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I.EXECUTIVE ORDERS - page 215 / 359





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C.The center shall have a written policy on participant civil rights. This policy shall give assurances that:

1.a participant's civil rights are not abridged or abrogated solely as a result of placement in the ADHC center’s program; and
2.a participant is not denied admission, segregated into programs or otherwise subjected to discrimination on the basis of race, religion or ethnic background.

D.The participant rights document shall include at least the following items:

1.the right to be informed, in writing, of:
a.all services available at the ADHC center;
b.the charges for those services; and
c.the center’s hours of operation;
2.the right to participate in each interdisciplinary staffing meeting and any other meeting involving the care of the participant;
3.the right to refuse any service provided in the ADHC center;
4.the right to present complaints or recommend changes regarding the center’s policies and services to staff or to outside representatives without fear of restraint, interference, coercion, discrimination or reprisal;
5.the right to be free from mental or physical abuse;
6.the right to be free from active or mechanical physical restraints, except when there is imminent risk of harm to the participant or others, and only after the least restrictive methods have been attempted:
a.physical restraint shall be used only when ordered by the primary care physician:
i.the physician's order for restraint must specify the reason for using restraint and include a specific time frame for using restraint;
ii.the physician order shall be filed in the participant's record;
b.physical restraint may be used without a physician's order in an emergency only under the following conditions:
i.use of restraint is necessary to protect the participant from injuring himself/herself or others; and
ii.use of restraint is reported at once to the primary care physician;
c.participants who are mechanically restrained shall be monitored at least every 30 minutes to insure that circulation is not impaired and that positioning is comfortable;
d.participants being mechanically restrained shall be released and be provided the opportunity for exercise at least every two hours. The ADHC center staff shall document this activity each time the participant is released;
7.the right to be treated with consideration, respect and full recognition of his or her dignity and individuality;
8.the right to privacy during the provision of personal needs services;
9.the right to communicate, associate, and meet privately with individuals of his/her choice, unless this infringes on the rights of another participant; and
10.the right not to be required to perform services for the ADHC center, except when the performance of a specific service is identified in the individualized service plan as an appropriate approach to meeting a need or resolving a problem of the participant.

E.A friendly, supportive, comfortable, and safe atmosphere shall be maintained at all times, and all participants shall be treated equitably with respect, kindness, and patience.

F.Each participant shall be encouraged and assisted to exercise his/her rights as a participant at the ADHC center and as a citizen.

G.Devolution of Participant Rights. If the participant rights have devolved to the personal representative or next of kin, that party shall receive the explanation of and sign the participant rights and any other documents described in these standards. Under the following conditions, the ADHC center shall ensure that participant rights devolve to the personal representative or next of kin.

1.The participant has been interdicted in a court of law. In such cases, the ADHC center shall ensure that the participant's rights devolve to the curator/curatrix of record. The ADHC center shall obtain an official document verifying that the participant has indeed been interdicted and the interdiction must be documented on the inside front cover of the participant's record.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and 40:2120.41-46.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 34:2184 (October 2008).

Subchapter D.ADHC Center Services

§4241.Mandatory Daily Program Components

A.There shall be a planned daily program of both individual and group activities which is sufficiently varied and structured so as to directly involve the participants in a stimulated and meaningful use of time while at the center. Emphasis shall be given to maintaining and improving the participants’ functional abilities.

B.Participants shall be encouraged to take part in the planning and directions of activities. Programming shall allow for active and passive participation.

C.Centers shall provide a detailed description of individual and group activities that are being provided to participants on a daily basis and shall make this information available upon request. This information shall also be made available to participants and their families.

D.When available, community resources may be used to provide educational programs, lectures, concerts and similarly stimulating activities to participants.

E.An arts and crafts activities program may be available to make use of the rehabilitative as well as the recreational values of such pastimes. A supply of materials adequate to accommodate all participants shall be on hand for this program.

F.An outdoor activities program, such as gardening or walking, may be maintained where space, weather, and participants’ health permit.

G.A daily rest period may be incorporated into the program.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and 40:2120.41-46.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 34:2185 (October 2008).

§4243.Core Services

A.At a minimum, each center shall provide the following services:

Louisiana Register   Vol. 34, No. 10   October 20, 2008

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