1) Participants have the right to be treated with dignity, respect and fairness at all times.
This includes:

• The right to be protected from discrimination due to age, race, color, sex, national origin or ancestry, religion, political belief or affiliation, disability or association with a person with a disability, sexual orientation, cultural or educational background, mental or physical ability or source of payment for your health care.
  
  
• The right to be free from harm including physical and mental abuse, restraint, neglect, corporal punishment, involuntary seclusion, excessive medication and any physical or chemical restraint imposed for the purposes of discipline or convenience and not required to treat the participants medical symptoms.
  
  
• The right to suggest changes in the way we work at Total Community Care in an accessible manner.
  
  
• The right to receive health care in a safe and clean setting.
  
  
• The right not to be required to perform work for Total Community Care
  
  
• The right to have reasonable access to a telephone at Total Community Care
  
  
• The right to be afforded privacy and confidentiality in all aspects of care and be provided humane care
  

Participants will be encouraged and helped to use their rights, including their rights under the rules of Medicare and/or Medicaid appeals processes should they choose as well as civil and other legal rights.



2) Participants have the Right to full information about services covered and costs related to enrollment in Total Community Care.
This includes:

• The right to be informed in writing of the services available by Total Community Care before enrollment, at enrollment and anytime there is a change in services. This includes what services are delivered through contracts instead of PACE staff, what costs are covered by TCC, what costs participants must pay and to receive an explanation from us about any bills they receive for services not covered by TCC.
  
  
• The right to have the enrollment agreement fully explained to our participants in a way they will understand.
  
  
• The right to receive a written copy of the Participant Bill of Rights and to review these rights with Total Community Care staff in a way they understand.
  
  
• The right to review the most recent Medicare or Medicaid survey of Total Community Care, including financial status and any plan of correction in effect.
  
  
• The right to get information about the qualifications of doctors and other health professional s and how we pay our providers.
  
  

3) Participants have the right to have access to medical services, including timely access to emergency services.
This includes:

• The right to access emergency care when and where our participants have the need without approval from Total Community Care. Emergency care is a life-threatening situation or when the participants’ health is in danger and every second counts.
  
  
• The right to receive urgently needed services when traveling outside of the TCC area.

4) Participants have several rights in regard to health care providers.
These include:

• The right to choose a primary care physician that works within the PACE program and the right to choose from our network of specialists.
  
  
• The right to request a qualified specialist for women’s health services for preventive or routine care.
  
  
• The right to timely access to a primary care provider and referrals to medical specialists when medically necessary.
  
  
• To be told of any continuing treatments, the name of the provider and time and place of the appointment.

5) Participants have the right to fully participate in decisions about their health and to make informed choices.
This includes:

• The right to be fully informed of his/her health status, how well the participant is doing and the prospects for recovering from an illness or injury.
  
  
• The right to have all treatment choices explained to our participants in a way they understand and to allow them to participate in making and carrying out their plan of care.
  
  
• The right to make health care decisions, including the right to refuse any treatments and to be told of the results that might happen if the participant chooses to refuse treatment.
  
  
• The right for participants to choose a person they trust to act on their behalf if the participant cannot fully participate in his/her treatment decisions or if the participant wants to have someone to help them.
  
  
• The right to be told about any medical risks involved in their treatment and to know whether the treatment is part of a research experiment.
  
  
• The right to have Total Community Care explain Advance Directives to the participant and to complete the form if the participant chooses. This form gives medical providers instructions about the participants’ wishes for medical care in the event that they are unable to make their own decisions.
  
  
• The right to be given notice of any transfer to another treatment setting and the reason why a participant might be transferred.
  
  
• The right to be informed about any medications prescribed, how to take them and their possible side effects.
  
  
• The right to disenroll from our program any time.
  
  
• The right to receive a reassessment by the interdisciplinary team.

6) Participants have the right to privacy and confidentiality of their medical records and personal information.
This includes:

• The right to communicate with any member of the Team or other health care providers in privacy and to have confidentiality protected.
  
  
• The right to have all health care information and personal information protected and remain confidential.
  
  
• The right to review, copy and request changes to their own medical records or personal information.
  
  
• The right to request limits on how we use and share their personal information.
  
  
• The right to request a listing of ways we have shared their personal information.
  
  
• The right to be assured that your written consent will be obtained before releasing personal information to those not authorized under law to receive it.

7) Participants have the right to information and assistance.
This includes:

• The right to get help with a language or communication barrier so the participant can understand all information provided and receive services in a culturally competent manner.
  
  
• The right to qualified interpreter services at no cost to the participants. (Participants have the right to not have to rely on their children, other relatives, or friends as interpreters).

8) Participants have the right to file grievances and appeals.
This includes:

• The right to a full explanation of the grievance and appeals processes.
  
  
• The right to a fair and timely process for solving differences between the participant and Total Community Care
  
  
• The right to be encouraged to voice grievances to Total Community Care staff or outside representatives about the services received without any interference or chance of punishment.
  
  
• The right to appeal any treatment decision by Total Community Care staff or other health care providers including involuntary disenrollment.
  
  
• The right to file a grievance if you feel that any of your rights have been violated. Please contact us directly about your grievance. You can also contact one of the outside agencies as described in our grievance process.