CONNECTICUT: Statutes affecting PATIENT RIGHTS or PERSONS WITH DISABILITIES

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PART III*  PATIENTS' RIGHTS 

Sec. 17a-540. (Formerly Sec. 17-206a). Definitions.
When used in sections 17a-540 to 17a-550, inclusive, unless otherwise expressly
stated or unless the context otherwise requires: (a) "Facility" means any inpatient or
outpatient hospital, clinic, or other facility for the diagnosis, observation or treatment
of persons with psychiatric disabilities; (b) "Patient" means any person being treated
in a facility; (c) "Persons with psychiatric disabilities" means those children and
adults who are suffering from one or more mental disorders as defined in the most
recent edition of the American Psychiatric Association's "Diagnostic and Statistical
Manual of Mental Disorders"; (d) "Voluntary patient" means any patient sixteen
years of age or older who applies in writing for and is admitted to a hospital for
observation, diagnosis or treatment of a mental disorder or any patient under sixteen
years of age whose parent or legal guardian applies in writing for such observation,
diagnosis or treatment; (e) "Involuntary patient" means any patient hospitalized
pursuant to an order of a judge of the Probate Court after an appropriate hearing or
a patient hospitalized for emergency diagnosis, observation or treatment upon
certification of a qualified physician; (f) "Family" means spouse or next of kin; (g)
"Head of the hospital" or "head of the facility" means the superintendent or medical
director of a hospital or facility, or his designated delegate; (h) "Informed consent"
means permission given competently and voluntarily after a patient has been
informed of the reason for treatment, the nature of the proposed treatment, the
advantages or disadvantages of the treatment, medically acceptable alternative
treatment, the risks associated with receiving the proposed treatment and the risk of
no treatment; (i) "Medically harmful" means capable of inflicting serious mental or
physical injury on the patient, or producing in the patient a disturbed mental state or
impaired judgment which may be grossly detrimental to his physical or mental well
being; (j) "Psychosurgery" means those operations defined as lobotomy, psychiatric
surgery, behavioral surgery, and all other forms of brain surgery, if the surgery is
performed for the purpose of modification or control of thoughts, feelings, actions,
or behavior rather than the treatment of a known and diagnosed physical disease of
the brain; (k) "Shock therapy" means a form of psychiatric treatment in which
electric current, insulin, carbon dioxide, or indoklon, or other similar agents is
administered to the patient and results in a loss of consciousness or a convulsive or
comatose reaction; (1) "Direct threat of harm" means that the patient's clinical
history demonstrates a pattern of serious physical injury or life-threatening injury to
self or to others which is caused by the psychiatric disabilities with which the patient
has been diagnosed and is documented by objective medical and other factual
evidence. Such evidence of past pattern of dangerous behavior shall be manifested
in the patient's medical history and there shall exist a high probability that the patient
will inflict substantial harm on himself or others.  (1971, P.A. 834, S. 1; P.A. 74-8, S. 1, 2; 74-9, S. 1, 2; P.A. 78-219, S. 5; P.A. 93-369, S. 2; P.A. 95-257, S. 48, 58.) 

Sec. 17a-541. (Formerly Sec. 17-206b). Deprivation of rights of patient prohibited.
Exception. No patient hospitalized or treated in any public or private facility for the
treatment of persons with psychiatric disabilities shall be deprived of any personal,
property or civil rights, including the right to vote, hold or convey property, and
contract, except in accordance with due process of law, and unless such patient has
been declared incapable pursuant to sections 45a-644 to 45a-662, inclusive. Any
finding of incapability shall specifically state which civil or personal rights the patient
is incapable of exercising. (1971, P.A. 834, S. 2; P.A. 93-369, S. 3; P.A. 95-257, S. 48, 58; P.A. 96-202, S. 1.) 

