D. Waiver Participant's Rights and Responsibilities
Every waiver participant is assured certain rights and must agree to certain responsibilities related to the waiver program.
As part of the approval process, the potential participant is presented with a copy of the Waiver Participant's Rights and Responsibilities for the NHTD waiver by the Service Coordinator.
The Service Coordinator is responsible for explaining the rights and responsibilities of being a waiver participant to the individual and/or legal guardian. These rights and responsibilities should be reviewed during the development of the application and at least annually, and any time the Service Coordinator is aware that the participant does not understand his/her rights or responsibilities. The Service Coordinator gives a copy to the participant.
The Waiver Participant's Rights and Responsibilities (refer to Appendix C – form C.5) must be signed and dated by the applicant and/or legal guardian during the application process and at least annually there after. The signed original document is maintained with the Application Packet in the Service Coordinator's record. A copy is given to the participant to be maintained in an accessible location in the participant's home.
The Waiver Participant has the Right to:
- Be informed of his/her rights prior to receiving waiver services;
- Receive services without regard to race, religion, color, creed, gender, national origin, sexual orientation, marital status, or disability;
- Be treated as an individual with consideration, dignity and respect including but not limited to person, residence and possessions;
- Have services provided that support his/her health and welfare;
- Assume reasonable risks and have the opportunity to learn from these experiences;
- Be provided with an explanation of all services available in the NHTD waiver and other health and community resources that may benefit him/her;
- Have the opportunity to participate in the development, review and approval of all Service Plans, including any changes to the Service Plan;
- Select service providers and choose to receive additional waiver services from different agencies or different providers within the same agency without jeopardizing participation in the waiver;
- Request a change in services (add, increase, decrease or discontinue) at any time;
- Be fully informed of the process for requesting an Informal Conference and Fair Hearing upon receipt of a Notice of Decision or at any time while on the waiver.
- Be informed of the name and duties of any person providing services to him/her under the Service Plan;
- Have input into when and how waiver services will be provided;
- Receive services from approved, qualified individuals;
- Receive from the Service Coordinator in writing a list of names, telephone numbers, and supervisors for all waiver service providers, the RRDS, the QMS and NHTD Complaint Hotline;
- Refuse care, treatment and services after being fully informed of and understanding the potential risks and consequences of such actions;
- Have his/her privacy respected, including the confidentiality of personal records, and have the right to refuse the release of the information to anyone not authorized to have such records, except in the case of his/her transfer to a health care facility or as required by law or Medicaid requirements;
- Submit complaints about any violation of rights and any concerns regarding services provided, without jeopardizing his/her participation in the waiver and not being subject to restraint, interference, coercion, discrimination or reprisal as a result of submitting a complaint;
- Receive support and direction from the Service Coordinator to resolve his/her concerns and complaints about services and service providers;
- Receive additional support and direction from the RRDS, QMS, and DOH Waiver Management staff as desired or in the event that his/her Service Coordinator is not successful in resolving concerns and complaints about services and service providers;
- Have his/her complaints responded to and be informed of the final resolution of the investigation;
- Have his/her service providers protect and promote his/her ability to exercise all rights identified in this document;
- Have all rights and responsibilities outlined in this document forwarded to his/her court appointed legal guardian or others authorized to act on his/her behalf; and
- Participate in surveys inquiring about your experiences as an NHTD waiver participant. This includes the right to refuse to participate in experience surveys without jeopardizing your continued participation in the NHTD waiver program.
Waiver Participant's Responsibilities
The participant is responsible for:
- Working with the Service Coordinator to develop/revise his/her Service Plan to assure timely reauthorization of the Service Plan;
- Working with his/her waiver providers as described in his/her Service Plan;
- Following his/her Service Plan and notifying his/her Service Coordinator if problems occur;
- Talking to his/her Service Coordinator and other waiver providers if he/she wants to change his/her goals or services;
- Providing to the best of his/her knowledge complete and accurate medical history including all prescribed and over-the-counter medications he/she is taking and understanding of the risk(s) associated with his/her decisions about care;
- Informing the Service Coordinator about all treatments and interventions he/she is involved in;
- Maintaining his/her home in a manner which enables him/her to safely live in the community;
- Asking questions when he/she does not understand his/her services;
- Not participating in any criminal behavior. He/she understands that, if he/she does, his/her service provider(s) may leave, the police may be called and his/her continuation in the waiver program may be jeopardized;
- Reporting any significant changes in his/her medical condition, circumstances, informal supports and formal supports to his/her Service Coordinator;
- Providing accurate information related to his/her coverage under Medicaid, Medicare or other medically-related insurance programs to your Service Coordinator;
- Notifying all providers as soon as possible if the scheduled service visit needs to be rescheduled or changed;
- Notifying appropriate person(s) should any problems occur or he/she is dissatisfied with services provided; and
- Showing respect and consideration for staff and their property.