Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-45 - Administered Waiver Service Providers › Section 5160-45-03 - Ohio department of medicaid (ODM) -administered waiver program: individual rights and responsibilities

Current through all regulations passed and filed through July 1, 2024
Enrollment on an Ohio department of medicaid (ODM)
				-administered waiver is voluntary. Individuals enrolled on an ODM-administered
				waiver in accordance with rule
				5160-46-02 of the Administrative
				Code 
								will be informed of their rights and responsibilities.
				Individuals also have choice and control over the arrangement and provision of
				home and community-based waiver services, and the selection and control over
				the direction of approved waiver service providers.
(A) Individual rights.
An individual enrolled in an ODM-administered waiver has the
				right to:
(1) Be treated with dignity
			 and respect.
(2) Be protected from
			 abuse, neglect, exploitation and other threats to personal health, safety and
			 well-being.
(3) Appoint an
			 authorized representative to act on their behalf in accordance with 5160-1-33
			 of the Administrative Code.
(4)
			 Receive waiver services in a person-centered manner that is in accordance with
			 an approved person-centered services plan, is attentive to the individual's
			 needs and maximizes personal independence.
(5) Conduct person-centered training of their
			 waiver service providers.
(6)
			 Choose his or her case management agency (CMA) and case managers, and
(a) Have the case manager explain what the
			 ODM-administered waiver is, how it will assist the individual and what the
			 individual's rights and responsibilities are;
(b) Participate with the case manager and the
			 team in the person-centered services plan development process, and when
			 possible, lead the process;
(c)
			 Request assistance with recruitment of providers;
(d) Be able to effectively communicate with
			 the case manager and team and receive information in a manner that is easy to
			 understand;
(e) Be able to meet
			 privately with the case manager;
(f) Receive ongoing assistance from the case
			 manager; and
(g) Be able to request
			 changes in CMA, as necessary, subject to ODM's approval.
(7) Make informed choices regarding the
			 services and supports he or she receives and from whom, including
			 provider-managed agency providers, non-agency providers, or
			 participant-directed providers as those terms are defined in rule
			 5160-45-01 of the Administrative
			 Code.
(8) Obtain the results of
			 criminal records checks about current agency providers or provider applicants
			 pursuant to section 5164.342 of the Revised Code and
			 rules 5160-45-07 and
			 5160-45-11 of the Administrative
			 Code.
(9) Obtain the results of
			 criminal records checks about current non-agency providers or provider
			 applicants pursuant to section
			 5164.341 of the Revised Code and
			 rules 5160-45-08 and
			 5160-45-11 of the Administrative
			 Code.
(10) Access files, records or
			 other information related to the individual's health care.
(11) Be assured of confidentiality of
			 personal and sensitive health care information pursuant to relevant
			 confidentiality and information disclosure laws.
(12) Request assistance with problems,
			 concerns and issues, and suggest changes without fear of
			 repercussion.
(13) Be fully
			 informed about how to contact the case manager and ODM with problems, concerns,
			 issues or inquiries.
(14) Be
			 informed of the right to appeal decisions made by ODM or its designee about
			 waiver eligibility or services pursuant to division 5101:6 of the
			 Administrative Code.