The program for the protection of patients’ rights in the State psychiatric hospitals in Maryland, the Resident Grievance System (RGS), was established in 1985 as part of the negotiated settlement of the class action lawsuit, Coe vs. Hughes, et al . The suit focused on providing patients’ effective access to the judicial system, which is guaranteed by the United States Constitution. The settlement stipulated that a two tiered patients’ rights advocacy system be created that would protect rights guaranteed to patients by federal and state laws. The program is governed by the Code of Maryland Regulations 10.21.14, entitled Resident Grievance System. Adopted March 28, 1994, amended January 26, 1998.

The first tier of the program is a four-stage grievance process that provides when a resident/patient files a grievance, the grievance is investigated and resolved at one of the four stages in a fair, efficient, and timely manner. In the event that a grievance is not resolved at Stage 4, the grievant will be informed by the Rights Advisor of additional relevant legal services which the grievant may contact.

The Rights Advisors (RAs) respond to complaints alleging resident/patient rights violations, abuses, and neglect and serve as advocates for a resident/patient at forced medication review panels. The RAs provide all newly admitted patients a brief explanation and a Patients’ Rights booklet describing their rights and the grievance system available to them.

The second tier of the program, the Legal Assistance Providers (LAPs) is a group of independent law firms whose services are obtained through state procurement and, who provide specific legal assistance and representation to residents/patients. In addition, they provide legal assistance to residents at Stage 3 and 4 of the RGS grievance process and at forced medication panels. The LAPs and RAs conduct quarterly informational meetings with residents/patients at the respective facility.

The RGS provides services to seven Mental Hygiene Administration psychiatric facilities and two Developmental Disabilities Administration state residential facilities and two Secure Evaluation Therapeutic Treatment units.

The Coe Board of Review is an independent board of attorneys, physicians, mental health professionals and representatives of patient advocacy groups. The Department of Health and Mental Hygiene and counsel for the Coe plaintiffs jointly appoint members to the board.