Oakland Community Health Network

Mission: Inspire hope, empower people, strengthen communities.

OCHN Training Team Mission Statement: “Educate and empower people with the skills and knowledge needed to create a shared responsibility to improve the quality of services being provided.”

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RECIPIENT RIGHTS

ANNUAL TRAINING

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IMPORTANT ANNOUNCEMENT

Please make sure to take the Annual test on a laptop/electronic device which is linked to a working printer. Once you pass(80%) the annual test, the certificate window will pop up and then you can print the certificate.

Note:Please make sure to print the certificate at that time. If you close the certificate window, you will not be able to access it again and will need to retake the course and test.

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OBJECTIVES

  • Review a brief history of the public mental health system.

  • Have a better understanding of the rights of persons served(Recipients) who receive public mental health services in MI.

3. Attain knowledge of abuse and neglect.

4. Learn the Office of Recipient Rights' functions, roles and reporting requirements.

5. Learn how to advocate for persons served.

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What is a Right versus What is a Privilege

  • Voting
  • Driving
  • Working
  • Freedom of Speech
  • Freedom of Religion
  • Use of communication devices

(phone, texting, computers, etc)

  • Having friends of your choosing
  • Receiving & sending mail

Right

•Are entitlements

•Belong to every

person

•Are given by direction

of law

Privilege

•Are earned

•Are easily limitable

•May be withheld

from some or all

Who is a Person Served?

  • A person served is an individual who receives public mental health services.
  • A person served is an individual who receives disability services and/or work accommodations.
  • A person served is an individual of any race, culture, religion, age and socioeconomic background.
  • A person served is an individual who may have a dual diagnosis.
  • A person served is an individual who is a parent, child, grandparent, neighbor, friend or relative..

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Hierarchy of Law

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We CAN ERASE

STIGMA

Choose To:

  • Use Person First Language
  • Avoid Labels
  • Respect Others
  • Focus on Abilities
  • Share BEST Philosophies

MCL 330.1702 (Sec. 702)

Legally competent

MCL 330.1704 (Sec. 704)

People who receive mental health services still have rights, benefits and privileges of any other person under the law.

It Includes:

  • Laws and rights set forth to protect those persons receiving mental health services.
  • Standardized operations.
  • Established the Rights Offices.

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Michigan Mental Health Code 1974

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Michigan Mental Health Code

Chapter 7 In Summary - Individuals have the right to:

  • To receive services suited to(their) condition(s)
  • To have a written plan of service developed in a PCP process
  • To be free from abuse and neglect
  • To be treated with dignity and respect
  • To have their information kept confidential
  • To be free of restraint and seclusion
  • To manage their finances
  • To have freedom of movement
  • To be Free from discrimination
  • To have least restrictive setting
  • To have a safe, sanitary, humane environment

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Treatment Suited to Condition

Services shall be provided in accordance with all applicable standards of care or treatment required by any of the following:

Standards of Care include all State or Federal laws, rules, or regulations; Provider's policies and procedures, written guidelines or protocols, written directives; and a recipient's Individual Plan of Service/PCP.

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Person/ Family Centered Planning Rights

The plan is centered around:

Who? The individual

What? Their goals

When? Their choice/annually/at a time of the person/family’s choice

Where? At a place of the person/family’s choosing

The Individual Plan of Service is the product of the

Person Centered Planning process.

The easiest way to avoid making a mistake that could be considered or constitutes a Rights Violation,

is to support the needs of the individual

by learning, knowing and following the

Individual Plan of Service

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What is Dignity and Respect?

It is NOT:

  • Being condensing when speaking with someone.
  • Being patronizing to others.
  • Assuming that someone receiving or applying for services is incompetent.

IT IS:

  • Being treated well by others.
  • Being treated as an equal.
  • Respecting another's person's right to privacy.
  • Giving a person the right to make choices about his/her life.

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Confidentiality is a Right

A possible violation could be:

  • Photographing, Audiotaping or Videotaping

  • Gossiping or verbally sharing private information

  • Computer communication including email

  • Social Media (Facebook, Twitter, etc.)

  • Talking to anyone without a release of information

  • Paper documents

  • Identifying a recipient in public/in the community

  • Knowing, respecting and maintaining professional boundaries in the above items.

  • Exceptions of confidentiality: signed release, reporting abuse or neglect, medical emergency, duty to warn, or if it’s required by a court of law.

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Let’s learn about Restraint

    • Use of a physical or mechanical device to restrict a recipient’s movement.

Let’s learn about Seclusion

    • Placement of a recipient in a room alone where egress is prevented by any means.

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Limitations and Restrictions

Limitations

are based on an individual's condition and they must be specified in the PCP (IPOS). Limitations are to ensure an individual‘s safety.

Restrictions/Rules

are based on the publicly shared living circumstances of a group of people and must be specified in the House Rules.

The house rules must be agreed upon by the residents of the home to ensure individual rights of privacy, dignity and respect, and freedom from coercion and restraint.

