Chapter 5124-2 Patient Rights

(A) Definitions.

(1) “Head of a hospital” means the head of a hospital as defined in division (K) of section 5122.01 of the Revised Code.

(2) “Hospital” means a public hospital, non-public hospital, or mental health clinical facility, as defined in divisions (F), (G), and (H) of section 5122.01 of the Revised Code.

(3) “Client advocate” means the person designated by the head of a hospital pursuant to paragraph (B)(1) below, or the alternate designee as set forth in paragraph (B)(2) below, or the person or persons designated to perform the function of the client advocate in the admitting room as set forth in paragraph (C)(1) below.

(4) “Referred (or referral) to the client advocate” means that the person making the referral shall (a) inform the person referred of the identity of the client advocate or alternate designee, (b) inform the person referred of the method of contacting the client advocate or alternate designee, (c) provide the person referred with assistance in contacting the client advocate or alternate designee if such assistance is needed, and (d) contact the client advocate or alternate designee and inform him or her of the identity of the person referred. It also means that the client advocate or alternate designee shall contact the person referred to determine the nature of the problem and provide whatever assistance is needed.

(5) “Patient” means a person admitted voluntarily or involuntarily to a hospital or other place under Chapter 5122. of the Revised Code, who is under observation or receiving treatment in such place.

(6) “Basic legal rights” means those rights enumerated in division (C) of section 5122.05 of the Revised Code and in paragraph (C)(2) below.

(B) Client advocate and staff responsibilities-general.

(1) The head of a hospital shall designate a client advocate who shall be the person primarily responsible for informing patients of their rights.

(2) The head of a hospital shall designate at least one alternate designee to perform the functions of the client advocate when the client advocate is not available.

(3) The head of a hospital shall insure that all staff (both direct care and non-direct care staff) are aware of the identity of the client advocate and the alternate designee. The head of a hospital shall also insure that all staff are aware of the procedures whereby a patient may contact the client advocate or the alternate designee and that all patients requesting assistance with their rights are referred to the client advocate or the alternate designee.

(4) The head of a hospital shall insure that all staff members are informed of patients’ rights under the law and that they directly assist patients in obtaining those rights or refer patients to the client advocate or the alternate designee.

(5) All patients who raise questions about their rights or about their status at the hospital shall be referred to the client advocate or alternate designee. Whenever a patient is so referred the client advocate or alternate designee shall make contact with the patient within twenty-four hours. After determining the nature of the problem, the client advocate or alternate designee shall explain to the patient the patient’s rights and shall provide the appropriate assistance in seeking those rights. The Ohio legal rights service is available to answer questions concerning patient rights from patients, client advocates or other hospital staff.

(6) Patients who raise questions concerning release or discharge shall be immediately told of their rights concerning release or discharge. Patients who wish to request release or discharge or a probable cause hearing shall also be told that assistance in making either request will be provided by the client advocate or alternate designee or by other hospital staff if assistance is needed. Such assistance shall be provided promptly. Whenever a patient makes a written request for release and the request is denied and an affidavit is filed against the patient, the client advocate or alternate designee shall contact the patient within twenty-four hours of the filing of the affidavit and shall explain to the patient the legal process that is to occur. The client advocate or alternate designee shall provide assistance to the patient in obtaining counsel or an independent expert evaluation, if such assistance is needed.

(7) Whenever a patient raises questions about release or discharge, treatment staff or other appropriate hospital staff may advise the patient of how a request for release or discharge may affect treatment, of the availability of community services, and of the risks involved in being released to the community. Hospital staff specifically shall not try to predict the legal consequences of requesting release or discharge in an attempt to coerce a patient into retracting a written request for release or discharge. In addition, hospital staff shall not use their authority over patients to coerce a patient into signing a voluntary application for admission.

(C) Client advocate and staff responsibilities – upon admission of a patient.

(1) The head of a hospital may designate one or more persons on the admitting staff who shall perform the functions of the client advocate upon the arrival of a person in the admitting room.

(2) The “basic legal rights” of a person who is involuntarily detained in a hospital or is otherwise in custody are that he or she may:

(a) Make immediately a reasonable number of telephone calls or use other reasonable means to contact an attorney, a physician, a licensed clinical psychologist, or to contact some other person or persons to secure legal, medical, or psychological assistance and be provided with assistance in making calls if assistance is needed and requested; and

(b) Retain counsel and have independent expert evaluation, both at public expense if he or she is indigent; and

(c) Have a probable cause hearing, upon request, and be provided with assistance in making such a request if assistance is needed.

(3) Immediately upon the arrival of a person brought to the hospital involuntarily, and before any admission or evaluation procedures are begun (regardless of the person’s mental condition), the client advocate or alternate designee shall orally inform the person of a patient’s “basic legal rights” and shall provide the person with a written statement thereof. The fact that the person has been so informed of a patient’s “basic legal rights” shall be documented in the person’s hospital records. This paragraph does not preclude immediate treatment for bona fide emergencies to prevent immediate physical harm to the person or to others.

