One stated intention of the proposed revisions to the Human Rights regulations is to streamline administrative process.  The proposed regulations do not clearly and successfully address this with regards to who holds responsibility for reviewing and approving policies and procedures related to human rights.  Specifically, 115-100 B, 7, e states program rules should be submitted to the LHRC upon request of the advocate or the LHRC, 115-175 E indicates that policies about complaints are to be submitted to the “department,” and 115-260 A, 9 states policies, procedures, or practices that may affect individual human rights are reviewed by the human rights advocate.  As a result, three different types of reviewers could provide input and one policy could need to be reviewed multiple times, as various reviewers provide different input and more than one needs to approve a policy.  This does not improve efficiency for DBHDS or for providers.

Should the decision be made to maintain 115-100 B, 7, e as is, please note this does not state program rules need to be submitted and approved in advance of implementation, nor is there a way of ensuring various advocates and LHRCs have a standard for requesting this information.  Clear expectations should be articulated here, to increase consistency and decrease potential bias. 

With regards to requiring LHRC approval for a restriction lasting longer than 7 days or that is imposed multiple times in 30 days (115-100, B, 5), these timeframes are impractical.  Requests for special meetings become a burden on LHRC members and the advocates and generally cannot be scheduled at the last minute.  This sets the expectation for the provider to presume a restriction could be needed for more than seven days and the provider would have to attempt to convene a special LHRC upon implementing the restriction.  Is there a more viable alternative?  Also – what constitutes “multiple”? If this is subject to provider’s interpretation, there will be a lack of consistency, as there currently is with regards to medication errors involving multiple missed doses.   

Shifting to a single process for Human Rights Complaints (115-175) is an improvement and, overall, the proposed regulations improve clarity.  However, the removal of the allowance for immediate resolution (115-170 A, 4, Step 1) potentially magnifies normal problem solving with individuals being served to the level of an investigation and does not serve to improve efficiency or streamline process.  Also, there is no allowance for an extension for a complaint that does not rise to the level of abuse.  Although rare, there are times when this is warranted.

Regarding 115-175 B, please revise to denote that the director or designee shall contact the individual within 24 hours or on the next business day.  This would be consistent with other aspects of the regulation, helps maintain appropriate boundaries between individuals receiving services and staff members of providers who conduct investigations, and avoids placing an undue burden on providers.