California Office of Patients' Rights (COPR)
The California Office of Patients' Rights is a DRC unit. We have a contract with the Department of State Hospitals. We advocate and train in the five state hospitals. We give technical assistance and training to county Patients' Rights Advocates. To learn more keep reading. The California Office of Patients' Rights (COPR) is a unit within Disability Rights California. Under contract with California's Department of State Hospitals, California Office of Patients' Rights provides direct advocacy and training for the five State Hospitals. In addition, COPR provides technical assistance and training to Patients' Rights Advocates in each county.
COPR is contracted by the Department of State Hospitals to ensure that the treatment and legal rights of people receiving mental health treatment are maintained. The Patients’ Rights Advocates (PRA) in the state hospitals are employees of Disability Rights California. Disability Rights California is a nonprofit agency that provides legal and other advocacy assistance to people with disabilities.
Disability Rights California began protecting the rights of Californians with disabilities in 1978.
The legislative mandated duties of the Patients' Rights Advocate are:
- To investigate and resolve complaints received from individuals about violations or abuse of their rights and/or to cause the investigation of such complaints.
- To act as an advocate for individuals who are unable or afraid to file a complaint.
- To monitor facilities for compliance with patients’ rights, laws, regulations, and policies.
- To train staff in areas regarding patients’ rights, laws, regulations, and policies.
- To assist staff in ensuring that all individuals are notified of their rights, including the right to contact the Advocate and the California Office of Patients’ Rights.
- To act as a consultant to mental health professionals in the area of Patients’ rights.
- To act as a liaison between the facility’s advocacy program and the California Office of Patients’ Rights.
In addition to the legislatively mandated functions above, the DMH contract delegates to the California Office of Patients' Rights the responsibility for coordinating the hospital patient complaint process, to include the intake and tracking of all complaints, identification of patients’ rights issues for advocate investigation or response and the referral of all other complaints to appropriate program/department staff for response and/or resolution.
The Right to Be Treated with Respect. All patients, regardless of their means, mental or physical health challenges, should expect to be treated respectfully and without discrimination by their providers, practitioners and payers. People receiving mental health treatment are protected by both state and federal laws, to include all rights and responsibilities unless limited by court order.
Advocacy is the process of promoting and representing patients’ rights through direct assistance, monitoring, training, and policy review.
- To advocate for patients interests as defined by the patient as long as those interests are within the law, applicable to patients’ rights, and achievable within the advocate’s resources.
- To educate staff for compliance with patients’ rights, laws, regulations, and policies.
- To investigate and address complaints received from patients about violations or abuse of their rights or to cause the investigation of such complaints.
In addition to the legislatively mandated functions, the DSH contract delegates to the California Office of Patients' Rights the responsibility for coordinating the hospital patient complaint process:
Intake and tracking of all complaints, identification of patients’ rights issues for advocate investigation or response, and referral of all other complaints to appropriate program/department staff for response and/or resolution.
Patients’ Rights Advocates in the state hospitals are employees of Disability Rights California. COPR is contracted by the Department of State Hospitals to ensure the treatment and legal rights of people receiving mental health care and treatment are maintained.
The complaint process is a confidential track, separate from other state hospital documentation or investigative services unless permission has been given by the patient to the advocacy office to disclose information.
Patients have the right to file a formal complaint at any time if they believed that one or more of their rights have been abused or neglected, unreasonably denied or punitively withheld.
What we cannot help with:
- Court decisions or legal status
- Getting someone out of the facility
- Firing staff or moving staff
- Changing the course of clinical treatment
- Changing laws or regulations
- Contacting family or others on your behalf
- Receiving packages, mail, or storing property in our office
- Releasing your medical records or altering them for you
COPR provides technical assistance and training to Patients' Rights Advocates in each county and address complaint appeals from county clients.
Technical Assistance Examples
Jail Transferee Issues
Mental health clients whose treatment cannot be managed in jail are transferred to LPS-designated acute psychiatric facilities in the community and patients’ rights issues often ensue when custody staff tries to impose jail rules in these treatment settings.
PRAs from three counties contacted COPR for assistance regarding jail transferees in the facilities they monitor. These issues included denying patients’ rights to visitors by policy or placing such onerous restrictions on potential visitors so as to constructively deny visitors, and placing patients in seclusion for their entire stay in the acute psychiatric facility.
COPR explained to these PRAs that LPS rights apply to all patients in designated community facilities and the right, including the right to visitors, may only be denied for ‘good cause’ as defined in regulation. Regarding “inmate” patients being housed in seclusion, COPR explained that seclusion and/or restraint may only be used when only when alternative methods are not sufficient to protect the patient or others from injury. Patients may not be housed in seclusion by policy or by order of custody staff, but only when the patient’s behavior warrants its use and only upon a physician’s order.
LPS Conservator Overreach
Technical assistance was provided to county PRAs in situations where facilities were mistakenly relying on the LPS conservator’s authorization for the denial of patients’ rights.
In one case, the public guardian requested that a patient be placed in restraints to allow a wound he was picking at to heal. COPR explained that conservators could not authorize the use of restraint. Restraint may only be applied to protect the patient or others from injury and only when alternative methods are not sufficient to protect the patient or others. COPR explained that, although there might be justification for use of restraint in this instance, that determination was up to the physician, not the conservator and less restrictive alternatives must be considered. COPR suggested that PRA explore with the facility whether the patient’s behavior could be monitored and controlled with 1:1 Supervision rather that the use of restraints. The PRA later reported that facility opted for bandaging the patient’s wound and providing a 1:1 rather than restraint.
Patients’ Rights Annual Training (PRAT)
Each year, COPR holds an advocacy training for County Title 9 Patients’ Rights Advocates (PRA). This training is not intended for other mental health staff. The training is held under a mandate found in Welfare and Institutions Code, section 5512.
Training of county patients' rights advocates shall be provided by the contractor specified in Section 5510 responsible for the provision of protection and advocacy services to persons with mental disabilities. Training shall be directed at ensuring that all county patients' rights advocates possess:
- Knowledge of the service system, financial entitlements, and service rights of persons receiving mental health services. This knowledge shall include, but need not be limited to, knowledge of available treatment and service resources in order to ensure timely access to treatment and services.
- Knowledge of patients' rights in institutional and community facilities.
- Knowledge of civil commitment statutes and procedures.
- Knowledge of state and federal laws and regulations affecting recipients of mental health services.
- Ability to work effectively and respectfully with service recipients and providers, public administrators, community groups, and the judicial system.
- Skill in interviewing and counseling service recipients, including giving information and appropriate referrals.
- Ability to investigate and assess complaints and screen for legal problems.
- Knowledge of administrative and judicial due process proceedings in order to provide representation at administrative hearings and to assist in judicial hearings when necessary to carry out the intent of Section 5522 regarding cooperation between advocates and legal representatives.
- Knowledge of, and commitment to, advocacy ethics and principles.
Download the COPR Grievance form.
DHCS “Rights for Individuals in Mental Health Facilities” handbook & poster order form and download