Client Rights - Limitation or Denial

The information listed here applies to any recipient of state or county funding in an inpatient facility who is receiving services for mental health, a developmental disability, or substance use in Wisconsin.

Certain rights of inpatients my be limited or denied

Under state law, certain rights of inpatients may be limited or denied for treatment, management, or security reasons. They are:

  • The right to make and receive telephone calls
  • The right to wear one’s own clothing and use one’s own possessions
  • The right to secure storage space
  • The right to privacy in toileting and bathing
  • The right to see visitors

These are the only rights that may be limited or denied through this process.

A right cannot be denied even though the limitation would accomplish an intended treatment goal. Rights limits can be imposed only for as long as they are necessary to protect the treatment, management, or security interest involved. Some limitations can be long-term, however, if an individual continues to pose a danger to him or herself or others.

All limits or denials must be documented

The law requires that any limits or denials of rights be documented. All treatment providers should use the following form.

Rights limitations and denials must be reviewed periodically by facility staff to determine if they are still necessary. At hospitals accredited by The Joint Commission, limits on phone calls and visitors must be reviewed weekly.  There is space on F-26100 for documenting the reviews. If a limitation or denial is long-term, form F-26100A (PDF, 54 KB) can be used to document ongoing additional reviews. 

The individual whose rights are limited or denied (or his or her guardian) must be given a copy of the documentation.

Within two calendar days, copies of the rights limitation or denial documentation must also be provided to the facility’s Client Rights Specialist and, if the individual is a county department patient, to the county’s Client Rights Specialist.

Other rights exceptions

The following is a list of other client rights and what exceptions, if any, can be imposed upon them. Any limits under these rights must be documented in the client's treatment records, but do not need a Client Rights Limitation or Denial form filled out since they are not part of Wis. Stat. § 51.61(2).

Other rights exceptions list A-D

Right to the opportunity to refute accusations

No exceptions. Everyone should have the chance to refute an allegation of a rule violation or claim mitigating circumstances

Right that prohibits arbitrary decisions

No exceptions. All decisions about clients must be rationally based on a legitimate treatment, or security reason

Right to conduct own businesses

Inpatients may conduct any legitimate business, so long as it does not interfere with treatment, the orderly operation of the facility, security, or clients' rights.

Right to community access

Inpatients should be allowed access to the community except for individualized security or safety reason.

Right to confidentiality of records

All records are confidential and can only be released with written consent, but there are 31 specific exceptions to the informed consent requirement listed in Wis. Stat. § 51.30(4)(b).

Right to nutritional diet and reasonable food choices

No exceptions. Inpatients must be provided a balanced, nutritional diet.

Right to a diet that suits religious, cultural, or personal needs

No exceptions. Inpatients are entitled to pursue their own religious or cultural diets or personal (like vegetarian) diets as can be provided.

Right to dignity and respect

No exceptions. All clients must be treated with respect and recognition of their dignity and individuality by all employees and by health care providers they meet.

Right to notification of rules and discipline policies

Rules should be in writing, but staff can verbally inform clients of rules and the possible consequences of violating those rules. It is harder to show actual notice if the rules are not in writing. Post them!

Right to freedom from drastic treatment

No exceptions. Clients can refuse any drastic treatment procedures.

Other rights exception list E-O

Right to a clean and safe environment

No exceptions. All inpatient facilities must be designed to be clean and safe.

Right to exercise opportunities

All inpatients must be given the opportunity for reasonable and regular exercise.

Right that prohibits filming or taping without consent

All filming or taping requires consent, but a facility can monitor common areas with cameras, they just cannot tape. A picture of the client can be taken for the treatment record.

Right to use one's own funds

All clients should be able to use their own funds as they wish - except for any guardianship and/or payee limitations. Inpatient facilities can limit the amount of cash that clients can possess.

Right to access to grooming/hygiene items

Inpatients should have access to grooming items. However, if there is a safety issue involved, the right to possess such items can be limited by policy for a group of patients (e.g. staff keep razors for clients) or individually through the client rights limitation and denial process if there is an item that one person cannot handle without supervision.

Right to be informed of rights

All clients must be informed of their rights on admission, but this can be postponed for a short while if the client is not capable of understanding them upon admission. Annual re-notification must be given to long-term clients.