Residents are allowed to make life choices for themselves, which includes choosing services, how services will be provided and in a setting that supports the individual's needs.

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LET’S LEARN ABOUT THE ABUSE CATEGORIES

Abuse I: A non-accidental act or provocation of another to act that results in:

  • Death

  • Sexual abuse Per the Michigan Penal Code, Sexual abuse is defined as any sexual contact or sexual penetration of the “Intimate parts” and “Sexual contact” done for a sexual purpose for: Revenge, to inflict humiliation or out of anger.

  • Serious physical harm is defined as physical damage suffered by a recipient that a physician or registered nurse determines caused or could have caused the death of a recipient, caused the impairment of his or her bodily functions, or caused the permanent disfigurement of a recipient.

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ABUSE I

Office of Recipient Rights received Incident Report which revealed that recipient alleged she had sex with the maintenance worker.

During the course of the investigation, it was determined that the maintenance worker was an Agent of the Provider and was responsible for all Recipient Rights standards and requirements in the Mental Health Code.

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Abuse II: A non-accidental act or provocation of another to act results in:

  • Non-serious physical harm: Physical determined by a physician or registered nurse which did not cause or contributed to the death of a recipient, the permanent disfigurement of a recipient, or an impairment of his or her bodily function e.g. cuts and bruises.
  • Unreasonable force: Any physical management or force that is applied by an employee, volunteer, or agent of a provider to a recipient where there is no imminent risk of significant injury to the recipient, staff or others.
  • Emotional harm: An impaired psychological functioning, growth, or development of a significant nature as evidenced by observable physical symptomatology or as determined by a psychologist or psychiatrists
  • Exploitation: Economic, material or emotional harm due to a staff person’s assumptions that the recipient is incompetent. Remember we went over dignity and respect and presumed incompetence.

Abuse Class II can also be

making a decision on behalf of a recipient

that results in:

Economic

Material

Emotional harm

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ABUSE CLASS II

Incident Report was received, documented recipient was behaving in a hostile manner towards Staff 1. Staff 2 intervened and in the process of de-escalating the hostile recipient, the recipient fell and staff noticed three reddish/bluish marks on his upper right arm.

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Abuse III: Using language (verbal) or other means of communication (non-verbal) to:

  • Degrade

  • Threaten

  • Sexually Harass

Abuse Class III

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ABUSE CLASS III

Office of Recipient Rights received an Incident Report, it was reported that recipient was exhibiting some challenging behaviors, staff person told her to "stop or the police would come pick her up and take her to jail."

The IR also stated "I threatened to complete an IR on the recipient."

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Abuse

Abuse I results in death, sexual abuse, or serious physical harm.

Abuse II is when unreasonable force is used when there is no risk of physical harm to self or others.

Abuse III is the use of language or other means of communication to degrade, threaten or sexually harass a recipient.

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LET’S LEARN ABOUT THE NEGLECT CATEGORIES

Neglect I: An act or failure to follow a standard of care:

  • Death

  • Sexual abuse

  • Serious physical harm

  • The Failure to report Abuse I or Neglect I

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There was a lake not far from the recipient's residence, since recipient did not know how to swim there was a requirement in the recipient's plan of service that he was not to be outside without supervision.

Recipient went outside onto the back porch. The staff person thought, "Oh, I'll just watch him from the window while I make dinner." Recipient wandered off and drowned in the lake.

NEGLECT CLASS I

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Neglect II: An act or failure to follow a standard of care…

  • Non-serious physical harm

  • Emotional harm

  • or the Failure to report Abuse II or Neglect II

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NEGLECT CLASS II

NON-SERIOUS PHYSICAL HARM

The Office of Recipient Rights received Incident Reports indicating that on 8/25/16 during the unloading process the recipient drove her wheelchair into the railing of the entrance ramp to the home, which resulted in recipient fracturing her tibia.

Recipient’s Plan of Service indicates that staff are to remain with her during the entire process of loading/unloading her in the van.

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Neglect III: An act or failure to follow a standard of care that either placed or could have placed a recipient at risk of harm:

  • Physical harm

  • Sexual abuse

  • The Failure to report Abuse III or Neglect III

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NEGLECT CLASS III

RISK OF PHYSICAL HARM

On 11/28/16 the Office of Recipient Rights received an IR, written on the same day, that alleged that on 11/27/16, Staff 1 failed to put on Recipient’s seizure bracelet after having showered him.

This bracelet per the Recipient’s Person Centered Plan, is to be worn at all times in accordance with seizure protocol.

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  • Self-Determination is a fundamental human right for people to be able to control their lives and resources.

  • May receive services from various service provider in and outside of county of residence.

  • May become an Employer of Record.

  • Beware of a possible dual relationship such as being a family member/friend and paid staff. Maintain professional boundaries.

Individuals may receive their services through a

Self- Determination arrangement.

