Participant Bill of Rights. When you join a PACE program, you have certain rights and protections. FHCN PACE, as your PACE program, must fully explain and provide your rights to you or someone acting on your behalf in a way you can understand at the time you join. At FHCN PACE, we are dedicated to providing you with quality health care services so that you may remain as independent as possible. This includes providing all Medicare-covered items and services and Medicaid services, and other services determined to be necessary by the interdisciplinary team across all care settings, 24 hours a day,7 days a week. Our staff and contractors seek to affirm the dignity and worth of each participant by assuring the following rights: You have the right to be treated with dignity and respect at all times, to have all of your care kept private and confidential, and to get compassionate, considerate care. You have the right: • To get all of your health care in a safe, clean environment and in an accessible manner. • To be free from harm. This includes excessive medication, physical or mental abuse, neglect, physical punishment, being placed by yourself against your will, and any physical or chemical restraint that is used on you for discipline or convenience of staff and that you do not need to treat your medical symptoms. • To be encouraged and helped to use your rights in the PACE program. • To get help, if you need it, to use the Medicare and Medicaid complaint and appeal processes, and your civil and other legal rights. • To be encouraged and helped in talking to PACE staff about changes in policy and services you think should be made. • To use a telephone while at the PACE Center. • To not have to do work or services for the PACE program. Discrimination is against the law. Every company or agency that works with Medicare and Medicaid must obey the law. They cannot discriminate against you because of your: • Race • Ethnicity • National Origin • Religion • Age • Sex • Mental or physical disability • Sexual Orientation • Source of payment for your health care (For example, Medicare or Medicaid) If you think you have been discriminated against for any of these reasons, contact a staff member at the PACE program to help you resolve your problem. If you have any questions, you can call the Office for Civil Rights at ▇- ▇▇▇-▇▇▇-▇▇▇▇. TTY users should call ▇-▇▇▇-▇▇▇-▇▇▇▇. You have the right to get accurate, easy-to-understand information and to have someone help you make informed health care decisions. You have the right: • To have someone help you if you have a language or communication barrier so you can understand all information given to you. • To have the PACE program interpret the information into your preferred language in a culturally competent manner, if your first language is not English and you can’t speak English well enough to understand the information being given to you. • To get marketing materials and PACE participant rights in English and in any other frequently used language in your community. You can also get these materials in Braille, if necessary. • To have the enrollment agreement fully explained to you in a manner understood by you. • To get a written copy of your rights from the PACE program. The PACE program must also post these rights in a public place in the PACE center where it is easy to see them. • To be fully informed, in writing, of the services offered by the PACE program. This includes telling you which services are provided by contractors instead of the PACE staff. You must be given this information before you join, at the time you join, and when you need to make a choice about what services to receive. • To be provided with a copy of individuals who provide care-related services not provided directly by FHCN PACE upon request. • To look at, or get help to look at, the results of the most recent review of your PACE program. Federal and State agencies review all PACE programs. You also have a right to review how the PACE program plans to correct any problems that are found at inspection. You have the right to choose a health care provider, including your primary care provider and specialists, from within the PACE program’s network and to get quality health care. Women have the right to get services from a qualified women’s health care specialist for routine or preventive women’s health care services. You have the right to have reasonable and timely access to specialists as indicated by your health condition. You also have the right to receive care across all care settings, up to and including placement in a long-term care facility when the FHCN PACE can no longer maintain you safely in the community. You have the right to get emergency services when and where you need them without the PACE program’s approval. A medical emergency is when you think your health is in serious danger— when every second counts. You may have a bad injury, sudden illness or an illness quickly getting much worse. You can get emergency care anywhere in the United States and you do not need to get permission from FHCN PACE prior to seeking emergency services. You have the right to fully participate in all decisions related to your health care. If you cannot fully participate in your treatment decisions or you want to have someone