§ 17a-238 — (Formerly Sec. 19a-469). Rights of persons under supervision of Commissioner of Developmental Services.

Connecticut § 17a-238

• Jurisdiction: Connecticut
• Title 17a: Social and Human Services and Resources
• Ch. 319b: Department of Developmental Services

Text

(a) No person placed or treated under the direction of the Commissioner of Developmental Services in any public or private facility shall be deprived of any personal, property or civil rights, except in accordance with due process of law. (b) Each person placed or treated under the direction of the Commissioner of Developmental Services in any public or private facility shall be protected from harm and receive humane and dignified treatment which is adequate for such person's needs and for the development of such person's full potential at all times, with full respect for such person's personal dignity and right to privacy consistent with such person's treatment plan as determined by the commissioner. No treatment plan or course of treatment for any person placed or treated under the direction of the commissioner shall include the use of an aversive device which has not been tested for safety and efficacy and approved by the federal Food and Drug Administration, except any treatment plan or course of treatment including the use of such devices that was initiated prior to October 1, 1993. No treatment plan or course of treatment prescribed for any person placed or treated under the direction of the commissioner shall include the use of aversive procedures except in accordance with recommendations from a regional human rights committee and any procedures established by the Commissioner of Developmental Services. For purposes of this subsection, “aversive procedure” means the contingent use of an event which may be unpleasant, noxious or otherwise cause discomfort to alter the occurrence of a specific behavior or to protect an individual from injuring himself or herself or others and may include the use of physical isolation and mechanical and physical restraint. Nothing in this subsection shall prohibit persons who are not placed or treated under the direction of the Commissioner of Developmental Services from independently pursuing and obtaining any treatment plan or course of treatment as may otherwise be authorized by law. The commissioner shall adopt regulations, in accordance with chapter 54, to carry out the provisions of this subsection. (c) The Commissioner of Developmental Services shall adopt regulations, in accordance with the provisions of chapter 54, with respect to each facility or institution under the jurisdiction of the commissioner, with regard to the following: (1) Prohibiting the use of corporal punishment; (2) when and by whom therapies may be used; (3) which therapies may be used; and (4) when a person may be placed in restraint or seclusion or when force may be used upon a person. (d) A copy of any order prescribing the use of therapy, restraint or seclusion in accordance with the regulations adopted under subsection (c) of this section shall be made a part of the person's permanent clinical record together with the reasons for each such order and made available in compliance with existing statutes relating to the right to know. (e) The Commissioner of Developmental Services shall ensure that each person placed or treated under the commissioner's direction in any public or private facility is afforded the following rights and privileges: (1) The right to prompt, sufficient and appropriate medical and dental treatment; (2) the right to communicate freely and privately with any person, including, but not limited to, an attorney or other legal representative of the person's choosing; (3) the right to reasonable access to a telephone, both to make and receive calls in private, unless such access is used in violation of any federal or state statute; (4) the right to send and receive unopened mail and to make reasonable requests for assistance in the preparation of correspondence; (5) the safety of each person's personal effects shall be assured including the provision of reasonably accessible individual storage space; (6) the right to be free from unnecessary or excessive physical restraint; (7) the right to voice grievances without interference; (8) the right to a nourishing and well-balanced diet; (9) the right to be employed outside a facility and to receive assistance in his or her efforts to secure suitable employment. The department shall encourage the employment of such persons and shall promote the training of such persons for gainful employment, and all benefits of such employment shall accrue solely to the person employed; (10) the right to have the complete record maintained by the Department of Developmental Services concerning such person released for review, inspection and copying to such person's attorney or other legal representative notwithstanding any provisions of subsection (g) of section 4-193 or section 4-194 ; and (11) the right to receive or purchase his or her own clothing and personal effects, including toilet articles, and the right to wear such clothing and use such personal effects except where determined to be dangerous to the health or safety of the individual or others. (f) The Commissioner of Developmental Services shall require the attending physician of any person placed or treated in a residential facility under the direction of the commissioner to obtain informed written consent from the following persons prior to authorizing any medical treatment or surgical procedure, excluding routine medical treatment which is necessary to maintain the general health of the person or to prevent the spread of any communicable disease: (1) The person if such person is eighteen years of age or over or is legally emancipated and competent to give such consent; (2) the parent of a person under eighteen years of age who is not legally emancipated; or (3) the legal representative of a person of any age who is adjudicated unable to make informed decisions about matters relating to such person's medical care. The person whose consent is required shall be informed of the nature and consequences of the particular medical treatment or surgical procedure, the reasonable risks, benefits and purpose of such medical treatment or surgical procedure and any alternative medical treatment or surgical procedure which is available. The consent of any person or of any parent or legal representative of any person may be withdrawn at any time prior to the commencement of the medical treatment or surgical procedure. The regional or training school director having custody and control of a person living in a residential facility may authorize necessary medical treatment or surgical procedure for such person where, in the opinion of the person's attending physician, the medical treatment or surgical procedure is of an emergency nature and there is insufficient time to obtain the required written consent provided for in this section. The attending physician shall prepare a report describing the nature of the emergency which necessitated such medical treatment or surgical procedure and shall file a copy of such report in the patient's record. (g) The commissioner's oversight and monitoring of the medical care of persons placed or treated under the direction of the commissioner does not include the authority to make treatment decisions, except in limited circumstances in accordance with statutory procedures. In the exercise of such oversight and monitoring responsibilities, the commissioner shall not impede or seek to impede a properly executed medical order to withhold cardiopulmonary resuscitation. For purposes of this subsection, “properly executed medical order to withhold cardiopulmonary resuscitation” (1) means (A) a written order by the attending physician or advanced practice registered nurse; (B) in consultation and with the consent of the patient or a person authorized by law; (C) when the attending physician or advanced practice registered nurse is of the opinion that the patient is in a terminal condition, as defined in section 19a-570 ; and (D) when such physician or advanced practice registered nurse has requested and obtained a second opinion from a Connecticut licensed physician or advanced practice registered nurse in the appropriate specialty that confirms the patient's terminal condition; and (2) includes the entry of such an order when the attending physician or advanced practice registered nurse (A) is of the opinion that the patient is in the final stage of a terminal condition but cannot state that the patient may be expected to expire during the next several days or weeks, or (B) in consultation with a physician qualified to make a neurological diagnosis, deems the patient to be permanently unconscious, provided the commissioner has reviewed the decision with the department's director of health and clinical services, or such director's designee, the legal representative of the patient and others whom the commissioner deems appropriate, and determines that the order is a medically acceptable decision. The provisions of this subsection shall not apply to individuals with a legally valid advance directive. (h) Any person applying for services from the Commissioner of Developmental Services or any person placed by a Probate Court under the direction of the Commissioner of Developmental Services, and such person's legal representative, shall be informed orally and in writing at the time of application or placement of the rights guaranteed by this section. A summary of such rights shall be posted conspicuously in the public areas of every public or private facility providing services to persons under the care of the Commissioner of Developmental Services.

