Client Rights and Grievances

   
DMHAS Office of the Commissioner
Client Rights and Grievance Specialist
DMHAS Office of the Commissioner
410 Capitol Avenue, 4th Floor, 
PO Box 341431, Hartford, CT 06134
860-418-7000, (TTY Relay 7-1-1), Confidential Fax: 860-418-6691
 
William Pierce, Client Rights and Grievance Specialist,
ADA Title II Coordinato
william.pierce@ct.gov
The Connecticut Department of Mental Health and Addiction Services (DMHAS) is a health care agency which promotes overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-sufficiency in those we serve (DMHAS mission statement). 

DMHAS complies with federal law state statutes and court rulings.  DMHAS does not discriminate on the basis of age, alienage; blindness color, gender identity, gender expression, national origin, race, sex, sexual orientation, person’s status as a veteran or ability to pay.

The Client Rights and Grievance Specialist at the DMHAS Office of the Commissioner helps DMHAS operated and DMHAS funded mental health and substance use disorder direct service providers understand the importance of federal laws, state statutes and court rulings in protecting people’s rights.

The Specialist promotes the use of the DMHAS Client Grievance Procedure by DMHAS operated and DMHAS funded providers to resolve complaints.

The Specialist is also the DMHAS ADA Title II Coordinator who helps DMHAS facilities, programs and services comply with Title II of the Americans with Disabilities Act.      

This page is a resource for helping people better understand their rights as well as how the DMHAS Client Grievance Procedure works. 

This webpage has three sections linked by one of the following short-cuts:

Rights

DMHAS Client Grievance Procedure

Resources

For more information on rights contact a state-wide advocacy organization listed in the resource section or seek legal advice. 

Rights      

Everyone receiving services from DMHAS state operated and DMHAS funded mental health and substance use disorder treatment providers have the same rights as all other adult residents of Connecticut. 

People’s rights include both Human Rights and Civil Rights. 

·        Human Rights are rights, all people have including but not limited to freedom of opinion and expression, freedom of religion, right to work, freedom from abuse.

·        Civil Rights are rights guaranteed by the United States Constitution and state constitutions.  Civil rights are protected by federal law, Connecticut statutes and court rulings. 

 “Treatment Rights” can be human or civil rights.  For example the American Medical Association suggests physicians protect a patient’s right to be treated with courtesy, respect, dignity, to provide timely and responsive attention to the patient's needs and to answer patient questions about their health status or recommended treatment as well as respecting the patient’s decisions regarding healthcare and the patient's privacy on confidentiality. 

Some rights need a someone to put them in effect.  For example, healthcare providers are responsible for protecting the right of effective communication of a patient with Limited English Proficiency by providing a qualified interpreter. 

Connecticut Patient Bill of Rights

Persons receiving treatment from a Connecticut psychiatric treatment facility (including substance use disorder treatment) either inpatient as a voluntary or involuntary patient or through an outpatient program have specific rights found in Connecticut General Statutes Sections 17a-540 through 17a-550.  These statutes are called the Connecticut Patient Bill of Rights (CPBOR). 

Connecticut General Statutes define a psychiatric treatment facility as one that diagnose, observe, or treat persons with psychiatric disabilities.

The CPBOR protects a person’s human and civil rights as well as other rights including:  

·        Personal Dignity

·        The right to be treated in a humane and dignified manner at all times.

·        The right to participate in treatment and discharge planning.

·        The right to be free from discrimination.

·        The right to effective communication.

·        The right to submit a complaint without retaliation.

·        The right to equal access to services, programs, and activities.

For information on the specific statutes that make up the Connecticut Patient Bill of Rights as well as other rights people have go to:

Connecticut Patient Bill of Rights

Other “Bill of Rights” include:

·        Connecticut Long term Care Bill of Rights

·        Connecticut Mental Health Bill for Deaf, Deafblind, Hard of Hearing Persons

·        CMS Patient Bill of Rights

·        Federal Mental Health Bill of Rights

The Right to Be Free from Discrimination: 

The Civil Rights Act of 1964 and other federal laws protect a person’s right to be free from discrimination due to “race, color, religion, sex and national origin.” 

Connecticut statutes identify more categories of discrimination than federal law including discrimination on the due to age, alienage (foreign national or undocumented), blindness, color, disability, gender identity, gender expression, national origin, race, sex, sexual orientation, and status as a veteran.  DiscriminationFlyerpdf.pdf (ct.gov)

The Connecticut Commission on Human Rights and Opportunities  is the state agency which addresses complaints about discrimination in employment, housing and public accommodation.   

