied  with  the  program's  findings,
conclusions, recommended remedial action, or implementation of recommended
remedial action, the complainant may appeal  within  15  working  days  of
receipt of the written report to the coordinating agency rights consultant
on forms provided by  the  office  and  distributed  to  programs  by  the
coordinating agency. Copies of such appeals shall be  distributed  to  the
complainant and to the program and  office  rights  coordinator  within  5
working days of receipt of the appeal by the  coordinating  agency  rights
consultant.
  (7) An appeal received by the coordinating agency shall be  reviewed  by
the coordinating agency  rights  consultant  within  10  working  days  of
receipt,  unless  the  time  limitation  is  waived  in  writing  by   the
complainant.  The  coordinating  agency  rights  consultant  may  hold  an
informal conference involving the complainant and the program director  to
determine the basis of the complaint and the position of the program.
  (8) If the coordinating agency recipient rights  consultant  finds  that
the  findings,   conclusions,   and   recommended   remedial   action   or
implementation of recommended remedial action by the program resolves  the
problem that caused the complaint, such finding, including  the  rationale
for such finding, shall be submitted in a  written  report  and  shall  be
mailed to the complainant, the program, and the office rights  coordinator
within 15 working days of receipt of the appeal. This report  shall  serve
as notice of the rights consultant's final recommendation  for  resolution
of the complaint.
  (9) If the coordinating agency recipient  rights  consultant  determines
that  the  findings,  conclusions,  and  recommended  remedial  action  or
implementation of recommended remedial action by the program do not appear
to resolve the problem that caused the complaint, or if  the  coordinating
agency  rights  consultant  feels  the  issues  cannot  be  satisfactorily
resolved at an informal conference, then the  coordinating  agency  rights
consultant shall initiate an investigation of the case within  15  working
days of receipt of the appeal.
  (10) A written report, including the procedures followed in the  conduct
of the investigation,  findings,  conclusions,  and  recommended  remedial
action to be implemented by the program director shall be completed by the
coordinating agency rights consultant within 25 working days of receipt of
the appeal at the coordinating agency.  Copies  of  the  report  shall  be
submitted within 5 working days of  completion  to  the  complainant,  the
program, and to the office rights coordinator. Such report shall serve  as
notice of the coordinating agency rights consultant's final recommendation
for resolution of the complaint.
  (11) Any recommended remedial  action  shall  include  time  limits  for
implementation and shall be evaluated by the coordinating agency recipient
rights consultant for its effectiveness  in  resolving  the  problem  that
caused the complaint.
  (12) The complainant may appeal within 15 working days of receipt of the
written report to the office rights coordinator on a form provided by  the
office and distributed by  the  coordinating  agency.  The  office  rights
coordinator shall distribute copies of  the  appeal  to  the  program  and
coordinating agency within 5 working days of receipt.  The  office  rights
coordinator shall review the appeal within 10 working days of the  receipt
of the  appeal.  The  office  rights  coordinator  may  hold  an  informal
conference of concerned parties to further explore the issues.
  (13) If the office rights  coordinator  concurs  with  the  coordinating
agency, the complainant shall be so notified within  15  working  days  of
receipt of the appeal by the office. Such notification shall  include  the
rationale for the decision. The complainant shall also be informed that he
or she may subsequently request, from the office administrator, a  hearing
pursuant to Act No. 306 of the Public Acts  of  1969,  as  amended,  being
S24.201 et seq. of the Michigan Compiled Laws, if not satisfied  with  the
decision of the office rights coordinator. Such request may be made  in  a
letter to the administrator from the complainant within 15 working days of
receipt of the notification from the office rights coordinator.
  (14) If the office rights coordinator decides to reinvestigate the case,
the complainant shall be so notified within 10 working days of receipt  of
the appeal. Copies of such notification  shall  be  sent  to  the  program
rights advisor and to the coordinating agency rights consultant.
  (15) A written report of the  investigation  procedures,  findings,  and
administrative or licensing action recommended to the office administrator
and resulting from the office rights coordinator's investigation shall  be
completed within 25 working days of receipt of the  appeal  and  shall  be
submitted to  the  administrator.  Copies  shall  be  distributed  to  the
coordinating agency rights consultant and to the program  rights  advisor.
Findings and recommended action shall  be  submitted  to  the  complainant
within 30 working days of receipt of the  appeal.  Such  findings  may  be
appealed in a letter to the administrator from the complainant  within  15
working days of receipt of the findings.

  History:  1981 AACS.


