Community Grievance Decision Digest
RULES AND SANCTIONS
THE LAW:
Each patient shall...
"Have a right to a humane
psychological... environment..."
§ 51.61(1)(m), 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.]
"Each patient shall
be given an opportunity to refute
any accusations prior to initiation of disciplinary action."
HFS 94.24(2)(g), Wis. Admin. Code
[Emphasis added.]
"No patient may be disciplined
for a violation of a treatment facility rule unless the patient has had prior notice of the rule."
HFS 94.24(2)(h), Wis. Admin. Code
[Emphasis added.]
[NOTE:
If a penalty is imposed
upon a patient as the result of a violation
of a rule, in order to deter that patient or others from exhibiting violating the rules,
then this is a “sanction” and
must meet the standards for imposing sanctions.
If a restriction is
imposed for security, treatment or
management reasons, rather than for a rule violation, then it is a risk-reduction
measure and standards for such measures apply. See the Risk-Reduction
section of this digest.
Any
consequence imposed on a
patient for a rule violation
must meet the following standards approved by the Client Rights Office to
be valid:
Standard
# 1: The patient must have adequate
notice of the rule and of the penalty
for violation of that rule. Notice should
be in writing and, regardless of how communicated, must be clear,
specific and objective. The
penalty may vary based upon written
criteria for aggravating
and mitigating circumstances.
Standard
# 2: A rule must be enforced
and the consequences applied
equally to patients in similar circumstances.
Differences in circumstances
that are relevant to differences in penalty for the same offense can be
left to staff discretion.
However, such discretion must be guided by the written criteria for
aggravating and mitigating
circumstances.
Standard
# 3: The judgment that a rule has been violated or that aggravating or
mitigating circumstances exist must be based on the best available evidence. A
certain amount of checking up on
facts must be done, the patient should be heard, and the facts must be
documented and made available to the patient.
Subjective judgments should be limited to deciding issues of credibility
and intent.
Standard # 4:
The patient must be able to
have chosen whether or not to commit the rule violation.
That is, he or she must be
responsible. (For
instance, if a patient is hallucinating and hits a peer, imposing a
penalty is not appropriate. Risk-reduction measures may certainly be taken, however, to prevent
the patient from hitting anyone else during the period of hallucination.)
Standard # 5:
The burden is on the staff to show that it is more
probable than not that the patient committed the rule violation.
Standard # 6:
The penalty must not be
excessive, either absolutely or in relation to the offense.
Documenting Consequences:
Staff must document: 1)
that the patient had proper notice
of the rule and the possible consequences of violating it;
2) Any aggravating or
mitigating circumstances; 3)
The facts relied upon as
objectively as possible; 4)
The patient's degree of
responsibility; and, 5)
The conclusions reached, based
on the facts and circumstances.]
[Note: See also Due Process section of this digest.]
DECISIONS:
[None at this time.]
Last Updated: November 08, 2006 |
