Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-43 - Specialized Recovery Services Program
Section 5160-43-03 - Specialized recovery services program individual rights and responsibilities
Universal Citation: OH Admin Code 5160-43-03
Current through all regulations passed and filed through September 16, 2024
(A) Enrollment in the specialized recovery services program is voluntary. Individuals enrolled in the program in accordance with rule 5160-43-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community- based services (HCBS), and the selection and control over the direction of approved services.
(B) An individual enrolled in a specialized recovery services program 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 his or her behalf in accordance with rule
5160-1-33 of the Administrative
Code.
(4) Receive program services
in a person-centered manner that is in accordance with an approved
person-centered service plan, that is attentive to the individual's needs and
maximizes personal independence.
(5) Choose his or her recovery management
agency and recovery managers from among qualified and available providers; and
(a) Have the recovery manager explain the
program, how it will assist the individual, and his or her rights and
responsibilities;
(b) Participate
with the recovery manager and the care team in the person- centered service
plan development process, and when possible, lead the process;
(c) Request assistance from the recovery
manager with recruitment of providers;
(d) Effectively communicate with the recovery
manager and care team and receive information in a manner that is easy to
understand;
(e) Be able to meet
privately with the recovery manager;
(f) Receive ongoing assistance from the
recovery manager; and
(g) Be able
to request a change of recovery management agency or recovery
manager.
(6) Make
informed choices regarding the HCBS and supports he or she receives and from
whom those services are received.
(7) Obtain the results of criminal records
checks for current agency providers or provider applicants pursuant to section
5164.34 of the Revised Code. All
personal identifying information such as home address, social security number,
and home phone number may be redacted to ensure the safety and security of the
provider.
(8) Access files, records
or other information related to his or her health care.
(9) Be assured of confidentiality of
protected health information pursuant to relevant confidentiality and
information disclosure laws.
(10)
Request assistance with problems, concerns, and issues, and suggest changes
without fear of repercussion.
(11)
Be fully informed about how to contact the recovery manager and the Ohio
department of medicaid (ODM) or its designee, with problems, concerns, issues,
or inquiries.
(12) Be informed of
the right to appeal decisions made by ODM or its designee about program
eligibility or services pursuant to division 5101:6 of the Administrative
Code.
(C) Upon enrollment in the program, the individual must accept responsibility to:
(1) Participate in, and cooperate during
assessments to determine ongoing program eligibility and service
needs.
(2) Decide who, in addition
to the recovery manager, will participate in the service planning
process.
(3) Participate in, and
cooperate with, the recovery manager and care team in the development and
implementation of the person-centered service plan.
(4) Participate in the recruitment, selection
and dismissal of his or her provider(s).
(5) Not direct any HCBS provider to act in a
manner that is contrary to relevant ODM- administered HCBS program
requirements, medicaid rules, regulations and all other applicable laws, rules
and regulations.
(6) Work with the
recovery manager when he or she wants to make a change in provider.
Notification to the recovery manager shall include the end date of the former
provider and the start date of the new provider.
(7) Authorize the exchange of information for
development of the person-centered service plan between the care team and his
or her service providers, and in compliance with the "Health Insurance
Portability and Accountability Act of 1996" (HIPAA) regulations set forth in 45
C.F.R. parts 160 and 164 (October 1, 2023), confidentiality of
alcohol and drug abuse patient records as set forth in 42 C.F.R part 2 (October 1, 2023) and the medicaid safeguarding
information requirements set forth in 42 C.F.R. parts 431.300 to 431.307
(October 1, 2023) along with sections
5160.45 to
5160.481 of the Revised
Code.
(8) Provide accurate and
complete information including up-to-date contact information and medical
history.
(9) Utilize services in
accordance with the approved person-centered service plan.
(10) Report to the recovery manager any
service delivery issue(s) including, but not limited to, service disruption,
complaints, and concerns about the provider and/or health and safety
issues.
(11) Keep and attend
scheduled appointments and notify the provider and recovery manager if he or
she is going to miss a scheduled visit or service.
(12) Treat the recovery manager, care team
and providers with respect.
(13)
Report to the recovery manager any significant change as defined in rule
5160-43-01 of the Administrative
Code that may affect the provision of services;
(14) Report to the recovery manager and when
applicable, the managed care plan care manager, in accordance with rule
5160-44-05 of the Administrative
Code, incidents that may impact his or her health and welfare.
(15) Refuse to participate in dishonest or
illegal activities involving providers, caregivers and care team
members.
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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