Five Principles of Self-Determination

  • FREEDOM- The opportunity to choose where and with whom one lives as well as how one organizes all important aspects of one’s life with freely chosen assistance as needed.
  • AUTHORITY-The ability to control some targeted amount of public dollars.
  • SUPPORT-The ability to organize that support in ways that are unique to the individual.
  • RESPONSIBILITY-The obligation to use public dollars wisely and to contribute to one’s community.
  • CONFIRMATION-The recognition that individuals with disabilities themselves must be a major part of the redesign of the human service system of long term care.

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Skills Promoting Rights Protection

Gentle Teaching is about learning how to interact and communicate with recipients in ways that make the recipient feel safe, loved or valued, loving toward others and engaged.

Cultural Competency refers to an ability to interact effectively with people of different cultures and socio-economic backgrounds, particularly in the context of human resource and non-profit organizations.

Recovery Model is the movement started by recipients who campaigned for more choice and improved services and user-led alternatives. This movement helped recipients take control of their treatment and their lives.

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Complaint Investigations

  • The purpose of a complaint is specifically to report a rights violation to report any situation that could constitute an alleged violation under the Michigan Mental Health Code.

  • In order for ORR to open a rights investigation, the accused must be an employee, a volunteer or a student working for CMH or a contracted agency and the victim must be a recipient.

  • If there is Abuse or Neglect, it has to be reported immediately by phone and a written complaint form must to faxed within 24 hours.

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Q. Who can make a rights complaint?

Anyone

Q. What is the purpose of a complaint?

Report an alleged violation under the code

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Who Should I Report To?

  • APS/CPS Abuse and Neglect

Toll Free (855) 444 - 3911

  • Office of Recipient Rights (ORR)

Toll Free (877) 744 – 4878

Video Conference Phone (248) 209 – 6902

  • Bureau of Child and Adult Licensing (BCAL)

(855) 444-3911

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Incident Report Policy Requirements

OCCMHA requires 24 hour submission

  • 3 C’s: clear, concise, complete

  • Failure to submit a timely Incident Report may result in a Rights violation

  • Two (2) or more employees need to complete an I/R if the two cannot agree upon the details of the event.

  • Each recipient should have a separate IR

  • Contact the Office of Recipient Rights immediately in circumstances of death, suspected abuse and/or neglect

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Incident Reports (IRs)

Who can file an IR: Employees

Purpose of the I/R: To report any unusual event, including rights issues

Employee Protection Laws

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Sec 755 (1)(b) of the Michigan Mental Health Code: Complainants, staff of the state office of recipient rights, and any staff acting on behalf of a recipient will be protected from harassment or retaliation resulting from recipient rights activities.

Whistleblower's Act (of 1980): If you are being discharged, threatened, or otherwise discriminated against regarding your compensation, terms, conditions, locations, or privileges of employment because you take part in a public hearing, investigation, inquiry, or court action you may bring a civil action within 90 days of the alleged violation.

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Office of Recipient Rights

ORR Functions

  • Monitoring
  • Prevention
  • Training
  • Interventions

ORR office responsibilities include

  • Volunteer Monitors
  • Peer Rights Allies
  • Investigations
  • Complaints
  • IR's
  • Residential site monitoring

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  • ORR has unimpeded access to all information at all site for investigations, interventions and monitoring.

  • Employees must comply with any request for information or interviews during the investigative process.

  • ORR completes investigations and makes a determination for preponderance of evidence of a rights violation.

  • ORR makes recommendations for remedial action.

  • Investigation is completed within 90 calendar days.

  • A “Report of Investigative Findings” will be given to the Director of OCCMHA and to the service provider.

  • The Director issues a summary report to the complainant and the recipient after 7 to 10 days of the investigation

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Due Process

File an action when services are:

Reduced

Terminated

Suspended

Denial

File an action by:

Medicaid Fair Hearing

Local Appeal

Rights Complaint

Grievance

Second Opinion

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CONTACT INFORMATION

Who should I call if I have questions?

Office of Recipient Rights(ORR): (248) 858-1202

ORR Toll Free: (877)744 – 4878

Customer Service: (800) 341 – 2003

Video Conference Phone for hearing impaired: (248) 209 – 6902

OCHN has a No Wrong Door Policy

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Today We Learned…

  • A brief historical view of the public mental health system.
  • Gained a better understanding of the rights of persons served who receive public mental health services in Michigan.
  • Learned about Mental Health categories such as Abuse, Neglect .
  • Learned the Office of Recipient Rights' functions, roles including the required reporting requirements.
  • Learned how to advocate for persons served.

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Please click the link below to take the Annual Test

Please make sure to take the Annual test on a laptop/electronic device which is linked to a working printer. Once you pass the annual test, the certificate window shall pop up.

Please make sure to print the certificate at that time. If you close the certificate window, you will not be able to access it again and will need to retake the course & test.

TAKE THE TEST

Annual Rights Powerpoint - Google Slides