Overview

CARF is clearly committed to the protection of clients' rights. There are several standards throughout the manual that address this topic. The organization should demonstrate through policy and practice that rights are adhered to, that there is an awareness of the diversity of the population(s) served, and that rights are communicated in an understandable manner to all clients. The organization must also adhere to all applicable local, state, and Federal regulatory requirements.

Accreditation Requirement(s)

• The organization takes into consideration the diversity of the persons served and communicates client rights in a manner that is meaningful to them.
  
• Clients are notified of their rights upon admission to services, and annually thereafter.
  
• Clients' rights should be readily available for review.
  
• Policies are developed concerning confidentiality, privacy, freedom from abuse, exploitation, retaliation, humiliation, neglect, releases of information, informed consent and refusal, access to legal representation, self-help, and advocacy support services.
  
• Adherence to research guidelines and ethics, and investigation and resolution of alleged infringement of rights are practiced.
  
• Client rights policies include the methods by which clients may review their records, the use of crisis intervention procedures, and the use of special treatment interventions and intrusive procedures.
  
• The opioid specific standards specify that clients' rights also address providing care in the least restrictive environment; receiving adequate, humane care; providing information about alternative treatments/medications that are evidence-based; access to and timely responses to requests for copies of the medical/client record, protection from the disruptions of other clients; equal access to treatment; and information about appeal procedures.

Implementation Tips

Some Implementation Tips provided, in part, by Robert Johnson at: www.accreditationnow.com.

• One of the areas that can significantly reduce a positive accreditation outcome is in the area of client rights. It is an area that cannot be compromised in any manner. Most states have specific legal and regulatory guidelines in the area of client's rights and responsibilities.
  
  
• The sample policy is not a substitute for your state and local laws and regulations. However, it should help fill in some of the gaps in terms of meeting the accreditation standards.
  
  
• The following are some tips and suggestions for policies and practices in the area of client's rights and responsibilities.
  
  
• It is important to provide information regarding client rights that is understandable. One of the most frequent problems organizations tend to have in this area is providing clients with written material that is far beyond their comprehension level. Due to the large amount of material they receive during their initial orientation, clients tend to struggle with retention of the information. Written handouts can assist filling this gap; however, they should be within your client population's comprehension level. It is a good practice to write all client materials within an eighth-grade comprehension level. Word processing software contains the ability to check the reading level of all your documents prior to distribution to clients.
  
  
• The Center for Health Care Strategies (CHCS) has developed Facts About Health Literacy. CHCS prepared these fact sheets in 1997 (revised in 2003). Since then, the number of publications on health literacy has grown exponentially, and the issue is now being incorporated into the Federal health policy agenda. The production of this series was made possible by funding from The Commonwealth Fund and Pfizer, Inc. You can access this valuable resource at www.chcs.org/publications3960/publications_show.htm?doc_id=291711
  
  
• When providing a handout to clients on rights and responsibilities, consider significantly modifying your policy statements into short, easy-to-understand "bullet" statements on a single page in a large font. Consider combining some of the statements into one statement. Remember, when respecting the dignity of your clients, it is equally important to make sure they have materials that are functional as it is to make sure the legal requirements of certain practices are being properly implemented.
  
  
• A client orientation/information book is a great place to provide a list of the client rights, as it will always be available to clients to access at any time. In addition, this version of the rights (condensed and put in simple language) makes a good document to frame and place in prominent locations throughout your organization. Clients' rights are often posted in waiting areas, main hallways, near dispensing units, on client bulletin boards, etc.
  
  
• The sample policy does not contain specific information on the use of special treatment interventions or restriction of rights, as these issues are typically dependant upon the organization's specific programming focus and environment. It is important that you acknowledge any special practices or rules that exist in your organization in your statement of client rights.