Legislative History

(P.A. 76-152, S. 1–3; P.A. 80-311, S. 1, 5; P.A. 81-150; P.A. 82-86; P.A. 86-41, S. 10, 11; P.A. 88-317, S. 81, 107; P.A. 93-253; 93-303; P.A. 01-140, S. 2; 01-195, S. 130, 181; P.A. 06-195, S. 60; P.A. 07-73, S. 2(a),(b); 07-252, S. 3; P.A. 17-96, S. 42; P.A. 18-32, S. 18, 19, 39; P.A. 21-135, S. 2; P.A. 24-122, S. 11.) History: P.A. 80-311 required as part of permanent record the reasons for each therapy order under Subsec. (d) and added Subsecs. (e) and (f) re patients' rights; P.A. 81-150 amended Subsec. (e) to add to the rights of persons under the supervision of the commissioner of mental retardation the right of such persons to receive or purchase their own clothing and personal effects, including toilet articles, and to wear or use them unless deemed dangerous to the health or safety or that of others; P.A. 82-86 inserted new Subsec. (d) requiring physician to obtain written consent before authorizing surgical procedure or medical treatment as specified, relettering as necessary; Sec. 19-575a transferred to Sec. 19a-469 in 1983; P.A. 86-41 substituted “director” for “superintendent” in Subsec. (f); P.A. 88-317 amended reference to Secs. 4-166 to 4-176 in Subsec. (c) to include new section added to Ch. 54, effective July 1, 1989, and applicable to all agency proceedings commencing on or after that date; Sec. 19a-469 transferred to Sec. 17a-238 in 1991; P.A. 93-253 amended Subsec. (b) re use of aversive devices and procedures, defined “aversive device” and required adoption of regulations; P.A. 93-303 inserted new Subsec. (g) to describe the commissioner's oversight and monitoring of medical care of persons under his direction with respect to medical orders to withhold cardiopulmonary resuscitation, relettering former Subsec. (g) as (h); P.A. 01-140 made technical changes in Subsecs. (b) to (h) and amended Subsec. (f) by adding provision re emergency surgery authorization by regional or training school director having custody and control of resident; P.A. 01-195 duplicated technical changes made in P.A. 01-140, effective July 11, 2001; P.A. 06-195 amended Subsec. (g)(3) by referencing “section 19a-570” instead of “subdivision (3) of section 19a-570”; pursuant to P.A. 07-73 “Commissioner of Mental Retardation” and “Department of Mental Retardation” were changed editorially by the Revisors to “Commissioner of Developmental Services” and “Department of Developmental Services”, effective October 1, 2007; P.A. 07-252 made a technical change in Subsec. (g); P.A. 17-96 amended Subsec. (h) to delete reference to Sec. 46a-11, effective July 1, 2017; P.A. 18-32 amended Subsec. (f) by adding references to residential facility, replacing references to resident with references to person, and replacing references to guardian and conservator with references to legal representative, effective July 1, 2018, amended Subsec. (g) by adding references to advanced practice registered nurse, replacing “director of community medical services” with “director of health and clinical services, or such director's designee”, replacing “family and guardian” with “legal representative”, adding provision re individuals with legally valid advance directive, and making technical changes, effective October 1, 2018, and amended Subsec. (h) by replacing “parents or guardian” with “legal representative” and making a technical change, effective July 1, 2018; P.A. 21-135 amended Subsec. (f) to replace references to treatment with references to medical treatment, replace “surgery” with “medical treatment or surgical procedure” re regional or training school director having custody and control of person living in residential facility, and make technical changes, effective July 7, 2021; P.A. 24-122 amended Subsec. (b) by adding “recommendations from a regional human rights committee and any” and making technical changes, effective June 5, 2024. Annotation to former section 19a-469: Cited. 221 C. 346.