Your Rights as a Client of A Caring Alternative, LLC.
WHAT ARE MY RIGHTS?
When you receive services from A Caring Alternative you have certain rights and
responsibilities. One of these rights is that you be informed of your rights
upon initiation of services. The information below will tell you about your
rights and responsibilities and what to do if you have questions or problems.
You are requested to please read (or have read to you) these rights and ask any
questions you may have. You will also be requested to sign a form stating you
have been informed of your rights.
What is a right? A right is something you can do by law.
What is a responsibility? A responsibility is something that you agree
to do to the best of your ability.
What is a rule? A rule is something set up in a program unit so things
will run smoothly.
What are rightsí restrictions?
Rightsí restrictions limit or take away a personís right to do something. A
personís rights should be restricted as a last resort and only after other
positive behavioral supports have been tried and have failed. Rightsí
restrictions cannot and should not be imposed on people without safeguards to
protect those rights. This does not mean that individual rights can never be
restricted. Due process must be in place before a personís rights are restricted
in any way except in real emergency situations. Any restrictions of your rights
must be part of your current Person Centered Plan. The agencyís Human Rights
Committee must approve any restrictions before they are used, except in
emergency situations. All restrictions must be time-limited and reviewed
periodically for reauthorization by a qualified professional.
What is due process?
Due process is a set of procedural safeguards to protect individual rights.
Before a personís rights can be restricted in any way, due process must be in
place to protect the person. The type and extent of due process used depends on
which right is being restricted. The greater the impact that the restriction has
on a personís life, the greater the requirement is for review and protection.
The personís participation in this decision making is an important part of due
Guidelines for using due process when
considering rights restrictions:
- A personís need should guide
- Restrict only specific rights.
- Use the least amount of restriction
- Always obtain consent and approval.
- Plan for review and reinstatement of
- Each the person what it takes to have
YOUR RIGHTS are guaranteed by Law
We have laws in North Carolina which protect the rights of persons receiving
mental health, developmental disabilities or substance abuse services. These
rights apply to services provided by A Caring Alternative and by other providers
of behavioral healthcare services in the state. (These rights are found in North
Carolina General Statutes 122C, Article 3.) It is the service providerís
responsibility to inform you of your rights within the first three visits to a
program (or within 72 hours if you receive service in a 24-hour facility). Any
program-specific rules must be explained at that time as well. Unless you have
been declared legally incompetent by a court, you may exercise all your civil
rights. This means that you may buy or sell property, make purchases, register
and vote, marry and divorce, bring civil actions, enter into contractual
relationships and sign legal papers.
You have basic HUMAN RIGHTS
It is our policy to assure your right to dignity, privacy, humane care and
freedom from mental and physical harm, abuse, neglect or exploitation is
You have a right to dignity, privacy, humane care, and freedom from
physical punishment, abuse, neglect or exploitation. Definitions of abuse,
neglect and exploitation are as follows:
Physical Abuse: any action that
results in physical injury or pain such as spanking, hitting, rough
treatment or unauthorized use of physical or mechanical restraints.
Psychological/Emotional Abuse: any action or threat that may cause an
individual to feel humiliation, harassment, deprivation, or intimidation.
Verbal Abuse: any action that belittles or threatens an individual.
It may include oral, written, or gestural use of language as well as the use
of profanity, calling people by inappropriate names, and/or referring to
adults with childlike references.
Sexual Abuse: non-consensual sexual activity of any kind. Any sexual
contact between an employee of A Caring Alternative and a person receiving
services is strictly forbidden, whether consent was present or not.
Neglect: any action or absence of action that fails to provide proper
care or treatment in a safe environment.
Exploitation: any illegal or improper use of a consumerís resources
for another personís profit or advantage.
