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Subject 290-4-6 PATIENTS' RIGHTS

Rule 290-4-6-.01 Purpose, Implementation, and Definitions

(1) Purpose. The Purpose of these regulations is to safeguard the rights of persons treated pursuant to the Official Code of Georgia Annotated (O.C.G.A.) Chapters 37-3, 37-4 and 37-7. Rules and regulations for persons treated in mental health centers will be issued separately.
(2) Applicability. These regulations shall apply to all facilities except mental health centers and those operated by Federal agencies as defined in O.C.G.A. Chapters 37-3, 37-4 and 37-7. They shall in general apply to all persons served in such facilities without regard to the type or source of entry into the program. When the patient is a minor or an adult with a legally appointed guardian, the regulations are applicable to that person with certain exceptions as specifically stated in various parts of the regulations. These variations are noted in the text of the regulations. For persons being served by virtue of a court order related to a criminal matter, the regulations are applicable to the extent that they do not violate the provisions of the order nor the need to provide for the safety of the individual or of others.
(3) Implementation. Each facility shall instruct each staff member in the contents of these regulations. Each facility also, at the beginning of each patient's treatment, shall notify the patient or his parent or guardian, if applicable, of the rights and remedies contained in these regulations, to their applicability to him. Notifications shall be done in such a manner commensurate with the individual's abilities and capabilities of comprehension and understanding. Further, prior to the restriction of any patient's rights (as permitted by these regulations), a staff member shall again inform the patient or his parent or guardian, if applicable, of his right to administrative complaint or judicial review of that restriction, except in cases where the resident's condition makes this impractical and the resident shall be informed at a time when his condition permits.
(4) Definitions. Unless a different meaning is required by the context, the following terms as used in these regulations shall have the meanings hereinafter set forth:
(a) "Abuse" means any unjustifiable intentional or grossly negligent act, exploitation or series of acts, or omission of acts which causes injury to a patient, including but not limited to verbal abuse, assault or battery, failure to provide treatment or care, or sexual harassment;
(b) "Chief Medical Officer" means the physician designated by the chief administrative officer of the facility with overall responsibility for patient treatment at any facility receiving patients pursuant to O.C.G.A. Chapters 37-3 or 37-7 or his designee. Where patients are receiving treatment under the provisions of O.C.G.A. Chapter 37-4, this term shall include the term "Superintendent" when applicable;
(c) "Community Mental Health Center" shall mean an organized program for the care and treatment of the mentally ill and alcoholics, drug dependent individuals or drug abusers operated by a county board of health or such similar program recognized by a county board of health or the Department;
(d) "Court" means, in the case of an individual who is 17 years of age or older, the probate court for the county of residence of the patient or the county in which such patient is found, and, in the case of an individual who is under the age 17 years, the juvenile court for the county of residence of the patient or the county in which such patient is found;
(e) "Department" means the Georgia Department of Human Resources and includes its duly authorized agents and designees;
(f) "Director" means the director of the Division of Mental Health, Mental Retardation and Substance Abuse of the Department of Human Resources;
(g) "Facility" for purposes of this Chapter 290-4-6, means any State-owned or State-operated hospital, or other facility utilized for the diagnosis, care, treatment, or hospitalization of patients, and any other hospital or facility within the State of Georgia approved for such purpose by the Department as defined in O.C.G.A. Chapters 37-3, 37-4 and 37-7, but does not mean community mental health center;
(h) "Guardian" means an individual appointed as provided by law to be over the person of an adult or of a minor. Whenever the word patient is used in these regulations, a guardian is entitled to exercise the patient's rights on behalf of his ward;
(i) "Individualized Service Plan."
1. "Individualized service plan" means a proposal that is developed during a patient's stay in a facility pursuant to O.C.G.A. Chapter 37-3 and that is specifically tailored to the individual patient's treatment needs. For the purpose of these regulations, it includes the corresponding individualized treatment plan for a patient's stay in a facility pursuant to O. C .G.A. Chapter 37-7. Each such plan shall clearly include:
(i) A statement of treatment goals or objectives, based upon and related to a proper evaluation, which can be reasonably achieved within a designated time interval;
(ii) Treatment methods and procedures to be used to obtain these goals, which methods and procedures are related to these goals and which include specific prognosis for achieving these goals;
(iii) Identification of the types of professional personnel who carry out the treatment and procedures, including appropriate medical or other professional involvement by a physician or other health professional properly qualified to fulfill legal requirements mandated under State and Federal law;
(iv) Documentation of patient involvement and, if applicable, the patient's accordance with the service plan;
(v) A statement attesting that the chief medical officer has made a reasonable effort to meet the plan's individualized treatment goals in the least restrictive available environment possible closest to the patient's home community;
2. For the purpose of these regulations, "individualized service plan" also includes the corresponding individualized program plan for a client's stay in a facility pursuant to Georgia Code Chapter 37-4. The "individualized service plan" is developed prior to admission and is updated on a continuing basis. As a minimum each plan shall include:
(i) A statement of the nature of the specific problem and the specific needs of the client;
(ii) A statement of the least restrictive setting available and conditions necessary to achieve the purposes of habilitation based upon the needs of the client;
(iii) A description of intermediate and long-range goals with the projected timetable for their attainment;
(iv) A description of proposed program, facility, or department(s) responsible for involvement with the client in order to attain these goals;
(v) An explanation of criteria for rejection of other alternative settings for habilitation;
(vi) Proposed criteria enumerated for release to less restrictive settings for habilitation;
(j) "Patient" means any mentally ill person who receives treatment pursuant to O.C.G.A. Chapter 37-3 and any alcoholic, drug dependent individual, or drug abuser who receives treatment pursuant to O.C.G.A. Chapter 37-7; it also includes any mentally retarded person who receives habilitation pursuant to O.C.G.A. Chapter 37-4. "Patient" also includes a person for whom treatment or habilitation is sought;
(k) "Physical restraint" means any mechanical device used to restrict a person's physical movement, except as noted in Section 290-4-6-.02 ( 1)(c)2. (ii);
(l) "Physician" means any person duly authorized to practice medicine in this State pursuant to O.C.G.A. Chapter 43-34.
(m) "Representatives" means the person appointed pursuant to Section 290-4-6-.06(2) of these regulations, to receive notices;
(n) "Restrictive Time-out" means the placement of a patient in a room or area from which egress is prevented for a brief period of time contingent upon the occurrence of a specified target behavior, but under observation by staff. Key-locks or other latching devices which will not automatically open when staff are not present are prohibited.
(o) "Seclusion" means the placement of a patient alone in a locked room when the procedure is not part of a systematic, Restrictive Time-out program (see definition of "Restrictive Time-out").
(p) "Staff member" means, for the purposes of these regulations only, any person who is an employee, independent contractor, or other agent of the Department. The use of "staff member" in these regulations for such persons shall in no way alter the legal relationship of such persons and the Department, or subject the Department to any liability to which it is not otherwise subject.