Section 1557 of the Patient Protection and Affordable Care Act (ACA) prohibits federally funded healthcare providers from discriminating on the basis of age, color, disability, gender identity, national origin, race, sex, sexual orientation, and sexual characteristics. Section 1557 also requires federally funded healthcare providers to provide effective communication when a person has Limited English Proficiency.

DMHAS complies with section 1557 of the ACA and provides Language Assistance for people receiving services from DMHAS state operated facilities. 

People have right to be free from discrimination due to a disability and persons with disabilities have the same right to access programs, services and activities as other persons under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act as well as other federal laws and state statutes.

DMHAS complies with the ADA and prohibits discrimination of people with disabilities who receive services from DMHAS or who are eligible to receive services or who are visitors and guests of DMHAS.  DMHAS provides persons with disabilities equal access to programs, services, and when requested reasonable modifications to policies, procedures and practices.   

DMHAS Commissioner’s Policies and Directives addressing people’s rights include:  

·         Commissioner’s Policy Statement, Client Rights

·         Commissioner’s Policy Statement, Equal Access (ADA Title II)

DMHAS webpages: Title II of the Americans with Disabilities Act ADA and DHOH Services.

DMHAS Client Grievance Procedure

The DMHAS Client Grievance Procedure is a written interactive process used by DMHAS state operated and DMHAS funded direct service providers to work with people when resolving complaints. 

DMHAS operated and DMHAS funded providers using the DMHAS Client Grievance Procedure designate a Client Rights Officer (CRO) who receives grievances and addresses complaints. 

The DMHAS Office of the Commissioner offers training and resources for providers and Client Rights Officers.  DMHAS Office of the Commissioner also distributes an annual survey to Client Rights Officers: 

o    2021-2022 Fiscal Year DMHAS Client Rights Officers’ Survey

o    2022-2023, Fiscal Year DMHAS Client Rights Officers’ Survey

What is a DMHAS Client Grievance?

Most complaints can be resolved informally by staff at the they occur.  The DMHAS Client Grievance Procedure addresses two kinds of complaints: 

·               Written complaints a provider denied, involuntary reduced or involuntary terminated services; or

·               Written complaints the person believes a provider or the provider’s staff: 

                i.        Violated rights provided by law or DMHAS directive.

              ii.        Treated the client in an arbitrary or unreasonable manner.

             iii.        Failed to provide services authorized by a treatment plan.

             iv.        Used coercion to improperly limit choice.

              v.        Failed to reasonably intervene when the client’s rights were put at risk by another client or patient in a setting controlled by the provider.

             vi.        Failed to treat the client or patient in a humane and dignified manner. 

How does the DMHAS Client Grievance Procedure Work?

1.   DMHAS Client Grievances are submitted to a provider’s Client Rights Officer within forty-five (45) calendar days of when the action complained of occurred unless the grievance is an Accelerated Grievance or the CRO accepts the complaint for good causes.

2.   The CRO acknowledges the grievance and works with the person to resolve their complaint.

·        If the CRO cannot address the person’s grievance or the person rejects the CRO’s proposed resolution, the grievance is reviewed separately by the provider’s Chief Executive Officer or designee. 

3.   The CEO or their designee issues a written Formal Decision within twenty-one (21) calendar days unless additional time is authorized by the provider, or the grievance is an Accelerated Grievance.   

4.   The person submitting the grievance has no more than fifteen (15) business days after the provider issues a Formal Decision (or if the provider fails to respond to the grievance) to submit a written request for a Commissioner’s Review.

·           The DMHAS Commissioner’s designee conducts the review and

issues a Final Determination which ends the DMHAS Client

Grievance Procedure. 

The person may submit a written request for a Fair Hearing within thirty (30) days of receiving a Final Determination when services were denied, involuntarily reduced or involuntarily terminated. 

What is an Accelerated Grievance?

An Accelerated Grievance can be submitted to a provider by a client or their authorized representative when the provider involuntarily reduces or terminates Opioid Substitution Therapy or terminates DMHAS funded inpatient treatment scheduled for 30 days or less.

1.   The person submits an Accelerated Grievance in writing to the provider within 5 business days of being notified of the involuntary reduction or termination.

2.   The provider has five business days to issue a written Formal Decision

3.   The client may submit a written request for a Commissioner’s Review after receiving the provider’s Formal Decision. 

What happens if my provider involuntarily terminates services?

