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Human Rights 101

for Human Rights Coordinators, Human

Rights Officers, Human Rights Committees and the

People You Serve.

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What Are Human Rights?

The Department of Mental Health defines Human Rights as the values and fundamental principles that are intended to support and promote the full respect, dignity, and care of each individual.

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humane and adequate care and treatment;

a humane and safe living environment;

freedom from physical, sexual, and verbal abuse; and

to the maximum extent possible and consistent with the client’s individual needs, preferences and capacities:

DMH Policy states that human rights include but are not limited to:

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•self determination and freedom of choice

•least restrictive services

•the opportunity to undergo normal experiences

•access to fresh air, exercise, and recreational opportunity

•privacy, including clearly defined private living, sleeping, and personal care spaces

•the opportunity to engage in style of living and activities consistent with the person’s individual desires

•the opportunity to move toward amore independent living environment

•the opportunity for persons from multicultural background or with physical needs to participate in programming.

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Five Fundamental Rights

sending and receiving mail telephone use receiving visitors (general) humane psychological and

physical environment visits or phone calls with

attorney, legal advocate, physician, social worker, psychologist or clergy (special visitors)

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RestrictionsIt may be necessary to temporarily limit someone’s rights if There is “significant risk of imminent, serious harm” (for

telephone access and general visitors) Good cause exists to believe that mail contains

contraband, and then staff may open and inspect a person’s mail (not read) in the presence of the individual.

This should not occur unless less restrictive alternatives have been tried and failed, or would be futile to attempt.

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Restrictions (cont.)

Any restriction must be done in accordance with applicable laws or policies.

The HRO is to be notified of the restriction as soon as possible.

The person’s record must include specific facts as to the reason

and timeline for the restriction and any review by the Human Rights Committee.

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Human Rights are important in helping to ensure that all people are treated as we would want to be treated – as thinking, feeling individuals.

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Dignity and Respect

Understanding Human Rights means having a commitment to treat every person with dignity and respect. Seeing the individual being served first as a person is critical to giving them dignity and respect.

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This means: Assisting a person in making

his or her own decisions about treatment, and about the daily events in their lives.

Fostering autonomy and positive self-regard

Understanding others’ points of view

Listening - taking others seriously

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The Dignity of Risk

Dignity of Risk is the principle of taking control of our lives - even when it includes some level of risk.

Most of us owe a large portion of our personal growth to the process of trial and error.

Failure becomes a learning experience, and subsequent attempts are bound to meet with greater success.

This principle is at the heart of the recovery process.

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Dignity of Risk (cont.)

Programs should strive to foster as much independence as possible and to instill a proportionate sense of responsibility.

We must be willing to allow the people we serve to experience social and personal chances to facilitate long term growth for independent living.

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ABOUT INFORMED CONSENT

Acceptance or rejection of treatment must be based upon a voluntary and informed decision. There should be an assessment of an individual’s

ability to understand the risks and benefits of a proposed treatment, as well as alternatives.

Before a client is asked to sign anything, staff should: Provide information first! Go over the risks and benefits Discuss possible outcomes Discuss side effects Discuss alternatives to treatment

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What is the Role of the Human Rights Officer ?

All programs have an assigned Human Rights Officer (HRO).

The main responsibility of the HRO is to inform, train, and assist clients served by the program to exercise their rights.

The HRO may attend treatment team meetings to advocate on behalf of the client.

The HRO is also staff to the Human Rights Committee

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It is everyone’s responsibility to treat the people we serve in a manner that provides the utmost respect and inclusion in the decisions that affect their lives, so they can participate fully in their own recovery process.

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Human Rights Committee

The Human Rights Committee (HRC) serves as an advisory committee to help the program protect the rights of its clients.

A majority of HRC members must be persons served, family members, or advocates.

The HRC visits programs and provides feed back to the program.

The HRC reviews complaints and treatment restrictions and makes recommendations.

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Complaints and Investigations

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Filing a Human Rights Complaint triggers a formal review.

The DMH Complaints and Investigations processes are governed by state regulation: 104 CMR 32.00

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Who must file a Human Rights Complaint and under what circumstances?

All staff in all programs are responsible for protecting the people they serve and for reporting abuse.

A formal Human Rights Complaint is filed with DMH when either a client or staff person believes that the client is in a situation or has received treatment that is illegal, dangerous, or inhumane.

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DMH REGULATIONS (104 CMR 32.00)

Definitions: Dangerous: poses or posed a danger or

the potential of danger to the health or safety of a client.

Illegal: a violation of state or federal statute, regulation, court decision or other law.

