Client Rights/Grievance Policy

Purpose
The purpose of this policy is to protect and enhance the rights of persons applying for or receiving public mental health services by establishing specific rights of clients and procedures for responsive and impartial resolution of client grievances.

Definitions

Board Lorain County Board of Mental Health

Complaint Means any concern communicated by a person questioning the personal care or clinical treatment received by the person served, the environmental conditions, or any aspect of services received. Complaints consist of issues less severe and complex than a grievance. Any complaint alleging violation, denial, exercise or abuse of client rights is considered a grievance. A complaint is a less formal process than a grievance.

Client An individual applying for or receiving mental health services from the Board or a mental health agency with a contract with the Board.

Client Rights Officer The individual designated by a mental health agency or the Board with the responsibility for assuring compliance with the client rights and grievance procedure as implemented within each agency and Board. For these purposes, the individual holds the specific title of Client Rights Officer.

Contract Agency A public or private service provider with which the Board enters into a contract for the delivery of providing mental health services.

Grievance A written complaint initiated either orally or in writing by a client or by any other person or agency on behalf of a client regarding denial or abuse of any client's rights.

Investigation Any steps taken toward substantiating or refuting the allegations and arriving at the resolution of a complaint, grievance or appeal. Steps may include chart reviews, interviews of persons involved, background information and review of appropriate policies, procedures and standards.

Mental Health Services Any of the services, programs, or activities named and defined in rule 5122:2-1-01 of the Ohio Administrative Code. Mental health services include both direct services and community services. Direct client services are listed and defined in paragraphs (D)(1) to (D)(10) of Rule 5122:2-1-01 of the Ohio Administrative Code. Community services are listed and defined in paragraphs (D)(11) to (D)(15) of Rule 5122:2-1-01 of the Ohio Administrative Code.

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Client Rights

Rule 1.1 Client Rights

1. Except for clients receiving forensic evaluation service as defined in Paragraph (D)(9) of Rule 5122:2-1-01 of the Ohio Administrative Code, from a certified forensic center, each client has all of the following rights:
   1. The right to be treated with consideration and respect for personal dignity, autonomy, and privacy;
   2. The right to service in a humane setting which is the least restrictive and feasible as defined in the treatment plan;
   3. The right to be informed of one's own condition, of proposed or current services, treatment or therapies, and of the alternatives;
   4. The right to consent to or refuse any service, treatment, or therapy at any time upon full explanation of the expected consequences of such consent or refusal. A parent or legal guardian may consent to or refuse any service, treatment or therapy on behalf of a minor client;
   5. The right to a current, written individualized service plan that addresses one's own mental health, physical health, social and economic needs, and that specifies the provision of appropriate and adequate services, as available, either directly or by referral;
   6. The right to active and informed participation in the establishment, periodic review, and reassessment of the service plan;
   7. The right to freedom from unnecessary or excessive medication;
   8. The right to freedom from unnecessary restraint or seclusion;
   9. The right to participate in any appropriate and available agency service, regardless of refusal of one or more other services, treatments, or therapies, or regardless of relapse from earlier treatment in that or another service, unless there is a valid and specific necessity which precludes and/or requires the client's participation in other services. This necessity shall be explained to the client and written in the client's current service plan;
   10. The right to be informed of and refuse any unusual hazardous treatment procedures;
   11. The right to be advised of and refuse observation by techniques such as one-way vision mirrors, tape recorders, televisions, movies, or photographs;
   12. The right to have the opportunity to consult with independent treatment specialists or legal counsel, at one's own expense;
   13. The right to confidentiality of communications and of all personally identifying information within the limitations and requirements for disclosure of various funding and/or certifying sources, state or federal statutes, unless release of information is specifically authorized by the client or parent or legal guardian of a minor client or court-appointed guardian of the person of an adult client in accordance with rule 5122:2-3-11 of the Ohio Administrative Code;
   14. The right to have access to one's own psychiatric, medical or other treatment records, unless access to particular identified items of information is specifically restricted for that individual client for clear treatment reasons in the client's treatment plan. "Clear treatment reasons" shall be understood to mean only severe emotional damage to the client such that dangerous or self-injurious behavior is an imminent risk. The person restricting the information shall explain to the client the factual information about the individual client that necessitates the restriction. The restriction must be renewed at least annually to retain validity. Any person authorized by the client has unrestricted access to all information. Clients shall be informed in writing of agency policies and procedures for viewing or obtaining copies of personal records;
   15. The right to be informed in advance of the reason(s) for discontinuance of service provision, and to be involved in planning for the consequences of that event;
   16. The right to receive an explanation of the reasons for denial of service;
   17. The right not to be discriminated against in the provision of service on the basis of religion, race, color, creed, sex, national origin, age, lifestyle, physical or mental handicap, developmental disability, or inability to pay;
   18. The right to know the cost of services;
   19. The right to be fully informed of all rights;
   20. The right to exercise any and all rights without reprisal in any form including continued uncompromised access to service;
   21. The right to file a grievance; and
   22. The right to have oral and written instructions for filing a grievance.
2. Each client receiving a forensic evaluation service from a certified forensic center has the following rights:
   1. The right to be treated with consideration and respect for personal dignity;
   2. The right to be evaluated in a physical environment affording as much privacy as feasible;
   3. The right to service in a humane setting which is the least restrictive feasible if such setting is under the control of the forensic center;
   4. The right to be informed of the purpose and procedures of the evaluation service;
   5. The right to consent to or refuse the forensic evaluation services and to be informed of the probable consequences of refusal;
   6. The right to freedom from unnecessary restraint or seclusion if such restraint or seclusion is within the control of the forensic center;
   7. The right to be advised of and refuse observation by techniques such as one-way vision mirrors, tape recordings, televisions, movies, or photographs, unless ordered by the court, in which case the client must be informed of such technique;
   8. The right not to be discriminated against in the provision of service on the basis of religion, race, color, creed, sex, national origin, age, lifestyle, physical or mental handicap, developmental disability, sexual orientation, or inability to pay;
   9. The right to be fully informed of all rights;
   10. The right to exercise any and all rights without reprisal in any form;
   11. The right to file a grievance;
   12. The right to have oral and written instructions for filing a grievance including an explanation that the filing of a grievance is exclusively an administrative proceeding within the mental health system and will not affect or delay the outcome of the criminal charges.