DMHAS operated and funded providers must notify a client when services are involuntarily reduced or terminated.  The person should receive notice of the reason for the action and right to submit a grievance to the provider’s CRO using the DMHAS Client Grievance Procedure.  

If the provider involuntarily terminates services, the provider notifies the person of modified services. 

If the provider fails to notify the person whose services are being involuntarily terminated of modified services:

1.   The person has 5 business days to submit a written request to the DMHAS Commissioner for a Continuation of Services.

·        The request needs to include the service being terminated, the reason why the client wants the service continued and when the client submitted a grievance to provider regarding the action.   

2.   The Commissioner’s designee will review the request and issue a response after considering safety and clinical concerns regarding the client and others. The response may:

·        Direct the provider to continue services or offer modified services.

·        Support the decision of the provider regarding the involuntary termination.

3.   The direction of the Commissioner’s designee will remain in effect until the client’s grievance is fully addressed either by the provider, Commissioner’s Review or Fair Hearing.  The designee may alter their direction depending on circumstances.  

What is a Fair Hearing?  

A client or their authorized representative may submit a written request to the DMHAS Commissioner for a “Fair Hearing.”

The request must be submitted no later than 30 calendar days after receiving the Final Determination of a grievance that concerns Denial, Involuntary Reduction or Termination of services.

The request must be mailed in writing to the Commissioner and identify the services denied, Involuntarily reduced or terminated along with the date of the final determination. 

A hearing officer will be designated by the Commissioner and a hearing scheduled no later than 45-calendar days after the date of the request.

Hearings are held under Chapter 54 of the Uniform Administrative Procedure Act  ( §§4-166 to 4-189 Inclusive) where the client has the burden of proving the Final Determination does not comply with state and federal law or is clearly erroneous

Are there exceptions to the DMHAS Client Grievance Procedure?   

Yes.

Complaints involving suspected or alleged incidents of abuse, neglect or exploitation are referred to the appropriate authority.  Client Rights Officers may refer complaints involving staff to their supervisor, CEO or designee or provider’s Human Resources as the CRO believes necessary.  

Complaints regarding programs or services that are not direct services operated by DMHAS or funded by DMHAS are not addressed by the DMHAS Client Grievance Procedure. 

These exceptions include:  

·        DMHAS funded providers that receive less than 20% of their funding from DMHAS and which have a grievance or complaint procedure approved by DMHAS may be exempt from using the procedure by the DMHAS Commissioner.

·        Complaints falling under the jurisdiction of the Psychiatric Security Review Board (PSRB) are not addressed by the DMHAS Client Grievance Procedure. 

·        Complaints that may be violations of law or personnel policy are referred to outside authorities as necessary.

·        Hospital inpatient units use the Centers for Medicare and Medicaid (CMS) grievance procedure: CMS Grievance Procedure and complaints are addressed by the hospital’s patient relations or patient rights office.

·        Complaints regarding healthcare providers including licensed clinicians and facilities are addressed by the Connecticut Department of Public Health: DPH Complaint Reporting

·        Complaints regarding federally funded rehabilitative services including Medicare funded substance use disorder treatment are addressed by the Connecticut Behavioral Health Partnership  Phone: 877-552-8247  Email: ctbhpappeals@carelon.com

·        Complaints regarding DSS funded programs like the Mental Health Waiver and Acquired Brain Injury Waiver are addressed by DSS. For more information contact the Waiver provider. 

·        Waiver denials are addressed by Department of Social Services (DSS) Office of Legal Counsel Regulations & Administrative Hearings, Appeals 55 Farmington Ave, Hartford, CT 06105  Phone: 860-424-5760  Email: olcrah.DSS@ct.gov  
·        Complaints regarding Behavioral Health Recovery programs including “Supported Recovery Homes” are addressed by Advance Behavioral Health Inc
·        Complaints regarding Certified Sober Living Homes are addressed by the home’s operator and certifying organization.  

·        Housing complaints regarding voucher denials and other matters. Complaints are addressed using the Coordinated Access Network (CAN), Connecticut Balance of State (CT BOS) and DMHAS Housing and Homeless Services Continuum of Care Project Complaint Procedure

·        Complaints regarding “Supported Recovery Homes” are addressed by Advanced Behavioral Health  www.abhct.com

·        Complaints regarding Certified Sober Living Homes may be addressed by either:

o   Connecticut Alliance of Recovery Residences (CTARR), www.ctrecoveryresidences.org

o   Connecticut Coalition of Recovery Residences (CCORR), www.ccorr.org telephone 860-995-9472.

