2019 -- H 5032

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LC000220

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS

     

     Introduced By: Representatives Diaz, Slater, Tobon, Bennett, and McNamara

     Date Introduced: January 04, 2019

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 40.1-22-13 of the General Laws in Chapter 40.1-22 entitled

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"Developmental Disabilities" is hereby amended to read as follows:

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     40.1-22-13. Visits.

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     No public or private developmental disabilities facility shall restrict the visiting of a

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client by anyone at any time of the day or night; however, in special circumstances when the

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client is ill or incapacitated and a visit would not be in his or her best interest, visitation may be

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restricted temporarily during the illness or incapacity when documented in the client's

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individualized program plan, as defined in § 40.1-21-4.3(7).

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     SECTION 2. Section 40.1-26-3 of the General Laws in Chapter 40.1-26 entitled "Rights

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for Persons with Developmental Disabilities" is hereby amended to read as follows:

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     40.1-26-3. Participants' rights.

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     In addition to any other rights provided by state or federal laws, a participant as defined

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in this chapter shall be entitled to the following rights:

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     (1) To be treated with dignity, respect for privacy and have the right to a safe and

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supportive environment;

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     (2) To be free from verbal and physical abuse;

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     (3)(i) To engage in any activity including employment, appropriate to his or her age, and

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interests in the most integrated community setting;

 

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     (ii) No participant shall be required to perform labor, which involves the essential

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operation and maintenance of the agency or the regular supervision or care of other participants.

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Participants may however, be requested to perform labor involving normal housekeeping and

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home maintenance functions if such responsibilities are documented in the participant's

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individualized plan;

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     (4) To participate in the development of his or her individualized plan and to provide

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informed consent to its implementation or to have an advocate provide informed consent if the

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participant is not competent to do so;

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     (5) To have access to his or her individualized plan and other medical, social, financial,

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vocational, psychiatric, or other information included in the file maintained by the agency;

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     (6) To give written informed consent prior to the imposition of any plan designed to

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modify behavior, including those which utilizes aversive techniques or impairs the participant's

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liberty or to have an advocate provide written informed consent if the participant is not competent

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to do so. Provided, however, that if the participant is competent to provide consent but cannot

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provide written consent, the agency shall accept an alternate form of consent and document in the

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participant's record how such consent was obtained;

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     (7) To register a complaint regarding an alleged violation of rights through the grievance

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procedure delineated in § 40.1-26-5;

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     (8) To be free from unnecessary restraint. Restraints shall not be employed as

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punishment, for the convenience of the staff, or as a substitute for an individualized plan.

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Restraints shall impose the least possible restrictions consistent with their purpose and shall be

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removed when the emergency ends. Restraints shall not cause physical injury to the participant

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and shall be designed to allow the greatest possible comfort. Restraints shall be subject to the

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following conditions:

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     (i) Physical restraint shall be employed only in emergencies to protect the participant or

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others from imminent injury or when prescribed by a physician, when necessary, during the

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conduct of a specific medical or surgical procedure or if necessary for participant protection

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during the time that a medical condition exists;

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     (ii) Chemical restraint shall only be used when prescribed by a physician in extreme

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emergencies in which physical restraint is not possible and the harmful effects of the emergency

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clearly outweigh the potential harmful effects of the chemical restraints;

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     (iii) No participant shall be placed in seclusion;

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     (iv) The agency shall have a written policy that defines the use of restraints, the staff

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members who may authorize their use, and a mechanism for monitoring and controlling their use;

 

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     (v) All orders for restraint as well as the required frequency of staff observation of the

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participant shall be written;

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     (9) To have reasonable access, at any time, to telephone communication;

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     (10) To receive visitors of a participant's choosing at any time all reasonable hours;

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     (11) To keep and be allowed to spend a reasonable amount of one's own money;

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     (12) To be provided advance written notice explaining the reason(s) why the participant

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is no longer eligible for service from the agency;

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     (13) To religious freedom and practice;

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     (14) To communicate by sealed mail or otherwise with persons of one's choosing;

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     (15) To select and wear one's own clothing and to keep and use one's own personal

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possessions;

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     (16) To have reasonable, prompt access to current newspapers, magazines and radio and

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television programming;

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     (17) To have opportunities for physical exercise and outdoor recreation;

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     (18)(i) To provide informed consent prior to the imposition of any invasive medical

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treatment including any surgical procedure or to have a legal guardian, or in the absence of a legal

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guardian, a relative as defined in this chapter, provide informed consent if the participant is not

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competent to do so. Information upon which a participant shall make necessary treatment and/or

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surgery decisions shall be presented to the participant in a manner consistent with his or her

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learning style and shall include, but not be limited to:

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     (A) The nature and consequences of the procedure(s);

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     (B) The risks, benefits and purpose of the procedure(s); and

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     (C) Alternate procedures available;

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     (ii) The informed consent of a participant or his or her legal guardian or, in the absence of

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a legal guardian, a relative as defined in this chapter, may be withdrawn at any time, with or

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without cause, prior to treatment. The absence of informed consent notwithstanding, a licensed

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and qualified physician may render emergency medical care or treatment to any participant who

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has been injured or who is suffering from an acute illness, disease, or condition if, within a

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reasonable degree of medical certainty, delay in initiation of emergency medical care or treatment

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would endanger the health of the participant;

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     (19) Each participant shall have a central record. The record shall include data pertaining

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to admissions and such other information as may be required under regulations by the

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department;

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     (20) Admissions -- As part of the procedure for the admission of a participant to an

 

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agency, each participant or applicant, or advocate if the participant or applicant is not competent,

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shall be fully informed, orally and in writing, of all rules, regulations, and policies governing

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participant conduct and responsibilities, including grounds for dismissal, procedures for

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discharge, and all anticipated financial charges, including all costs not covered under federal

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and/or state programs, by other third party payors or by the agency's basic per diem rate. The

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written notice shall include information regarding the participant's or applicant's right to appeal

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the admission or dismissal decisions of the agency;

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     (21) Upon termination of services to or death of a participant, a final accounting shall be

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made of all personal effects and/or money belonging to the participant held by the agency. All

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personal effects and/or money including interest shall be promptly released to the participant or

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his or her heirs;

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     (22) Nothing in this chapter shall preclude intervention in the form of appropriate and

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reasonable restraint should it be necessary to protect individuals from physical injury to

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themselves or others.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS

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     This act would expand certain rights of persons with developmental disabilities.

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     This act would take effect upon passage.

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