you trust help you, you have the right to choose that person to act on your behalf. You have the right: • To have all treatment options explained to you in a language you understand, to be fully informed of your health status and how well you are doing, and to make health care decisions. This includes the right not to get treatment or take medications. If you choose not to get treatment, you must be told how this will affect your health. • To have the PACE program help you create an advance directive if you choose. An advance directive is a written document that says how you want medical decisions to be made in case you cannot speak for yourself. You should give it to the person who will carry out your instructions and make health care decisions for you. • To participate in making and carrying out your plan of care. You can ask for your plan of care to be reviewed at any time. • To be given advance notice, in writing, of any plan to move you to another treatment setting and the reason you are being moved. • You have the right to talk with health care providers in private and to have your personal health care information kept private and confidential, including health data that is collected and kept electronically, as protected under State and Federal laws. • You have the right to look at and receive copies of your medical records and request amendments. • You have the right to be assured that your written consent will be obtained for the release of information to persons not otherwise authorized under law to receive it. • You have the right to provide written consent that limits the degree of information and the persons to whom information may be given. There is a patient privacy rule that gives you more access to your own medical records and more control over how your personal health information is used. If you have any questions about this privacy rule, call the Office for Civil Rights at ▇-▇▇▇-▇▇▇-▇▇▇▇. TTY users should call 1-800- ▇▇▇- ▇▇▇▇. You have a right to complain about the services you receive or that you need and don’t receive, the quality of your care, or any other concerns or problems you have with your PACE program. You have the right to a fair and timely process for resolving concerns with your PACE program. You have the right: • To a full explanation of the complaint process. • To be encouraged and helped to freely explain your complaints to PACE staff and outside representatives of your choice. You must not be harmed in any way for telling someone your concerns. This includes being punished, threatened, or discriminated against. • To contact 1-800-Medicare for information and assistance, including to make a complaint related to the quality of care or the delivery of a service. You have the right to request services from FHCN PACE that you believe are necessary. You have the right to a comprehensive and timely process for determining whether those services should be provided. You also have the right to appeal any denial of a service or treatment decision by the PACE program, staff, or contractors. If, for any reason, you do not feel that the PACE program is what you want, you have the right to leave the program at any time and have such disenrollment be effective the first day of the month following the date FHCN PACE receives your notice of voluntary disenrollment. If you feel any of your rights have been violated or you are dissatisfied and want to file a grievance or an appeal, please report this immediately to your social worker or call our office during regular business hours at ▇▇▇-▇▇▇-▇▇▇▇. If you would like to talk to someone outside of FHCN PACE about your concerns, you may contact ▇-▇▇▇-▇▇▇▇▇▇▇▇ (1-800-633- 4227) or ▇-▇▇▇-▇▇▇-▇▇▇▇ (Health Consumer Alliance – Medi-Cal Ombudsman Program) We believe that you and your caregiver play crucial roles in the delivery of your care. To assure that you remain as healthy and independent as possible, please establish an open line of communication with those participating in your care and be accountable for the following responsibilities: You have the responsibility to: ● Cooperate with the Interdisciplinary Team in implementing your care plan. ● Accept the consequences of refusing treatment recommended by the Interdisciplinary Team. ● Provide the Interdisciplinary Team with a complete and accurate medical history. ● Utilize only those services authorized by FHCN PACE. ● Take all prescribed medications as directed. ● Call the FHCN PACE physician for direction in an urgent situation. ● Notify FHCN PACE within 48 hours or as soon as reasonably possible if you require emergency services out of the service area. ● Notify FHCN PACE when you wish to initiate the disenrollment process. ● Notify FHCN PACE of a move or lengthy stay outside of the service area. ● Pay required monthly fees as appropriate. ● Treat our staff with respect and consideration. ● Not ask staff to perform tasks that they are prohibited from doing by PACE or agency regulations. ● Voice any concerns or dissatisfaction you may have with your care. ● FHCN PACE will make every reasonable effort to provide a safe and secure environment at the center. However, we strongly advise participants and their families to leave valuables at home. FHCN PACE is not responsible for safeguarding personal belongings.