You have a right not to be discriminated
against in the provision of services on the basis of age, sex, ethnic
background, religious preference, financial condition, sexual preference, or
You have a right to live as normally as possible while receiving services
from A Caring Alternative. A Caring Alternative has no restrictive rules or
regulations that you are expected to follow while receiving services from A
You have a right to befree of the following interventions prohibited by
- Corporal punishment;
- Contingent use of painful body
- Substances administered to induce
painful bodily reactions;
- Electric shock;
- Insulin shock;
- Unpleasant tasting foodstuffs;
- Contingent application of any noxious
substances which include but are not limited to noise, bad smells or
splashing with water; and
- Any potential physically painful
procedures or stimulus administered for the purpose of reducing the
frequency or intensity of a behavior.
You have a right to be informed of the agency's on-call service. You may
receive some of your services when our office is not open (before 8:00 a.m.,
after 5:00 p.m., or on weekends). Each service department has been provided a
crisis phone so that you or your worker may contact them during scheduled hours
of service when the office is closed.
You have a right to know the names and qualifications of all people
involved in your care. You may also request a change in the professionals who
provide you services.
You have THE RIGHT TO BE FREE FROM UNNECESSARY PHYSICAL RESTRAINT AND
Some services may be authorized to use restrictive interventions (i.e. an
approved restraint) to control dangerous behaviors. You will be informed about
these approved interventions if the services you receive involve the use of any
restrictive interventions. To protect our service recipients, there are very
strict rules governing staff conduct when a restrictive intervention is used.
You have the right to refuse any planned restrictive interventions.
Only A Caring Alternative authorized and trained staff may use restrictive
interventions if it is an emergency situation and the individualís behavior is
perceived as being dangerous to him/herself, to other people, to property or if
is determined, based on very strict rules, that it is necessary for the personís
care. Special safeguards must be in place when these interventions are used, and
service recipients or their guardians have the right to request that a
designated person be notified.
Some emergencies may require law enforcement assistance or initiation of
involuntary commitment procedures. These interventions and protective devices
(used in a few programs) may never be used as retaliation, for the convenience
of staff or in a manner that may cause harm or undue discomfort to the
At no time is corporal punishment allowed. Staff must protect service recipients
from harm in the treatment setting and must report any suspicion of abuse,
neglect or exploitation.
You have THE RIGHT to confidentiality.
You have a right to confidential treatment based on state and federal laws. The
very fact that you are receiving services or any other information about your
care is confidential. These same laws also require us to share information with
others under the following conditions:
- When you give us written permission,
we may share information with any person that you name;
- Your next of kin or other family
members with a legitimate role in your services may receive certain
information about your services, if it is in your best interest; and if
you are under 18, your parents may be informed about your care when it
is in your best interest and not considered to be harmful;
- When a doctor needs information to
provide emergency treatment;
- To other professionals when necessary
to coordinate appropriate and effective care;
- If we transfer your care to another
- If we are ordered by the court to
release your record;
- If an attorney needs information from
your record because of a suit, a commitment proceeding, or guardianship
- If you become imprisoned, we may share
your files with prison officials;
- When a client advocate has been
assigned to work on your behalf;
- When a staff member suspects abuse or
- If we have reason to believe you are a
danger to yourself or others, or if we believe that your are likely to
commit a crime, we may share this information with law enforcement
- When a child is receiving services and
his/her parents are divorced, both biological parents may have access to
their child's record unless parental rights have been terminated; and
- For the purpose of audits and program
evaluation by internal or external sources.
A Caring Alternative maintains a computer
system for billing and statistical purposes. Security measures are maintained to
abide by all confidentiality regulations and laws. All A Caring Alternative
staff sign statements, which obligate them to maintain confidentiality on all
information according to all regulations and laws.
You have THE RIGHT to privacy.
You have the right to be free from any unwarranted search of your person or
property. Some service programs in the Provider Network have special procedures
about Search and Seizure which will be explained to you if you receive services
from these programs.
You have the right to exercise all civil rights and only if you have been
declared incompetent, can these rights be restricted.