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Rule 1.2 Provider Responsibilities

1. It is the policy of the Lorain County Board of Mental Health to assure that all clients receiving service from a contract agency of the Lorain County Board of Mental Health have their rights protected in applying for and receiving mental health services.
   1. The Lorain County Board of Mental Health shall review annually the implementation of the client rights policy and grievance procedures for each of its contract agencies.
   2. Contract agencies shall develop and maintain client rights and grievance procedures that are consistent with those outlined in the Ohio Administrative Code 5122:2-1-02.
   3. The Board shall receive annually from each contract agency the Client Rights Officer's summary of the number of grievances received, type of grievances, and resolution status of grievances.
2. A copy of the Lorain County Board of Mental Health client rights and grievance policy is on file with every contract agency. The document shall be available in English and Spanish.
3. The Board shall maintain oversight of the grievance process and assure all clients equal protection.
   1. The Board shall also keep records of grievances it receives, the subject of the grievances, and the resolution of each.
   2. The Board shall assure the availability of these records for review by the Department of Mental Health upon request.
   3. The Board shall summarize annually its records to include number of grievances received, types of grievances, and resolution status.
   4. The Board shall include client rights and grievances in its Quality Management activities.
   5. All staff of the Lorain County Board of Mental Health shall be informed and clearly understand their continuing responsibility to advise immediately any client or any other person who is articulating a concern, complaint or grievance, about the name and availability of the Board's Client Rights Officer and the complainant's right to file a grievance.

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Grievance Process

Rule 2.1 Where to File a Grievance

1. A grievance should be filed with the entity closest to the incident and progress to other sources of relief if resolution cannot be obtained at the level closest to the incident.
   1. The client who has a concern, complaint or grievance should first try to obtain resolution through the contract agency's grievance procedure by contacting that agency's Client Rights Officer.
   2. If there is evidence that the client has been unable to file a grievance with the contract agency, a client may choose the option of initiating a complaint with the Lorain County Board of Mental Health. They should be encouraged to do so in a timely fashion (30 days from the date of the incident which is being grieved).
   3. Any client, on completion of the grievance procedure of a contract agency, may initiate a grievance with the Lorain County Board of Mental Health.
   4. If the griever is not satisfied with the decision rendered by the Board Client Rights Officer, he or she shall have the right to request a hearing by the Grievance Committee of the Lorain County Board of Mental Health.
      1. The Board Grievance Committee is the Quality Management Committee.
      2. The Grievance Committee will make every effort to resolve the grievance in accordance with the procedures outlined in 2.3(C) below.
      3. The decision of the Board's Grievance Committee will be final.
   5. The griever has the option to further grieve with any or all of the following: (see attachment entitled "Outside Entities"). The Client Rights Officer will provide upon request, relevant information about the grievance to one or more of the organizations specified in "Outside Entities".

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Rule 2.2 Time Frames

1. Every effort should be made to file timely grievances.
   1. Initial grievances should be filed within 30 days of the incident being grieved.
   2. Once a grievance has been filed, there should be resolution or a decision rendered in writing to the client within 20 working days.
   3. If the client is dissatisfied with the decision at one level, a grievance may be filed at the next level within 30 days of receipt of the written decision.
2. In determining whether a grievance has been filed in a timely manner, the Client Rights Officer shall take into consideration whether the delay was caused in whole or in part by any limitations or circumstances such as the client's illness, client's confinement, client's ability to understand and pursue the grievance process, etc.
3. The time frames for filing a grievance are only guidelines and should never be the sole reason for determining that the grievance is inappropriate or does not need to be responded to.

