Oregon Administrative Rules › Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES › Division 45 - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) › Section 411-045-0110 - Participant Rights

Current through Register Vol. 63, No. 7, July 1, 2024
(1) PACE
			 programs must have written policies and procedures that ensure PACE
			 participants have the rights and responsibilities included in this rule. The
			 PACE organization must inform a participant upon enrollment, in writing, of his
			 or her rights and responsibilities, and all rules and regulations governing
			 participation.
(2) PACE programs
			 must communicate these policies and procedures to PACE staff and participating
			 providers.
(3) PACE programs must
			 monitor compliance with policies and procedures governing PACE participant
			 rights and responsibilities, take corrective action as needed, and report
			 findings to the PACE programs Quality Improvement Committee.
(4) PACE participants must have the following
			 rights:
(a) To be treated with dignity and
			 respect. To be free from abuse or neglect;
(b) To be treated by providers the same as
			 other people seeking health and long term care services;
(c) To change primary care providers within
			 the guidelines of the PACE program;
(d) To have a friend, family member,
			 representative, or advocate, present during appointments and at other times as
			 needed within clinical guidelines;
(e) To be actively involved in the
			 development of his or her care plan;
(f) To be given information about his or her
			 condition and covered and non-covered services necessary to allow an informed
			 decision about proposed treatment(s);
(g) To consent to treatment or refuse
			 services, and be told the consequences of that decision, except for court
			 ordered services;
(h) To receive
			 written materials describing rights, responsibilities, benefits available, how
			 to access services, and what to do in an emergency;
(i) To have written materials explained in a
			 manner that is understandable to the PACE participant;
(j) To receive necessary and reasonable
			 services to diagnose the presenting condition;
(k) To receive covered services under the
			 PACE program that meet generally accepted standards of practice and are
			 medically appropriate;
(l) To
			 obtain covered preventive services;
(m) To have access to urgent and emergency
			 services 24 hours a day, 7 days a week as described in OAR
			 411-045-0080(3);
(n) To receive a referral to specialty
			 practitioners for medically appropriate covered services;
(o) To have a clinical record maintained that
			 documents conditions, services received, and referrals made;
(p) To have access to one's own clinical
			 record, unless restricted by statute;
(q) To transfer a copy of one's clinical
			 record to another provider;
(r) To
			 execute a statement of wishes for treatment, including the right to accept or
			 refuse medical, surgical, chemical dependency or mental health treatment and
			 the right to execute directives and powers of attorney for health care
			 established under ORS 127 as amended by the Oregon Legislative Assembly 1993
			 and the OBRA 1990 -- Patient Self-Determination Act;
(s) To receive written notices before a
			 denial of, or change in, a benefit or service level is made, unless such notice
			 is not required by federal or state regulations;
(t) To receive information on how to make a
			 grievance with the PACE program and receive a response as defined in
			 411-045-0120;
(u) To request an administrative hearing with
			 the Department of Human Services;
(v) To receive interpreter services as
			 defined in OAR 411-045-0070 of the
			 rule;
(w) To have the use of
			 restraints (both physical and chemical) limited to the least restrictive and
			 most effective method available. The use of such restraints must meet the
			 requirements in
			 42
			 CFR 460.114; and
(x) To request that a qualified specialist
			 for women's health services furnish routine or preventive women's health
			 services.