You have a right to receive a free appropriate education. All US citizens
have a right to be educated in a non-segregated setting within the public school
You have a right to work. Laws protect individuals from discrimination
based on specific characteristics unrelated to job performance ability
(Americans with Disabilities Act). People cannot be paid less money than others
would be for the work they do.
You have a right to be heard in court, to bring lawsuits, to have the
representation of an attorney, to bring witnesses on your behalf. This is known
as ďdue process.Ē
You have a right to free speech and expression. Everyone has the right to
speak up for him or herself and to express himself or herself in the manner they
You have the right to equal access to treatment for all persons in
need regardless of race, ethnicity, gender, age, sexual orientation, or sources
You have THE RIGHT to an Individualized Person centered Plan.
You have the right to take part in the development and periodic review of your
individualized Person Centered Plan. This plan must be in use no later than 30
days after your services start. You have the right to request a copy of your
Person Centered Plan. You have the right to receive services in the least
restrictive environment possible that is appropriate for your age and situation.
You have the right to request an accommodation for individual needs. Examples of
accommodations include but are not limited to: transportation, specific staff,
Sign Language Interpreter, Foreign Language Interpreter, etc. To request an
accommodation, please notify ACA staff of your needs.
You have the right to receive services from A Caring Alternative if you
meet the following admission criteria:
- A Caring Alternative has the resources to
staff and supervise the services you receive;
- Your needs can be safely and adequately
met in the service location;
- You live in the geographic area served by
A Caring Alternative;
- A Caring Alternative can provide the
services within the time lines established by the contracting agency/funding
- Your safety as well as the employees'
safety can be assured within the service location;
- You agree to receive the services.
You have THE RIGHT to be informed about
If medication is part of your agreed upon Person-Centered Plan, only a physician
will prescribe necessary medication based on accepted medical standards. You
have the right to know the risks, benefits and alternatives to medication.
You may refuse to take medications, but you will be informed of the risks of
You have THE RIGHT to accept or to refuse Treatment
Before you agree to your individualized Person Centered Plan, you will be
informed of the benefits and/or risks involved in the treatments and services
you will receive. You have the right to consent to your individualized Person
Centered Plan and the right to withdraw consent at any time. You will be
informed of the risks of refusing treatment/service. There are situations (i.e.
if you are a risk to yourself or others) when you may be legally required to
You have a right to the extent allowed by law,to accept or refuse all
- In an emergency;
- If your treatment has been order by the
- If you are under 18 years old, your
parents can give permission even if you object.
- IF you are voluntarily admitted you or
your legally responsible person has the right to consent to or refuse any
treatment offered. Consent may be withdrawn. If treatment is refused, the
qualified professional will determine if other treatment modalities are
possible. If all appropriate treatment modalities are refused, you may be
You have THE RIGHT to be free from
unjustified suspension or termination of services.
Each consumer should be free from the threat or fear of unwarranted suspension
or expulsion from a facility. Suspension/discharge from services should only
occur upon the recommendation of the consumerís Person Centered Planning team
and review and agreement by the Agency Director. You have a right to be free
from unwarranted suspension or expulsion from services. Suspension of services
will occur only if your safety or the safety of A Caring Alternative staff
cannot be assured. A Caring Alternative and the lead agency will make every
effort to correct the reasons resulting in suspension. If after two weeks your
or the employees' safety cannot be assured, then you will be expelled from
services. You may be re-admitted for services when your safety or the employees'
safety can be assured.
You Have a Right to be Informed of A Caring Alternative Discharge Criteria.
A Caring Alternative will terminate services based on the following criteria:
- If your condition deteriorates
(physical/behavioral) to the degree that your needs cannot be adequately met
by A Caring Alternative resources;
- If you refuse to participate in services
as determined by your individualized plan of care;
- If all relevant goals are accomplished and
need for services no longer exists;
- If you no longer meet the eligibility
requirements of the sponsoring funding source as determined by the lead
- If you move out of the geographical area
served by A Caring Alternative;
- If you choose to discontinue services;
- Failure to pay for services provided (if
You Have the RIGHT to Access Self Help
Groups within your community.
