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TREATMENT, RIGHT TO PROMPT AND ADEQUATE

THE LAW:

Each patient shall... "Have a right to receive prompt and adequate treatment, rehabilitation and educational services appropriate for his or her condition..."

§ 51.61(1)(f), Wis. Stats. [Emphasis added.]

“All patients shall be provided prompt and adequate treatment, habilitation or rehabilitation, supports, community services and educational services as required under s. 51.61(1)(f), Stats., and copies of applicable licensing and certification rules and program manuals and guidelines.”

HFS 94.08, Wis. Admin. Code [Emphasis added.]

DECISIONS 1-15:

Decisions 16-30

  1. The alcohol treatment program did not require the individuals to attend Alcoholics Anonymous (AA) or the steps that have religious aspects.  Thus, his right to be freedom of religious worship was not violated. (Level III decision in Case No. 98-SGE-02 on 10/13/98, upheld at Level IV.)

  2. A county found a 17-year old ineligible for developmental disabilities services.  She had been diagnosed as having a developmental disability at the age of 6 months. At the age of 12, she was diagnosed as autistic by a multi-disciplinary team of professionals.  Autism is developmental disability that is a life-long condition.  The question was whether or not she met the eligibility threshold of a 30% or more functional limitation in at least two of five areas of skills.  The county conceded she met that threshold in the area of “self-direction and independence”.  The records indicate that she also meets the threshold in the area of “self care”. Thus, she should have been eligible for the county’s programs.  Her right to prompt and adequate treatment was violated by the county’s denial of her eligibility.  (Level III decision in Case No. 98-SGE-03 on 11/10/98.)

  3. A complainant claimed on appeal that “alcoholism is not a disease and that there is not treatment for it.”  The Level IV decision pointed out that the state Bureau of Substance Abuse Services developed a paper titled, “Disease concept of Alcoholism” and that numerous national and international organizations and associations define and classify alcoholism as a disease.  The decision also pointed to statistics showing that, although no form of treatment can guarantee 100% success, there is a high rate of success for post-treatment abstinence with post-discharge support group utilization. (Level IV decision in Case No. 98-SGE-02 on 1/22/99.)

  4. A client was deprived of one of her medications just prior to taking a long trip, due to a series of errors and omissions on the service provider’s part.  This was a violation of her right to prompt and adequate treatment. (Level III decision in Case No. 00-SGE-02 on 6/17/00, upheld at Level IV.)

  5. A mother complained that her son’s condition was worsening since his medications were discontinued.  Her son’s doctor was on maternity leave and the service provider would not temporarily assign him to another doctor. She was instructed to call back the next month when the doctor was scheduled to return. The desperate mother put her son back on the discontinued medication, without any medical assistance.  The service provider violated the son’s right to prompt and adequate treatment. (Level III decision in Case No. 00-SGE-08 on 7/28/00, upheld at Level IV.)

  6.  Where a developmentally disabled young woman ended up in an acute inpatient mental health setting, it was appropriate for the Level I Client Rights Specialist to recommend a potential “crisis intervention plan” for her in case the situation arose again. Such an approach is an element of ongoing quality assurance on the part of the County program, too.  (Level III decision in Case No. 99-SGE-07 on 1/3/01.)

  7. When a patient raises treatment issues, it is not sufficient for the Client Rights Specialist to simply note the response of the patient’s attending physician.  Further investigation may be required. (Level III decision in Case No. 99-SGE-12 on 1/3/01.)

  8. A client’s mother filed a written complaint on his behalf about the treatment he was receiving from his doctor.  She was referred to the doctor, instead of the Client Rights Specialist.  Since this was a formal complaint, the doctor had a conflict of interest and it was inappropriate to refer the matter to him. (Level IV decision in Case No. 00-SGE-08 on 2/21/01.)

  9. 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.)

  10. A woman complained about her therapist and the quality of services she received. The allegations included concerns about the therapist’s professionalism, timeliness, and the large amount of personal information and opinions that were communicated to her during therapy sessions. In a non-secure treatment setting, a therapist’s sharing personal information with the client can help to build the relationship by allowing the therapist and client to relate to one another.  However, the therapist and patient here seemed to have divergent opinions on social, political, and religious issues. Thus, in this case the sharing of personal information may have compromised the quality of the therapeutic relationship. It seems to have detracted from the client’s ability to relate to her therapist or discuss details of her treatment issues with the therapist.  This seems to have occurred both because of the content of the information and the frequency with which it was shared, leaving the client less time to address treatment needs during the therapy sessions. The client did not verbally express her disagreeable response to the sharing of this information to the therapist during sessions. This is unfortunate because the nature of their dialog may have changed if this concern had been clearly stated early in the relationship.  However, this is more of a personality conflict rather than a patient rights issue.  Thus, this does not rise to the level of a patient rights violation. (Level III decision in Case No. 00-SGE-03 on 9/12/01.)

  11. A woman complained about her therapist because of cancelled appointments. The Level I decision found that her right to receive prompt treatment was violated by the high number of cancellations.  The service provider implemented a formal plan and consistently followed up on it to reduce the number of cancellations.  It was found at Level III that the frequency of cancellations did rise to the level of a patient rights violation and the Level I finding was upheld. The actions taken by the service provider remedied the rights violation.   (Level III decision in Case No. 00-SGE-03 on 9/12/01.)

  12. A patient wanted to bring a friend to her therapy sessions.  The service provider agreed that there are times that it may be appropriate, especially if the person is a primary support person for the client. Bringing another person to a therapy session requires a signed release from the patient.  Since the requested remedy was provided, this issue was considered resolved. (Level III decision in Case No. 00-SGE-03 on 9/12/01.)

  13. A patient threatened to kill his wife, her boyfriend and his therapist.  The transitional living facility he was in was justified in not allowing him to be re-admitted. (Level III decision in Case No. 01-SGE-06 on 10/18/01.)

  14. 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 right 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.)

  15. A patient’s treatment plan focused on the patient’s suicidal ideation and safety. His doctor developed the plan based on the information he had at the time.  Where the patient claimed, at a much later dated, that he lied to the doctor, his right to prompt and adequate treatment was not violated.  (Level IV decision in Case No. 99-SGE-05 on 3/29/02, upholding the Level III.)

Next Set of Decisions

Last Updated: November 13, 2006