(q) "Superintendent" means the chief administrative officer who has overall management responsibility at any facility receiving patients pursuant to O.C.G.A. Chapters 37-3, 37-4 and 37-7, or an individual appointed as the designee of such superintendent;
(r) "Treatment" means care; diagnostic services; therapeutic services, including the administration of drugs; and any other service for the treatment of an individual pursuant to O.C.G.A. Chapter 37-3; it includes such services, as well as social service care, vocational rehabilitation and career counseling, for an individual pursuant to O.C.G.A. Chapter 37-7; it also includes habilitation of an individual pursuant to O.C.G.A. Chapter 37-4.

Rule 290-4-6-.02 Treatment

(1) Appropriateness.
(a) General. Each patient shall receive care and treatment that is suited to his needs in the least restrictive environment available offering appropriate care and treatment.
(b) Individual Service Plans.
1. The examination of patients shall be governed as follows:
(i) For persons being treated pursuant to O.C.G.A. Chapters 37-7 and 37-3, each patient shall be assessed by the staff as soon as possible after admission but within the time limits contained within O.C.G.A. Chapters 37-7 and 37-3 or 72 hours, whichever comes first;
(ii) For persons treated pursuant to O.C.G.A. Chapters 37-4, each patient shall be assessed on the day of admission to an inpatient facility.
2. The development of an individualized service plan shall be governed as follows:
(i) For persons being treated in a hospital pursuant to O.C.G.A. Chapters 37-7 and 37-3, staff shall develop an individualized service plan for each patient as soon after the initial assessment as practical but within the time limits contained within O.C.G.A. Chapters 37-7 and 37-3 or 10 days, whichever comes first;
(ii) For persons treated pursuant to O.C.G.A. Chapters 37-4, individualized service plans for each person shall be developed prior to admission to a hospital.
3. Each individualized service plan shall be reviewed at regular intervals to determine the patient's progress toward the stated goals and objectives of the plan to determine whether the plan should be modified because of the patient's present condition. These reviews should be based upon relevant progress notes in the patient's clinical record and upon other related information. Information from the patient and other sources, including family members, should be obtained and utilized where feasible. Reviews should be conducted as required by applicable standards such as medicare, medicaid, JCAH, policies, etc.
(c) Physical Restraints, and Seclusion.
1. All physical restraints, and seclusion shall be used solely for the purposes of providing effective treatment and protecting the safety of the patient and other persons and shall not be used as punishment or for the convenience of staff. Physical restraints and seclusion should only be used when no less restrictive methods of controlling behavior which would reasonably insure the safety of the patient and other persons are feasible.
2. The use of physical restraints shall be governed as follows:
(i) For patients treated pursuant to O.C.G.A. Chapters 37-7 and 37-3, physical restraints shall not be applied unless it is determined by an attending physician to be absolutely necessary to prevent a patient from seriously hurting himself or others and is required by his medical needs. This determination shall expire after 24 hours. An attending physician must then make a new determination after personally examining the person before the restraints may be continued. Every use of a restraint and the reasons therefore shall be made a part of the clinical record of the patient. A copy of each of these entries shall be forwarded to the chief medical officer for review. A patient placed in physical restraints shall be checked at least every 30 minutes by staff members trained in the use of restraints, and a written record of these checks shall be made. While in restraints each person should be spoken to, checked for indications of obvious physical distress, be offered liquids and an opportunity to meet his need to urinate and defecate as needed or at least every 2 hours unless the person is asleep or his condition does not permit. The person should be periodically removed from restraints if his condition permits. A person in restraints should receive all means available to other patients except as otherwise ordered by a physician based upon the person's health needs and as his condition to take meals which in restraints permits. Restraints are to be discontinued when they are no longer needed to prevent a person from hurting himself or others and his medical needs allow removal;
(ii) For persons treated pursuant to O.C.G.A. Chapter 37-4, the following procedures shall apply:
(I) Physical restraints shall not be applied, except in emergencies as provided in the next subsection, unless it is determined by a physician to be necessary to prevent a patient from seriously injuring himself or others. The physician's order for restraints shall expire after 12 hours. The physician must then make a new determination that the application of restraints is necessary to prevent the client from seriously injuring himself or others and must make such a determination for each 12 hour period that the restraint is continued. The physician must issue a written order for each use of restraints. Restraints are to be discontinued when they are no longer needed to prevent the person from seriously injuring himself or others;
(II) When the application of a restraint is necessary in emergency situations to protect the patient from immediate injury to himself or others, restraints may be authorized by attending staff who must immediately report the action taken to the physician. The facility shall have written policies and procedures that govern the use of restraints and that clearly delineate, in descending order, the personnel who can authorize the use of restraints in emergency situations;
(III) Every use of a restraint shall be made a part of the patient's clinical record. The following shall be documented for the record:
I. The reasons for applying the restraints;
II. The signature of the person authorizing the restraints;
III. The time of application and removal of the restraint; and
IV. A record of checks at least every 30 minutes by a staff member trained in use of restraints with the signature of the person making such checks. While in restraints each person should be spoken to or in some manner communicated with, checked for indications of obvious physical distress, be offered liquids and an opportunity to urinate or defecate as needed or at least every 2 hours unless the person is asleep or his condition does not permit. A person in restraints must be given an opportunity for motion and exercise for a period not less than 10 minutes during each 2 hours of restraint. A person in restraints should receive all meals available to other patients except as otherwise ordered by a physician based upon the person's health needs and as his condition to take meals while in restraints permit. A copy of each use of restraints shall be followed to the superintendent for review;
(IV) For the purposes of this subsection 290-4-6-.02(1)(c)2. (ii), those devices which restrain movement, but are applied for protection from accidental injury or required for the medical treatment of the client's physical condition or for supportive or corrective needs of the client, shall not be considered physical restraints. However, devices used in such situations must be authorized and applied in compliance with the facilities' policies and procedures. The use of such devices shall be a part of the patient's individual program plan.
3. The use of seclusion shall be governed as follows:
(i) For persons treated pursuant to O.C.G.A. Chapters 37-7 and 37-3, procedures for the use of seclusion shall be the same as those for physical restraints contained in Subsection 290-4-6-.02(1)(c)2. (i).
(ii) For persons treated pursuant to O.C.G.A. Chapter 37-4, the use of seclusion is not allowed.
(iii) For persons treated pursuant to O.C.G.A Chapter 37-4 the use of Restrictive Time-out is permitted.
(d) Medications.
1. All medications shall be used solely for the purposes of providing effective treatment and protecting the safety of the patient and other persons and shall not be used as punishment or for the convenience of staff. Physical restraints and seclusion should only be used when no less restrictive methods of controlling behavior which would reasonably insure the safety of the patient and other persons are feasible.
(2) Participation of Patient.
(a) Access to information. Each patient and his guardian or parent of a minor, if applicable, shall have the right to review the patient's own medical records in accordance with Section 290-4-6-.05(3) of these regulations, to be told his diagnosis, to be consulted and informed about the treatment recommendation and any risk involved. The patient will be fully informed about his medication, including its side effects and available treatment alternatives. Such disclosures shall be made unless the disclosure to the patient himself is determined by the chief medical officer or the patient's treating physician to be detrimental to the patient's physical or mental health and unless a notation to that effect is made part of the patient's record. The patient shall be informed to the fullest extent possible in a manner that is commensurate with his abilities of comprehension and understanding. Such information shall not be withheld from a guardian or parent of a minor child in cases in which disclosure is to be made to that person.
