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Minnesota Legislature

Office of the Revisor of Statutes

Chapter 253B

Section 253B.03

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253B.03 RIGHTS OF PATIENTS.
    Subdivision 1. Restraints. (a) A patient has the right to be free from restraints. Restraints
shall not be applied to a patient in a treatment facility unless the head of the treatment facility, a
member of the medical staff, or a licensed peace officer who has custody of the patient determines
that they are necessary for the safety of the patient or others.
(b) Restraints shall not be applied to patients with developmental disabilities except as
permitted under section 245.825 and rules of the commissioner of human services. Consent must
be obtained from the person or person's guardian except for emergency procedures as permitted
under rules of the commissioner adopted under section 245.825.
(c) Each use of a restraint and reason for it shall be made part of the clinical record of the
patient under the signature of the head of the treatment facility.
    Subd. 1a. Administrative restriction. (a) A patient has the right to be free from unnecessary
or excessive administrative restriction. Administrative restriction shall not be used for the
convenience of staff, for retaliation for filing complaints, or as a substitute for program treatment.
Administrative restriction may not involve any further deprivation of privileges than is necessary.
(b) Administrative restriction may include separate and secure housing.
(c) Patients under administrative restriction shall not be limited in access to their attorney.
(d) If a patient is placed on administrative restriction because the patient is suspected
of committing a crime, the secure treatment facility must report the crime to the appropriate
police agency within 24 hours of the beginning of administrative restriction. The patient must
be released from administrative restriction if a police agency does not begin an investigation
within 72 hours of the report.
(e) A patient placed on administrative restriction because the patient is a subject of a
criminal investigation must be released from administrative restriction when the investigation
is completed. If the patient is charged with a crime following the investigation, administrative
restriction may continue until the charge is disposed of.
(f) The secure treatment facility must notify the patient's attorney of the patient being placed
on administrative restriction within 24 hours after the beginning of administrative restriction.
    Subd. 2. Correspondence. A patient has the right to correspond freely without censorship.
The head of the treatment facility may restrict correspondence if the patient's medical welfare
requires this restriction. For patients in regional treatment centers, that determination may
be reviewed by the commissioner. Any limitation imposed on the exercise of a patient's
correspondence rights and the reason for it shall be made a part of the clinical record of the patient.
Any communication which is not delivered to a patient shall be immediately returned to the sender.
    Subd. 3. Visitors and phone calls. Subject to the general rules of the treatment facility, a
patient has the right to receive visitors and make phone calls. The head of the treatment facility
may restrict visits and phone calls on determining that the medical welfare of the patient requires
it. Any limitation imposed on the exercise of the patient's visitation and phone call rights and the
reason for it shall be made a part of the clinical record of the patient.
    Subd. 4. Special visitation; religion. A patient has the right to meet with or call a personal
physician, spiritual advisor, and counsel at all reasonable times. The patient has the right to
continue the practice of religion.
    Subd. 4a. Disclosure of patient's admission. Upon admission to a facility where federal
law prohibits unauthorized disclosure of patient or resident identifying information to callers and
visitors, the patient or resident, or the legal guardian of the patient or resident, shall be given the
opportunity to authorize disclosure of the patient's or resident's presence in the facility to callers
and visitors who may seek to communicate with the patient or resident. To the extent possible,
the legal guardian of a patient or resident shall consider the opinions of the patient or resident
regarding the disclosure of the patient's or resident's presence in the facility.
    Subd. 5. Periodic assessment. A patient has the right to periodic medical assessment,
including assessment of the medical necessity of continuing care and, if the treatment facility
declines to provide continuing care, the right to receive specific written reasons why continuing
care is declined at the time of the assessment. The treatment facility shall assess the physical and
mental condition of every patient as frequently as necessary, but not less often than annually. If
the patient refuses to be examined, the facility shall document in the patient's chart its attempts to
examine the patient. If a person is committed as developmentally disabled for an indeterminate
period of time, the three-year judicial review must include the annual reviews for each year as
outlined in Minnesota Rules, part 9525.0075, subpart 6.
