Community Grievance Decision Digest
HUMANE ENVIRONMENT
THE LAW:
Each patient shall...
"Have a right to a humane...
physical environment within the hospital facilities.
These facilities shall be designed to afford patients with comfort
and safety, to promote dignity
and ensure privacy.
Facilities shall also be designed to make a positive
contribution to the effective attainment of the treatment goals of the
hospital."
§ 51.61(1)(m), Wis. Stats. [Emphasis
added.]
"Treatment facilities
shall provide patients with a clean,
safe and humane
environment..."
HFS 94.24(1), Wis. Admin. Code
[Emphasis added.]
DECISIONS
1.
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.)
2.
The individual’s right to treatment includes specific protocols as necessary to ensure
health and sanitary living conditions. The treatment needs of the
client need to be considered and clearly documented in the contract
between the county and any contract agencies, with a plan for monitoring
and updating those treatment goals. Any
barriers to achieving these needs must be documented, the guardian must be
informed, and a plan to resolve such issues needs to be implemented.
These treatment protocols
are an essential feature for
the treatment and management of the client, and they are an integral
part of the client’s right to prompt and adequate treatment.
(Level III Decision in Case No. 03-SGE-04 on 6/15/04.)
3.
The sister/guardian of a woman filed a grievance about the care
the woman had received while she was living
in her own apartment. She
had been receiving supportive home care services from an independent
service provider under a general contract with the county.
The guardian alleged “abuse of a vulnerable adult” because the
woman’s apartment was not kept clean by the contractor and was
“unlivable due to filth”. The
contract contained no specific requirements, but there was a list of
duties for the staff who visited her apartment.
One duty was to clean the apartment weekly. During one particular
period, the contractor’s employees did not complete many of the required
items and the apartment became very dirty.
Instead, they spent the time providing
companionship to the woman. Regardless of her desire for
companionship, the employees were responsible for keeping the apartment clean. Whenever possible the caregivers should be making
sure the task list is completed while working with the client to model
those skills, and to create a social situation where tasks can be
completed together and in a way that is therapeutic for her by reinforcing
daily living skills. The contractor
violated her right to a humane
environment. (Level III
Decision in Case No. 03-SGE-04 on 6/15/04.)
4.
The county is ultimately
responsible for the health and
safety of a client to whom they provide services.
Even though they have a contract
for an independent service provider
to do the hands-on services, the contracted
agency’s failure to perform its duties is
also the county’s failure. The county must monitor the providers it
contracts with in order to ensure that vital services are provided for
their clients. (Level III Decision in Case No. 03-SGE-04 on 6/15/04.)
Last Updated: November 07, 2006 |