(b) Consent. No treatment of any kind shall be administered to a patient if that patient refuses the treatment prior to the treatment except that:
1. Medication may be administered without the consent of the patient or other person where a physician determines that refusal would be unsafe to the patient or others. If the patient continues to refuse medication after such initial emergency treatment, a concurring opinion from a second physician must be obtained before medication can be continued without the patient's consent.
2. If an adult patient has been judicially determined to be incompetent to give such consent or to make decisions of a similar nature, such consent shall be obtained from the patient's guardian with capacity to make such decisions. If the patient is a minor, such consent shall be obtained from the minor's parent or guardian;
3. If the guardian or parent, where applicable, cannot be found after a diligent search, or if an adult patient, though legally competent, is physically unable (due to unconsciousness or otherwise) to give or withhold such consent, such consent shall be obtained from any one of the following persons: for an adult or minor patient, the patient's spouse; for a minor patient, any adult brother or sister, any grandparent, or any person temporarily standing in loco parentis, whether formally serving or no. When the treatment for which consent is sought is not standard psychiatric treatment, the consent obtained from the persons listed in this Section 290-4-6-.02(2)(b) 3. shall not be sufficient to authorize the treatment unless court approval is also obtained after a hearing. Standard psychiatric treatment shall not include insulin coma, or psychosurgery.
4. In cases of grave emergency where the medical staff of the facility determines that immediate surgical or other intervention is necessary to prevent serious physical consequences or death, and where delay in obtaining consent would create a grave danger to the physical health of the patient as determined by at least two physicians, then essential surgery or other intervention may be administered without the consent of the patient or other person. In such cases, a record of the determination of the physicians shall be entered into the medical records of the patient and this will be the prior consent for such surgery or other intervention. Such consent shall be valid notwithstanding the type of admission of the patient, and it shall also be valid whether or not the patient has been adjudged incompetent. Actual notice of any action taken pursuant to this section shall be given to the patient and the spouse, next of kin, attorney, guardian or representative of the patient as soon as practicably possible.
(3) Participation of Representative.
(a) Participation of representatives shall be governed as follows for patients being treated on an inpatient basis in a hospital pursuant to Georgia Code Chapters 37-7 and 37-3 and persons ordered to involuntary outpatient treatment by a community mental health center on an outpatient basis.
1. At the time that an adult patient's representative is designated or selected, and at least every 12 months thereafter, such patient shall be notified that, unless objected to by the patient, such representative will be permitted to consult with the facility regarding the development of the patient's individualized service plan and the patient's treatment under such plan.
2. At least 7 days prior to any substantial change in the individualized service plan or treatment thereunder of an adult patient, such patient shall be notified that such patient's representative will be notified of such change unless objected to by the patient within 24 hours. The representative of an adult patient not objecting to notification of such representative as herein authorized, shall be notified at least 5 days prior to any substantial change in such patient's individualized service plan or the treatment under such plan.
3. In an emergency where delay due to providing prior notification under Section 290-4-6-.02(3)(a) 2. would create serious damage to the health of the patient, such a substantial change may be made without such prior notification if:
(i) The patient's record specifies the circumstances surrounding the emergency;
(ii) Within 48 hours after the change an adult patient is notified of his rights to object, within 24 hours, to his representative's being notified of such change; and
(iii) The representative of a minor patient, and the representative of an adult patient not objecting to notification of such representative as herein authorized, shall be notified of such change within 5 days after such change occurs.
4. For purposes of Sections 290-4-6-.02(3)(a) 2. and 290-4-6-.02(3)(a)3.,"substantial change" means a significant change including but not limited to the transfer of a patient from a unit primarily serving patients under 18 years of age to a unit primarily serving patients 18 years of age or over or the transfer of a patient from one facility to another, but shall not include:
(i) Changes in the routine day-to-day care of the patient;
(ii) Routine or periodic changes or adjustments in patient medication;
(iii) Changes relating to routine or necessary medical care needs of the patient;
(iv) Formulation of the patient's initial individualized plan;
(v) Discharge of the patient from the facility; nor
(vi) Changes specifically contemplated in an individualized service plan regarding which the representative has already received notification.
5. Notification to representatives under Sections 290-4-6-.02(3)(a) 2. and 290-4-6-.02(3)(a)3., may be made by telephone if the date and time of such notification is entered on the patient's clinical record and if such notification is followed within 15 days by written notification.
6. A patient's legal guardian shall have the consultation and notification rights of a patient's representative under Sections 290-4-6-.02(3)(a) 1., 290-4-6-.02(3)(a)2., and 290-4-6-.02(3)(a)3. without regard to whether or not the patient is a minor and without regard to whether or not the patient objects to such consultation, notification, or both. A patient for whom a legal guardian has been appointed shall not be notified of any right to object under this Section 290-4-6-.02(3).
7. For purposes of this Section 290-4-6-.02(3),"representative" means the representative designated by the patient or, in the absence of such designation, the person selected as a representative in the order of listing under Section 290-4-6-.06 of these regulations but shall not mean the patient's legal guardian. At the time of being designated or selected, such representative shall be given notice of his notification and consultation rights under this Section 290-4-6-.02(3). In order to exercise such rights, the representative shall be required to notify the Department, on a form supplied by the Department, of his election to exercise such rights. Upon receiving such notice, the Department shall thereafter provide that representative the notification and consultation required by this Section 290-4-6-.02(3) until said representative notifies the Department to the contrary. A patient whose representative has not elected to exercise such rights shall not be required to be notified of his representatives' rights under this Section 290-4-6-.02(3).
(i) The provisions in Section 290-4-6-.02(3)(a) are not applicable to patients treated pursuant to O.C.G.A. Chapter 37-4. Participation of representatives shall be governed as provided in applicable regulations and policies.
(4) Location.
(a) The Department may designate the State-owned or State-operated facility to which a patient is admitted. When the needs of the patient or efficient utilization of any such facility may require, a patient may be transferred from one such facility to another. At the time of any such transfer, notice shall be given in writing to the patient and to his representatives in accordance with Section 290-4-6-.06 (1) of these regulations, and the patient shall be advised in writing of the reasons for his transfer. A voluntary patient pursuant to O.C.G.A. Chapters 37-7 and 37-3 may be transferred only with his consent. Notice of transfer for patients treated pursuant to O.C.G.A. Chapter 37-4 must be given at least 14 days prior to the transfer.
(b) Patients may be admitted to a hospital approved as a private facility as provided by law if accepted for treatment by the approved private facility.
(c) If a patient is able to pay for treatment in a private facility approved by the Department, he may apply to the Department for transfer at his expense to such private facility. If the private facility agrees to accept the patient, the Department shall transfer the patient to that facility.
