Introduction: Community Grievance Decision Digest
Who this applies to:
"Patient" means anyone who is receiving services for mental
illness, developmental disabilities, or substance abuse from
any provider in Wisconsin. The rights of those "patients" are found in
§ 51.61, Wis. Stats., and HFS 94, Wis. Admin. Code.
The Community Grievance Decision Digest does not
apply to anyone receiving services from a state-operated facility. There
are separate digests of case decisions for those facilities that are made
available only through the DHFS internal web site.
What this digest is:
This digest consists of summaries of the patient
rights decisions issued at the state levels (Level III and Level IV) of
the HFS 94 community grievance process. It does not contain any summaries
of decisions saved at the provider level (Level I) or the county level
(Level II).
(The grievance process is set
forth in Subchapter III of HFS
94 (exit DHFS; PDF), starting at HFS 94.40,
Wis. Admin. Rules. A simplified flow
chart (PDF, 5 KB) of the grievance process
is available on the Client Rights Internet Site.)
What the purpose is:
Each Level III or Level IV grievance decision that sets
"precedent" by interpreting the laws and facts applicable to a
given situation. These "precedents" are summarized in this
digest.
The purpose of setting forth the summary of decision
"precedents" is to provide guidance for the
interpretation of the patient rights laws and rules.
Given a particular
fact situation, the Client Rights
Office (CRO) finds that it is helpful to
allow both service providers and consumers to see what interpretations
have been made in the past.
Although it is mainly intended for use by grievance personnel, CRO hopes this will help everyone understand the complex patient rights laws and rules. It is hoped that
this digest will promote consistency in decision-making and provide
accessible, inexpensive technical assistance to consumers and client
rights specialists across the state.
How it is organized:
The law and rules
for each specific patient right are set forth first, followed by a brief
description of the facts the outcome of the decisions that
interpreted that section of the law. The precedent set by the decision is set forth under
the appropriate "rights" category.
However, some cases are complicated and thus set
several different precedents and thus may be listed under several
different categories or even several times under the same category.
Some rights categories do not have any decisions summarized in
them. That is because no issues under that category have been
addressed at Level III or Level IV of the HFS 94 grievance process.
The law and rules are still set forth for reference purposes and to
provide a framework for future updates of this digest.
Cases are organized by date of the decision,
rather than case number. The State Grievance Examiner’s office assigns
case numbers upon receipt. The first number is the year the grievance
began in.
Middle section is "SGE" for State Grievance Examiner
and the last section is the consecutive number of the case. Example:
04-SGE-09 is the 9th Level III grievance received by the SGE in
2004. All cases have recently been renumbered to correspond to the current
system.
Can I get a copy of a Level III or Level IV decision?
Sorry, we cannot provide copies. Due to the amount of
details in most of these decisions, it would be nearly impossible to block
out all the information that might identify who the individual patient
was. Sending out copies of these decisions could violate the consumer's
confidentiality rights.
As a client, can I "cite" decision
precedents in a complaint?
Yes, you may. CRO intends these precedents to be usable
by clients and service providers alike. You need to be aware, however,
that the circumstances of your complaint may differ sufficiently from the
facts of the case you "cited" so that the precedent may not,
upon closer inspection, apply to your specific situation.
As a service provider, can we "cite"
decision precedents in response to a complaint?
Yes, you may. CRO intends these precedents to be usable
by clients and service providers alike. Level III and Level IV grievance
personnel try to consistently apply the
laws and rules, including our decision precedents, to given fact
situations.
If there is a clear precedent and the facts of a grievance are
nearly identical, you should be able to rely on the precedents to respond
appropriately to any complaints from your clients. This would not, of
course, mean that the client could not still appeal any grievance decision
to the state levels.
Will the digest be updated in the future?
The digest will be updated periodically as new
decisions are issued. Each section of the digest has a note at the very
end about the last time it was updated.
Summary:
The Client Rights Office (CRO) staff hope that both
client rights personnel and patients alike find these precedents helpful.
Any questions about them from clients should be addressed to
the service provider’s Client Rights staff. We would like the
community client rights specialists to be the first line of response. The
client rights staff can always ask CRO for further clarification if
necessary.
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Last Updated: November 16, 2004 |
