One of the most underlitigated
features of VA law has to do
with it's very own Patient Rights
statutes which licensed lawyers
seem to show no interest in whatsoever
and neither does the Congress or
the VA law enforcement entity.

I introduce to you the null and
void, broken and dysfunctional
VA Patient Rights regulation under
38 CFR Part 17.33

I do think Veterans themselves
misread this regulation and don't
follow the abra-cadabra chain
of back-and-forth that this
regulation weaves, but I have
included the entire text below
for everybody to wrap their brains
around.

On first assumptions, people do
make the mistake that somehow
this regulation only pertains
to "inpatients". Well, NO it doesn't.
Only those clauses which specifically
are designated with the words "inpatient"
are holding exclusive voice to
inpatients. Outpatients are included
in the intent and spirit of the language
in all other generalized clauses of
the regulation. (just in case ya didn't
know)

Of particular interest is the
pronouncement of fair and equal
legal rights and protections
under the law for all in and out
patients for those who are trapped
in the national Claims backlog.
By reason of your patienthood
inside the VA system, are YOU
being deprived and denied your
fair and equal legal rights ??
H-m-m-m-m-m-m --- Susan you are
just too DEEP sometimes!!!

At a first glance, this Patient
Rights statute has the outward
appearance of actually protecting
the interests of Veterans who
are hopelessly trapped inside
the VA Hospital and disability
claims system. B-u-u-u-t-t-t-t -----
holdup, what is THIS???

When you ask the "enforcement"
question, it is here that the
entire statute completely falls
apart. You will have to rub
your eyes a couple of times in
complete utter disbelief.

Just about NOBODY is in charge.
This used to be assigned to
the oversight of a dumb and
useless "patient advocate" but
in the past 3 years of my advocacies
in Washington, I have apparently
succeeded in getting them to revise
that clause and take the "patient
advocate" out of everything. But
they have then replaced it basically
with nothing at all. The GRIEVANCE
paragraph comes out to say "just
anybody who will listen to ya, fat
chance of that."

There is NO law enforcement authority
designated and mandated on this
Patient Rights reporting system,
which is no system at all by the
way.

I have been hard pressed to find
any lawyer case law from Veterans
represented with breach allegations
of this Patient Rights statute.
Nobody is litigating under it,
and apparently the lawyers themselves
are too dumb to know it's out there
to even solicit to find those
kinds of cases.

And so the beat goes on, La-Dee-Da-Dee-Dee....

It's time VFJ activists wake up from
their COMA's and start injecting
this protection statute into your
advocacy dialogues when you are out
pounding the pavement for legislative
change. Right now I am using this
regulation in 2 of my civil rights cases
against the VA which is also filed at
the Dept. of Justice. I wanted DOJ
to get a load of what is going on
right under their Donut-Shop noses
while everybody holds onto their
excuses as to why nobody at the VA can
be prosecuted or FIRED for any
reason.

Now is a good time to put the VA
Patient Rights statute, and all
of the nullifying and voiding that
it holds, from the one simple clause below
passing "enforcement" authority over
to essentially NOBODY or "anybody
who walks by" as I have interpreted
this paragraph (G) to mean.

Everybody wants to know why the
system is broken, and this right
here is a key control panel to
enforcement and prosecution once
a mandated grievance authority
is designated. This is the place
where it all has to be fixed.

Don't look for the VSO's to tell you
about this regulation, because they are
dumber than the VA is when it comes
to knowing how to invoke proscuting
grievances.

What is known for sure is that VA
civil rights cases can be filed under
this regulation, bungled and nullified
or NOT, and that is a VA Form 10-0381.
I have yet to see any Tort claims
be listed under this regulation.

___________________________________


Title 38 Code of Federal Regulations
Sec. 17.33 Patients' rights.

(a) General. (1) Patients have a right to be treated with dignity in
a humane environment that affords them both reasonable protection from
harm and appropriate privacy with regard to their personal needs.

(2) Patients have a right to receive, to the extent of eligibility
therefor under the law, prompt and appropriate treatment for any
physical or emotional disability.

(3) Patients have the right to the least restrictive conditions
necessary to achieve treatment purposes.