(d) The facility shall assist the patient in securing placement in available noninstitutional community facilities and programs when those programs represent the least restrictive appropriate care and treatment available.
(5) Private Physician.
(a) If a patient is able to secure the services of a private physician who is not on the medical staff of the facility, the patient shall have the right to have that physician visit him at the inpatient facility. The patient or his guardian or parent, if applicable, shall sign a written form indicating the name, telephone, and address of the private physician and requesting that the physician be allowed to make such visits. Thereafter, the private physician shall be allowed to visit the patient at the inpatient facility at any reasonable time, and subject only to other reasonable regulations. The staff shall require the private physician to produce proper identification and proof of current certification as a physician upon the initial visit and thereafter as necessary. The private physician shall be provided a private area in which to examine and consult with the patient. Upon the patient's written authorization, the private physician shall be allowed to examine the patient's clinical record.

Rule 290-4-6-.03 Treatment Environment

(1) General. The individual dignity of each patient shall be respected at all times and upon all occasions, including any occasion on which the patient is taken into custody, detained, or transported. Except where required under conditions of extreme urgency, those procedures, facilities, vehicles and restraining devices normally used for criminals or those accused of crime shall not be used in connection with patient, to the extent that this is under the Department's control.
(2) Abuse and Sexual Activity.
(a) Abuse of any patient is prohibited. A staff member may use only such force as is necessary to restrain and secure a patient threatening imminent harm or committing harm to himself or others, and may use only such force as is necessary to prevent an involuntary patient from leaving a facility. Such necessary force shall not constitute abuse. For the purpose of this section, an involuntary patient is one who is being treated involuntarily or who is being examined or evaluated to determine the need for involuntary treatment or who is the subject of a petition and certificate seeking involuntary treatment.
(b) No staff member shall engage in any sort of sexual activity with any patient.
(c) A staff member who witnesses an incident of such abuse or sexual activity shall report the incident to the Human Rights Committee and the superintendent of the facility as soon as possible, which Committee shall notify the Personal Advocacy Unit. Upon receiving such a report, the Committee or its designee shall assist the reporting staff member or the patient (or his guardian or parent, if applicable) in initiating a complaint pursuant to Section 290-4-6-.07 of these regulations. If the incident appears to constitute criminal conduct, the superintendent shall also report the incident to the appropriate law enforcement agency. A staff member who fails to comply with the applicable requirements of this Section 290-4-6-.03(2)(c) shall be subject to adverse action in accordance with personnel procedures of the Department.
(3) Personal Effects.
(a) A patient's right to his personal effects shall be respected. Each patient admitted to or treated in a facility must be provided with individual storage space for his belongings as space permits. A patient's right to retain his personal property may be restricted for the following reasons:
1. To protect the health or safety of the patient or others;
2. To prevent the patient from using an item that would interfere with the orderly operation of the facility;
3. To protect the patient's valuable property when there is substantial risk that it will be lost or stolen;
4. Where the property constitutes contraband.
(b) Each facility shall encourage and assist patients to provide for the safekeeping of their money in bank accounts and of their other valuables in safe places maintained by the facility.
(c) Whenever a patient's personal property is retained by the facility, a notation listing the items retained by the facility shall be made in the patient's record. In addition, the patient shall be provided with a receipt if he so requests.
(d) At the time a patient is discharged or as agreed to by the patient, all money and personal effects placed in the facility's custody shall be returned, except where possession of a certain item by a patient would be illegal.
(e) No staff member shall be responsible for the loss of or damage to a patient's property where reasonable efforts to assure the safety of that property have been made.
(f) A patient's personal effects may not be examined or searched after his admission unless he (or his guardian or parent, if applicable) consents to the search or unless the chief medical officer or superintendent, upon personal knowledge or information provided by staff members or other reliable persons, determines that there is reasonable cause for believing that the patient has an item or items that may be dangerous or whose possession is illegal. If a search is deemed necessary, the reasons for it must be recorded in the patient's record along with the date, time and result of the search. The patient has a right to be present at any search and told the reason for the search, except when such search is deemed urgent for safety reasons and the patient or resident is not immediately available. Nothing in this Section 290-4-6-.03(3)(f) shall prevent the facility from making an inventory of items in the patient's possession at the time of his admission or from assisting the patient, as required by his condition, in the care and upkeep of his belongings.
(4) Communications and Visits.
(a) Mail. Receiving and sending of mail shall be governed as follows for patients being treated on an inpatient basis in a hospital pursuant to O.C.G.A. Chapters 37-7, 37-3 and 37-4.
1. Each patient shaH be allowed to receive, send, and mail sealed, unopened correspondence, and no patient's correspondence shall be opened, delayed, held or censored by the facility, except under the following conditions.
(i) if there are reasonable grounds to believe that incoming mail contains items or substances which may be dangerous to the patient or others, the chief medical officer may direct reasonable examination of such mail and disposition of items or substances found therein. All writings must be presented to the patient within 24 hours of inspection;
(ii) The chief medical officer may apply to the court for a temporary order to restrict outgoing mail. The court, upon a showing of probable cause that such mail is dangerous to the patient or others, may grant a temporary restriction of the patient's mail privileges, provided that within 5 days after the issuance of such temporary order, the court holds a hearing to determine whether or not an order of restriction for an extended time shall issue.
(I) In no event shall mail be restricted pursuant to such temporary order for more than 5 days.
(II) If the court determines at the hearing that the patient's outgoing mail is dangerous to the patient or others, it may order the mail restricted for a period not to exceed 30 days.
(III) The court order for restriction of mail for an extended period may be renewed as necessary for periods not to exceed 30 days with a new hearing to take place each time.
(IV) The chief medical officer of the facility shall restrict communication as provided in the court order.
(iii) Any restriction of incoming or outgoing mail under this Section 290-4-6-.04(4)(a) shall not exceed a period of 5 days, except that such restriction may be renewed by the chief medical officer for a period not to exceed 5 days, provided that such renewal periods in the aggregate shall not exceed the period specified in the court order when outgoing mail is restricted pursuant to such order. Prior to a renewal, the chief medical officer shall make a new determination that such mail continues to be dangerous to the patient or others;
(iv) Correspondence of the patient with his attorney shall not be restricted under this Section 290-4-6-.03(4)(a), nor shall correspondence to a patient from a public official be restricted under this section.
(v) Each time that a patient's incoming or outgoing mail is examined, written notice of the examination, and notice of the right to a full and fair hearing within 5 days after a temporary court order, shall be served on the patient and his representatives as provided in Section 290-4-6-.06 of these regulations. A voluntary patient may waive in writing such notice to his representatives. In addition, the circumstances surrounding the examination of any mail shall be recorded in the patient's clinical record. Each facility shall maintain policies that encourage the patients' exercise of their communication rights, including supply to indigent patients of writing materials and postage in reasonable amounts.
(b) Telephone calls.
1. Each patient has the right to make reasonable use of telephones. In order to assure this right, each facility shall:
(i) Maintain locations for calling (including pay telephones where feasible) which allow for privacy;
(ii) Supply indigent patients with funds or access to telephones for making a reasonable number of calls;
(iii) Prohibit any monitoring of patient calls without consent from the patient except pursuant to a court order.
