Individual Rights and Responsibilities A Rights Training for

Individual Rights and Responsibilities A Rights Training for Direct Support Professionals

§ The Universal Declaration of Human Rights All People Have Rights… is a document developed and adopted by the United Nations in 1948. This document outlines the basic rights afforded all human beings. § To view this document, follow this link: § Universal Declaration of Human Rights

Additional Rights Afforded to… People with Intellectual and Developmental Disabilities

People with disabilities have the same basic civil rights and remedies as other citizens, including, but not limited to… The Right to: § Vote and engage in the process of local, state, and national government. Rights Guaranteed by Federal Law § § § § § Due process, and to access legal counsel. Buy, sell, or dispose of personal property. Equal employment opportunities. Your personal privacy. Freedom of religious expression. Freedom of expression and speech. Access healthcare when you are not well. Marry, have children and raise a family. The freedom of movement. Free, equal and appropriate education opportunities.

People with disabilities have additional civil rights and remedies afforded by North Carolina Law… § The rights guaranteed by North Carolina General Rights Guaranteed by North Carolina Law Statutes 122 C, Article 3, including: § The right to dignity, privacy, humane care, and freedom from physical punishment, abuse, neglect, and exploitation. § People with disabilities have the right or the legally responsible person to receive a written summary of those rights within the first three visits (or the first 72 hours if in a 24‐hour facility), from the provider agency providing those services.

§ If a person’s primary need is related to the fact Special Rights of People with Intellectual & Developmental Disabilities that they have intellectual/developmental disabilities and are placed in a residential facility, they are entitled to assistance in finding another place to live if their original placement can no longer serve them. § This right exists unless they have broken the rules they agreed to follow or if the facility offers another place that can meet the persons needs and they refuse that offer. § The facility or provider agency must give the person or their legal guardian, along with the MCO/LME, a 60 -days advance-notice if it intends to discharge the person. § This right does not apply if they live in a privately‐operated ICF‐MR facility.

§ THE RIGHT TO TREATMENT, including access to medical care and habilitation, regardless of age or degree of disability. Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § THE RIGHT TO A WRITTEN TREATMENT PLAN, based on the individual’s needs. § The Right for their treatment plan to be implemented within 15 calendar days of admission. § The Right to take part in the development and periodic review of the treatment plan. § The Right to treatment in the most normal, age‐appropriate and least restrictive environment possible. § The Right to review the individual treatment plan and to understand how to obtain a copy of it.

RIGHT TO REFUSE TREATMENT § Before they agree to their treatment plan, be informed of the benefits or risk involved in the services to receive. § They have the right to consent to treatment and may withdraw that consent at any time. Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § They have the right to refuse treatment as described in the statute without threat or termination of services except as outlined in the statute. § If they have asked to receive services, they always have a right to agree to or refuse any specific treatment. § The only time they can be treated without their consent is in an emergency, when it has been court‐ordered, or if they are a minor and their parents have given permission. § A minor may seek and receive periodic services from a physician without parental consent for the prevention, diagnosis and treatment of: § (1) venereal disease and other diseases reportable under G. S. 130 A-135, § (2) pregnancy, § (3) abuse of controlled substances or alcohol, and § (4) emotional disturbance.

RIGHT TO BE INFORMED ABOUT MEDICATIONS § They have the right to have medication administered in Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies accordance with accepted medical standards and upon the order of a physician. § When medication is needed, they have the right to receive it in the lowest possible therapeutic dose. § They cannot be treated with experimental drugs or procedures without their written permission and without being informed of the risks, benefits and alternatives. § They may refuse to take medication; however, they will be informed of the risks of doing this. § Medication cannot be used for punishment, discipline or staff convenience.

RIGHT TO CONFIDENTIALITY § The confidentiality of their care and treatment is protected by law. § Except as allowed by law and agency regulations, their Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies records and other information about them will not be released without their written permission. § Circumstances under which a provider may be required to share information with another about the services they receive include: § If they give permission, a provider may share information § § with any person that they name. The next of kin may be informed that they are an individual supported, if it is in the person’s best interest. With their permission, their next of kin, a family member with a legitimate role in their service, or another person whom they name may be given other information about their care. A consumer advocate may review the record when assigned to work on the person’s behalf. The court may order a provider agency to release records.

RIGHT TO CONFIDENTIALITY § Circumstances under which a provider may be required to share information with another about the services they receive include: § An attorney may need to see the file because of legal Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § § § § proceedings. Request from the funding source, or an audit Another facility or HIPAA Covered Entity may need to receive the files when the care is transferred. If they become imprisoned, a provider agency may share the file with prison officials. In an emergency, another professional who is treating them may receive the records. A physician or other professional who referred them to an agency/facility may receive the files. If it is believed that they are a danger to themself or to others, or if it is believed that they are likely to commit a crime, an agency may share information with law enforcement. Special rules may apply if they have a legal guardian appointed, are a minor, or are receiving treatment for substance abuse.

§ RIGHT TO SEE THEIR OWN RECORDS § Except under certain circumstances, specified by law, Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies they have the right to have those circumstances explained to them. § RIGHT TO BE INFORMED OF THE RULES § They have the right to be informed of the rules that they are expected to follow in a particular facility or practice and possible penalties for violation of the rules. § This information will be provided when they enter a program. § They have the right to be free from unwarranted suspension or expulsion from programs and services. § If they are discharged from a facility/agency or practice, they are entitled to a copy of the discharge plan.