Sec. 17a-542. (Formerly Sec. 17-206c). Humane and dignified treatment required.
Formulation of discharge plan. Every patient treated in any facility for treatment of
persons with psychiatric disabilities shall receive humane and dignified treatment at
all times, with full respect for his personal dignity and right to privacy. Each patient
shall be treated in accordance with a specialized treatment plan suited to his
disorder. Such treatment plan shall include a discharge plan which shall include, but
not be limited to, (1) reasonable notice to the patient of his impending discharge, (2)
active participation by the patient in planning for his discharge and (3) planning for
appropriate aftercare to the patient upon his discharge.  (1971, P.A. 834, S. 3; P.A. 82-329, S. 1, 3; P.A. 93-369, S. 4; P.A. 95-257, S. 48, 58.) 

Sec. 17a-543. (Formerly Sec. 17-206d). Procedures governing medication, treatment, psychosurgery and shock therapy.
(a) No patient shall receive medication for the treatment of the psychiatric
disabilities of such patient without the informed consent of such patient, except in
accordance with procedures set forth in subsections (b), (d), (e) and (f) of this
section or in accordance with section 17a-566 or 54-56d. (b) No medical or surgical
procedures may be performed without the patient's written informed consent or, if
the patient has been declared incapable of caring for himself or herself pursuant to
sections 45a-644 to 45a-662, inclusive, and a conservator of the person has been
appointed pursuant to section 45a-650, the written consent of such conservator. If
the head of the hospital, in consultation with a physician, determines that the
condition of an involuntary patient not declared incapable of caring for himself or
herself pursuant to said sections is of an extremely critical nature and such patient is
incapable of informed consent, medical or surgical procedures may be performed
with the written informed consent of: (1) The patient's conservator or guardian, if
he or she has one; or (2) such person's next of kin; or (3) a qualified physician
appointed by a judge of the Probate Court. Notwithstanding the provisions of this
section, if obtaining the consent provided for in this section would cause a medically
harmful delay to a voluntary or involuntary patient whose condition is of an
extremely critical nature, as determined by personal observation by a physician or
the senior clinician on duty, emergency treatment may be provided without consent.
(c) No psychosurgery or shock therapy shall be administered to any patient without
such patient's written informed consent, except as provided in this subsection. Such
consent shall be for a maximum period of thirty days and may be revoked at any
time. If it is determined by the head of the hospital and two qualified physicians that
the patient has become incapable of giving informed consent, shock therapy may be
administered upon order of the Court of Probate if, after hearing, such court finds
that the patient is incapable of informed consent and there is no other reasonable
alternative procedure. (d) A facility may establish an internal procedure governing
decisions concerning involuntary medication treatment for inpatients. This
procedure shall provide (1) that any decision concerning involuntary medication
treatment shall be made by a person who is not employed by the facility in which
the patient is receiving treatment, provided the selection of such person shall not be
made until the patient's advocate has had reasonable opportunity to discuss such
selection with the facility, (2) written and oral notification to the patient of available
advocacy services, (3) notice to the patient and his advocate, if one has been
chosen, of any proceeding for the determination of the necessity for involuntary
treatment not less than forty-eight hours prior to such proceeding, (4) the right of
the patient to representation during any such proceeding, (5) questioning of any
witness at any such proceeding including, if requested, one or both of the physicians
who made the determination pursuant to subsection (e) of this section concerning
the patient's capacity to give informed consent and the necessity of medication for
the patient's treatment, and (6) a written decision. If a decision is made in
accordance with the standards set forth in this section that a patient shall receive
involuntary medication, and there is substantial probability that without such
medication for the treatment of the psychiatric disabilities of such patient the
condition of the patient will rapidly deteriorate, such involuntary medication may be
provided for a period not to exceed thirty days or until a decision is made by the
Probate Court under subsection (e) or (f), whichever is sooner. (e) (1) If it is
determined by the head of the hospital and two qualified physicians that a patient is
incapable of giving informed consent to medication for the treatment of such
patient's psychiatric disabilities and such medication is deemed to be necessary for
such patient's treatment, a facility may utilize the procedures established in
subsection (d) of this section and may apply to the Court of Probate for