(4) No patient in the Department of Veterans Affairs medical care
system (meaning outpatients), except as otherwise provided by the applicable State law, shall be denied legal rights solely by virtue of being voluntarily admitted or
involuntarily committed. Such legal rights include, but are not limited
to, the following: (yes this means outpatients)

(i) The right to hold and to dispose of property except as may be
limited in accordance with paragraph (c)(2) of this section;

(ii) The right to execute legal instruments (e.g., will); (disability cases)

(iii) The right to enter into contractual relationships;

(iv) The right to register and vote;

(v) The right to marry and to obtain a separation, divorce, or
annulment;

(vi) The right to hold a professional, occupational, or vehicle
operator's license.

(b) Residents and inpatients. Subject to paragraphs (c) and (d) of
this section, patients admitted on a residential or inpatient care basis
to the Department of Veterans Affairs medical care system have the
following rights:

(1) Visitations and communications. Each patient has the right to
communicate freely and privately with persons outside the facility,
including government officials, attorneys, and clergymen. To facilitate
these communications each patient shall be provided the opportunity to
meet with visitors during regularly scheduled visiting hours, convenient
and reasonable access to public telephones for making and receiving
phone calls, and the opportunity to send and receive unopened mail.

(i) Communications with attorneys, law enforcement agencies, or
government officials and representatives of recognized service
organizations when the latter are acting as agents for the patient in a
matter concerning Department of Veterans Affairs benfits, shall not be
reviewed.

(ii) A patient may refuse visitors.

(iii) If a patient's right to receive unopened mail is restricted
pursuant to paragraph (c) of this section, the patient shall be required
to open the sealed mail while in the presence of an appropriate person
for the sole purpose of ascertaining whether the mail contains
contraband material, i.e., implements which pose significant risk of
bodily harm to the patient or others or any drugs or medication. Any
such material will be held for the patient or disposed of in accordance
with instructions concerning patients' mail published by the Veterans
Health Administration, Department of Veterans Affairs, and/or the local
health care facility.

(iv) Each patient shall be afforded the opportunity to purchase, at
the patient's expense, letter writing material including stamps. In the
event a patient needs assistance in purchasing writing material, or in
writing, reading or sending mail, the medical facility will attempt, at
the patient's request, to provide such assistance by means of
volunteers, sufficient to mail at least one (1) letter each week.

(v) All information gained by staff personnel of a medical facility
during the course of assisting a patient in writing, reading, or sending
mail is to be kept strictly confidential except for any disclosure
required by law.

(2) Clothing. Each patient has the right to wear his or her own
clothing.

(3) Personal Possessions. Each patient has the right to keep and use
his or her own personal possessions consistent with available space,
governing fire safety regulations, restrictions on noise, and
restrictions on possession of contraband material, drugs and
medications.

(4) Money. Each patient has the right to keep and spend his or her
own money and to have access to funds in his or her account in
accordance with instructions concerning personal funds of patients
published by the Veterans Health Administration.

(5) Social Interaction. Each patient has the right to social
interaction with others.

(6) Exercise. Each patient has the right to regular physical
exercise and to be outdoors at regular and frequent intervals.
Facilities and equipment for such exercise shall be provided.

(7) Worship. The opportunity for religious worship shall be made
available to each patient who desires such opportunity. No patient will
be coerced into engaging in any religious activities against his or her
desires.

(c) Restrictions. (1) A right set forth in paragraph (b) of this
section may be restricted within the patient's treatment plan by written
order signed by the appropriate health care professional if--

(i) It is determined pursuant to paragraph (c)(2) of this section
that a valid and sufficient reason exists for a restriction, and

(ii) The order imposing the restriction and a progress note
detailing the indications therefor are both entered into the patient's
permanent medical record.

(2) For the purpose of paragraph (c) of this section, a valid and
sufficient reason exists when, after consideration of pertinent facts,
including the patient's history, current condition and prognosis, a
health care professional reasonably believes that the full exercise of
the specific right would--

(i) Adversely affect the patient's physical or mental health,

(ii) Under prevailing community standards, likely stigmatize the
patient's reputation to a degree that would adversely affect the
patient's return to independent living,

(iii) Significantly infringe upon the rights of or jeopardize the
health or safety of others, or

(iv) Have a significant adverse impact on the operation of the
medical facility, to such an extent that the patient's exercise of the
specific right should be restricted. In determining whether a patient's
specific right should be restricted, the health care professional
concerned must determine that the likelihood and seriousness of the
consequences that are expected to result from the full exercise of the
right are so compelling as to warrant the restriction. The Chief of
Service or Chief of Staff, as designated by local policy, should concur
with the decision to impose such restriction. In this connection, it
should be noted that there is no intention to imply that each of the
reasons specified in paragraphs (c)(2)(i) through (iv) of this section
are logically relevant to each of the rights set forth in paragraph
(b)(1) of this section.