(4) Before any person signs a written application for voluntary admission (regardless of the person’s mental condition) the client advocate or alternate designee shall orally inform the person of the consequences of signing the written application. Specifically, the person shall be told that voluntary admission does not mean that he or she may leave the hospital at will, and that a written request for release or discharge may result in the commencement of involuntary civil commitment proceedings if the head of the hospital disagrees with the request for release or discharge. The client advocate or alternate designee may also inform the person that he or she has a right to question the prescribed treatment and to refuse to accept or to comply with such treatment, and that the hospital has a right to consider discharging a patient who refuses to accept or comply with prescribed treatment. The fact that the patient has been informed of patients’ rights relating to voluntary admission pursuant to this paragraph shall be documented in the person’s hospital records.

(5) As part of the admission process for any patient, a pamphlet containing a detailed explanation of patients’ rights shall be given to the person along with a brief oral explanation of patients’ rights under the law. The fact that the person has been so informed of patients’ rights under the law shall be documented in the person’s hospital records.

(6) Within twenty-four hours of a patient’s admission to the hospital, the client advocate or alternate designee shall contact the patient and shall explain in detail the contents of the patients’ rights pamphlet. The client advocate or alternate designee shall answer any questions the patient may have about patients’ rights and about his or her status at the hospital. If the patient has further questions about patients’ rights or about his or her legal status at the hospital, the client advocate or alternate designee may refer the patient to the legal rights service and shall provide assistance in contacting the legal rights service if such assistance is needed. The fact that this explanation of rights has been given shall be documented in the patient’s hospital records.

(7) If the patient was incapable of understanding the explanation of patients’ rights given pursuant to paragraph (C)(6) above, the client advocate or alternate designee shall contact the patient within three days and every week thereafter until such time as the patient is capable of understanding the explanation of the patients’ rights. If, after ninety days, the patient is still unable to understand the explanation of patients’ rights, the client advocate or alternate designee shall continue to contact the patient every ninety days until such time as the patient is capable of understanding the explanation of patients’ rights. Each attempt to explain patients’ rights shall be documented in the patient’s hospital records. When the patient has understood the explanation of patients’ rights given pursuant to paragraph (C)(6) above or pursuant to this paragraph, the patient shall be asked to sign a written statement to that effect. The signed statement or a statement signed by the client advocate or alternate designee documenting the patient’s refusal to sign a written statement after he or she has understood the explanation of patients’ rights shall be made a part of the patient’s hospital records.

(8) After a patient has received an explanation of patients’ rights which he or she is capable of understanding, the client advocate or alternate designee should make an attempt to contact the patient again at reasonable intervals until discharge to repeat the explanation and to provide any needed assistance with patients’ rights. Each such contact shall be documented in the patient’s hospital records.

(9) The client advocate or alternate designee shall make clear to all patients that their right to have reasonable access to telephones to make and receive confidential calls includes the right to make a reasonable number of telephone calls to obtain legal, medical or psychological assistance at reasonable times (usually during normal business hours). Patients shall also be informed that they may specify that they wish to make calls to obtain such assistance if access to a telephone is denied. Whenever a patient requests to use the telephone to call the client advocate or alternate designee, an attorney, or personal physician or psychologist, the patient shall be given access to a telephone as soon as possible and assistance shall be provided to the patient in making the call if such assistance is needed.

(D) Statements of patients’ rights.

(1) The head of a hospital shall maintain a supply of cards (approximately three-inch by five-inch) which are separate and distinguishable from all other patients’ rights information and admission information which shall contain involuntary patients’ “basic legal rights” printed in bold type, and shall insure that copies of the card are given to all current involuntary patients and to all persons who are brought to the hospital involuntarily as in paragraph (C)(3) above. Copies of this card shall be provided in Braille to blind persons who are brought to the hospital involuntarily or the contents of the card shall be read to any such blind person with the understanding that the card will be read again whenever the patient so requests.

(2) The head of a hospital shall maintain a supply of pamphlets which shall contain a clear and concise statement of patients’ rights under the law. Such pamphlets shall be given to all patients as set forth in paragraph (C)(5) above. Such a pamphlet shall be made available in Braille to any blind person or shall be read to any blind person or any person unable to read with the understanding that the pamphlet will be read again whenever the patient so requests.

(3) The head of a hospital shall insure that any deaf person arriving at the hospital is, as soon as possible within twenty-four hours, provided with someone capable of communicating with the deaf who shall perform the functions of the client advocate for the deaf person.

(4) The head of a hospital shall insure that any person arriving at the hospital who does not understand English is, as soon as possible within twenty-four hours, provided with someone able to communicate in his or her primary language who shall perform the functions of the client advocate for the non-English speaking person.

(5) Additional copies of the cards and pamphlets containing patients’ rights shall be made available to patients at all times on the wards, at the social services desk, in the patients’ recreation areas, and in other central locations.

(6) A notice shall be posted in a conspicuous place on each ward, in the social services area, in the patients’ recreation areas, and in other central locations, setting forth patients’ rights, the name of and the method of reaching the client advocate, and the address and phone number of the legal rights service.

Note: This rule was filed pursuant to chapter 111. of the Revised Code; Eff 9-18-78

Rule authorized by: RC 5122.27(G)