Standards for Canadian organizations

2020 Edition

Client Rights (CA-CR) 1: Client Rights and Responsibilities

The organization protects the legal and ethical rights of all clients by:
  1. informing clients of their rights and responsibilities;
  2. providing fair and equitable treatment; and
  3. providing clients with sufficient information to make an informed choice about using the organization and its services.
2020 Edition

Currently viewing: CLIENT RIGHTS (CA-CR)

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Purpose

The rights and dignity of clients are respected throughout the organization.
1
The organization's practices fully meet the standard as indicated by full implementation of the practices outlined in the CA-CR 1 Practice standards.
 
2
Practices are basically sound but there is room for improvement as noted in the ratings for the CA-CR 1 Practice standards.
3
Practice requires significant improvement as noted in the ratings for the CA-CR 1 Practice standard.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the CA-CR 1 Practice standards.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Client rights policy
  • Client rights procedures
  • Grievance procedures
  • Policy for providing services to minors without the consent of the parent or legal guardian
  • Fee schedule
  • Rights and responsibilities document provided to individuals and families at initial contact
  • Grievance reports for the past six months
  • Interviews may include:
    1. Relevant personnel
    2. Persons served
  • Review case records
  • Observe facility

 
Fundamental Practice

CA-CR 1.01

All persons served receive, and are helped to understand, information about their rights and responsibilities that is:
  1. provided in writing;
  2. distributed during their initial contact;
  3. available in the major languages of the defined service population;
  4. effectively and appropriately communicated to persons with special needs; and
  5. posted in the reception or common area of each service delivery site or residential facility.

Interpretation

If an organization provides services remotely using technology, client rights and responsibilities should be made available on the organization's public website and the organization must implement a system for assuring and documenting that clients receive and understand their rights and responsibilities.

Interpretation

If a client is disoriented, suffering from impaired cognition, or in immediate crisis at initial contact, the summary of client rights and responsibilities should be provided at an appropriate time.

EAP

Interpretation

 Affiliates who deliver services on behalf of an EAP are not required to post client rights and responsibilities in the reception area of their service delivery location, but information regarding client rights must be made available upon service initiation.
Note: Please see the Case Record Checklist and Facility Observation Checklist for additional guidance on this standard.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • Information about rights is routinely provided; however, one of the required elements is not fully addressed; or
  • All sites have postings but some of the postings could be larger or in a better location to increase client awareness of information and/or for easier reading.
3
Practice requires significant improvement; e.g.,
  • Two of the required elements are not fully addressed; or
  • One of the elements is not addressed at all; or
  • Information is not consistently provided at the initiation of services, but is provided upon request; or
  • At least one program does not provide client rights information; or
  • Not all reception sites or site locations have postings; or
  • Rights posters are missing important information; or
  • Rights posted on websites for services delivered remotely, using technology, are missing information.
4
The organization does not provide persons served with written rights and responsibilities.

 
Fundamental Practice

CA-CR 1.02

Written rights and responsibilities include, but are not limited to:
  1. basic expectations for use of the organization’s services including the responsibility to provide information needed to receive services;
  2. hours in which services are available;
  3. rules, behavioural expectations, and other factors that could result in discharge or termination;
  4. the right of the person served to receive service in a manner that is non-coercive and that protects the person’s right to self-determination;
  5. the right of the person served, families, and/or legal guardians to participate in decisions regarding the services provided; and
  6. basic information about how to lodge complaints, grievances, or appeals.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • One of the required elements is not fully addressed.
3
Practice requires significant improvement; e.g.,
  • Two of the required elements are not fully addressed; or
  • One of the elements is not addressed at all.
4
The organization does not provide persons served with written rights and responsibilities.