appointment of a conservator of the person with specific authority to consent to the
administration of medication or, in a case where a conservator of the person has
previously been appointed under section 45a-650, the facility or the conservator
may petition the Probate Court to grant such specific authority to the conservator.
The conservator shall meet with the patient and the physician, review the patient's
written record and consider the risks and benefits from the medication, the
likelihood and seriousness of adverse side effects, the preferences of the patient, the
patient's religious views, and the prognosis with and without medication. After
consideration of such information, the conservator shall either consent to the patient
receiving medication for the treatment of the patient's psychiatric disabilities or
refuse to consent to the patient receiving such medication. (2) The authority of a
conservator to consent to the administration of medication under subdivision (1) of
this subsection shall be effective for no more than one hundred twenty days. In the
case of continuous hospitalization of the patient beyond such one hundred twenty
days, if the head of the hospital and two qualified physicians determine that the
patient continues to be incapable of giving informed consent to medication for the
treatment of such patient's psychiatric disabilities and such medication is deemed to
be necessary for such patient's treatment, the authority of the conservator to
consent to the administration of medication may be extended for a period not to
exceed one hundred twenty days by order of the Probate Court without a hearing
upon application by the head of the hospital. Prompt notice of the order shall be
given to the patient, conservator and facility. (f) (1) If it is determined by the head
of the hospital and two qualified physicians that (A) a patient is capable of giving
informed consent but refuses to consent to medication for treatment of such
patient's psychiatric disabilities, (B) there is no less intrusive beneficial treatment and
(C) without medication, the psychiatric disabilities with which the patient has been
diagnosed will continue unabated, and place the patient or others in direct threat of
harm, as defined in subsection (l) of section 17a-540, the facility may utilize the
procedures established in subsection (d) of this section and may apply to the Court
of Probate to authorize the administration to the patient of medication for the
treatment of the patient's psychiatric disabilities, despite the refusal of the patient to
consent to such medication. (2) An order authorizing the administration of
medication under subdivision (1) of this subsection shall be effective for no more
than one hundred twenty days. In the case of continuous hospitalization of the
patient beyond such one hundred twenty days, if the head of the hospital and two
qualified physicians determine that (A) the patient continues to be capable of giving
informed consent but refuses to consent to medication for treatment of such
patient's psychiatric disabilities, (B) there is no less intrusive beneficial treatment and
(C) without medication, the psychiatric disabilities with which the patient has been
diagnosed will continue unabated, and place the patient or others in direct threat of
harm, as defined in subsection (l) of section 17a-540, the order may be extended for
a period not to exceed one hundred twenty days by order of the Probate Court
without a hearing. Prompt notice of the order shall be given to the patient and
facility. (g) If a decision has been made to administer involuntary medication to a
patient pursuant to subsection (d) of this section, the patient may petition the Court
of Probate to expedite the hearing on an application filed by the facility pursuant to
subsection (e) or (f) of this section or, if no application has been filed, to hold a
hearing to decide whether to allow the administration of involuntary medication.
Either hearing shall be held within fifteen days after the date of the patient's petition.
(h) For the purposes of this section, "voluntary patient" means any patient sixteen
years of age or older who applies in writing for, and is admitted to, a hospital for
observation, diagnosis or treatment of a mental disorder. (i) Unless there is a serious
risk of harm to the patient or others, based upon the patient's past history or current
condition, nothing in this section authorizes any form of involuntary medical,
psychological or psychiatric treatment of any patient who in the sincere practice of
his religious beliefs is being treated by prayer alone in accordance with the principles
and practices of a church or religious denomination by a duly accredited practitioner
or ordained minister, priest or rabbi thereof. (j) The Department of Mental Health
and Addiction Services shall adopt regulations, in accordance with chapter 54, to
implement the purposes of this section. (1971, P.A. 834, S. 4; P.A. 74-35, S. 1, 2; P.A. 76-227, S. 6, 7; P.A. 77-4, S. 1, 2; 77-595, S. 9; P.A. 78-219, S. 1; P.A. 80-189, S. 3; P.A. 93-369, S. 1; P.A. 95-257, S. 5, 11, 48, 58; P.A. 96-180, S. 47, 166; 96-202, S. 2; 96-215, S. 1, 4.) 