2. The facility may place reasonable restrictions, such as those relating to the distance, time, length, and frequency of calls, upon the use of telephones by all patients generally. In addition, reasonable restrictions may be placed upon an individual patient's use of telephones under the following conditions:
(i) The restriction must be required by the type of seriousness of the patient's mental condition and must be ordered by the patient's attending physician;
(ii) The type and extent of the restriction, along with the specific reason for the restriction must be stated in the order;
(iii) The order shall expire automatically 24 hours after it is given, unless it is terminated sooner, but additional 24-hour orders may be given according to the same procedure as that required for the original order.
3. The patient may consent in writing to restrictions to the use of the telephones.
4. Telephone communication of a patient with his attorney or private physician shall not be restricted in accordance with Sections 290-4-6-.03(4)(b) 2. (i) and (iii).
(c) Visitation. Visitation shall be governed as follows for patients being treated on an inpatient basis in a hospital pursuant to O.C.G.A. Chapters 37-7, 37-3 and 37-4:
1. Each patient admitted to a facility has the right to receive visitors daily or to refuse in writing to receive any visitors or particular visitors. Privacy, to the extent that it is possible, should be provided;
2. The facility may place reasonable restrictions, such as those relating to time and place, upon visitation by persons from outside of the facility for all patients generally. Visiting hours shall be set for at least 4 hours daily, 2 hours of which shall be after 6 p.m. In addition, reasonable restrictions may be placed upon an individual patient's right of visitation under the following conditions:
(i) The restriction must be required by the type of seriousness of the patient's mental or physical condition and must be ordered by the patient's attending physician;
(ii) The type and extent of the restriction, along with the specific reasons for the restriction, must be stated in the order;
(iii) The order shall expire automatically 24 hours after it is given, unless it is terminated sooner, but additional 24-hour orders may be given according to the same procedure as that required for the original order.
3. The patient may consent in writing to restrictions on visitation.
4. Visitation by a patient's attorney or private physician shall not be restricted in accordance with Sections 290-4-6-.03(4)(c) 2. (i) and (iii).
(d) Other.
1. Each patient admitted to a facility shall have the right to regular social interaction with others, including persons of the opposite sex, subject only to the provisions of Section 290-4-6-.02(1)(c) of these regulations (seclusion) and to other reasonable regulations, such as those relating to time and place.
2. Each patient admitted to a facility shall have the right to attend religious services, but no patient may be compelled to attend such services. The patient should be assisted in the observance of his religion to the extent possible.
(5) Transportation.
(a) The governing authority of the county of the patient's residence shall arrange for all required transportation of the patient. Whenever possible, marked vehicles normally used for the transportation of criminals or those accused of a crime shall not be used for the transportation of patients. However, the type of vehicle to be furnished for the transportation shall be in the discretion of the governing authority of the county.
(b) The court shall, upon the request of the county board of health, order the sheriff to transport the patient in such manner as the patient's condition demands. At any time that the county board of health is satisfied that the patient can be transported safely by family members or friends, such private transportation shall be encouraged and authorized.
(c) No female patient shall be transported to or from a hospital at any time without another female in attendance who is not a patient, unless such female patient is accompanied by her husband, father, adult brother or adult son.

Rule 290-4-6-.04 Personal Affairs

(1) General. No patient, whether voluntary or involuntary, shall be deprived of any civil, political, personal, or property rights or be considered legally incompetent for any purpose without due process of law. These rights include, but are not limited to:
(a) The right to dispose of property;
(b) The right to execute legal instruments;
(c) The right to make purchases;
(d) The right to enter into contractual relationships;
(e) The right to register and vote;
(f) The right to marry and to obtain a separation, divorce, or annulment;
(g) The right to hold a driver's license; nor
(h) the right to make a will.
(2) Legal Counsel.
(a) Each patient admitted to a facility has the right to secure legal counsel to represent him in his personal affairs during his hospitalization. The patient should be assisted by staff members to the extent possible in securing legal counsel.
1. If the patient can afford legal counsel, he may secure counsel at his own expense.
2. If the patient needs legal counsel for his personal affairs but cannot afford such counsel, he may contact the local legal aid service for assistance.
3. Each facility shall post on every treatment unit the name, address, and telephone number of local lawyer referral services and local agencies which provide legal services to indigent persons.
(b) The securing of legal counsel for patients at hearings concerning their committal or treatment is not governed by these regulations.
(c) Each patient admitted to a facility shall have the right to have his legal counsel for personal affairs visit him at the facility. The patient (or his guardian or parent, if applicable) or the attorney shall provide the facility with the attorney's name, telephone number and address. The staff shall require the attorney to produce proper identification and proof of current certification as an attorney upon the initial visit and thereafter as necessary. The attorney shall be allowed to visit the patient at the facility at any reasonable time, and subject to other reasonable regulations. The attorney shall be provided a private area in which to consult with the patient. Upon the patient's written authorization, the attorney shall be allowed to examine the patient's clinical record.
(3) Voting.
(a) Each patient admitted to a facility who is entitled to vote shall be given his right to vote in primary, special and general elections and in referenda.
(b) The superintendent of each facility, or his designee, shall:
1. At least 30 days prior to a national or statewide election, post notice of the election in each hospital treatment unit;
2. Notify patients 18 years old and over of their right to register to vote, to obtain absentee ballots, and to cast ballots. The notification shall be conducted to allow sufficient time for voter registration and acquisition of absentee ballots;
3. When clinically suitable and if staffing of the facility permits, allow residents to leave the premises to exercise voting privileges, or to register to vote, and require personnel, where available, to accompany residents; otherwise voting by absentee ballot is sufficient;
4. Make arrangements with state and local officials to provide for voter registration and casting of ballots by interested patients; and
5. Assist election officials in determining a patient's place of residence for voting purposes.
(4) Education.
(a) The right of any minor patient and of any other patient entitled by law to an appropriate education at public expense shall not be abridged during hospitalization. The special education needs of each minor patient or patient entitled to such educational services shall be individually considered and respected.
(b) To insure the appropriate education of every minor patient or other patient entitled to such services during hospitalization, the Department of Human Resources and the Department of Education have executed a number of agreements which delineate each agency's responsibilities in providing such an education. These agreements shall be made available by the Department of Human Resources for review and copying by the patient's parents or guardian at their request or by the adult patient entitled by law to such services.
(5) Employment Outside Facility.
(a) Each facility shall encourage and assist a patient in securing suitable employment outside the facility, if the patient wishes to be so employed and if such employment will aid in the patient's treatment. The training of patients for gainful employment shall also be encouraged through appropriate resources and referrals.
(b) All wages and benefits earned by employment outside the facility shall belong solely to the patient.