Right to be informed of costs of care

All clients must be informed of the costs of their care on admission, but the service provider can give general costs (e.g. hourly) and an estimate of total costs.

Right regarding performance of labor of financial benefit to facility

Clients performing such labor must consent to it and be paid at least minimum wage.

Right regarding expectation to personal housekeeping

Inpatients can be expected to clean up after themselves and do light housekeeping work if the work is shared equally among clients.

Right to legal access to courts/attorneys

No exceptions, but there may be extreme circumstances where legal calls, for instance, can be limited. Providers should seek legal advice for any such limits.

Right to send and receive mail

(Except for those held under a Chapter 980) Patients have a right to send and receive sealed mail. Mail can be opened (if it is not "legal mail") if there is probable cause to believe the letter may contain contraband. Otherwise, sending/receiving mail can be limited only by court order or consent of the client or guardian.

Right to at least 30 minutes to eat at meal times

Inpatients must be given the full half-hour to eat unless it is contraindicated for individuals for documented reasons.

Right to media access (TV, radio, etc.)

Inpatients must have access to the media unless there is a documented safety or security reason for limiting the access.

Right to no excessive and unnecessary medication

Medications must be appropriate to the client's condition and in dosages within normal ranges. Any deviations from that need to be well-documented by a physician.

Right regarding use and ownership of musical instruments

Inpatients should be given the opportunity to use their own guitar, etc., except for documented safety or security reasons. Time and place limits may be imposed.

Right to off-unit exercise

Inpatients should be given access to exercise and other off-unit activities unless there are documented, individualized security or safety reasons for not allowing.

Right to regular and frequent outdoor access

Can only limit for health reasons or for documented, individualized security reasons. Where necessary, the outdoor access can be supervised.

Other rights exception list P-Z

Right to recreation opportunities

Inpatients should be given access to recreational activities except for individualized security or safety reasons.

Right to refusing treatment or medication

Clients can refuse all treatment and medications (except in an emergency) unless court ordered. 

Right to religious worship

Inpatients should be allowed to attend on-unit religious activities unless they display disruptive behavior.

Right to religious worship off the unit

Inpatients should also be allowed to attend off-unit religious activities unless there are documented security reasons for not allowing them to go.

Right regarding participation in research studies

Clients have to give their written, informed consent for all techniques used on them.

Right regarding freedom from restraint

Clients cannot be restrained except in an emergency when it is likely they pose a danger to self or others. Restraint must be used for the shortest time possible.

Right regarding room decorations

Inpatients should be allowed to decorate their own rooms in any way they wish, but they don't have the right to display offensive or gang-related décor. An inpatient facility can restrict areas for clients who want to display sexually explicit materials (e.g. on the back of their room door where staff don't have to see it.)

Right to self-expression through art, music, etc.

Inpatient should be allowed to express themselves artistically unless there are documented safety or security reasons for limiting it.

Right to safety

Staff must protect inpatients from safety hazards, including other patients.

Right to searches of the person

Only inpatients may be subject to personal searches.

Right regarding search of a client's room

Only inpatients can be subject to a search of their rooms and only where there is "probable cause" to believe security rules have been violated.

Right to freedom from seclusion

Clients cannot be secluded unless in an emergency where it is likely they will pose a danger to self or others. Seclusion must be used for the shortest time possible.

Right regarding snacks

Snacks must be accessible to inpatients, except when contraindicated for individual clients.

Right to social contact with members of the opposite of sex

Inpatients should be allowed to mix with the opposite sex unless there are treatment, safety or security reasons for limiting it.

Right to toilet access

Access to a toilet and sink must be unscheduled, except a client in seclusion must be allowed access every 30 minutes.

Right regarding participation in treatment

All clients should participate in the planning of their treatment and care, but the client does not necessarily get to "pick and choose" the parts of the plan the client likes best. The client's treatment team makes the final decisions about what is the most appropriate treatment. The client can refuse the treatment or ask for a second opinion if they disagree.

Right to prompt and adequate treatment

All clients are entitled to treatment that is appropriate to their condition and delivered promptly and adequately.

Right regarding buying own TV, radio, etc.

Inpatients should be allowed to purchase their own TV's, etc., but this can be limited per policy for security, or safety reasons.

Last Revised: September 29, 2015