Appears in 1 contract
Sources: Participant Enrollment Agreement
Participant Bill of Rights. When you join a PACE program, you have certain rights and protections. FHCN PACE, as your PACE program, must fully explain and provide your rights to you or someone acting on your behalf in a way you can understand at the time you join. At FHCN PACECEI, we are dedicated to providing you with quality health care services so that you may remain as independent as possible. This includes providing all Medicare-covered items and services and Medicaid services, and other services determined to be necessary by the interdisciplinary team across all care settings, 24 hours a day,7 days a week. Our staff and contractors seek seeks to affirm the dignity and worth of each participant Participant by assuring the following rights: . You are entitled to the rights listed below. You may designate a family member, caregiver, or other representative to exercise any or all of the rights to which you are entitled. If you feel that your rights have been violated, please follow the grievance procedures described in Chapter 8, “Member Grievance & Appeals Process.” You have the right to be treated with dignity and respect at all times, to have all of your care kept private and confidentialprivate, and to get compassionate, considerate care. You have • Be treated in a respectful manner that honors your dignity and privacy. • Receive care from professionally trained staff. • Know the right: names and responsibilities of the people providing your care. • To get all of Know that decisions regarding your care will be made in an ethical manner. • Receive comprehensive health care provided in a safe, safe and clean environment and in an accessible manner. • To be Be free from harm. This includes , including unnecessary physical or chemical restraints or isolation, excessive medication, physical or mental abuse, abuse or neglect, physical punishment, being placed by yourself against your will, and any physical or chemical restraint that is used on you for discipline or convenience of staff and that you do not need to treat your medical symptomshazardous procedures. • To be Be encouraged and helped to use your rights in the PACE program. • To get helpReceive reasonable access to a telephone at the center, both to make and receive confidential calls, or to have such calls made for you, if you need it, to use the Medicare and Medicaid complaint and appeal processes, and your civil and other legal rightsnecessary. • To be encouraged and helped in talking to PACE staff about changes in policy and services you think should be made. • To use a telephone while at the PACE Center. • To not Not have to do work or services for the PACE programProgram. Discrimination is • Not be discriminated against in the law. Every company or agency that works with Medicare and Medicaid must obey the law. They cannot discriminate against you because delivery of your: • Race • Ethnicity • National Origin • Religion • Age • Sex • Mental PACE services based on race, ethnicity, national origin, religion, sex, age, sexual orientation, mental or physical disability • Sexual Orientation • Source disability, or source of payment for your health care (For example, Medicare or Medicaid) If you think you have been discriminated against for any of these reasons, contact a staff member at the PACE program to help you resolve your problem. If you have any questions, you can call the Office for Civil Rights at ▇- ▇▇▇-▇▇▇-▇▇▇▇. TTY users should call ▇-▇▇▇-▇▇▇-▇▇▇▇payment. You have the right to get accurate, easy-to-understand information and to have someone help you make informed health care decisions. You have the rightright to: • To have someone help you if you have a language or communication barrier so you can understand all information given to you. • To have the PACE program interpret the information into your preferred language Be fully informed, in a culturally competent mannerwriting, if your first language is not English and you can’t speak English well enough to understand the information being given to you. • To get marketing materials and PACE participant rights in English and in any other frequently used language in your community. You can also get these materials in Braille, if necessary. • To have the enrollment agreement fully explained to you in a manner understood by you. • To get a written copy of your rights from the PACE program. The PACE program must also post these rights and responsibilities and all rules and regulations governing participation in a public place in the PACE center where it is easy to see themCEI. • To be Be fully informed, in writing, of the services offered by the PACE program. This includes telling you which CEI, including services are provided by contractors instead of the PACE CEI staff. You must be given this information before you joinenrollment, at enrollment, and at the time your needs necessitate the disclosure and delivery of such information, in order for you join, and when you need to make a choice about what services to receivean informed choice. • To be provided with a copy A full explanation of individuals who provide care-related services not provided directly by FHCN PACE upon requestthe Enrollment Agreement and an opportunity to discuss it. • To look at, Have an interpreter or get help a bilingual provider available to look at, you if your primary language is not English. • Examine the results of the most recent federal or state review of your PACE program. Federal CEI and State agencies review all PACE programs. You also have a right to review how the PACE program CEI plans to correct any problems that are found at inspection. You have the right to choose a health care provider, including your primary care provider and specialists, from within the PACE program’s network and to get quality health care. Women have the right to get services from a qualified women’s health care specialist for routine or preventive women’s health care services. You have the right to have reasonable and timely access to specialists as indicated by your health condition. You also have the right