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Rights and Responsibilities

You Have the Right to:

  • Ask for and receive information about the services available to you
  • Have access to and choice of qualified service providers
  • Be informed of your rights before getting selected and approved services
  • Receive services without regard to race, religion, color, creed, gender, national origin, political beliefs, sexual orientation, marital status or disability
  • Have access to appropriate services that support your health and welfare
  • Make decisions concerning your care needs
  • Choose between a nursing facility and a Home Based Supportive Care (HBSC), (whichever meets your needs)
  • Assume risk after being fully informed about the potential risks and consequences of your decisions
  • Participate in the development of and make changes to your plan of care
  • Request changes in services at any time, including adding, increasing, decreasing, or discontinuing services
  • Ask for, and receive from your Care Manager, a list of names and duties of any person(s) assigned to provide services for you under your plan of care
  • Receive help and guidance from your Care Manager to resolve concerns about your care needs and/or complaints about services or providers
  • Be informed of and receive, in writing, facility-specific resident rights upon admission to an institutional or residential setting
  • Be informed of all the covered/required services you are entitled to by the institutional or residential setting, and any charges not covered by our health plan while in the facility (what services would an institutional/residential setting require? Or could this be worded incorrectly/implying something that is incorrect?)
  • Not be transferred or discharged out of a facility except for medical necessity
  • To protect your physical welfare and safety or the welfare and safety of other residents, or
  • After reasonable notice, you fail to make payments to the facility that are based on your statement of available income for Medicaid payment

You Have the Responsibility to:

  • Provide all health and treatment-related information, including, but not limited to, medication, circumstances, living arrangements, informal and formal supports to your Care Manager, in order to identify care needs and develop a plan of care
  • Understand your health care needs and work with your Care Manager to develop or change goals and services
  • Work with your Care Manager to develop and/or change your plan of care to facilitate timely authorization and implementation of services
  • Ask questions when you don’t understand something
  • Understand the risks associated with your decisions about care
  • Report any significant changes to your health condition, medication, circumstances, living arrangements, informal and formal supports to your Care Manager
  • Let your Care Manager know if any problems occur or you’re not happy with the services being provided
  • Follow our rules and/or those rules in an institutional or residential setting