The Life of a Complaint

1. The Life of a Complaint Human Rights Regulations Training Office of Human Rights Musa Ansari Assistant Human Rights Director May 2002

2. This Human Rights Regulations Training is being held in Region II • The Regional Advocate for this region is Ms. Mary Towle. • Ms. Ann Petrie is the Human Rights Advocate at NVMHI. • Ms. Ophelia Okafor is the Human Rights Advocate at NVTC. • Regional Secretary is Ms. Joyce January • Toll Free: 887-600-7431

3. The Human Rights Regulations protects the rights of Individuals Like Us • Regardless of age, ethnic background, gender, occupation, or other conditions of life.

4. The Human Rights Regulations protects the rights of Individuals Like Us • Regardless of where we are from.

5. If I need mental health, mental retardation, or substance abuse services. • What will happen to me? • What will happen to my freedom, my legal rights, my civil rights, my constitutional rights, my human rights? • If I have a complaint, will anybody listen? • Will anybody help me exercise my rights?

6. What policy is expressed in the Human Rights Regulations? • The expressed policy of the State Board of Mental Health, Mental Retardation and Substance Abuse Services is that: • 1. Each individual has a right to exercise his or her legal, civil, and human rights, and the rights contained in the Human Rights Regulations. • 2. Each individual has the right to be protected, and supported in exercising these rights.

7. It is also the expressed policy of the State Board that: • 3. Providers cannot partially or totally take away or limit the rights of the individual solely because: • A. The individual has a mental illness, mental retardation, or substance abuse problem and is receiving services for these conditions. • B. Or because the individual has a physical or sensory condition that may pose a barrier to communication or mobility.

8. If I have a complaint will anybody listen?

9. The Life of a Complaint • We may not be able to keep a complaint from being born-- • But how long a complaint lives depends on the nature of the complaint and the efforts to resolve it at the earliest possible step.

10. If I complain will anything happen? • When an individual makes a complaint, the provider shall make every attempt to resolve the complaint to the individual’s satisfaction at the earliest possible step. • Providers shall not take, threaten to take, permit, or condone any action to retaliate against or prevent anyone from filing a complaint or helping an individual to filea complaint. • Providers shall assist the complainant in understanding the full complaint process, the options for resolution, and the elements of confidentiality involved.

11. The provider must listen to my complaint, protect my rights, and my right to complain? Yes, each individual has a right: • to complain that his or her provider has violated any of the rights assured under the human rights regulations. • to have a timely and fair review of any complaint according to the Human Rights Regulations. • to have someone file a complaint on his or her behalf. • to use the Human Rights Complaint Procedures and any other complaint procedures. • to complain under any other applicable law, including complaints to the protection and advocacy agency.

12. If I complain, Who will help protect my rights? • The provider’s designee, and the provider’s employee must listen and help resolve the complaint. • The Human Rights Advocate will help you protect your rights. • The LHRC and SHRC will help to protect your rights.

13. The provider has specific things to do to protect my rights? • Yes. The provider must: • Identify a person or persons accountable for helping individuals to exercise their rights and resolve complaints regarding services. • Require competency-based training upon employment, and annually thereafter. • Communicate information about the availability of the human rights advocate. • Assure that an LHRC is available for all individuals receiving services.

14. The employee has a duty to listen, resolve, and report my complaint to the provider? • Yes, the employee must: • Become familiar with the Human Rights Regulations and comply with them in all respects. (e.g., employer orientation and training). • Protect the individual from any form of abuse, neglect and exploitation. • Cooperate with any investigation, meeting, or hearing, or appeal held under the Human Rights Regulations. • Help individuals understand and assert their rights.

15. What are the roles of the Human Rights Advocate? The Advocate: • Provides consultation to individuals, providers, governing bodies, directors and employees regarding individuals’ rights, providers’ duties, and complaint resolution. • Provides orientation, training, and technical assistance to the LHRC. • Investigates and examines all conditions which may interfere with the free exercise of individuals’ rights. • Represent any individual making a complaint or, upon request, consult with and help any other representative the individual chooses.

16. What’s the LHRC and SHRCWhat can they do to help? • The LHRC and SHRC: • Upon the request of the Human Rights Advocate, provider, director, and individual or individuals receiving services, or on its own initiative, an LHRC or the SHRC may review any existing or proposed policies, procedures, or practices that could jeopardize the rights of one or more individuals receiving services.

17. What’s the LHRC and SHRCWhat can they do to help? • The LHRC and SHRC: • May consult with any Human Rights Advocate, employee of the director or anyone else. • Makes recommendations to the director concerning changes in policies, procedures, and practices. • Receives complaints of alleged rights violations. • Holds hearings according to the Human Rights Regulations.