R  325.14304   Recipient rights generally.
  Rule 304. (1) A recipient shall not be denied appropriate service on the
basis of race, color, national  origin,  religion,  sex,  age,  mental  or
physical  handicap,  marital  status,  sexual  preference,  or   political
beliefs.
  (2) The admission of a recipient to a treatment program  or  receipt  of
prevention services shall not result in the recipient  being  deprived  of
any rights, privileges, or benefits which are guaranteed to individuals by
state or federal law or by the state or federal constitutions.
  (3) A recipient may present grievances or  suggest  changes  in  program
policies and services to the program staff, to governmental officials,  or
to another person within or outside the  program.  In  this  process,  the
program shall not in any way restrain the recipient.
  (4) A recipient has the right to review, copy, or receive a  summary  of
his or her program  records,  unless,  in  the  judgment  of  the  program
director, such action will be detrimental to the recipient  or  to  others
for either of the following reasons:
  (a) Granting the request for disclosure will cause substantial  harm  to
the relationship between the recipient and the program or to the program's
capacity to provide services in general.
  (b) Granting the request for disclosure will cause substantial  harm  to
the recipient.
  If the program director determines that such action will be detrimental,
the recipient is allowed to review nondetrimental portions of  the  record
or a summary of the nondetrimental portions of the record. If a  recipient
is denied the right to review all or part of his or her record, the reason
for the denial shall be stated to the recipient. An  explanation  of  what
portions of the record are detrimental and  for  what  reasons,  shall  be
stated in the client record and shall be signed by the  program  director.
  (5) A program staff member shall not physically  or  mentally  abuse  or
neglect or sexually abuse a recipient.
  (6) A recipient has the right  to  review  a  written  fee  schedule  in
programs where recipients are charged for services. Policies on  fees  and
any revisions thereto shall be approved by the governing authority of  the
program and shall be recorded in the administrative record of the program.
  (7) A recipient is entitled to receive an  explanation  of  his  or  her
bill, regardless of the source of payment.
  (8) A recipient has the right to information concerning any experimental
or research procedure proposed as a  part  of  his  or  her  treatment  or
prevention services and has the right to  refuse  to  participate  in  the
experiment  or  research  without  jeopardizing  his  or  her   continuing
services. A  program  shall  comply  with  state  and  federal  rules  and
regulations concerning research which involves human subjects.

  History:  1981 AACS.


R  325.14305   Treatment programs; specific rights; fingerprints.
  Rule 305. (1) A recipient shall participate in the development of his or
her treatment plan.
  (2) A recipient has the right to refuse treatment and to be informed  of
the consequences of that refusal. When a refusal of treatment  prevents  a
program from providing services  according  to  ethical  and  professional
standards, the relationship with the  recipient  may  be  terminated  upon
reasonable notice.
  (3) A recipient shall  be  informed  if  a  program  has  a  policy  for
discharging recipients who fail to comply with  program  rules  and  shall
receive, at admission and thereafter upon  request,  a  notification  form
that includes written procedures which explain all of the following:
  (a) The types of infractions that can lead to discharge.
  (b) Who has the authority to discharge recipients.
  (c) How and in what situations prior notification is to be given to  the
recipient who is being considered for discharge.
  (d) The mechanism for review or appeal of a discharge decision.
  A copy of the  notification  form  signed  by  the  recipient  shall  be
maintained in the recipient's case file.
  (4) A recipient  shall  have  the  benefits,  side  effects,  and  risks
associated with the use of any drugs fully explained in language which  is
understood by the recipient.
  (5) A recipient has the right to give prior informed consent, consistent
with  federal  confidentiality  regulations,  for  the  use   and   future
disposition of products of special observation and audiovisual techniques,
such as 1-way vision  mirrors,  tape  recorders,  television,  movies,  or
photographs.
  (6) Fingerprints may be taken and used in connection with  treatment  or
research or to determine the name of a recipient only if expressed written
consent has been obtained from the recipient. Fingerprints shall  be  kept
as a separate part of the recipient's records and shall  be  destroyed  or
returned to the recipient when the fingerprints are no longer essential to
treatment or research.

  History:  1981 AACS.


R  325.14306   Inpatient and residential programs; specific rights.
  Rule 306. (1) A recipient has the right to associate  and  have  private
communications and consultations with his or her physician  and  attorney.
  (2) A program shall post its policy  concerning  visitors  in  a  public
place.
  (3) Unless contraindicated by program  policy  or  individual  treatment
plan, a recipient is allowed visits  from  family  members,  friends,  and
other persons of his or her choice at reasonable times, as  determined  by
the program director or according to posted visitors' hours.  A  recipient
shall be informed in writing of visitors'  hours  upon  admission  to  the
program.
  (4) To protect the privacy of all other recipients, a  program  director
shall ensure, to the extent reasonable and possible, that the visitors  of
recipients will only see or have contact with  the  individual  they  have
reason to visit.
  (5) A recipient has the right to be  free  from  physical  and  chemical
restraints, except those authorized  in  writing  by  a  physician  for  a
specified and limited time. Written  policies  and  procedures  which  set
forth the circumstances that require  the  use  of  restraints  and  which
designate the program personnel responsible for applying restraints  shall
be approved in writing by a physician and shall be adopted by the  program
governing authority. Restraints may be applied in an emergency to  protect
the recipient from injury to  self  or  others.  The  restraint  shall  be
applied by designated staff. Such action shall be reported to a  physician
immediately and shall be reduced to writing in the client record within 24
hours.
  (6) A recipient has the right to be  free  from  doing  work  which  the
program would otherwise employ someone else to do, unless the work and the
rationale for its therapeutic benefit are included in program policy or in
the treatment plan for the recipient.
  (7) A recipient has the right to a reasonable amount of personal storage
space for clothing and other personal property. All such  items  shall  be
returned upon discharge.
  (8) A recipient has the right to deposit money, earnings, or  income  in
his or her name in an account with a commercial financial  institution.  A
recipient has the right to get money from the account and to spend  it  or
use it as he or she chooses, unless restricted by program policy or by the
treatment plan for the recipient. A recipient has the right to receive all
money or other belongings held for him or her by  the  program  within  24
hours of discharge.

  History:  1981 AACS.