Minnesota Session Laws - 1986, Regular Session

  

                         Laws of Minnesota 1986 

                        CHAPTER 326-S.F.No. 1919
           An act relating to mental health; extending the 
          patients' bill of rights to cover people receiving 
          out-patient mental health treatment and minors 
          receiving residential chemical dependency or mental 
          health treatment; defining a minimum grievance 
          procedure for health care facilities; including in the 
          patients' bill of rights the right of access to 
          protection and advocacy services; requiring the 
          reporting of certain information by residential 
          treatment programs for mentally ill, chemically 
          dependent, and emotionally disturbed minors; amending 
          Minnesota Statutes 1984, section 144.651, subdivisions 
          2, 4, 20, and by adding subdivisions; proposing coding 
          for new law as Minnesota Statutes, chapter 253C. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1984, section 144.651, 
subdivision 2, is amended to read: 
    Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
"patient" means a person who is admitted to an acute care 
inpatient facility for a continuous period longer than 24 hours, 
for the purpose of diagnosis or treatment bearing on the 
physical or mental health of that person.  "Patient" also means 
a minor who is admitted to a residential program as defined in 
section 7.  For purposes of subdivisions 1, 3 to 16, 18, 20 and 
30, "patient" also means any person who is receiving mental 
health treatment on an out-patient basis or in a community 
support program or other community-based program.  "Resident" 
means a person who is admitted to a nonacute care facility 
including extended care facilities, nursing homes, and board and 
care homes for care required because of prolonged mental or 
physical illness or disability, recovery from injury or disease, 
or advancing age.  
    Sec. 2.  Minnesota Statutes 1984, section 144.651, 
subdivision 4, is amended to read: 
    Subd. 4.  [INFORMATION ABOUT RIGHTS.] Patients and 
residents shall, at admission, be told that there are legal 
rights for their protection during their stay at the facility or 
throughout their course of treatment and maintenance in the 
community and that these are described in an accompanying 
written statement of the applicable rights and responsibilities 
set forth in this section.  In the case of patients admitted to 
residential programs as defined in section 7, the written 
statement shall also describe the right of a person 16 years old 
or older to request release as provided in section 253B.04, 
subdivision 2, and shall list the names and telephone numbers of 
individuals and organizations that provide advocacy and legal 
services for patients in residential programs.  Reasonable 
arrangements accommodations shall be made for those with 
communication impairments and those who speak a language other 
than English.  Current facility policies, inspection findings of 
state and local health authorities, and further explanation of 
the written statement of rights shall be available to patients, 
residents, their guardians or their chosen representatives upon 
reasonable request to the administrator or other designated 
staff person, consistent with chapter 13, the data practices 
act, and section 626.557, relating to vulnerable adults.  
     Sec. 3.  Minnesota Statutes 1984, section 144.651, 
subdivision 20, is amended to read: 
    Subd. 20.  [GRIEVANCES.] Patients and residents shall be 
encouraged and assisted, throughout their stay in a facility or 
their course of treatment, to understand and exercise their 
rights as patients, residents, and citizens.  Patients and 
residents may voice grievances and recommend changes in policies 
and services to facility staff and others of their choice, free 
from restraint, interference, coercion, discrimination, or 
reprisal, including threat of discharge.  Notice of the 
facility's grievance procedure of the facility or program, as 
well as addresses and telephone numbers for the office of health 
facility complaints and the area nursing home ombudsman pursuant 
to the Older Americans Act, section 307(a)(12) shall be posted 
in a conspicuous place.  
    Every acute care in-patient facility, every residential 
program as defined in section 7, every nonacute care facility, 
and every facility employing more than two people that provides 
out-patient mental health services shall have a written internal 
grievance procedure that, at a minimum, sets forth the process 
to be followed; specifies time limits, including time limits for 
facility response; provides for the patient or resident to have 
the assistance of an advocate; requires a written response to 
written grievances; and provides for a timely decision by an 
impartial decision maker if the grievance is not otherwise 
resolved.  Compliance by hospitals, residential programs as 
defined in section 7 which are hospital-based primary treatment 
programs, and outpatient surgery centers with section 144.691 
and compliance by health maintenance organizations with section 