(3) If it has been determined under paragraph (c)(2) of this section
that a valid and sufficient reason exists for restricting any of the
patient's rights set forth in paragraph (b) of this section, the least
restrictive method for protecting the interest or interests specified in
paragraphs (c)(2)(i) through (iv) of this section that are involved
shall be employed.

(4) The patient must be promptly notified of any restriction imposed
under paragraph (c) of this section and the reasons therefor.

(5) All restricting orders under paragraph (c) of this section must
be reviewed at least once every 30 days by the practitioner and must be
concurred in by the Chief of Service or Chief of Staff.

(d) Restraint and seclusion of patients. (1) Each patient has the
right to be free from physical restraint or seclusion except in
situations in which there is a substantial risk of imminent harm by the
patient to himself, herself, or others and less restrictive means of
preventing such harm have been determined to be inappropriate or
insufficient. Patients will be physically restrained or placed in
seclusion only on the written order of an appropriate licensed health
care professional. The reason for any restraint order will be clearly
documented in the progress notes of the patient's medical record. The
written order may be entered on the basis of telephonic authority, but
in such an event, an appropriate licensed health care professional must
examine the patient and sign a written order within an appropriate
timeframe that is in compliance with current community and/or
accreditation standards. In emergency situations, where inability to
contact an appropriate licensed health care professional prior to
restraint is likely to result in immediate harm to the patient or
others, the patient may be temporarily restrained by a member of the
staff until appropriate authorization can be received from an
appropriate licensed health care professional . Use of restraints or
seclusion may continue for a period of time that does not exceed current
community and/or accreditation standards, within which time an
appropriate licensed health care professional shall again be consulted
to determine if continuance of such restraint or seclusion is required.
Restraint or seclusion may not be used as
a punishment, for the convenience of staff, or as a substitute for
treatment programs.

(2) While in restraint or seclusion, the patient must be seen within
appropriate timeframes in compliance with current community and/or
accreditation standards:

(i) By an appropriate health care professional who will monitor and
chart the patient's physical and mental condition; and

(ii) By other ward personnel as frequently as is reasonable under
existing circumstances.

(3) Each patient in restraint or seclusion shall have bathroom
privileges according to his or her needs.

(4) Each patient in restraint or seclusion shall have the
opportunity to bathe at least every twenty-four (24) hours.

(5) Each patient in restraint or seclusion shall be provided
nutrition and fluid appropriately.

(e) Medication. Patients have a right to be free from unnecessary or
excessive medication. Except in an emergency, medication will be
administered only on a written order of an appropriate health care
professional in that patient's medical record. The written order may be
entered on the basis of telephonic authority received from an
appropriate health care professional, but in such event, the written
order must be countersigned by an appropriate health care professional
within 24 hours of the ordering of the medication. An appropriate health
care professional will be responsible for all medication given or
administered to a patient. A review by an appropriate health care
professional of the drug regimen of each inpatient shall take place at
least every thirty (30) days. It is recognized that administration of
certain medications will be reviewed more frequently. Medication shall
not be used as punishment, for the convenience of the staff, or in
quantities which interfere with the patient's treatment program.

(f) Confidentiality. Information gained by staff from the patient or
the patient's medical record will be kept confidential and will not be
disclosed except in accordance with applicable law.

(g) Patient grievances. Each patient has the right to present
grievances with respect to perceived infringement of the rights
described in this section or concerning any other matter on behalf of
himself, herself or others, to staff members at the facility in which
the patient is receiving care, other Department of Veterans Affairs
officials, government officials, members of Congress or any other person
without fear or reprisal.


(h) Notice of patient's rights. Upon the admission of any patient,
the patient or his/her representative shall be informed of the rights
described in this section, shall be given a copy of a statement of those
rights and shall be informed of the fact that the statement of rights is
posted at each nursing station. All staff members assigned to work with
patients will be given a copy of the statement of rights and these
rights will be discussed with them by their immediate supervisor.

(i) Other rights. The rights described in this section are in
addition to and not in derogation of any statutory, constitutional or
other legal rights.

(Authority: 38 U.S.C. 501, 1721)

_________________________________________
End of VA Regulation

This message has been edited. Last edited by: McClellanVet,

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