Community Grievance Decision Digest
CLIENT CHOICES, RESPECTING
THE LAW:
Each patient shall: "Have a right to a humane
psychological... environment within the hospital facilities..."
§ 51.61(1)(m), Wis. Stats. [Emphasis added]
Each patient shall: "Have the right to be treated
with respect and recognition of the patient's dignity and individuality
by all employees of the treatment facility or community mental health
program and by licensed, certified, registered or permitted providers of
health care with whom the patient comes in contact."
§ 51.61(1)(x), Wis. Stats. [Emphasis added.]
"Patients have the right to be free from having arbitrary
decisions made about them. To be non-arbitrary, a decision about a
client must be rationally based upon a legitimate treatment,
management or security interest."
HFS 94.24(3)(h), Wis. Admin. Code [Emphasis added.]
DECISIONS
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A client was placed in a more
restrictive setting than necessary under an emergency
detention. She was advised
to execute an Advance Directive to identify her hospital preference and her treating physician and to
provide a copy to the county, too.
That would assist the county to appropriately place her if she
ever needed emergency detention again. (Level IV decision in Case No.
99-SGE-03 on 11/3/99, reversing the Level III decision.)
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A client who was about to be discharged from an inpatient
facility felt she was not being
given enough input or choices in terms of to where
she would be discharged. She
wanted to be placed in an
apartment in the community. Facility staff were considering
placement at other inpatient settings or a CBRF (group home) setting.
Ultimately, she was transferred to a community supported
living arrangement in an apartment.
Since this was what she wanted, the grievance was dismissed at
Level III as being “resolved”. (Level III decision in Case No. 00-SGE-05 on 2/16/01.)
-
A
client was denied CIP 1-B
funding for an addition to
her house. The county followed all applicable laws and policies in
denying the request, so the client’s rights
were not violated. However,
the county and the department worked together to find another
way to pay for the remodeling project.
(Level III decision in Case No. 00-SGE-06 on 2/5/01.)
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An
inpatient complained about lack
of interactions with staff during her six-day stay.
Each patient’s needs and perceptions are unique, and staff
cannot use a “one size fits all” approach.
There is a thin line between respect for a patient’s privacy and choices
(e.g. to not have many interactions with others and to be given
personal space), and going too far in the
other direction (e.g., in trying to probe for interaction with
many questions). In the
latter instance, the patient could have complained that she was not
respected and not given reasonable space or privacy. Here, the record
reflects a reasonable degree of staff attentiveness and vigilance and, in the
latter part of the stay, more discussion with her about issues.
It was concluded that the patient’s right
to a humane psychological and physical environment was not
violated in this circumstance. (Level III decision in Case No.
99-SGE-08 on 3/23/01.)
-
A man made several statements about wanting
to take his own life. His
wife called the police and he was emergency
detained. He wanted to be detained at a local
hospital, but the police made the decision to detain him at a
state mental health facility, over his objections.
Since other,
less-restrictive options were available and he adamantly did not
want to go to the state facility,
his right to the least restrictive conditions was violated.
(Level III decision in Case No. 00-SGE-04 on 4/9/01.)
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A client complained that a Community
Service Provider (CSP) had not done enough to get him re-involved in a local
community center. This was considered part of his right to reasonable
access to community activities. The grievance was resolved by an
agreement between the CSP and the client that the CSP would assist him
with an inter-personal problem-solving protocol that would hopefully
enable him to return to the community center. (Level
III decision in Case No. 00-SGE-12 on 8/6/01.)
-
A patient threatened
to kill his wife, her
boyfriend and his therapist.
The transitional living facility he had been in was justified
in not allowing him to be re-admitted.
(Level III decision in Case No. 01-SGE-06 on 10/18/01.
-
A
service recipient felt her case
manager was too controlling of her life.
She usually accompanied
the individual to her doctor
appointments, but did most of the talking.
However, the doctor had ordered the case manager to monitor the
individual’s psychotropic medications and to visit her weekly.
