HONORING INDIVIDUAL RIGHTS

1. HONORING INDIVIDUAL RIGHTS Alabama Department of Mental Health Division of Developmental Disabilities

2. Introduction:Individuals supported are afforded all rights and personal freedoms as all citizens. Exercised in the least restrictive environment.

3. DD Administrative Code Chapter 580-5-33 -.04Promotion and Protection of Individuals Rights • The organization implements a policy and procedure that clearly defines it commitment to and addresses the promotion and protection of individual rights of people. • The policy lists rights afforded all citizens as indicated by the United Nation’s Declaration of Human Rights, by the constitution, laws of the country and State of Alabama

4. Honoring Individual Rights • The policies and procedures describe the organization’s due process that includes individual rights in the event of proposed restriction of a person’s rights. (4) The organization has no standing policies or procedures that restrict peoples rights without due process

5. Honoring Individual Rights • The organization documents upon admission and annually thereafter, verification that it provides to persons and their legally authorized representatives an oral and written summary of rights/responsibilities and how to exercise them, in a language that the person understands

6. Honoring Individual Rights • Each person’s ability to understand and exercise his or her rights is assessed and updated on an ongoing basis, but at least annually. • The rights assessment results, including supports needed to protect and promote the person’s rights , are clearly documented in the person’s record • The rights assessment addresses people’s civil and legal rights and personal freedoms. The assessment includes, but is not limited to the ability to do the following:

7. Honoring Individual Rights Exercising freedom of movement • Individuals move freely in their home, daily activities, neighborhood and community • Have access to everything in the home • No areas of the home are off limits/locked

8. Honoring Individual Rights Manage Money • Individuals supported should be able to manage their money anyway they choose including: • Having a checking account • Savings account • A debit card, credit cards • To earn money • How they spend their money • Manage their money

9. Honoring Individual Rights Send/Receive Mail • Individuals should be able to send/receive mail • To read their mail or have someone read it with their permission • This may include email, text messaging, face book, skype, face time

10. Honoring Individual Rights • Make and receive telephone calls and use other forms of communication whenever they choose. • Other forms of communication may include email, skype, face book, text messaging, twitter, face time, etc. • Staff members provide assistance to individuals with communication as needed/requested by the person.

11. Honoring Individual Rights Visit or be visited by anyone they choose • Individuals may visit and be visited by the frequency they desire. • People respect the privacy of the individuals and their visitors.

12. Honoring Individual Rights Access Personal Possessions • Individuals should have free access to their personal possession whenever they choose. • Individuals should never have to ask for their personal possessions.

13. Honoring Individual Rights Vote and otherwise participate in the political process • Individuals supported who are 18 years and older and have not been deemed incompetent. • Have expressed an interest in voting • Become involved in a campaign of a candidate they support • Staff members provide support by educating the person in voter registration and the process.

14. Honoring Individual Rights Make Choices about Religious Affiliation and Participation • A person should be able to choose their own faith and participate as often as they would like. • The person may want to have more involvement in their faith for example become a member of the choir or have more of a leadership role.

15. Honoring Individual Rights Interact socially with members of either gender • A person supported should be able to have opportunities to establish and maintain relationships. • The individual should have as much contact with these relationships at the frequency they choose. • The support staff assists the individual in exploring opportunities to meet people and socialize if they are interested.

16. Honoring Individual Rights An individual’s most basic freedom: Making Choices • Examples: Where should I live? Who I want to live with? What kind of job do I want? What services do I want? What daily activities do I want to do? What goals do I want to accomplish? What social roles do I want to perform?

17. Honoring Individual Rights Responsibilities of the individual • People supported should also understand with rights come responsibility. • The rights of others are respected as individuals enjoy exercising theirs.

18. Honoring Individual RightsExercising and Prioritizing Rights • People supported prioritize and exercise rights that are important to them • People choosehow and how often they exercise their rights

19. Honoring Individual RightsPrioritizing Rights • Support Staff recognize and respect individuals preferences for exercising their rights including how people choose to exercise their rights. • Support Staff provide assistance for individuals to identify goals related to exercising their rights and provide the supports in the attainment of those goals. • The individual’s outcomes and supports in regards to exercising their rights are part of their person centered plan. The progress made is tracked with target and completion dates.

20. Prioritizing Rights Examples • Example: “Being a registered voter is something I value and is very important to me. I want to vote in all elections not just national elections. I would also like to be involved in a campaign of a candidate I support.” • Example: “My faith is important to me. I enjoy attending St. John’s Catholic church, but I only want to attend every other Sunday. I do like to spend some Sunday mornings just drinking coffee and reading the paper.”

21. Honoring Individual RightsWhat is a Rights Restriction? A restriction means anything that limits or prevents a person from freely exercising his/her rights. Something is usually considered restrictive if it impedes the enjoyment of general liberties that are available to all citizens.

22. Honoring Individual RightsExamples of Rights Restrictions • Locked areas • Restricted diet • Representative Payee • Schedules (smoke, snack, activity, etc.) • Not allowed to date • Bed Times

23. Honoring Individual RightsExamples of Rights Restrictions, Cont. • Privacy • Not able to choose my activities/entertainment • Taking medication • Asking permission • Telling staff before I do things

24. Honoring Individual RightsDue Process • An individual’s rights cannot be restricted without due process. • Due process is defined as providing people supported and their legally authorized representatives with a fair process requiring, at least an opportunity to present objections to the proposed action being contemplated. Due process, including review by a human rights committee, is implemented when it is proposed that a person’s rights be restricted for any reason. 580-5-33-(22)

25. Honoring Individual Rights Due Process (Continued) • The support team must meet with the individual/legal representative and provide a valid reason for the restriction in a language that is understood. • The individual/legal representative can provide input regarding any objections to the restriction.

