Introduction to Client Rights

Applies to: Anyone who is receiving services for mental illness, a developmental disability, or substance abuse in the state of Wisconsin.

Brief History of Client Rights in Wisconsin: A 1972 Wisconsin Supreme Court decision, entitled Lessard v. Schmidt, set forth the rights of mental health patients.

These rights were adopted into state law with the creation of Wisc. Stats. 51 (State Alcohol, Drug Abuse, Developmental Disability and Mental Health Act) subsections 51.61 and 51.30 (exit DHS; PDF) in 1976.

The law required the Department of Health and Social Services (now the Department of Health Services) to create administrative rules for a grievance procedure to ensure patient rights.

The Department created the Client Rights Office (CRO) to oversee the development of administrative rules and the grievance process.

CRO staff drafted administrative rules to implement patient rights and confidentiality. These were adopted as Wisconsin Administrative Codes:

• DHS 94, Patient Rights and Resolution of Patient Grievances (exit DHS, PDF)
• and DHS 92, Confidentiality of Treatment Records (exit DHS, PDF).

The original grievance process rules permitted counties to "opt into" the state’s process or have their own procedure. Counties were mandated to use the state's grievance process by changes in DHS 94, Wisconsin Administrative Code, in 1997.

Subchapter III of DHS 94 (exit DHS, PDF) sets forth the grievance procedure rules for people receiving services in the community. A simplified flow chart of the Community Grievance Resolution Procedures Process is available. (PDF, 19 KB)

Now all community grievance procedures must allow for an appeal to the State Grievance Examiner (SGE) in the department’s Client Rights Office. The SGE issues a Level III grievance decision.

If either party to the complaint is not happy with the results, they can appeal to Level IV of the process, which is the Administrator of the department’s Division of Mental Health and Substance Abuse Services (DMHSAS).

The following is a brief summary of the rights of patients under Section 51.61, Wisconsin Statutes, and DHS 94, Wisconsin Administrative Code.

• The rights with an asterisk (*) behind them may be limited or denied for certain reasons. See Client Rights Limitation or Denial for further information.

TREATMENT RIGHTS - Every patient has the right to:

• Receive prompt and adequate treatment
• Participate in their treatment planning
• Be informed of their treatment and care
• Refuse treatment and medications (unless court-ordered)
• Be free from unnecessary or excessive medications

RECORD PRIVACY AND ACCESS - (See also Confidentiality of Treatment Records)

• Staff must keep patient information confidential
• Records cannot be released without patient consent (with some exceptions)
• Patients may see their records
• They can always see records of their medications and health treatments
• During treatment, access may be limited if the risks outweigh benefits
• Patients may challenge the accuracy, completeness, timeliness or relevance of entries in their records

COMMUNICATION RIGHTS - Every (in)patient has the right to:

• Have reasonable access to a telephone *
• See (or refuse to see) visitors daily *
• Send or receive mail
• Contact public officials, lawyers or patient advocates

PERSONAL RIGHTS - Every (in)patient has the right to:

• Have the least restrictive environment (except for forensic patients)
• Not be secluded or restrained except in an emergency when necessary to prevent harm to self or others
• Wear their own clothing and use their own possessions *
• Have regular and frequent exercise opportunities
• Have regular and frequent access to the outdoors
• Have staff make reasonable (non-arbitrary) decisions about them
• Refuse to work – except for personal housekeeping tasks
• Be paid for work they agree to do that is of financial benefit to the facility

PRIVACY RIGHTS - Every (in)patient has the right to:

• Not be filmed or taped without his or her consent
• Have privacy in toileting and bathing *
• Have a reasonable amount of secure storage space for his or her possessions *
• See also the Office of Quality Assurance memo on Patient Privacy during Inpatient Psychiatric Treatment (06-025, dated 11/26/06)

MISCELLANEOUS RIGHTS - Every patient has the right to:

• Be treated with dignity and respect by all staff of the provider
• Be informed of his or her rights
• Be informed of any costs of his or her care
• Refuse electro-convulsive therapy (ECT)
• Refuse drastic treatment measures
• File complaints about violations of his or her rights
• Be free from any retribution for filing complaints

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Last Updated: December 22, 2011