Sec. 17a-544. (Formerly Sec. 17-206e). Placement of patient in seclusion or mechanical restraint.
Medication not to be used as substitute for habilitation. (a) No patient may be
placed involuntarily in seclusion or a mechanical restraint unless necessary because
there is imminent physical danger to the patient or others and a physician so orders.
A written memorandum of such order, and the reasons therefor, shall be placed in
the patient's permanent clinical record within twenty-four hours. (b) Medication
shall not be used as a substitute for an habilitation program.  (1971, P.A. 834, S. 5; P.A. 78-219, S. 2.) 

Sec. 17a-545. (Formerly Sec. 17-206f). Physical and psychiatric examinations.
Every patient hospitalized under any of sections 17a-540 to 17a-550, inclusive, shall
receive a physical examination within five days of his hospitalization, and at least
once each year thereafter. Every patient shall be examined by a psychiatrist within
forty-eight hours of his hospitalization, and at least once each six months thereafter.
Reports of all physical and psychiatric examinations shall be completed and signed
by the examining physicians and made a part of the patient's permanent clinical
record.  (1971, P.A. 834, S. 6.) 

Sec. 17a-546. (Formerly Sec. 17-206g). Communication by mail and telephone.
(a) Every patient shall be permitted to communicate by sealed mail with any
individual, group or agency, except as herein provided. (b) Every hospital for
treatment of persons with psychiatric disabilities shall furnish writing materials and
postage to any patient desiring them. (c) If the head of the hospital or his authorized
representative receives a complaint from a person demonstrating that such person is
receiving threatening or harassing mail from a patient, the head of the hospital or his
authorized representative may, after providing a reasonable opportunity for the
patient to respond to the complaint, restrict such patient's mail to the complainant.
The head of the hospital or his authorized representative shall notify the patient of
the availability of advocacy services if such patient's mailing rights are restricted.
Any such restriction shall be noted in writing, signed by the head of the hospital, and
made a part of the patient's permanent clinical record. (d) If the head of the hospital
or his authorized representative determines that it is medically harmful to a patient
to receive mail, all such correspondence shall be returned unopened to the sender,
with an explanation, signed by the head of the hospital, for its return. A copy of this
explanation shall be made a part of the patient's permanent clinical record. (e) Every
patient shall be permitted to make and receive telephone calls, except as herein
provided. Public telephones shall be made available in appropriate locations. (f) If
the head of the hospital or his authorized representative determines that a patient
has made obscene or threatening telephone calls, he may restrict such patient's right
to make telephone calls. Any such restriction shall be noted in writing, signed by the
head of the hospital, and made a part of the patient's permanent clinical record. (g)
If the head of the hospital or his authorized representative determines that it is
medically harmful to a patient to make or receive telephone calls, this fact shall be
explained, in writing, signed by the head of the hospital, to the patient's family and
any persons who regularly make calls to, or receive calls from, the patient. A copy
of the explanation shall be signed by the head of the hospital and placed in the
patient's permanent clinical record.  (1971, P.A. 834, S. 7; P.A. 93-369, S. 5; P.A. 95-257, S. 48, 58; P.A. 96-121, S. 2, 3.) 