18. What’s the LHRC and SHRCWhat can they do to help? • The LHRC and SHRC: • Can conduct investigations, and hold fact-finding conferences. • Each facility operated by DMHMRSAS is served by an LHRC. • Each Community Services Board (CSB), BHA, and/or provider licensed or funded by DMHMRSAS is required to establish an LHRC, or affiliate with an LHRC established by another provider.

19. The LHRC and SHRC Who are they? • The LHRC: • Consists of members broadly representative of professional and consumer interest. • None are employees of DMHMRSAS, the provider, or serve on the board of the provider for which the LHRC provides oversight. • Members are appointed by the SHRC. • Is supervised by the SHRC.

20. The LHRC and SHRC Who are they? • The SHRC: Appoints the members of the LHRC. • Determines the appropriate number and geographical boundaries of LHRCs. • Consolidates LHRCs serving only one provider into regional LHRCs to assure greater protection of rights under the Human Rights Regulations. • Review decisions of LHRCs. • Hold hearings and make recommendations to the commissioner, the board, and provider’s governing bodies regarding alleged violations of individuals’ rights. • Provides oversight and assistance to LHRCs.

21. The SHRC--Who are they? • The SHRC: • Consist of members appointed by the DMHMRSAS Board. • None are DMHMRSAS board members, or employees of DMHMRSAS, or a CSB. • Members broadly represent professional and consumer interest and geographic areas of the Commonwealth.

22. If I have a complaint who will listen? • The Provider. • The Provider’s designee. • The Provider’s employee. • The Human Rights Advocate. • The LHRC. • The SHRC. • The SHRD. • The Protection and Advocacy Agency.

23. What is a Human Rights Complaint? • A Complaint is: • An expression of dissatisfaction, grievance, or concern. • By an individual receiving services; or, by someone (e.g., an employee, human rights advocate, Legally Authorized Representative) on behalf of the individual. • Brought to the attention of the Provider, Advocate, or Protection and Advocacy Agency. • And alleges a violation of the Human Rights Regulations, or program policies and procedures related to the Human Rights Regulations.

24. What happens when I complain? • The Complaint process starts when an allegation is brought to the attention of anyone. • The Provider is required to have in place an informal complaint process by which the complaint can be resolved at the earliest possible step.

25. How does the Informal Complaint Process work? • You complain. • The employee listens and proposes a solution or brings about a solution within five work days or less; unless you want the complaint to be a formal complaint. • If you are satisfied, the complaint process is completed. The complaint process resolved your concern. It is documented in accord with the provider’s policy. • If want the complaint to be formal, or you are not satisfied, the informal complaint process ends and the formal process begins. The Human Rights Advocate is notified immediately that you are not satisfied with the provider’s proposed solution.

26. I am not satisfied, what happens next? • The employee, or the director’s designee will follow the provider’s policy and notify the director that you have a formal complaint. • The Human Rights Advocate will be notified immediately that you have a formal complaint. • If you contacted the advocate directly. The Advocate would notify the director that you have a formal complaint. • In all instances you must be informed of your rights under the Human Rights Regulations.

27. What can the Advocate do when he or she is contacted for a Formal Complaint? • The Advocate must review the complaint to determine: • A. Is there reason to believe that there is substantial risk that serious and irreparable harm will result if the complaint is not resolved immediately. • B. Is this a matter that requires investigation, consultation, technical advise, prevention or correction, monitoring, mediation, negotiation, or enhance the voice of the individual.

28. If there is substantial risk that serious and irreparable harm will result if the complaint is not resolved immediately. • The Advocate informs the director, the provider’s governing body, and the LHRC. • The LHRC conducts and concludes a hearing according to special procedures for emergencies within 72 hours. • The director develops and implements an action plan within 24 hours of getting the LHRC recommendation. • The LHRC must conduct a full hearing within five work days if the Advocate or the Individual objects to the LHRC recommendations or the director’s action plan.

29. What if there IS NOT substantial risk that serious and irreparable harm will result if the complaint is not resolved immediately? • The Advocate notifies the director of the complaint(e.g., sends a documented complaint to him or her). • The director attempts to resolve the complaint by meeting within 24 hours with the Individual, and conducting an investigation if necessary. • The director gives a written decision (e.g., an action plan) to the Individual within 10 working days of being notified of the complaint. • If the Individual is satisfied, the formal complaint process is finished. • If the Individual is not satisfied, the complaint process continues.