Please use the following contact information for your resources. If you wish
to obtain additional resources for your county please request this from A Caring
- Burke County Health Department
- Burke County United Way 828-433-0681
- Salvation Army 828-430-8392
- Burke United Christian Ministries
- Transportation Assistance 828-439-0867
- Good Samaritan Clinic 828-439-9948
- Burke Council on Alcoholism and Chemical
- Western Regional Vocational Rehabilitation
- United Way 704-324-4357
- Vocational Rehabilitation 828-328-2331
- Salvation Army 828-322-8109
- Catawba County Health Department
- Social Security Administration
- United Way 828-758-9300
- Caldwell County DSS 828-757-1180
- Caldwell County Health Department
- Yoke Fellow Christian Service Center
- McDowell County DSS 828-652-3355
- McDowell Mission Ministry 828-689-3981
- Vocational Rehabilitation 704-245-1223
- McDowell County Health Department
- Alexander County DSS 828-632-1080
- Alexander Health Department 828-632-9704
- Christian Crisis Center 828-632-0022
- Emergency Management 828-632-2241
- Vocational Rehabilitation 828-328-2331
You have THE RIGHT to see your own record.
If you wish to see your record, you have the right to do so under certain
circumstances specified by law and according to agency procedures. You have the
right to have those circumstances and procedures explained to you. Your
therapist or case manager must be present to answer your questions. You have a
right to review the information in your record with a staff person unless more
than one professional determines that it would be harmful for you to have it.
You have THE RIGHT to know the cost of services.
Fees for services should be discussed with you at your first visit. If this does
not occur, please let us know. A listing of charges for services is available to
you upon request. You may appeal the fee set for services by completing a
request for reduction of fees. If you are covered by health insurance, you will
need to contact the insurance company for specific information (i.e.
co-payments, covered services and other terms and conditions that may affect
your reimbursement) regarding your particular coverage. You have a right to know
the costs of services. If the area program or the Department of Social Services
refer you, A Caring Alternative does not charge you any fee for the services we
provide. If you have a Medicaid deductible, services you receive by A Caring
Alternative may be used to meet part or all of your deductible. If services are
used to meet your Medicaid deductible, you may be asked to pay this directly to
A Caring Alternative.
YOUR RIGHTS in a 24-Hour Facility
You are guaranteed additional rights by NC State law and by the Division of
Mental Health, Developmental Disabilities and Substance Abuse Servicesí rules
when you are living in a treatment facility in the community. These rights must
be shared with you within 72 hours after entering the facility.
At the time of admission to a 24-hour facility,
staff may search you and your belongings to prevent dangerous or illegal
substances from being brought into the facility. If there is reasonable belief
that dangerous or illegal substances are present, then the facility itself may
be searched. Staff may also search individuals who are minors.
YOUR RIGHTS as an ADULT Living in a 24-Hour facility
Rights (1 -4) may not be restricted (limited or taken away). Rights (5 Ė 23)
may be restricted under some circumstances related to your treatment by the
qualified professional responsible for your services. There is a special
procedure to establish a restriction.
You have the right to:
- Prompt medical treatment when you are
ill and for medical services for prevention of illnesses. (You or your
insurance company may be billed for medical care beyond the facilityís
- Send and receive unopened mail and
have access to writing materials and assistance from staff with written
communications and postage.
- Contact and consult with a doctor,
lawyer, advocate or other private professional at your own expense.
- Make and receive confidential calls.
You can ask people to leave the room or not to listen when you are
talking on the phone. Long distance calls will be at your expense or
- Have visitors on a regular basis.
- Meet with people you choose under
- Have the right to make visits outside
the facility unless you have special circumstances related to your
- Be outside daily and have access to
facilities and equipment for physical exercise several times each week.
- Keep and use personal clothing and
possessions except as prohibited by law. (The facility will help you to
develop and maintain an inventory of clothing and possessions to prevent
- Participate in religious worship of
- Keep your driverís license unless
prohibited by law.