62D.11 is deemed to be compliance with the requirement for a 
written internal grievance procedure. 
     Sec. 4.  Minnesota Statutes 1984, section 144.651, is 
amended by adding a subdivision to read: 
    Subd. 30.  [PROTECTION AND ADVOCACY SERVICES.] Patients and 
residents shall have the right of reasonable access at 
reasonable times to any available rights protection services and 
advocacy services so that the patient may receive assistance in 
understanding, exercising, and protecting the rights described 
in this section and in other law.  This right shall include the 
opportunity for private communication between the patient and a 
representative of the rights protection service or advocacy 
service. 
    Sec. 5.  Minnesota Statutes 1984, section 144.651, is 
amended by adding a subdivision to read: 
    Subd. 31.  [ISOLATION AND RESTRAINTS.] A minor patient who 
has been admitted to a residential program as defined in section 
7 has the right to be free from physical restraint and isolation 
except in emergency situations involving a likelihood that the 
patient will physically harm the patient's self or others.  
These procedures may not be used for disciplinary purposes, to 
enforce program rules, or for the convenience of staff.  
Isolation or restraint may be used only upon the prior 
authorization of a physician, psychiatrist, or licensed 
consulting psychologist, only when less restrictive measures are 
ineffective or not feasible and only for the shortest time 
necessary. 
    Sec. 6.  Minnesota Statutes 1984, section 144.651, is 
amended by adding a subdivision to read: 
    Subd. 32.  [TREATMENT PLAN.] A minor patient who has been 
admitted to a residential program as defined in section 7 has 
the right to a written treatment plan that describes in 
behavorial terms the case problems, the precise goals of the 
plan, and the procedures that will be utilized to minimize the 
length of time that the minor requires inpatient treatment.  The 
plan shall also state goals for release to a less restrictive 
facility and follow-up treatment measures and services, if 
appropriate.  To the degree possible, the minor patient and his 
or her parents or guardian shall be involved in the development 
of the treatment and discharge plan. 
    Sec. 7.  [144.706] [REPORTING BY RESIDENTIAL TREATMENT 
PROGRAMS REQUIRED.] 
    Subdivision 1.  [DEFINITION.] As used in this section, 
"residential program" means (1) a freestanding primary treatment 
program or hospital-based primary treatment program that 
provides residential treatment to chemically dependent or 
mentally ill minors, or (2) a facility licensed by the state to 
provide services for emotionally disturbed minors on a 24-hour 
basis. 
    Subd. 2.  [ANNUAL REPORT REQUIRED.] Beginning June 1, 1986, 
each residential program shall collect the information listed in 
this subdivision.  Each residential program shall file a report 
no later than December 31, 1986, containing the information 
collected as of that date.  Thereafter, each residential program 
shall prepare an annual report for the year ending June 30 of 
each year and file the report no later than December 31 of each 
year.  Hospital-based primary treatment programs shall file the 
report with the commissioner of health.  All other residential 
programs shall file the report with the commissioner of human 
services.  The reports are public data and must contain at least 
the following information for the period covered by the report: 
    (1) number of minors admitted to the program; 
    (2) number of minors discharged from the program; 
    (3) primary diagnoses of each admitted minor; 
    (4) number of minors who remained in residence for less 
than 30 days; 
     (5) number of minors who remained in residence for between 
30 and 60 days; 
     (6) number of minors who remained in residence for more 
than 60 days; 
     (7) average length of stay of minors in the program; 
     (8) number of minors who have received psychotropic 
medications; 
     (9) age, race, and sex of each minor; 
     (10) copy of written notices, forms, and other procedures 
being used to advise minors and their parents of their rights; 
     (11) number of minors admitted or presently in residence 
who have previously had residential treatment; 
    (12) number of minors who are on private pay or third-party 
reimbursement payment and number who are receiving government 
funds for treatment; 
    (13) criteria for admission and continued stay; 
    (14) number of minors whose admission is court-ordered; and 
    (15) number of beds on a locked unit and number of beds on 
an unlocked unit. 
     The information required by this subdivision must be 
separately stated for chemically dependent, mentally ill, and 
emotionally disturbed minors as defined by the residential 
programs. 
     Subd. 3.  [RELEASE AND SUMMARY OF DATA.] The reporting 
requirement of this section must not release individual names of 
minors or other identifying information.  The commissioner of 
health and the commissioner of human services shall make the 
reports available to interested persons upon request. 
    Approved March 17, 1986