Thus, it was appropriate for the case manager to accompany her
and report to the doctor. The
individual also had private appointments with her doctor, so her right
to treatment was not violated. (Level III decision in Case No.
01-SGE-05 on 11/29/01.)
-
A patient wanted to continue
the individual therapy she had received for 9 years, but the
service provider shifted to only
doing group therapy with her.
She had been made aware months in advance of the upcoming
change in services. The
treatment team agreed that this
change was appropriate for her treatment needs. Thus, her rights
to treatment and her right to be free from arbitrary decision-making
were not violated. (Level
III decision in Case No. 01-SGE-09 on 3/27/02.)
-
A patient wanted to
choose a new psychiatrist after her case was transferred from a
doctor she had been seeing to another doctor.
The service provider tried
to accommodate her request, but the two psychiatrists she asked
for declined to accept her on their caseloads.
The accommodation attempts were
reasonable. No violation of her rights was found. (Level III decision in Case
No. 01-SGE-09 on 3/27/02.)
-
A father/guardian wanted
to choose a different county case manager for his son. He noted
that the Medical Assistance
Waivers Manual emphasizes a choice
of providers. The father wanted
to choose a specific case manager who worked for the county. The
county had only five case managers and had a solid rationale for why they were not willing to reassign the son to
the case manager the father requested.
They gave him the option
of choosing either the county
as a provider or an outside agency. Thus,
the county was providing him
with a choice of provider.
The county was not
mandated to provide him with a choice
amongst their own case managers.
The counties still maintain final decision-making authority in how
they manage their staff and the workload that is assigned to those
staff. No rights violation
occurred. (Level III Decision in Case No. 03-SGE-06 on 2/18/04.)
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A man complained on his wife’s behalf that she was given a new therapist without
consulting her first.
A treating facility has the right to change therapists for
business management reasons. It
is good practice to consult
with the patient first, but it does
not rise to the level of a rights violation not
to do so. (Level IV decision in Case No. 02-SGE-07 on 3/10/04,
reversing the Level III decision.)
-
A
client of a methadone clinic had
difficulties receiving psychiatric treatment for anxiety that was
accessible and affordable to her and which was also acceptable to the
clinic. She found one she
liked, but was told to quit
seeing him by the clinic or her services would be terminated.
The psychiatrist in question does
not have a good reputation in the field of substance abuse treatment
because he has a reputation for prescribing
medications that may not be appropriate. She then found a new
psychiatrist who charged more and was less accessible for her to
visit. Her right to choose
her own psychiatrist was not violated because the clinic had good
reasons to ask her to see a different psychiatrist. It was not an
arbitrary decision by the clinic in these circumstances.
(Level III decision in Case No. 04-SGE-02 on 12/20/04)
- The
primary rationale for the proposed
change in vocational services for a client was economic. The county
Health and Human Services program faced increasing
waiting lists for people who need services while having less
fiscal support to provide those services.
In the face of a decreasing budget, the HHS was looking at
areas where money could be saved.
The costs of
continuing this client’s current vocational service provider were considerably
more than other, similar
providers in the area. It
was reasonable for the county to consider
cutting costs without cutting programs. The client rights question
was whether or not the other providers would be able to offer like services that adequately
met the client’s individualized
needs and supported her right to receive prompt and adequate treatment appropriate to her condition.
It was found that the support services the other vocational
provides could offer would be comparable. The client
would continue working in the same settings at the same times, and
with a support person available for the same amount of time.
The changes would necessarily include different persons
providing those services and doing so under a different organizational
structure. However, the
vocational services would essentially be the same under the county’s
proposal. The county’s
request that the client choose between two other, less expensive,
vocational services providers was reasonable and fair.
The need to serve as many clients as possible outweighs the potential
benefits of one individual to continue receiving services from a more
costly service provider than is necessary to provide support
services in a similar manner that other agencies may provide in the
same setting. Thus,
requiring the client to choose between the two less expensive of three
possible providers was not a violation of her rights.
(Level III decision in Case No. 03-SGE-09 on 4/11/05)
Last Updated: November 07, 2006 |