- Have individual storage space for your
own private use.
- Privacy in the bathroom and adaptive
equipment, if needed.
- Dignity, privacy and humane care in
the provision of personal health, hygiene and grooming care. You will
have the opportunity for a shower or tub bath and to shave on a daily
basis. Personal hygiene articles will be provided if you cannot afford
- Receive regular services of a barber
- Have a quiet atmosphere for
uninterrupted sleep during scheduled sleeping hours. Unless determined
inappropriate by the treatment team, the facility will provide areas
accessible for personal privacy for at least limited periods of time.
- Keep and spend a reasonable amount of
your own money.
- Decorate your own room within
- Have opportunities for social
integration in the community. You may participate in community
activities of your choosing.
- Attend your Person Centered Planning
team meetings and make suggestions concerning your care.
- Help make rules for your program.
- Be free from unnecessary medication.
- Receive an individualized written
discharge plan containing recommendations for further services. The
discharge plan will be given to you or your legally responsible person.
YOUR RIGHTS as a MINOR residing in a 24-Hour
If you are a minor in a residential facility, you have the following
You have the right to:
- Adult supervision and guidance.
- Access to opportunities to mature
physically, emotionally, intellectually, socially and vocationally.
- An appropriate level of structure,
supervision and control.
- Treatment separate and apart from
adult service recipients, when practical.
- Communicate with your parents or the
guardian, agency or individual having legal custody.
- Special education and vocational
training in accordance with federal and state laws.
If you are an ADULT or a MINOR who is
receiving services in a day/night or 24-Hour program, you have two special
rights which relate to social integration and self governance.
You have THE RIGHT to:
- Participate in appropriate and
generally acceptable social interactions.
- Provide input into program operations
and rules to the extent possible, given your length of stay.
In North Carolina, an advanced instruction for mental health treatment is a
legal document that tells doctors and health care providers what mental health
treatments you would want and what treatments you would not want if you later
become unable to decide for yourself.
The designation of a person to make your health care decisions, should you be
unable to make them yourself, must be established as part of a Health Care Power
of Attorney. Further information can be requested from the person in charge of
your care or from A Caring Alternative.
You have the right to disagree with the clinical decision made by A Caring
Alternative clinical staff to:
- Deny a request for services and
- Reduce, suspend or terminate a current
Medicaid provides consumers who receive
Medicaid funding with an appeal process that follows Federal and State laws and
helps to resolve disagreements.
A Caring Alternative or approved service provider will evaluate your treatment
needs. Sometimes evaluations show that a person who requests a specific service
may not benefit from or be eligible for that service. Evaluations may also show
that a person who is receiving a service may no longer need it. When either of
these clinical decisions is made, the agency must inform you in writing.
The letter contains the reason for the decision, the laws that support your
appeal rights and the appeal steps and deadlines. The complete appeal process is
outlined in the Medicaid Appeal Rights policy which can be
accessed from any A Caring Alternative, LLC office.
A Caring Alternative RULES Related to Service Recipients
The following rules apply to all programs and
- All programs and buildings are
maintained as smoke free environments. Smoking is not allowed in agency
- As in all public buildings, no
weapons, drugs or alcoholic beverages are permitted on the premises.
- Sometimes service recipients who are
eligible for transportation services are transported in agency vehicles.
Adults must wear seatbelts and children, depending on their age, must be
seated according to state and federal law.
- Depending on the circumstances, your
failure to follow rules might result in suspension or dismissal from a
We want to partner with you to help provide you with the best and most
appropriate services possible and to protect your rights. In turn, we ask that
you accept these responsibilities:
- Know and understand that you choose
your treatment and service providers. Let us know who you prefer to see.
- Give us all the facts about the
problems that bring you to us for help along with a list of all other
doctors providing care for you.
- Participate in the development of your
Person Centered Plan, and do your best to follow your plan.
