048-45 Wyo. Code R. §§ 45-4 - Rights of Participants Receiving Services

(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.

Notes

048-45 Wyo. Code R. §§ 45-4

Amended, Eff. 6/21/2017. Amended, Eff. 7/26/2018. Amended, Eff. 12/20/2019.