    Subd. 6. Consent for medical procedure. A patient has the right to prior consent to any
medical or surgical treatment, other than treatment for chemical dependency or nonintrusive
treatment for mental illness.
The following procedures shall be used to obtain consent for any treatment necessary to
preserve the life or health of any committed patient:
(a) The written, informed consent of a competent adult patient for the treatment is sufficient.
(b) If the patient is subject to guardianship which includes the provision of medical care, the
written, informed consent of the guardian for the treatment is sufficient.
(c) If the head of the treatment facility determines that the patient is not competent to consent
to the treatment and the patient has not been adjudicated incompetent, written, informed consent
for the surgery or medical treatment shall be obtained from the nearest proper relative. For this
purpose, the following persons are proper relatives, in the order listed: the patient's spouse, parent,
adult child, or adult sibling. If the nearest proper relatives cannot be located, refuse to consent
to the procedure, or are unable to consent, the head of the treatment facility or an interested
person may petition the committing court for approval for the treatment or may petition a court
of competent jurisdiction for the appointment of a guardian. The determination that the patient
is not competent, and the reasons for the determination, shall be documented in the patient's
clinical record.
(d) Consent to treatment of any minor patient shall be secured in accordance with sections
144.341 to 144.346. A minor 16 years of age or older may consent to hospitalization, routine
diagnostic evaluation, and emergency or short-term acute care.
(e) In the case of an emergency when the persons ordinarily qualified to give consent cannot
be located, the head of the treatment facility may give consent.
No person who consents to treatment pursuant to the provisions of this subdivision shall be
civilly or criminally liable for the performance or the manner of performing the treatment. No
person shall be liable for performing treatment without consent if written, informed consent was
given pursuant to this subdivision. This provision shall not affect any other liability which may
result from the manner in which the treatment is performed.
    Subd. 6a.MS 1990 [Renumbered subd 6c]
    Subd. 6a. Consent for treatment for developmental disability. A patient with a
developmental disability, or the patient's guardian, has the right to give or withhold consent before:
(1) the implementation of any aversive or deprivation procedure except for emergency
procedures permitted in rules of the commissioner adopted under section 245.825; or
(2) the administration of psychotropic medication.
    Subd. 6b. Consent for mental health treatment. A competent person admitted voluntarily
to a treatment facility may be subjected to intrusive mental health treatment only with the person's
written informed consent. For purposes of this section, "intrusive mental health treatment"
means electroshock therapy and neuroleptic medication and does not include treatment for a
developmental disability. An incompetent person who has prepared a directive under subdivision
6d regarding treatment with intrusive therapies must be treated in accordance with this section,
except in cases of emergencies.
    Subd. 6c.[Repealed, 1997 c 217 art 1 s 118]
    Subd. 6d. Adult mental health treatment. (a) A competent adult may make a declaration
of preferences or instructions regarding intrusive mental health treatment. These preferences or
instructions may include, but are not limited to, consent to or refusal of these treatments.
(b) A declaration may designate a proxy to make decisions about intrusive mental health
treatment. A proxy designated to make decisions about intrusive mental health treatments and
who agrees to serve as proxy may make decisions on behalf of a declarant consistent with any
desires the declarant expresses in the declaration.
(c) A declaration is effective only if it is signed by the declarant and two witnesses. The
witnesses must include a statement that they believe the declarant understands the nature and
significance of the declaration. A declaration becomes operative when it is delivered to the
declarant's physician or other mental health treatment provider. The physician or provider must
comply with it to the fullest extent possible, consistent with reasonable medical practice, the
availability of treatments requested, and applicable law. The physician or provider shall continue
to obtain the declarant's informed consent to all intrusive mental health treatment decisions if the
declarant is capable of informed consent. A treatment provider may not require a person to make
a declaration under this subdivision as a condition of receiving services.