DMHAS Client Grievance Procedure documents:                             

·         Commissioner's Policy Statement, DMHAS Client Grievance Policy

·         DMHAS Client Grievance Policy Implementing Procedure

·         Grievance Procedure Summary - (En Español)

·         Fair Hearing Regulations

·         Client Rights Officers

·     Client Grievance Procedure Complaint Form - (En Español)

DMHAS Notices:             

The DMHAS Commissioner’s Office distributes notices to DMHAS operated facilities and funded providers for posting in public locations. 

·         Know Your Rights Notice (English) - (En Español): This notice includes a list of the CPBOR as well as references to other statutes and federal laws
which protect people’s rights.  The notice is distributed by DMHAS OOC to DMHAS facilities and DMHAS funded providers for posting in public locations

·         DMHAS Grievance Procedure Summary: This notice is distributed by DMHAS OOC to DMHAS facilities and DMHAS funded providers for posting in public locations.

The DMHAS Office of the Commissioner also distributes the following notices to DMHAS facilities:

·         Americans With Disabilities Act (ADA) Notice

·         Language Access and Non-Discrimination Notice

Notices are available on request from the DMHAS Office of the Commissioner (OOC) free of charge in alternative languages and formats by calling 860-418-7000.

Resources

Advocacy:  

Connecticut has three statewide advocacy organizations:  

Advocacy Unlimited, Inc. (AU)
AU is a peer run, non-profit organization that assists people and helps them advocate for themselves. AU,
2075 Silas Deane Highway, Rocky Hill, CT 06067   

1-800-573-6929 or 860-505-7581 (email: info@advocacyunlimited.org)

·         Connecticut Legal Rights Project, (CLRP)

CLRP attorneys and paralegals primarily advocate on behalf of persons with psychiatric disabilities who receive services from DMHAS-operated facilities and contracted providers. CLRP, PO Box 351, Silver Street, Middletown, CT 06457

1-877-402-2299 or 860-262-5030 (email: info@clrp.org)

·         Disability Rights Connecticut, (DRCT)
DRCT is Connecticut’s federally funded independent Protection and Advocacy System which advocates on behalf of persons with disabilities. DRCT, 75 Charter Oak Ave. Ste 1-101, Hartford, Connecticut 06106

1-800-842-7303 or 860-297-4300 (email: info@DisRightsCT.org)

Other Resources:

Legal Resources:

·        State-Wide Legal Services  State-Wide Legal Services helps people on low income with legal questions on non-criminal matters.  Phone number: 1-800-453-3320.

·        Connecticut Bar Association: The Connecticut Bar Association offers,  Connecticut Free Legal Answers is a CBA online legal service for people who cannot afford to pay for an attorney in civil cases.

·        For information on criminal matters, contact the clerk at the court where the case is being held:  Connecticut Judicial Branch 

·        For information on Probate Courts, including conservators and wills contact the court for the community where you reside: Connecticut Probate Courts

State agencies and departments:

·        Connecticut Commission on Human Rights and Opportunities 

The CHRO enforces civil and human rights to eliminate discrimination and to establish equal opportunity and justice for all persons within the state.

·        Connecticut Department on Aging and Disability

Provides and coordinate aging and disability programs and services in the areas of employment, education, independent living, accessibility, and advocacy for the rights of Connecticut residents with disabilities and older adults.

·        Connecticut Department of Children and Families Office of Community Relations

The Office of Community Relations serves to resolve disputes and respond to inquiries concerning the Department, in the best interests of children.

·        Connecticut Department of Developmental Services Office of the Ombudsperson

The DDS Ombudsperson provides information on rights and means of resolving disputes regarding persons receiving services from DDS and their families.

·        Connecticut Office of the Healthcare Advocate

OHA assists consumers with healthcare issues and in resolving  problems with their health insurance plans

·        Connecticut Long Term Care Ombudsman Program

LTCOP works to improve the quality of life and quality of care of Connecticut citizens residing in nursing homes, residential care homes and assisted living communities.  The LTCOP responds to, and investigates complaints brought forward by residents, family members, and/or other individuals acting on their behalf.

·        Connecticut Department of Public Health

DPH works to prevent disease, injury, and disability, and promotes the equal enjoyment of the highest attainable standard of health, which is a human right and a priority of the state.

211 Infoline: Infoline provides information on services and supports across Connecticut. 

For more information see the DMHAS Webpage:  Advocacy and Support

Links listed on this page were working at the time this page was published.  To report an error or correction contact William Pierce

DMHAS Office of the Commissioner  william.pierce@ct.gov

Updated February 2024