30. I am not satisfied with the proposed solution. • The Individual must inform the director the he or she is not satisfied in writing within 5 working days after getting the director’s decision. • The director either does an additional investigation, or issues his or her final decision (to the Individual and Advocate) within 10 working days of the Individual’s notice of dissatisfaction. • If the Individual is satisfied with the director’s decision, the formal complaint process is finished. • If the Individual is not satisfied, the formal complaint process continues to the LHRC.

31. LHRC’s authority to hear and review allegations of rights violation. • The LHRC is authorized to hold a hearing to review allegations made by an Individual under the following conditions: • A. The Individual is notsatisfied with a provider’s final decision and action plan. • B. The Individual is not satisfied with a provider’s final action following a report of abuse, neglect or exploitation. • C. The Individual is not satisfied with a provider’s final decision following a complaint of discrimination.

32. What happens if I am not satisfied with the Action Plan or the LHRC decision? • Any party (i.e., the Individual or the provider) may appeal to the State Human Rights Committee if not satisfied with: • A. The LHRC’s final findings of fact and recommendation. • B. A director’s final action plan following the LHRC hearing. • C. The LHRC’s final decision regarding the capacity of an individual to consent to treatment, research, or disclosure of confidential information. • D. The LHRC’s final decision concerning whether consent is needed for the director to take a certain action.

33. What are some of my Individual Rights? • Dignity -- right to be protected, respected, supported. • Services -- right to obtain services in accord with law and sound therapeutic practice. • Participation in decision making-- right to participate meaningfully in decisions regarding all aspects of services. • Confidentiality -- right to all information about me remain confidential. • Access to and correction of service records -- right to see, read, and get a copy of my services records.

34. What are some of my Individual Rights? • Restrictions to freedoms of everyday life -- right to enjoy freedoms of everyday life consistent with my need for services, my protection, and the protection of others. • Use of seclusion, restraint, and time out -- right to be completely free from unnecessary use of seclusion, restraint, and time out. • Work -- right to engage or not engage in work or work-related activities consistent with my service needs. • Research -- right to choose to participate or not participate in human research.

35. I have a Complaint, will anybody listen? • As Provider? • As Employee? • As Advocate? • As LHRC?

36. To Resolve a complaint you will need an Plan of Action • Identify the issues and recommended resolutions. • Thoughts : • Informal resolution process. Developed? Is it known? • Completed within five working days? Formal complaint process? • Provider’s role? Provider’s designee’s role? • HR Poster? Advocate identification, information? • Staff duties, training? • Individual’s rights? Dignity? Confidentiality? Services? • Diet? Individual Service Plan? Abuse, Neglect, Exploitation? • Restrictions on everyday life? • Notice to Director, Director’s designee? Notice to Advocate?

37. Allegation ReportTaken by Ed. Vokitt, Human Rights Advocate • On the 22nd A. Keem Plaint came to me and said: • On the 16th I didn’t know who to talk with to get help. • I didn’t see anything that said who the Advocate was, or that you worked here, or how to get in touch with you. • I asked two of the workers to help me keep E. Tall from taking my snacks and eating my dessert. • Steff Newhire said she was getting off work in a minute, so I should tell Mr. Nex Shiff about it. • Mr. Nex Shiff told me to talk with Ms. Rea Play when she comes in. • Ms. Rea Play came in at 3 pm the next day. She said I could call the Advocate, but she’d have to find the number and give it to me. • Ms. Rea Play gave me the number around 8 pm last night, the 21st. I called you first thing this morning. I can’t take this! E. Tall eats all my sweats! Nobody stops him! I can’t get no help! Can’t he be locked up in his room? Can’t he be move to another unit? He’s a diabetic too!

38. What actions would you take to resolve the issues in this complaint? • If you were the provider’s director? • If you were the Advocate? • If you were an LHRC member? • If you were the head of the treatment team?

39. Allegation ReportTaken by Employee • On the 1st I came to work. Ms. Younglady came to me and said, “she likes Ms. Nicestaff but she’s getting in my way.” • “She is always straightening out my blouse. She means well, but I like my clothes the way I wear them. I am not a child!” • “I asked her to stop. “She just smiles and says, ‘you want to look nice don’t you?’ ‘If you want to get out of here you need to be able to take care of yourself.” • “Every time she does this I feel bad. I told the social worker”. • “I told the treatment team. Everybody says, ‘she means well, we will talk to her.’ But, she keeps on doing it!” • “Don’t I have any rights?”

40. What actions would you take to resolve the issues in this complaint? • If you were the provider’s director? • If you were the Advocate? • If you were an LHRC member? • If you were the head of the treatment team?

41. Thank you for attending The Life of a Complaint • We may not be able to keep a complaint from being born-- But how long a complaint lives depends on the nature of the complaint and the efforts to resolve it at the earliest possible step.