Opinion ID: 2399359
Heading Depth: 2
Heading Rank: 1

Heading: The RRMHS Regulations

Text: [¶ 10] BDS has published regulations that purport to govern treatment and rights of mental health patients at both state and private mental health facilities. The regulations, entitled Rights of Recipients of Mental Health Services appear at 13 C.M.R. 14 193 001-3 to 80 (1995) of the Code of Maine Rules. The regulations at issue in this proceeding were last amended effective January 1, 1995. Id. at 001-4, Introduction. Under the RRMHS regulations, a Mental Health Facility is defined as any facility that provides in-patient psychiatric services and any agency or facility providing in-patient, residential or outpatient mental health services that is licensed by, or funded by or has a contract with either . . . BDS or the Department of Human Services. Id. at 001-8 § A(II)(H). Under subparagraphs I and J there are separate definitions for Mental Health Institute, meaning state operated inpatient facilities, id. § A(II)(I), and Non-State Mental Health Institution, meaning institutions administered by an entity other than the State which provide in-patient care and treatment for people with mental illness, id. § A(II)(J). [¶ 11] In subparagraph M, an individual such as Geary, who receives inpatient care, is defined as a recipient meaning any person over age 18 receiving mental health treatment from any mental health facility, agency or program. Id. § A(II)(M). [¶ 12] According to the RRMHS regulations, recipients . . . may bring grievances claiming that the practices, procedures or policies of the Department, [or] a non-State mental health institution . . . violate the terms of these rules, the terms of the Bates v. Davenport [5] Settlement Agreement, or any other applicable law or regulation. Id. at 001-12 § A(V)(D). Part A, section VII, subparagraph C authorizes recipients or their representatives to: bring grievances regarding possible violations of basic rights, including any rights enumerated in these rules and the Settlement Agreement in Bates v. Davenport or any other applicable law or regulation; any questionable or inappropriate treatment or method of treatment; or any policy or procedure or action, or lack of thereof, of the mental health agency or facility. Id. at 001-14 § A(VII)(C). [¶ 13] Pursuant to Part A, section VII, subparagraph G(2), a three level grievance process is established. Id. at 001-15 § A(VII)(G)(2). The first level of grievance consideration is by the supervisor of the program or unit or another agencyemployee designated to hear grievances. Id. § A(VII)(G)(2)(a). The second level of grievance consideration for inpatient facilities is by the administrator of the facility, id. § A(VII)(G)(2)(b), and the third level of consideration of grievances is by the Commissioner of BDS. Id. § A(VII)(G)(2)(c). Subparagraph J provides exceptions to the regular grievance procedures. Id. at 001-18 § A(VII)(J). When, upon a level two review, the chief administrative officer of a mental health facility finds a grievance to be without apparent merit, the grievance may not be appealed administratively beyond Level Two. Id. at 001-19 § A(VII)(J)(3)(c). This dismissal constitutes final agency action for purposes of judicial review. Id. [¶ 14] The reference to judicial review when level two grievances are determined to be without apparent merit is different from the reference to judicial review when grievances proceed through the level three determination by the Commissioner of BDS. The regulations state that both constitute final agency action, but the level three grievance regulation refers specifically to the Maine Administrative Procedure Act, 5 M.R.S.A. § 11001 et seq.  Id. at 001-18 § A(VII)(H).