2019 -- H 5032

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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:

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

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

     40.1-22-13. Visits.

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

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

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

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

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

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

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

     40.1-26-3. Participants' rights.

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

in this chapter shall be entitled to the following rights:

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

supportive environment;

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

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

interests in the most integrated community setting;

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

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

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

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

individualized plan;

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

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

participant is not competent to do so;

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

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

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

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

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

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

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

participant's record how such consent was obtained;

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

procedure delineated in § 40.1-26-5;

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

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

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

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

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

following conditions:

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

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

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

during the time that a medical condition exists;

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

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

clearly outweigh the potential harmful effects of the chemical restraints;

     (iii) No participant shall be placed in seclusion;

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

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

participant shall be written;

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

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

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

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

is no longer eligible for service from the agency;

     (13) To religious freedom and practice;

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

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

possessions;

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

television programming;

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

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

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

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

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

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

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

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

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

     (C) Alternate procedures available;

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

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

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

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

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

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

would endanger the health of the participant;

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

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

department;

     (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,

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

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

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

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

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

the admission or dismissal decisions of the agency;

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

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

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

his or her heirs;

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

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

themselves or others.

     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.

     This act would take effect upon passage.

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