 
Fundamental Practice

CA-CR 1.03

Clients have the right to fair and equitable treatment including:
  1. the right to receive services in a non-discriminatory manner;
  2. the consistent enforcement of program rules and expectations; and
  3. the right to receive services that are respectful of, and responsive to, cultural and linguistic differences.
Examples: Fair and equitable treatment may include the provision of effective, equitable, understandable, and respectful services that are responsive to: diverse cultural beliefs and practices, such as the freedom to express and practice religious and spiritual beliefs; preferred languages; and other communication needs.
 
Other categories that should be protected from discrimination and disrespect include, but are not limited to: race and ethnicity, military status, age, sexual orientation, gender identity, and developmental level.

One way organizations can be responsive to the unique, culturally-defined needs of persons and families being served is by ensuring that program information, signs, posters, printed material, electronic and multimedia communications, and trainings are available and presented:
  1. in the language(s) of the major population groups served; and
  2. in a manner that is non-discriminatory and non-stigmatizing.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • One of the elements is not fully addressed.
3
Practice requires significant improvement; e.g.,
  • Two elements are not fully addressed; or
  • One element is not addressed at all.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 
Fundamental Practice

CA-CR 1.04

Clients provide consent prior to receiving services and have the right to:
  1. participate in all service decisions;
  2. be informed of the benefits, risks, side effects, and alternatives to planned services;
  3. be offered the most appropriate and least restrictive or intrusive service alternative to meet their needs;
  4. receive service in a manner that is free from harassment or coercion and that protects the person’s right to self-determination;
  5. refuse any service, treatment, or medication, unless mandated by law or court order; and
  6. be informed about the consequences of such refusal, which can include discharge.
Note: Please see the Case Record Checklist for additional guidance on this standard.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • One of the elements is not fully addressed; or
  • In a few instances evidence of consent was not found.
3
Practice requires significant improvement; e.g.,
  • Two of the elements are not fully addressed; or
  • One element is not addressed at all; or
  • In many instances, evidence of consent was not found.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 
Fundamental Practice

CA-CR 1.05

The organization maintains a formal mechanism through which applicants, clients, and other stakeholders can express and resolve grievances, including denial of service, which includes:
  1. the right to file a grievance without interference or retaliation;
  2. timely written notification of the resolution and an explanation of any further appeal, rights, or recourse; and
  3. at least one level of review that does not involve the person about whom the complaint has been made or the person who reached the decision under review.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • Procedure or documentation related to one of the elements needs strengthening.
3
Practice requires significant improvement; e.g.,
  • Procedure or documentation related to two of the elements needs strengthening.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 
Fundamental Practice

CA-CR 1.06

The organization states in writing circumstances under which it will serve minors without consent from a parent or legal guardian, and provides this information upon request.
NA The organization does not serve minors without consent from a parent or legal guardian.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • The standard is met in practice, but the policy needs minor clarification; or
  • In a few instances the information was not provided; or
  • In a few instances there was no documentation that clients were informed.
3
Practice requires significant improvement; e.g.,
  • The policy is clearly inadequate, or is not well-understood by staff; or
  • In a significant number of cases the information was not provided; or
  • In a significant number of cases there was no documentation that clients were informed.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.

 

CA-CR 1.07

Clients receive a schedule of any applicable fees and estimated or actual expenses, and are informed prior to service delivery about:
  1. the amount that will be charged;
  2. when fees or co-payments are charged, changed, refunded, waived, or reduced;
  3. the manner and timing of payment; and
  4. the consequences of nonpayment.
NA The organization does not charge the client any fees, co-payments, or other forms of payment in exchange for services.
Note: Please see the Case Record Checklist for additional guidance on this standard.
1
The organization's practices reflect full implementation of the standard.
2
Practices are basically sound but there is room for improvement; e.g.,
  • There have been a few instances when the information was not provided at the initiation of services; or
  • One of the elements is not fully addressed.
3
Practice requires significant improvement; e.g.,
  • Information is not consistently provided at the initiation of services but is available on request; or
  • Two of the elements are not fully addressed; or
  • One of the elements is not addressed at all.
4
Implementation of the standard is minimal or there is no evidence of implementation at all.