to receive care across all care settings, up to and including placement in a long-term care facility when the FHCN PACE can no longer maintain you safely in the community. You have the right to get emergency services when and where you need them without the PACE program’s approval. A medical emergency is when you think your health is in serious danger— when every second counts. You may have a bad injury, sudden illness or an illness quickly getting much worse. You can get emergency care anywhere in the United States and you do not need to get permission from FHCN PACE prior to seeking emergency services. You have the right to fully participate in all decisions related to your health care. If you cannot fully participate in your treatment decisions or you want to have someone you trust help you, you have the right to choose that person to act on your behalf. You have the right: • To have all treatment options explained to you in a language you understand, to be fully informed of your health status and how well you are doing, and to make health care decisions. This includes the right not to get treatment or take medications. If you choose not to get treatment, you must be told how this will affect your health. • To have the PACE program help you create an advance directive if you choose. An advance directive is a written document that says how you want medical decisions to be made in case you cannot speak for yourself. You should give it to the person who will carry out your instructions and make health care decisions for you. • To participate in making and carrying out your plan of care. You can ask for your plan of care to be reviewed at any time. • To be given advance notice, in writing, of any plan to move you to another treatment setting and the reason you are being moved. • You have the right to talk with health care providers in private and to have your personal health care information kept private and confidential, including health data that is collected and kept electronically, as protected under State and Federal laws. • You have the right to look at and receive copies of your medical records and request amendments. • You have the right to be assured that your written consent will be obtained for the release of information to persons not otherwise authorized under law to receive it. • You have the right to provide written consent that limits the degree of information and the persons to whom information may be given. There is a patient privacy rule that gives you more access to your own medical records and more control over how your personal health information is used. If you have any questions about this privacy rule, call the Office for Civil Rights at ▇-▇▇▇-▇▇▇-▇▇▇▇. TTY users should call 1-800- ▇▇▇- ▇▇▇▇. You have a right to complain about the services you receive or that you need and don’t receive, the quality of your care, or any other concerns or problems you have with your PACE program. You have the right to a fair and timely process for resolving concerns with your PACE program. You have the right: • To a full explanation of the complaint process. • To be encouraged and helped to freely explain your complaints to PACE staff and outside representatives of your choice. You must not be harmed in any way for telling someone your concerns. This includes being punished, threatened, or discriminated against. • To contact 1-800-Medicare for information and assistance, including to make a complaint related to the quality of care or the delivery of a service. You have the right to request services from FHCN PACE that you believe are necessary. You have the right to a comprehensive and timely process for determining whether those services should be provided. You also have the right to appeal any denial of a service or treatment decision by the PACE program, staff, or contractors. If, for any reason, you do not feel that the PACE program is what you want, you have the right to leave the program at any time and have such disenrollment be effective the first day of the month following the date FHCN PACE receives your notice of voluntary disenrollment. If you feel any of your rights have been violated or you are dissatisfied and want to file a grievance or an appeal, please report this immediately to your social worker or call our office during regular business hours at ▇▇▇-▇▇▇-▇▇▇▇. If you would like to talk to someone outside of FHCN PACE about your concerns, you may contact ▇-▇▇▇-▇▇▇▇▇▇▇▇ (1-800-633- 4227) or ▇-▇▇▇-▇▇▇-▇▇▇▇ (Health Consumer Alliance – Medi-Cal Ombudsman Program) We believe that you and your caregiver play crucial roles in the delivery of your care. To assure that you remain as healthy and independent as possible, please establish an open line of communication with those participating in your care and be accountable for the following responsibilities: You have the responsibility to: ● Cooperate with the Interdisciplinary Team in implementing your care plan. ● Accept the consequences of refusing treatment recommended by the Interdisciplinary Team. ● Provide the Interdisciplinary Team with a complete and accurate medical history. ● Utilize only those services authorized by FHCN PACE. ● Take all prescribed medications as directed. ● Call the FHCN PACE physician for direction in an urgent situation. ● Notify FHCN PACE within 48 hours or as soon as reasonably possible if you require emergency services out of the service area. ● Notify FHCN PACE when you wish to initiate the disenrollment process. ● Notify FHCN PACE of a move or lengthy stay outside of the service area. ● Pay required monthly fees as appropriate. ● Treat our staff with respect and consideration. ● Not ask staff to perform tasks that they are prohibited from doing by PACE or agency regulations. ● Voice any concerns or dissatisfaction you may have with your care. ● FHCN PACE will make every reasonable effort to provide a safe and secure environment at the center. However, we strongly advise participants and their families to leave valuables at home. FHCN PACE is not responsible for safeguarding personal belongings.
Appears in 1 contract
Sources: Member Enrollment Agreement