26. Honoring Individual Rights Due Process (Continued) • The support team will develop a plan of removal of the restriction with a training component. The plan is explained to the person/legal representative including the benefits of the training component. • The individual is supported to attend the HRC meeting including an invitation to attend. The individual does not have to attend the meeting and may send a representative. However, it is important to provide additional supports to prepare the individual for the meeting • The HRC and in some cases the BPRC will review the restriction and the plan of removal and make a determination the restriction and plan is in the best interest of the person.

27. Honoring Individual Rights Due Process? (continued) • Once a determination is made by the HRC and BPRC (if applicable) a restriction is imposed. • The progress of the training component is tracked with target and completion dates • The restriction and plan is reviewed by the QDDP at least quarterly or at the request of the person and at least annually by the HRC and BPRC (if applicable)

28. Preparing for my HRC meeting • Training in due process • Understanding the restriction is only temporary • An understanding of the of the plan of removal and satisfaction with it • Benefits of the training component and the importance of target and completion dates • Risks involve should the plan include physical holds to manage my behavior • Knowing I have support to present any objections of the restriction or provide any input I choose

29. Honoring Individual Rights Guardianship • Guardianship is a legally appointed representative of an individual who has been deemed incompetent by the court. • A person’s rights should not be limited because they have a legal guardian. • If a person has a legal guardian is important to know the type and scope of guardianship.

30. Honoring Individual RightsTypes of Guardianship in Alabama • Limited: The guardianship is specific so the person’s freedoms and choices are retained. • Full: The guardian can make decisions in areas of a person’s life where the person does not have the capability in making those decisions which includes financial, medical, where the person lives and social interaction. • Conservatorship: Similar to guardianship as it is appointed by the probate court, however is limited to only making financial decisions for the person.

31. Honoring Individual Rights Decision Making • Decision making supports are provided for people as needed. • Organizations refrain from presuming incompetence or denying people their rights to manage financial or personal affairs or exercise their rights solely by his/her having received support services, unless legally determined otherwise. 580-5-33-04 (17)

32. Honoring Individual Rights Decision Making • People make decisions in their daily lives for example: Excepting a job offer Choosing a roommate Buying a new television Taking a new medication CQL

33. Honoring Individual RightsDecision Making • When making decisions people typically talk to a friend or someone they trust or that has more experience • They may want to make a list of pros and cons before they make a decision • Get more information about options CQL

34. Honoring Individual RightsDecision Making • Learn about the person • Not making the decision for the person • Putting people in charge in exploring options and providing assistance as needed will empower them • Let the person make the wrong decision, they will learn from it CQL

35. Honoring Individual RightsDecision Making • Unless a legal determination of incompetence to participate in one or all of the following activities has been made, every person is free to access courts, attorneys and administrative procedures, execute instruments, dispose of property, marry and divorce or participate in those activities generally requiring legal representation, without fear of reprisal, interference or coercion. 580-5-33-04 (17) • People only receive the level of support needed to make their own decisions. Supports include advocating for themselves. 580-5-33-04 (18)

36. Honoring Individual Rights • Each person has a written plan to obtain advocacy guardianship and alternatives to guardianship if those supports are needed.580-5-33-04 (18) • The level of supports needed should be clearly identified in the individual’s person centered plan.

37. Honoring Individual Rights “ Nothing about me without me” • Individuals/legally authorized representative should give written informed consent before any information is shared about them . • Consent can be withdrawn by the individual/legally authorized representative at any time. • Individuals should know what personal information is in their file about them • Have someone to explain the information in their file should they want more information about it. • Have access to their personal information

38. Honoring Individual Rights Abuse, Neglect, Mistreatment and Exploitation • Abuse can physical, verbal and emotional and is not limited to the following: Examples: “People yell at me, hit me or embarrass me.” “ My staff member pinched me the other day.” • Neglect is the failure to carry out duty through inattentiveness or disregard of duty exposing an individual/individuals to harm Examples: “There’s never enough food in my house” “ I feel sick, but no one will take me to the doctor” “ My staff member comes to work, but always falls asleep on the sofa”.

39. Honoring Individual Rights • Mistreatment is any act or threat of intimidation or harassment Examples: “My staff member told me I was fat and needed to go on a diet.” “ I want to learn how to drive, but my staff member told me I wasn’t smart enough to learn how.” • Exploitation is utilizing the position of employment to take advantage of an individual for personal benefit Examples: “My staff member told me to wash her car.” “ I went to the ATM with a staff member yesterday and he took $20.00 from me.”

40. Honoring Individual Rights Dignity of Risk • Individuals supported are constantly growing and changing. Through their training programs they will become more capable and confident. • While assuring their safety, staff members can provide support by asking, listening and negotiating. • People who are supported must be given the opportunity to make decisions that may be risky. They may fail or make a mistake, but as all of us will learn from it.

41. Honoring Individual Rights “Assist me to have a voice listen to what I say when I tell you what I want, respond in a way that tells me I’m a person first and foremost and respect me by acting on what I say” CQL

42. The End