Rule 290-4-6-.05 Patient Records

(1) Contents. A clinical record shall be maintained at each facility for each patient treated at that facility. The record shall contain information on all matters relating to the admission, care, treatment, discharge and legal status of the patient, and shall include all documents relating to the patient. The record specifically shall contain at least the following progress notes; documents describing or arising from the patient's history; the results of all psychiatric and physical examinations; individualized service plans, evaluations and reevaluations; orders for treatment; orders for physical restraints, seclusion, and other restrictions permitted by these regulations or other applicable law; accident and incident reports; and court orders and other court documents received by the facility. When clinical records or parts of clinical records are released as provided in this Section 290-4-6-.05 copies of the clinical record should be released unless the original is required by law. If particular documents in the clinical record includes the name or names of other patients, these will be erased or obliterated from any copies when released as authorized by this Section 290-4-6-.05.
(2) Confidentiality.
(a) The clinical record shall not be a public record and no part of it shall be released to anyone other than the patient, or if appropriate, the parent of a minor patient or guardian, except:
1. When the chief medical officer of the facility where the record is kept deems it essential for continued treatment, the record or parts thereof may be released to physicians when and as necessary for the treatment of the patient;
2. A copy of the record may be released to any person or entity as designated in writing by the patient or, if appropriate, the parent of a minor patient or guardian;
3. When a patient is admitted to a facility, the patient's record or information contained in the record at another facility, community mental health center, or in the records of a private practitioner may be released to the admitting facility. When the service plan of a patient involves transfer of that patient to another facility, community mental health center, or private practitioner, the patient's record or information contained in the record may be released to that facility, community health center, or private practitioner;
4. The record or any part thereof may be disclosed to any employee or staff member of the facility when it is necessary for the proper treatment of the patient;
5. The record shall be released to the patient's attorney if the attorney so requests and the patient consents to the release;
6. In a bona fide medical emergency as determined by a physician treating the patient, the chief medical officer may release the patient's record to the treating physician.
7. The record shall be produced by the entity having custody thereof at any hearing concerning the patient's treatment at the request of the patient or his attorney;
8. The record of patients treated pursuant to O.C.G.A. Chapters 37-3 and 37-4 shall be produced in response to a valid subpoena or order of any court of competent jurisdiction, except for matters privileged under the laws of this State. For patients treated pursuant to O.C.G.A. Chapter 37-7, a valid subpoena must be accompanied by the order of a court of competent jurisdiction ordering the release of the record after a full and fair show cause hearing.
9. Notwithstanding any other provision of law to the contrary, a law enforcement officer in the course of a criminal investigation may be informed whether a person is or has been a patient in a State facility as well as the patient's current address, if known. This provision is not applicable to persons who are being treated or hospitalized in accordance with O.C.G.A. Chapter 37-7 pertaining to alcoholics, drug dependent individuals and drug abusers.
10. For patients treated pursuant to O.C.G.A. Chapter 37-4, when the treatment plan of the patient involves transfer to another facility, or involves the receipt of community services by the patient as defined in that code chapter, the record may be released to that facility or entity rendering such service;
11. Nothing in this Section 290-4-6-.05(2) shall prevent patient records or information contained therein from being reproduced, transmitted, transferred or stored within the Department for administrative purposes in accordance with other applicable law.
(b) In connection with any hearing concerning the patient's treatment, any physician who is treating or who has treated the patient shall be authorized to give evidence as to any matter concerning the patient, including evidence as to communications otherwise privileged under O.C.G.A. 24-9-40.
(c) Any disclosure authorized by these regulations or other applicable law, or any unauthorized disclosure of confidential or privileged patient information or communications, shall not in any way abridge or destroy the confidential or privileged character thereof, except for the purpose for which such authorized disclosure is made. Any person making a disclosure authorized by these regulations or other applicable law shall not be liable to the patient or any other person notwithstanding any contrary provision of O.C.G.A. 24-9-21 or 24-9-40, as now or hereafter amended.
(3) Examination by patient.
(a) Every patient and former patient shall have the right to examine all clinical records kept in his name by the Department or the facility where the patient is or was hospitalized or treated, unless:
1. The disclosure of such records to the patient is determined, by the chief medical officer or the patient's treating physician, to be detrimental to the patient's physical or mental health; and
2. A notation to that effect is made in the patient's record. The exception contained in these Sections 290-4-6-.05(3)(a) 1. and 2. shall be applicable only to persons who are presently patients, and not to former patients.
(b) Each facility shall assist patients in reviewing their own records but may establish reasonable limitations, such as those relating to time, place, and frequency, upon such review.
(4) Correction by patient.
(a) Every patient or former patient shall have the right to request that any inaccurate information found in his clinical record be corrected. A current patient's request shall be made in writing to the individual in charge of records at the facility or individual designated by the superintendent. That individual will consult the appropriate staff at the facility if needed. If the request is made orally to a staff member, that staff member will assist the patient in making the request to the appropriate person.
(b) Upon receipt of a request for correction of a patient's or former patient's record, the individual in charge of records at the facility or the person so designated shall within 5 days:
1. Make the requested correction, and provide the patient or former patient with a copy of the corrected record; or
2. Notify the patient or former patient, in writing of the inability to obtain amendment of the record and the reason therefore, and notify the patient or former patient that he may file a complaint regarding this refusal in accordance with Section 290-4-6-.07(1) of these regulations. Such notification shall be complete upon mailing;
3. If amendments are made, they should be added to the record and the original record should be preserved.
(5) Copies.
(a) It is the policy of the Department to provide routine information to the general public without charge whenever possible. In no event shall charges for special information services (such as copies of patient records upon request) exceed the cost, including staff time and materials, to the State of providing such services. Requests for information or for copies of patient records should be complied with as quickly as possible.
(b) Fees charged for copying services in State facilities shall comply with policies set by the Department.
(c) Waiver or reduction of fees may be granted where such action is in the public interest or when based on a patient's ability to pay.
(d) Staff members shall assist the patient in the selection of records for copying purposes. A policy of full disclosure and assistance shall be followed, while waste in copying practices is to be discouraged.

Rule 290-4-6-.06 Notice; Representatives and Guardians Ad Litem

(1) Notice:
(a) To patient: At any time that notice is required to be given to a patient by these regulations or other applicable law, the date on which the notice is given shall be entered in the patient's clinical record. If the patient is unable to read a notice understandably, a reasonable effort shall be made to explain the notice to him.
(b) To Representatives: At any time that notice is required to be given to a patient's representatives, the notice shall be served on those persons designated in accordance with Section 290-4-6-.06(2) of these regulations. The patient's guardian ad litem shall likewise be served. Unless otherwise provided, notice may be served in person or by first class mail. When notice is served by mail, a record shall be made of the date of mailing and shall be placed in the patient's clinical record. Service shall be complete upon mailing to the last known mailing address.
(c) Judicial orders. At any time that a court enters an order affecting a patient pursuant to these regulations or other applicable law and serves said order on the Department, a copy to that order shall be served on the patient and his representative as provided in Section (a) and (b) of this Section 290-4-6-.06(1), unless the order contains an accompanying certificate that such service has already been made.
(2) Representatives and Guardians Ad Litem.
(a) Selection. At the time that a patient is admitted to a facility, the names and addresses of at least two representatives shall be entered in the patient's clinical record. The patient has the right to designate one representative.
