Current through September 21, 2024
(a) Each
participant receiving services has the same legal rights and responsibilities
guaranteed to all other U.S. citizens under the United States and Wyoming
constitutions and federal and state laws.
(b) Participant rights shall not be modified
or suspended except in accordance with state or federal law and this Chapter. A
participant's right to dignity and respect, to be free from coercion, and to
receive services in settings that are physically accessible to the participant
shall not be limited or restricted.
(c) The participant, the participant's
legally authorized representative(s), the participant's case manager, and the
Division shall be informed in writing of the grounds for a denial or limitation
of rights. Such notice shall be written in plain language and shall include a
statement that the participant may choose an alternative provider, if the
participant or legally authorized representative disagrees with the denial or
limitation. If the Division disallows a limitation of a right in an
individualized plan of care, this decision will apply to any provider offering
services to the participant. Rights restrictions shall constitute a material
change to the individualized plan of care. The following participant rights
shall not be denied or limited, except for the purpose of an identified health
or safety need, which shall be included in the participant's individualized
plan of care:
(i) The right to
privacy;
(ii) The right to freedom
from restraint;
(iii) The right to
privacy in their sleeping or living quarters;
(iv) The right to sleeping and living
quarters that have entrance doors that can be locked by the individual, with
only appropriate staff having keys to doors;
(v) The right to choose with whom and where
they live;
(vi) Freedom to furnish
and decorate their sleeping or living quarters within the lease or other
agreement;
(vii) Freedom and
support to control their own schedules and activities;
(viii) Freedom and support to have access to
food at any time;
(ix) Freedom to
have visitors of their choosing at any time, and associate with people of their
choosing;
(x) Freedom to
communicate with people of their choosing;
(xi) Freedom to keep and use their personal
possessions and property;
(xii)
Control over how they spend their personal resources;
(xiii) The right to access the community;
and
(xiv) The right to make and
receive telephone calls. No person shall limit a participant's right to make
calls to Protection & Advocacy, or state and federal oversight or
protection agencies as protected by
42 U.S.C.
10841(1)(M), such as the
Division or Department of Family Services.
(d) A participant's right to be free from
physical, mechanical, and chemical restraints shall not be denied or limited
unless a court, the participant, or the participant's legally authorized
representative authorizes the denial or limitation in writing. The request
shall be accompanied by letters from a licensed medical and behavioral
professional that detail medical and psychological contraindications that may
be associated with a restraint.
(i) Such
denial or limitation shall be included in the participant's individualized plan
of care, shall address how other less restrictive interventions will be used
prior to a restraint, and shall detail the manner in which a restraint may be
used pursuant to Section
18 of this Chapter.
(ii) The authorizing document shall be made
part of the participant's individualized plan of care.
(e) A provider that offers direct services
shall have and implement policies and procedures that ensure:
(i) Except as identified in this section,
participants have the opportunity to maximize their rights and
responsibilities;
(ii) Participants
have the right to refuse services and shall not be disciplined or charged with
a monetary fee for refusing home and community based waiver services;
(iii) Participants, parents of a minor, and
legally authorized representatives are informed of the participant's rights and
responsibilities;
(A) The information shall be
given at the time of entry to direct care and case management services,
annually thereafter, and when significant changes occur; and
(B) The information shall be provided in a
manner that is easily understood, given verbally and in writing, in the native
language of the participant or legally authorized representative(s), or through
other modes of communication necessary for understanding;
(iv) Participants are supported in exercising
their rights while receiving waiver services;
(v) Rights shall not be treated as privileges
or things that should be earned; and
(vi) Retaliation against a participant's
services and supports due to the participant, family members, or legally
authorized representatives advocating on behalf of the participant or
initiating a complaint with an outside agency, is prohibited.
(f) Providers shall not request or
require participants to waive or limit their rights as a condition of receiving
service.
(g) Providers shall not
intimidate, threaten, coerce, discriminate against, or take other retaliatory
action against any individual who exercises any right established by, or for
participation in any process provided in, these rules or the Wyoming Medical
Assistance and Services Act.
(h)
When rights restrictions are deemed necessary, the individualized plan of care
shall include a rights restriction protocol that addresses the reasons for the
rights restriction(s), including the legal document, court order, guardianship
papers, or medical order, that allows a person other than the participant to
authorize a restriction to be imposed.
(i) For
any rights restriction imposed, the following items shall be addressed and
documented in the individualized plan of care:
(A) Identification of the specific and
individualized assessed need;
(B)
Documentation of the positive interventions and supports used prior to any
modifications to the individualized plan of care;
(C) Documentation of less intrusive methods
of meeting the need that have been tried but did not work;
(D) A clear description of the condition that
is directly proportionate to the specific assessed need;
(E) A system of regular data collection and
review to measure the ongoing effectiveness of the modification;
(F) Established time limits for periodic
reviews, not to exceed six (6) months, to determine if the modification is
still necessary or can be terminated;
(G) Informed consent of the individual;
and
(H) Assurance that
interventions and supports will cause no harm to the individual.
(ii) In addition to the items
mentioned in this Section, the individualized plan of care shall address how
the team will work to restore any right described in this Section that has been
limited or denied.