Inhumane: without regard for client dignity.

Person In Charge (PIC): the person with day-to-day responsibility for the program or his/her designee.

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The Person in Charge ensures that:

All complaints are reviewed when they are submitted.

Immediate protective action is instituted if client or staff are thought to be in jeopardy.

A decision is made as to who will formally look into the complaint.

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FinalDecision30 Days

Person In ChargeResponsible for assigning

Public Log and notifyingParties to Complaint

ComplaintFiled

AboveLine[Investigation]

Below Line

AreaInvestigations

Investigationbegins

w/in 2 Days

Investigator

Submits

Report to 1

PIC/

Area Director

Within 30 Days*

A.D./Assist.Commissioner

Issues DecisionLetter

w/in 10 Days

Copy of Decision to allparties (PICResponsibility)

Fact Finding &Decision within 10

Days

(Central Office ) Office of Investigations Responsibility

Reconsideration

Request forReconsideration

**Reaffirm/Amend Decision

w/in 10 Days

FurtherAppeal

Deputy Comm.Program Oper.

Person In Charge Responsibility

Central Office

Reaffirm/Ammend

Decision w/in 10Days

Area Director/Assistant CommissionerResponsibility**

FurtherAppeal to

Commissioner

Final Decision w/in30 Days

Central Office Responsibility

Decision byPerson In Charge

(PIC)

Out-of-Scope

Decision

Appeal orReconsideration

Request

**Reaffirm/Amend

Decision w/in10 DaysPerson in Charge Responsibility

*Days refer to working days excluding holidays and weekends

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goes to all parties at the end of the investigation

There is an appeal process for decisions that are disputed.

A formal decision letter

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All staff are mandated reporters and, under penalty of law, must report client abuse to one of the following agencies:

DCF for youth under the age of 18.

1-800-792-5200

DPPC for persons 18 through 59 years.

1-800-426-9009

Office of Elder Affairs for persons 60 years +

1-800-922-2275

Telephone numbers for the above agencies should be posted in your workplace.

I have the forms right here. How old is the client?

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What about kids?

Children and adolescents are also protected by the

Five Fundamental Rights

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Mail

Each person hasthe right to send and receive mail.

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Phone Calls

Each person has the right to make and receive confidential telephone calls at reasonable times.

* A program may temporarily restrict a client’s telephone rights if that use would constitute a criminal act, or if it is an unreasonable infringement on another person’s telephone access.

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Visits

Each person has unrestricted rights to visit with his/her lawyer, doctor, psychologist, clergy, or social worker at any reasonable time.

The person may have other visitors at reasonable times, unless restricted by the program.

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Personal Belongings

Each person has the right to wear his/her own clothes. She or he has the right to keep and use personal belongings, including toiletries.

The program may keep certain items, such as lotions or sharp objects, in a separate locked area for safety reasons.

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Legal Advocacy Resources Mental Health Legal Advisors Committee (MHLAC) provides advice and representation for children

and adults with mental disabilities, as well as many training resources and publications.

www.mass.gov/MHLAC (617) 338-2345 (800) 342-9092

Disability Law Center(DLC) is the Protection & Advocacy agency for Massachusetts, providing protection and advocacy for disabled residents of the Commonwealth.

www.DLC-MA.org (617) 723-8455, (800) 872-9992 (413) 584-6337, (800) 222-5619

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Legal Advocacy Resources (cont.)

More information regarding these and other resources is available in the Appendix of the Human Rights Handbook:

Center for Public Representation: specializes in legal rights and discrimination.

(617)965-0776, (413)587-6265

Committee for Public Counsel Services: the Mental Health unit of the Public Defender’s Office provides attorneys for persons involved in commitment or Rogers proceedings and other types of civil and criminal cases.

(617)482-6212

www.MassLegalServices.org to locate these and other legal services near you.

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References

Massachusetts General Laws Chapter 123, Section 23

DMH Regulations 104 CMR 27.00 and 104 CMR 28.00 104 CMR 32.00

DMH Policy #03-1 (Human Rights) DMH Human Rights Handbook

All are accessible online at the Dept Of MH: www.mass.gov/dmh

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Human Rights Contacts

Site Human Rights Coordinator/HRO:

DMH Area Human Rights Coordinator: DMH Director of Human Rights: Star Sims

(617) 626 – 8218, Startese.Sims01@DMH.state.ma.us

DMH Asst. Dir Human Rights for Community & Child/Adol services: Kerry Brooke: (617) 626-8139Kerry.Brooke@DMH.state.ma.us