1. If the patient designates one representative, the facility shall designate the second, who shall be selected from the following persons in the order of listing: the patient's legal guardian, spouse, an adult child, parent, attorney, adult next of kin, or adult friend.
2. If the patient does not exercise his right to designate one representative, the facility shall designate both of the patient's representatives.
(i) One of the representatives shall be selected from the following persons in the order of listing: the patient's legal guardian, spouse, an adult child, parent, attorney, adult next of kin, or adult friend. The second representative shall be selected from the same list without regard to the order of listing but shall not be the person who signed the petition allowed under the provisions of O.C.G.A. Chapters 37-3, 37-4 and 37-7.
(ii) If the facility is unable to secure at least two representatives after diligent search, or if the Department is the guardian of the patient, that fact shall be entered in the patient's record and the facility shall apply to the court in the county of the patient's residence for the appointment of a guardian ad litem, which shall not be the Department.
(iii) On application of any person or on its own motion, the court may also appoint a guardian ad litem for a patient for whom representatives have been named whenever the appointment of a guardian ad litem is deemed necessary for protection of the patient's rights. Such guardian ad litem shall act as the representative of the patient on whom notice is to be served under the applicable provision of law and shall have the powers granted to representatives by those provisions.
(b) Powers.
1. Representatives shall have the power to receive the notices required to be sent to them by these regulations and other applicable law, and the power to consult with the facility staff as required in Section 290-4-6-.02(3) of these regulations.
2. Guardians ad litem shall have the power to receive the notices required to be sent to them by these regulations or other applicable law. Such guardianship shall be for the limited purpose stated in the order of the court and shall expire automatically after 90 days or after a lesser time stated in the order. The responsibility of the guardian ad litem shall not extend beyond the specific purpose of the appointment.

Rule 290-4-6-.07 Remedies for Violations

(1) Complaint Procedures. Any patient (or his guardian or parent of a minor patient, if applicable) or his representative or any staff member may file a complaint alleging that a patient's rights under these regulations or other applicable law have been violated by staff members or persons under their control. Such complaints shall be governed by the procedure established by this Section 290-4-6-.07(1). A person who considers filing such a complaint is encouraged to resolve the matter informally by discussing it first with the staff members or other persons involved or member of the Human Rights Committee or similar mechanism, if applicable, as provided in Section 290-4-6-.07(1)(b). The patient is not required to use the procedure established by this Section 290-4-6-.07(1) in lieu of other available legal remedies
(a) For patients being treated in State facilities complaint procedures shall be governed as follows:
1. The superintendent of each facility shall appoint a minimum of three persons to serve as a Human Rights Committee with the responsibility of investigating and attempting to resolve complaints from patients. If possible, at least one member of the Committee appointed by the Superintendent shall be a person not on the staff of or otherwise affiliated with the Department.
(i) Staff persons appointed to serve on the Human Rights Committee should be representative of the various service components of the facility. Membership on the Committee should be time-limited and rotated periodically. Facilities may have more than one Human Rights Committee if the size of the facility is too large for one Committee to handle effectively.
(ii) The Human Rights Committee of each facility shall have the authority to investigate complaints, use whatever means are available to resolve complaints, and consult with management on the development of policies and procedures that safeguard the rights of patients served in the facility.
2. First step.
(i) The complaint shall be filed with the Human Rights Committee of the patient's facility and it may be filed on a form provided by the Committee. If the patient states the complaint orally, specific assistance should be given in proceeding with the complaint and completing the form. Complaints may be made by telephone to a representative of the Human Rights Committee, who will complete the form. Staff members whose alleged conduct gave rise to the complaint may be informed of the complaint.
(ii) As soon as possible, but within 7 working days after the complaint is filed, the Committee shall investigate the complaint, resolve it if possible, and complete a disposition report; however, if after interviewing the complainant, it is found that complaint does not state an allegation that, if true, would constitute a violation of these regulations or other applicable law, the Committee may reject the complaint in writing. In other cases of such rejection, the original of the rejection notice shall be filed in the Committee records and a copy shall be sent to the complainant. In all investigated complaints, the Committee shall employ the investigatory method deemed most suitable to determine the facts. This method may include, but is not limited to, personal interviews, telephone calls, review of documents, and correspondence. The Committee and its designees shall have access to all files, documents, records, and personnel of the Department deemed by the Committee to be relevant to its investigation. The Committee shall resolve the complaint through mediation and conciliation whenever possible. The patient or someone in his behalf may appear before the Committee on behalf of the patient whose rights are alleged to have been violated.
(iii) The Committee shall complete a brief disposition report on each investigated complaint. The report shall state the parties involved, the gist of the complaint, the facts disclosed by the investigation, and whether the complaint was resolved or not. The original report shall be filed in the Committee records, and a copy shall be sent to the superintendent. All parties involved in the complaint shall be notified of the action taken by the Committee.
3. Second Step.
(i) If the complaint is rejected or is not resolved by the Committee to the satisfaction of the patient (or his guardian or parent of a minor patient, if applicable) or the complainant, either the patient (or his guardian or parent of a minor patient, if applicable) or the complainant may file with the superintendent a written request for a review of the complaint. The request shall be filed no later than 10 working days after the person filing the request receives a copy of the rejection notice or the disposition report of the Committee. The superintendent may reject the request in writing without a review if either the complaint or the request for review is not filed in a timely fashion, or if the complaint does not state an allegation that, if true, would constitute a violation of these regulations or other applicable law. The original of the rejection shall be filed in the superintendent's records, and a copy shall be sent to the complainant. In all other cases, the superintendent shall designate a staff member who has no connection with the complaint to conduct a review of the complaint.
(ii) The person conducting the review shall review all reports and documents which were utilized in Section 290-4-6-.07(1)(a) 2. In addition, the reviewer may interview any person who may have information related to the complaint. The complainant, or someone acting in his behalf if the patient is the complainant, shall be given an opportunity to discuss the complaint directly with the reviewer and present any information relevant to the complaint. Staff members whose alleged conduct gave rise to the complaint shall also be given an opportunity to discuss the complaint with the reviewer and present any information relevant to the complaint. This review process is designed to be an informal process and not a formal hearing. The reviewer shall document his findings. The review should be completed as soon as possible, but within 10 working days after the request for review is filed.
(iii) Within 5 days after the conclusion of the review, the reviewer shall submit to the superintendent a written report of the review. The report shall contain a list of the pertinent facts established during the review, a list of the pertinent provisions of these regulations or other applicable law, and a recommendation for disposition. Within 3 working days after receiving the reviewer's report, the superintendent shall issue a written decision disposing of the complaint. The superintendent's decision, in addition to the disposition, shall contain lists of the pertinent facts and law; however, it may incorporate by reference those lists contained in the reviewer's report. In this decision, the superintendent may accept, reject, or modify the reviewer's recommendation, or he may return the case to the reviewer for further proceedings. If the superintendent returns the case to the reviewer, the superintendent shall specify the matters to be addressed in the further proceedings and shall specify the period within which those proceedings shall be concluded. In no event shall the period for completing the further proceedings, including the reviewer's submission of an additional report to the superintendent and the superintendent's issuance of a decision, exceed 10 working days. The original of the superintendent's decision shall be filed in the superintendent's records, and a copy shall be sent to each party.
