PURPOSE: This rule describes the rights of individuals being served and grievance procedures in Alcohol and Drug Abuse Treatment Programs, Comprehensive Substance Treatment and Rehabilitation Programs (CSTAR), Compulsive Gambling Treatment Programs, Substance Abuse Traffic Offender Programs (SATOP), Required Education Assessment and Community Treatment Programs (REACT), Community Psychiatric Rehabilitation Programs (CPRP), and Psychiatric Outpatient Programs.

1. (1) General Policy and Practice. The organization shall demonstrate through its policies, procedures and practices an ongoing commitment to the rights, dignity, and respect of the individuals it serves. In addition to the requirements of this rule, the organization must also comply with 9 CSR 10-5.200 regarding protection from abuse and neglect and investigations of any such allegations.

2. (2) Information and Orientation. Immediately upon admission, each individual shall be informed and oriented as to what will happen as care and treatment are provided.

   1. (A) An individual who is admitted on a voluntary basis shall be expected to give written, informed consent to care and treatment.

   2. (B) The orientation given to each individual shall address service costs, availability of crisis assistance, rights, responsibilities, and grievance procedures.

      1. 1. Information regarding responsibilities

shall include applicable program rules, participation requirements or other expectations.

1. 2. Information regarding grievance pro-

cedures shall include how to file a grievance, time frames, rights of appeal, and notification of outcome.

1. 3. Each client shall be given the name,

address and phone number of the department’s client rights monitor and informed that the monitor may be contacted regarding a complaint of abuse, neglect or violation of rights.

1. (C) The orientation information shall be provided in written form using simple, straightforward language understandable to the individual and explained by staff as necessary.
2. (D) When appropriate, families receive information to promote their participation in or decisions about care and treatment.

1. (3) Rights Which Cannot Be Limited. Each individual has basic rights to humane care and treatment that cannot be limited under any circumstances.

   1. (A) The following rights apply to all settings:

      1. 1. To receive prompt evaluation, care

and treatment;

1. 2. To receive these services in the least

restrictive environment;

1. 3. To receive these services in a clean

and safe setting;

1. 4. To not be denied admission or ser-

vices because of race, gender, sexual preference, creed, marital status, national origin, disability or age;

1. 5. To confidentiality of information and

records in accordance with federal and state law and regulation;

1. 6. To be treated with dignity and

addressed in a respectful, age appropriate manner;

1. 7. To be free from abuse, neglect, cor-

poral punishment and other mistreatment such as humiliation, threats or exploitation;

1. 8. To be the subject of an experiment or

research only with one’s informed, written consent, or the consent of an individual legally authorized to act;

1. 9. To medical care and treatment in

accordance with accepted standards of medical practice, if the certified substance abuse or psychiatric program offers medical care and treatment; and

1. 10. To consult with a private, licensed

practitioner at one’s own expense.

1. (B) The following additional rights apply to residential settings, and where otherwise applicable, and shall not be limited under any circumstances:

   1. 1. To a nourishing, well-balanced, var-

ied diet;

1. 2. To attend or not attend religious ser-

vices;

1. 3. To communicate by sealed mail with

the department and, if applicable, legal counsel and court of jurisdiction; 9 CSR 10-7

1. 4. To receive visits from one’s attorney,

physician or clergy in private at reasonable times; and

1. 5. To be paid for work unrelated to treat-

ment, except that an individual may be expected to perform limited tasks and chores within the program that are designed to promote personal involvement and responsibility, skill building or peer support. Any tasks and chores beyond routine care and cleaning of activity or bedroom areas within the program must be directly related to recovery and treatment plan goals developed with the individual.

1. (4) Rights Subject to Limitation. Each individual shall have further rights and privileges, which can be limited only to ensure personal safety or the safety of others.

   1. (A) Any limitation due to safety considerations shall occur only if it is—

      1. 1. Applied on an individual basis;
      2. 2. Authorized by the organization’s

director or designee;

1. 3. Documented in the individual’s

record;

1. 4. Justified by sufficient documentation;
2. 5. Reviewed on a regular basis at the

time of each individualized treatment plan review; and

1. 6. Rescinded at the earliest clinically

appropriate moment.

1. (B) In all care and treatment settings, each individual shall have the right to see and review one’s own record, except that specific information or records provided by other individuals or agencies may be excluded from such review. The organization may require a staff member to be present whenever an individual accesses the record.

2. (C) The following additional rights and privileges apply to individuals in residential settings, and where otherwise applicable:

   1. 1. To wear one’s own clothes and keep

and use one’s own personal possessions;

1. 2. To keep and be allowed to spend a

reasonable amount of one’s own funds;

1. 3. To have reasonable access to a tele-

phone to make and to receive confidential calls;

1. 4. To have reasonable access to current

newspapers, magazines and radio and television programming;

1. 5. To be free from seclusion and

restraint;

1. 6. To have opportunities for physical

exercise and outdoor recreation;

1. 7. To receive visitors of one’s choosing

at reasonable hours; and

1. 8. To communicate by sealed mail with

individuals outside the facility. (5) Other Legal Rights. The organization shall ensure that all individuals have the same legal rights and responsibilities as any other citizen, unless otherwise limited by law.

1. (6) Access to Services. An individual shall not be denied admission or services solely on the grounds of prior treatment, withdrawal from treatment against advice, or continuation or return of symptoms after prior treatment.

2. (7) Grievances. The organization shall establish policies, procedures and practices to ensure a prompt, responsive, impartial review of any grievance or alleged violation of rights.

   1. (A) Reasonable assistance shall be given to an individual wishing to file a grievance.
   2. (B) The review shall be consistent with principles of due process.
   3. (C) The organization shall cooperate with the department in any review or investigation conducted by the department or its authorized representative.

3. (8) Practices to Promote Safety and Well- Being. The organization shall demonstrate a commitment to the safety and well-being of the individuals it serves. The organization’s policies, procedures and practices shall—

   1. (A) Promote therapeutic progress by addressing matters such as medication compliance, missed appointments, use of alcohol and drugs, and other program expectations or rules;
   2. (B) Encourage appropriate behavior by providing positive instruction and guidance; and
   3. (C) Ensure safety by effectively responding to any threats of suicide, violence or harm. Any use of seclusion or restraint shall be in accordance with 9 CSR 10-7.060 Behavior Management.

AUTHORITY: sections 630.050 and 630.055, RSMo 2000.* Original rule filed Feb. 28, 2001, effective Oct. 30, 2001. Amended: Filed Dec. 12, 2001, effective June 30, 2002. *Original authority: 630.050, RSMo 1980, amended 1993, 1995 and 630.055, RSMo 1980.