Sec. 17a-547. (Formerly Sec. 17-206h). Visitors.
Restrictions on mail, telephone and visitor privileges, when allowed. (a) Every
patient shall be permitted to receive visitors at regular visiting hours, except as
herein provided. The head of the hospital shall: (1) Establish visiting hours, and
inform all patients and their families and other visitors of these hours; and (2)
designate the areas of the hospital where a patient may receive visitors, and inform
all patients and their families and other visitors of these areas. (b) If, because of
extenuating circumstances, a patient's family cannot visit during the regular visiting
hours, the head of the hospital shall designate one two-hour period per week, at a
mutually convenient time, during which the patient's family may visit the patient. (c)
A patient's clergyman, lawyer or physician may visit the patient at any reasonable
time. (d) If the head of the hospital determines that it is medically harmful for the
patient to receive visitors, he shall so inform the patient's family and other visitors.
When the patient has recovered sufficiently to receive visitors, the head of the
hospital shall immediately notify the patient's family and other visitors who have
requested notification. A copy of the notification of any restriction of visitors, and
the reasons therefor, shall be signed by the head of the hospital and placed in the
patient's permanent clinical record. (e) The provisions of this section shall not apply
to any patient in a program or facility for the treatment of drug-dependent persons.
(f) No restriction of any patient's rights to send and receive mail, make and receive
telephone calls, or receive visitors shall be made in any manner, or for any reasons,
other than prescribed in section 17a-546 and this section.  (1971, P.A. 834, S. 8; P.A. 78-219, S. 3; P.A. 82-329, S. 2, 3.) 

Sec. 17a-548. (Formerly Sec. 17-206i). Patient's rights re clothing, possessions, money and access to records.

List of rights to be posted. (a) Any patient shall be permitted to wear his or her own
clothes; to keep and use personal possessions including toilet articles; except for
patients hospitalized in Whiting Forensic Division; to be present during any search
of his personal possessions; to have access to individual storage space for such
possessions; and in such manner as determined by the facility to spend a reasonable
sum of his or her own money for canteen expenses and small purchases. These
rights shall be denied only if the superintendent, director, or his authorized
representative determines that it is medically harmful to the patient to exercise such
rights. An explanation of such denial shall be placed in the patient's permanent
clinical record. (b) In connection with any litigation related to hospitalization, or at
any time following discharge from the facility, any patient or his or her attorney
shall have the right, upon written request, to inspect all of such patient's hospital
records, and to make copies thereof. Unless the request is made in connection with
any litigation related to hospitalization, the facility may refuse to disclose any portion
of a patient's record which the facility determines: (1) Would be medically harmful
to the patient; (2) would constitute an invasion of privacy of another person; or (3)
would violate an assurance of confidentiality furnished to another person. Any
patient aggrieved by a facility's refusal to disclose under this subsection may petition
the Superior Court for relief in the same manner as a patient proceeding under
section 4-105, except that in addition to notice and a hearing, the court may conduct
an in camera review of the record. The court shall order disclosure of the record by
the facility unless the court determines that the disclosure will be medically harmful
to the patient or would constitute an invasion of privacy of another person or would
violate an assurance of confidentiality furnished to another person. (c) A list of all
in-hospital rights shall be prominently posted in each ward of all mental health
facilities. (d) Nothing in subsection (b) of this section shall limit a patient's right of
access to his records under section 4-104.  (1971, P.A. 834, S. 9; P.A. 78-219, S. 4; P.A. 79-389, S. 1, 2; P.A. 93-119; P.A. 95-257, S. 20, 58.) 

Sec. 17a-549. (Formerly Sec. 17-206j). Denial of employment, housing, licenses, because of history of mental disorder restricted.

(a) No person shall be denied employment, housing, civil service rank, any license
or permit, including a professional license, or any other civil or legal right, solely
because of a present or past history of mental disorder, except as so provided by the
general statutes. (b) The burden shall be on the person or agency denying any such
right to prove that the person so denied is not suitable solely because of his present
or past history of mental disorder. (1971, P.A. 834, S. 10.) 

Sec. 17a-550. (Formerly Sec. 17-206k). Remedies of aggrieved persons.

Any person aggrieved by a violation of sections 17a-540 to 17a-549, inclusive, may
petition the superior court within whose jurisdiction the person is or resides for
appropriate relief, including temporary and permanent injunctions, or may bring a
civil action for damages.  (1971, P.A. 834, S. 11; P.A. 76-436, S. 365, 681.) 

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