(d) The physician or other provider shall make the declaration a part of the declarant's
medical record. If the physician or other provider is unwilling at any time to comply with the
declaration, the physician or provider must promptly notify the declarant and document the
notification in the declarant's medical record. If the declarant has been committed as a patient
under this chapter, the physician or provider may subject a declarant to intrusive treatment in a
manner contrary to the declarant's expressed wishes, only upon order of the committing court. If
the declarant is not a committed patient under this chapter, the physician or provider may subject
the declarant to intrusive treatment in a manner contrary to the declarant's expressed wishes, only
if the declarant is committed as mentally ill or mentally ill and dangerous to the public and a court
order authorizing the treatment has been issued.
(e) A declaration under this subdivision may be revoked in whole or in part at any time
and in any manner by the declarant if the declarant is competent at the time of revocation. A
revocation is effective when a competent declarant communicates the revocation to the attending
physician or other provider. The attending physician or other provider shall note the revocation as
part of the declarant's medical record.
(f) A provider who administers intrusive mental health treatment according to and in good
faith reliance upon the validity of a declaration under this subdivision is held harmless from any
liability resulting from a subsequent finding of invalidity.
(g) In addition to making a declaration under this subdivision, a competent adult may
delegate parental powers under section 524.5-211 or may nominate a guardian under sections
524.5-101 to 524.5-502.
    Subd. 7. Program plan. A person receiving services under this chapter has the right
to receive proper care and treatment, best adapted, according to contemporary professional
standards, to rendering further supervision unnecessary. The treatment facility shall devise a
written program plan for each person which describes in behavioral terms the case problems, the
precise goals, including the expected period of time for treatment, and the specific measures to
be employed. Each plan shall be reviewed at least quarterly to determine progress toward the
goals, and to modify the program plan as necessary. The program plan shall be devised and
reviewed with the designated agency and with the patient. The clinical record shall reflect the
program plan review. If the designated agency or the patient does not participate in the planning
and review, the clinical record shall include reasons for nonparticipation and the plans for future
involvement. The commissioner shall monitor the program plan and review process for regional
centers to insure compliance with the provisions of this subdivision.
    Subd. 8. Medical records. A patient has the right to access to personal medical records.
Notwithstanding the provisions of section 144.292, every person subject to a proceeding or
receiving services pursuant to this chapter and the patient's attorney shall have complete access to
all medical records relevant to the person's commitment. A provider may require an attorney to
provide evidence of representation of the patient or an authorization signed by the patient.
    Subd. 9.[Repealed, 1997 c 217 art 1 s 118]
    Subd. 10. Notification. All persons admitted or committed to a treatment facility shall
be notified in writing of their rights regarding hospitalization and other treatment at the time
of admission. This notification must include:
(1) patient rights specified in this section and section 144.651, including nursing home
discharge rights;
(2) the right to obtain treatment and services voluntarily under this chapter;
(3) the right to voluntary admission and release under section 253B.04;
(4) rights in case of an emergency admission under section 253B.05, including the right to
documentation in support of an emergency hold and the right to a summary hearing before a judge
if the patient believes an emergency hold is improper;
(5) the right to request expedited review under section 62M.05 if additional days of inpatient
stay are denied;
(6) the right to continuing benefits pending appeal and to an expedited administrative hearing
under section 256.045 if the patient is a recipient of medical assistance, general assistance
medical care, or MinnesotaCare; and
(7) the right to an external appeal process under section 62Q.73, including the right to a
second opinion.
    Subd. 11. Proxy. A legally authorized health care proxy, agent, or guardian may exercise the
patient's rights on the patient's behalf.
History: 1982 c 581 s 3; 1983 c 251 s 5,6; 1986 c 444; 1987 c 185 art 2 s 2,3; 1988 c 623 s
5; 1988 c 689 art 2 s 118,119; 1989 c 282 art 2 s 100; 1990 c 568 art 5 s 31; 1991 c 148 s 2; 1993
c 54 s 4,5; 1995 c 136 s 5,6; 1995 c 189 s 2,3; 1997 c 217 art 1 s 19-28; 1998 c 313 s 1; 2001 c 26
s 1; 1Sp2001 c 9 art 9 s 22-24; 2002 c 379 art 1 s 11; 2004 c 146 art 3 s 21-25; 2004 c 288 art 3
s 17; 2005 c 56 s 1; 2007 c 147 art 10 s 15