Enrollee/Consumer Rights

All recipients of behavioral health services from NCWBH and its network providers have the right to be treated with dignity and respect and with due consideration for privacy and confidentiality. Medicaid enrollees have additional rights, including access to a Grievance system if they believe their rights have been violated. Service recipients may also access Behavioral Health Ombuds Services for advocacy assistance, including assistance in accessing the Grievance system.

A review of services, enrollee rights, and the grievance system is available in the DSHS Behavioral Health Benefits Booklet. Additional languages are available from the DSHS website.

All NCWBH enrollees have the right to:
1.  Receive information from NCWBH in accordance with 42 CFR 438.10;
2.  Be treated with respect and due consideration of the enrollee’s dignity and privacy;
3.  Receive information on available treatment options and alternatives in a manner appropriate to the enrollee’s ability to understand;
4.  Participate in decisions regarding their healthcare, including the right to refuse services;
5.  Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation;
6.  Request and receive a copy of their medical records, and request amendments or corrections as specific in 45 CFR 164.524 and 164.526.

Individual Rights (per WAC 388-877-0600):
1. Receive services without regard to race, creed, national origin, religion, gender, sexual orientation, age or disability;
2.  Practice the religion of choice as long as the practice does not infringe on the rights and treatment of others or the treatment service. Individual participants have the right to refuse participation in any religious practice;
3.  Be reasonably accommodated in case of sensory or physical disability, limited ability to communicate, limited English proficiency, and cultural differences;
4.  Be treated with respect, dignity and privacy, except that staff may conduct reasonable searches to detect and prevent possession or use of contraband on the premises;
5.  Be free of any sexual harassment;
6.  Be free of exploitation, including physical and financial exploitation;
7.  Have all clinical and personal information treated in accord with state and federal confidentiality regulations;
8.  Review your clinical record in the presence of the administrator or designee and be given an opportunity to request amendments or corrections.
9.  Receive a copy of agency grievance system procedures upon request and to file a grievance with the agency, or Behavioral Health Organization (BHO), if applicable, if you believe your rights have been violated; and
10.  Lodge a complaint with the department when you feel the agency has violated a WAC requirement regulating behavioral health agencies.

Medicaid-recipient Rights:
1.  Receive information and services you ask for covered under Medicaid;
2.  Be treated with respect, dignity, and privacy;
3.  Help make decisions about your care, including the right to refuse treatment;
4.  Be free from restraint or seclusion;
5.  Receive a copy of behavioral health care patient rights;
6.  Receive a copy of your medical records and request that they be amended or corrected;
7.  Receive information on available behavioral health benefits;
8.  File a grievance, appeal, or administrative hearing if you are not satisfied;
9.  Receive a list of crisis phone numbers;
10.  Make changes at any time to your providers or case managers and receive the services of an Ombuds in filing a grievance, appeal, or fair hearing;
11.  Receive services in a barrier-free location (accessible);
12.  Receive the name, address, telephone number, and any languages offered other than English of providers in your BHO yearly or when you request it;
13.  Receive the amount and duration of services you need;
14.  Receive a written Notice of Action from the BHO if services are denied, limited, reduced, suspended, or terminated or you disagree with the plan;
15.  Receive information about the structure and operation of the BHO;
16.  Receive emergent or urgent care or crisis services;
17.  Receive post-stabilization services after you receive emergent, urgent care or crisis services that result in a hospitalization;
18.  Receive age and culturally appropriate services;
19.  Be provided a certified interpreter and translated material at no cost to you;
20.  Receive information you request and help in the language or format of your choice;
21.  Have available treatment options and alternatives explained to you
22.  Refuse any proposed treatment;
23.  Receive care that does not discriminate against you (e.g. age, race, type of illness);
24.  Be free of any sexual exploitation or harassment;
25.  Receive an explanation of all medications prescribed and possible side effects;
26.  Make a mental health advance directive that states your choices and preferences for mental health care;
27.  Receive information about medical advance directives;
28.  Receive quality services which are medically necessary;
29.  Receive a second opinion from a mental health professional in your BHO area if you disagree with your provider;
30.  Choose a provider for yourself and your child (if your child is under 13 years of age); and
31.  Request and receive a copy of your health records. You will be told the cost for copying

Client Responsibilities include:
1.  Provide accurate financial, medical and mental health information both at intake and during the course of your treatment. This includes any changes in address, telephone number, or other contact information;
2.  Notify the Behavioral Health Agency providing services at least 24 hours in advance if you must cancel a scheduled appointment;
3.  Not terminate treatment without first discussing your reasons for wanting to end your care with your Mental Health Care Provider.

 

Printable statements of rights:
English
Spanish
Russian
Ukrainian