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Rule 2.3 Client Rights Officers and their Responsibilities

1. The Board Client Rights Officer is the person named below and is available at the following location and times:

   Adults (18 and older)
   Blanche Dortch, Director of Community Services
   Lorain County Board of Mental Health
   1173 North Ridge Road East, Suite 101
   Lorain, Ohio 44055
   Hours: M - F 8:30 a.m. - 4:30 p.m.

   Children and Adolescents (younger than 18)
   Sandra McBee Strayer, Ph.D.
   Director of Child and Adolescent Services
   Lorain County Board of Mental Health
   1173 North Ridge Road East, Suite 101
   Lorain, Ohio 44055
   Hours: M - F 8:30 a.m. - 4:30 p.m.

   Client Rights Officers for other community agencies are listed below and are available at the following locations:

   Marcella Krause
   Far West Center
   29133 Health Campus Drive
   Westlake, OH 44145
   (440) 835-6212 x 239

   Franca Curci
   Nord Center
   6140 S. Broadway
   Lorain, OH 44053
   (440) 233-7232 x 4198

   Juliet Stephens
   Bellefaire JCB
   22001 Fairmount Blvd.
   Shaker Heights, OH 44118
   (800) 879-2522

   Marilyn Zeidner
   Safe Harbor
   P.O. Box 718
   Lorain, OH 44052
   (440) 323-3400

   Ralph Thompson
   Pathways Counseling & Growth Center
   312 Third Street
   Elyria, OH 44035
   (440) 323-5707

   Valerie Caruso, LSW
   Applewood Centers
   5255 N. Abbe Road, Suite 1
   Elyria, OH 44035
   (216) 741-2241 x 1312

   Melva Tolbert
   New Sunrise Properties
   1100 N. Abbe Road, Suite A
   Elyria, OH 44035
   (440) 365-9600 x 21

   Carol Hartman
   Gathering Hope House
   1173 North Ridge Road East, Suite 100
   Lorain, OH 44055
   (440) 233-7400 x 4255

   Al Zgonc
   Lorain County Labor Agency
   1936 Cooper Foster Park Road
   Lorain, OH 44053
   (440) 282-7401

   Carol Peck
   Lucy Idol Center
   435 Nicholson Avenue
   Vermilion, OH 44089
   (440) 967-6724

   Nicole Miller
   El Centro de Servicios Sociales
   1888 East 31st Street
   Lorain, OH 44055
   (440) 277-5327 x 22

   Maria Seeley
   Catholic Charities
   628 Poplar Street
   Elyria, OH 44035
   (440) 366-1106 Ext 24

   Brenda Gray
   Beech Brook
   347 Midway Blvd. Suite 301
   Elyria, OH 44035
   (216) 831-2255, Ext 2343 / Toll-Free (877) 546-1225

   
   
2. The Board Client Rights Officer's responsibilities are:
   1. Receive/record the grievance,
   2. If needed, the Client Rights Officer will assist the client in filing the grievance,
   3. Obtain a signed release of information form permitting the Client Rights Officer to discuss complaints/grievances with the contract agency.
   4. Represent the griever at a grievance hearing if the griever desires.
   5. Investigate the grievance on behalf of the griever,
      1. At the discretion of the Client Rights Officer, interviews may be conducted with individuals who may have information relevant to the grievance.
      2. Information from agency files may be reviewed with the client's signed permission.
      3. Investigating the grievance includes obtaining all relevant information about the grievance at the agency level.
   6. Will make every effort to resolve the grievance. If the grievance is successfully resolved at the Client Rights Officer level, a written statement of the resolution signed by the client, the Director of the agency involved, and the Board's Client Rights Officer, shall be forwarded to the client, the agency involved, and a copy in the Board's Client Rights Grievance file.
   7. If no resolution occurs, the Client Rights Officer will issue a formal decision based upon his investigation of the grievance. A copy will be sent to the griever and the individual and/or agency involved.
   8. Maintain records of the grievance, investigation, and resolution/decision.
   9. Prepare Board annual grievance report.

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RESOURCE AGENCIES

Outside Entities

Ohio Department of Mental Health
30 East Broad Street
11th Floor
Columbus, Ohio 43266-0414
(614) 466-2596

Ohio Legal Rights Service
8 East Long Street
5th Floor
Columbus, Ohio 43215-2999
(614) 466-7264

Attorney General's Office
Medicaid Fraud Control Section
30 East Broad Street
17th Floor
Columbus, Ohio 43266-0410
(614) 466-4320

Governor's Office of Advocacy for People with Disabilities
35 East Chestnut Street
Columbus, Ohio 43215-2541
(614) 466-9956

U. S. Department of Health & Human Services
Office for Civil Rights, Region V
300 South Wacker Drive
Chicago, Illinois 60606
(312) 353-1711

Counselor and Social Worker Board
77 South High Street
Columbus, Ohio 43266
(614) 466-0912

State Medical Board
77 South High Street
17th Floor
Columbus, Ohio 43266-0315
(614) 466-3934

Nursing Education & Nurse Registration Board
77 South High Street
17th Floor
Columbus, Ohio 43266-0316
(614) 466-3947

State Board of Psychology
77 South High Street
18th Floor
Columbus, Ohio 43266-0321
(614) 466-8808

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