- Keep appointments and attend all
activities that are part of your individualized Person Centered Plan. It
is required that you arrive on time for all group and individual
- Call and let us know if you cannot
keep an appointment. Failure to meet scheduled appointments will be
identified as non-compliance.
- Participation in any illegal or
suspicious activity or acting out, or defacing A Caring Alternative
property will not be tolerated. Any threat or act of violence directed
toward staff, other clients, or visitor to the clinic is grounds for
immediate dismissal from the program. Any individual dismissed under
these circumstances will be barred from reentry for one (1) year and
must have approval from the staff and President.
- Selling, giving away, or using drugs
on A Caring Alternative premises will be defined as non-compliance and
will result in an immediate discharge.
- If you have Medicaid or Medicare,
please bring your card each time you come in for an appointment.
- Known or suspected abuse or neglect
will be reported immediately.
- Spouses, family members, or
significant others will be permitted to participate in your treatment
with your expressed permission and consent.
- You are encouraged to discuss with
your assigned staff any sexual and/or physical abuse, with expectation
of a referral to the most appropriate service provider for assistance.
- Let us know about changes in your
name, insurance, address, telephone number or your financial status.
- Be responsible for the fee you have
agreed to pay. Let us know if you have problems making payments.
- Be considerate of our staff and other
people you may meet in our offices.
- Respect the rights and confidentiality
of our other service recipients. You will be expected to honor the
Federal Confidentiality Law.
- Tell us how you feel about the
services you receive. ACA would like to receive feedback in regards to
the services you are receiving. This information will be collected
though ACAís quarterly surveys. In addition to the surveys, please
utilize our consumer suggestion boxes which are located in the lobby of
all office locations.
- Tell us if you have a concern or
complaint about your services.
A Caring Alternative Consumer Rights
A Caring Alternative (ACA), serving Burke, Catawba, Caldwell, McDowell and
Alexander Counties, has established a Client Rights Committee (CRC) to manage
the operational oversight of client rights issues. The CRC is charged with
ensuring the protection of client rights for all consumers served by A Caring
Alternative. The CRC is made up of volunteers who donate their time and energy
to ensure that client rights are upheld. Members represent specific disability
areas and ages and work together across the disabilities. CRC members are
appointed by ACA President. All CRC meetings are open to the public.
For further information on client rights or the ACA Client Rights Committee
please contact ACA Quality Assurance Director at (828) 437-3000.
You Have THE RIGHT to Make a Complaint
A complaint is an oral or written expression of concern regarding rights,
services or administrative issues that the person making the complaint believes
is a problem.
You have the right to make a complaint if you are not satisfied with your
services. The Division of Mental Health, Developmental Disabilities and
Substance Abuse Services has created a statewide complaint process that is used
by all Local Management Entities in North Carolina to resolve complaints from
consumers about rightsí violations, clinical service decisions and
administrative issues and service quality. We want to know your concerns, and we
try very hard to resolve everyoneís complaints. While it is the intent of this
agency and our employees to provide quality services to you, there may be times
when you are dissatisfied. If you have complaints about your services, you
should contact A Caring Alternative supervisory staff at the office located in
your area. Your complaint will be investigated within 72 hours and a response
will be given to you within (5) working days. If you make a complaint about
services, you will not be subject to discrimination or reprisal. Documentation
of your complaint and the resolution of your complaint will be maintained in the
A Caring Alternative office.
If you are not satisfied with the resolution of your complaint,you have a
rightto file a grievance. Please contact the Team Leader from the department in
which you receive services in order to discuss your concern(s).
- Community Support Services: (828) 437-3000
- Community Support Team Services: (828)
- Intensive In-Home Services: (828) 437-3000
- Targeted Case Management: (828) 430-4388
- Day Treatment Services: (828) 413-2251
You may also express your grievance in writing by sending a letter to:
A Caring Alternative
PO Box 1536
Morganton, NC 28680
A Caring Alternative will respond to your
grievance within ten (10) working days from receipt of the grievance.