§ RIGHT TO KNOW THE TREATMENT COSTS § Fees for services (if applicable) should be discussed with them at their first visit. Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § Provider agencies are contracted with MCOs and bill Medicaid for ID/DD services through these MCOs, with prior approval only. § If an agency receives private pay for services not covered by and/or prior approved by Medicaid, a schedule of private pay rates should be provided upon request. § A provider agency should never privately bill a person for Medicaid covered services that have been denied for payment by either an MCO or Medicaid.

§ THEY HAVE THE RIGHT TO PRIVACY § They have the right to be free from any unwarranted search of their person or property. § At the time of admission to a 24‐hour facility, staff may Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies search them and their belongings to prevent dangerous or illegal substances from being brought into the facility. § The facility itself may be searched if dangerous or illegal substances are reasonably believed to be present, and staff may search persons who are minors. § Should search and seizure apply to a program from which they are receiving treatment, the specific procedures will be explained when they enter the program.

§ THE RIGHT NOT TO BE ABUSED § At the time of admission to a specific program, they will be informed of the types of interventions that are approved for use by that program. § The program cannot administer any potentially painful Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies procedure or stimulus to reduce the frequency or intensity of a behavior, and at no time is corporal punishment allowed. § Employees must protect persons from harm and report any form of abuse, neglect or exploitation. § In an emergency, if their behavior is dangerous to themselves/others/property, or if it is determined – based on very strict rules – that it is necessary for their care, an authorized facility may use restrictive interventions such as restraint, seclusion or isolation time‐out. § Special safeguards must be in place when these interventions are used, and they or their guardian have a right to request that a designated person be notified.

§ THE RIGHT NOT TO BE ABUSED - considerations § The gravity of some emergencies may require law enforcement assistance or initiation of involuntary commitment procedures. Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § Strict compliance with regulations is also necessary when interventions such as withdrawing or delaying access to possessions, taking away items, halting scheduled activities, or overcorrection are used. § Facilities/providers using protective devices to provide support or enhance safety must comply with certain very strict safeguards. § These interventions and devices may never be used as retaliation, for the convenience of staff, or in a manner that causes harm or undue discomfort.

§ RIGHT TO MAKE INSTRUCTIONS FOR TREATMENT Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies IN ADVANCE § In the event, that they become incapacitated and unable to make decisions about their treatment, they may prepare a document which outlines their intentions for their treatment, and a person to make decisions based upon their instructions.

§ RIGHT TO MAKE A COMPLAINT § If dissatisfied with a service delivered through a facility/provider agency, they have the right to state a complaint or file a grievance at any time. Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § Before starting a written complaint, they should attempt discuss the matter with staff or management of the facility/agency and allow them an opportunity to help resolve it. § Each facility/provider agency has grievance and complaint procedures that the person should receive upon intake and at their yearly plan meeting. § If the complaint process with any facility/agency is unsuccessful, the person should contact their MCO, NC-DHHS and/or Disability Rights NC.

Rights Afforded People Receiving IDD Services Rights and Requirements of Service Provider Agencies § RIGHT TO APPEAL § If a person has Medicaid, they have the right to request an appeal hearing if they are denied a requested service, or if current services are reduced, suspended or terminated.

§ Follow the agreed upon Plan of Care. § Notify the facility/provider if the visit/services schedule or § § Persons with IDD Receiving Services RESPONSIBILITIES § § § staffing needs to be changed within a reasonable amount of time prior to (at least 3 days if possible) Keep appointments and notify the facility/agency if unable to do so. Provide a safe environment for support and care to be provided. Notify the facility/agency of changes in their condition or care situation (hospitalization, symptoms, etc. ). Inform facility/agency of any medication changes and provide a photo-copy of each prescription bottle, so that medication orders can be confirmed with their physician and entered on Medication Administration Record. Inform facility/agency of the existence of, and any changes to, advance directives. Inform facility/agency of the existence of guardianship or power of attorney documents. Advise facility/agency of any problems or dissatisfaction with the service. Carry out all other mutually agreed upon responsibilities.

§ Alliance Behavioral Healthcare § 800/510 -9132 Cardinal Innovations Healthcare § 704/467 -3808 § Eastpointe MCO Participant Complaint Contacts § 800/513 -4002 § Partners Behavioral Healthcare § 877/864 -1454 § Sandhills Center § 800/256 -2452 § Trillium Healthcare § 866/998 -2597 § Vaya Healthcare § 800/849 -6127

State Agency Complaint Contacts § NC Medicaid § 800 -624 -3004 § NC-DHHS § 800 -624 -3004

§Disability Rights NC This statewide agency is designated under federal and state law to protect and advocate for the rights of persons who have disabilities. NC Consumer Protection Agency 3724 National Drive Suite 100 Raleigh, NC 27612 Toll Free: 877‐ 235‐ 4210 Local: 919856‐ 2195 TTY: 888 -268 -5535 Fax: 919‐ 856‐ 2244 www. disabilityrightsnc. org