4. Third Step.
(i) The patient (or his guardian or parent of a minor patient, if applicable) or the complainant may appeal the superintendent's rejection or other decision by filing a written request for review with the director of the Division of Mental Health and Mental Retardation. The request for review shall be filed no later than 5 working days after the person filing the request receives a copy of the superintendent's rejection or other decision. Upon the filing of such a request, the superintendent shall be notified and the superintendent shall immediately transmit to the director a copy of the superintendent's rejection, or decision, together with a copy of the reviewer's recommendation, the superintendent's decision, and other documents utilized in the review, if any.
(ii) Within 10 working days of the filing of the request for review, the director or his designee shall issue a decision disposing of the appeal. This decision of the director or his designee shall be based upon a review of the request for review and the documents forwarded by the superintendent; no evidentiary hearing shall be conducted by the director or his designee. In this decision, the director or his designee may affirm, reverse, or modify the superintendent's rejection or other decision, or he may return the case to the superintendent for further proceedings. If the director or his designee returns the case to the superintendent, the director or his designee shall specify the matters to be addressed in the further proceedings and shall specify the period within which those proceedings shall be concluded. In no event shall the period for completing the further proceedings, including the reviewer's submission of an additional report, the superintendent's issuance of another rejection or other decision, and the director's or his designee's issuance of a decision, exceed 14 working days. The original of the director's or his designee's decision shall be filed in the director's records, and copies shall be sent to the superintendent and to each party. The decision of the director shall be final and no judicial review of such decision shall be available.
5. General Provisions.
(i) Whenever the Human Rights Committee or the Personal Advocacy Unit becomes aware of a situation that appears to require immediate action to protect the welfare and safety of any patient, the Committee or the Personal Advocacy Unit shall immediately notify the nearest available staff member with authority to correct the situation. In any situation that requires immediate action to protect a patient's welfare or safety, the superintendent may be notified instead. If adequate corrective action is not taken by that staff member, the Committee or the Personal Advocacy Unit shall immediately notify the superintendent, or if necessary the director or the Commissioner of the Department.
(ii) No person shall be subject to any form of discipline or reprisal solely because he has sought a remedy through or participated in the procedures established by this Section 290-4-6-.07(1).
(iii) Obstruction of the investigation or disposition of a complaint by any person shall be reported to the superintendent, who shall take action to eliminate the obstruction. Staff members are subject to adverse action in accordance with personnel procedures of the Department for engaging in such obstruction.
(iv) Time limits designated in this Section 290-4-6-.07(1) may be extended by the decision maker at each step for good cause only.
(v) This complaint procedure does not replace or invalidate any other Department policy or procedure pertaining to reporting requirements, disciplinary matters, or the like.
(vi) Staff members who are involved in a complaint shall not be involved in the processing of that complaint.
(b) The following complaint procedures may be used for patients being treated in private facilities designated pursuant to O.C.G.A. Chapters 37-3, 37-4 and 37-7:
1. Each private facility shall establish a Human Rights Committee as provided in Section 290-4-6-.07(1)(a) 1. or some similar mechanism to investigate and resolve complaints and consult with management on the development of policies and procedures that safeguard the rights of patients served in the private facility;
2. Each private facility shall establish a complaint procedure which contains at least the following elements:
(i) A written procedure whereby a patient (or his guardian or parent of a minor child if applicable) or any staff member may make a complaint and a procedure for having the Human Rights Committee or similar mechanism investigate the complaint.
(ii) A process so the complainant may appeal the decision of the Committee or any similar mechanism to the superintendent of the private facility.
3. General Provisions.
(i) Whenever the Human Rights Committee or similar mechanism becomes aware of a situation that appears to require immediate action to protect the welfare and safety of any patient, the Committee or similar mechanism shall immediately notify the nearest available staff member with authority to correct the situation. In any situation that requires immediate action to protect the patient's welfare or safety, the superintendent of the private facility may be notified instead. If adequate corrective action is not taken by a staff member, the Committee or similar mechanism shall immediately notify the superintendent.
(ii) No person shall be subject to any form of discipline or reprisal solely because he has sought a remedy through or participated in the procedures established by this Section 290-4-6-.07(1)(b).
(iii) Obstruction of the investigation or disposition of a complaint by any person shall be reported to the superintendent, who shall take action to eliminate the obstruction. Staff members are subject to adverse action in accordance with personnel procedures of the private facility for engaging in such obstruction.
(iv) This complaint procedure does not replace or invalidate any other policy or procedure of the private facility pertaining to reporting requirements, disciplinary matters, or the like.
(2) Judicial Supervision.
(a) Any patient (or his guardian or parent of a minor patient, if applicable) or his representative may file a petition in the appropriate court alleging that:
1. The patient is being unjustly denied a right or privilege granted by these regulations or other applicable law; or
2. A procedure authorized by these regulations or other applicable law is being abused; or
3. The patient objects to the treatment being administered to him;
(b) Upon the filing of such a petition as in (a) preceding, the court shall have the authority to conduct a judicial inquiry and to issue appropriate orders to correct any abuse of these regulations or other applicable law. The patient, his representatives, or his attorney may appeal any such order of the probate court or of the court's hearing officer to the superior court of the county in which the proceeding was held, and may appeal any such order of the Juvenile Court to the Court of Appeals and to the Supreme Court.
(c) At any time and without notice, a person detained by a facility, or a relative or friend on behalf of such person, may petition as provided by law for a writ of habeas corpus to question the cause and legality of detention and to request any court of competent jurisdiction on its own initiative to issue a writ of release. In the case of any such petition for the release of a person detained in a facility pursuant to a court order under O.C.G.A. 17-7-130 or 17-7-131, as not or hereafter amended, a copy of the petition, along with proper certificate of service, shall also be served upon the presiding judge of the court ordering such detention and the prosecuting attorney for such court, which service may be made by certified mail, return receipt requested.
(3) Attorney's Access.
(a) An attorney representing a patient in a matter relating to the patient's hospitalization shall have the right to visit and consult with the patient at the facility in accordance with Section 290-4-6-.04(2)(c) of these regulations.
(b) At reasonable times, and subject to the notification and identification provisions of Section 290-4-6-.04(2)(c) of these regulations, the patient's attorney for hospitalization matters shall have the right to interview the physician and staff members who have attended or are now attending the patient and the right to have the patient's records interpreted by them.
(c) The chief medical officer of each facility shall establish reasonable policies to make available to the patient's attorney all information in the possession of the facility which the attorney requires in order to advise and represent the patient concerning his hospitalization.
(4) Medication Prior to Hearings. The patient has a right to appear and testify at hearings as free from any side effects or adverse effects of the medication as is reasonably possible. The patient's attorney, if any, should be informed of any medication the patient is receiving at the time of the hearing.