As a member of EBCI Tribal Option, you have certain rights and responsibilities. Providers must also adhere to these rights and responsibilities when providing services and supports to you.

Your rights:

Right to considerate and respectful care

You have the right to:

• Expect that we will respect your dignity and privacy as you utilize our care, services, and providers.
• Expect that we will respect your values and beliefs. We will support your beliefs as long as they do not hinder the well-being of others or your planned course of care.
• Be cared for and supported with respect without regard to health status, sex, race, color, religion, national origin, age, marital status, sexual orientation, or gender identity.
• To report abuse, neglect, discrimination, or harassment to any healthcare worker, manager, or executive director.

Right to information

You have the right to:

• Diagnosis, treatment, and prognosis, except in emergencies in which you lack decision-making capacity and the need for treatment is urgent.
• Discuss and request information related to specific procedures and treatments, including risks involved and reasonable alternatives, and have the information interpreted, when necessary. You or someone you choose will have access to this information, which will be interpreted as necessary, except when restricted by law.

Right to decide or refuse treatment

You have the right to:

• Take part in planning your care and having an active role in the person-centered plan, including the right to refuse treatment, support, or recommendations at any time.
• Be consulted if a doctor wants you to take part in a research program or donor program, and make your own choice whether or not to do so. You will receive quality care and support whether you choose to take part or not.

Right to privacy

You have the right to:

Every consideration of privacy. Discussion of your care, consultations, examinations, and treatment will be conducted privately and discreetly. Individuals not directly involved in your care must have your permission to be present.

Right to confidentiality

You have the right to:

Expect that all communications and records pertaining to your care will be treated as confidential (except in cases of suspected abuse and public health hazards) when reporting is required by law.

Right to reasonable response

You have the right to:

Obtain second opinions or request external assistance in accomplishing your care plan goals. You may include family, friends, and advocates on your care team to assist you with understanding and addressing your identified care support needs.

Right to continuity of care

You have the right to:

• Reasonable continuity of care. You have the right to know in advance what appointment times and physicians are available.
• Expect that your providers and other support agencies will keep you informed of your continuing healthcare requirements following discharge.

Right to advance directive

You have the right to:

• An Advance Directive, such as Five Wishes, a Living Will, or Healthcare Power of Attorney. These documents express your choices about your future care or name someone to make decisions if you cannot speak for yourself. A copy of the Healthcare Power of Attorney will be required whenever that person is making decisions on your behalf.
• Receive information and assistance in the formulation of an Advance Directive. You can receive this help by contacting your Primary Care Provider, Care Manager, or EBCI Tribal Option Member Services.

Right to knowledge of policies and practices affecting your care

You have the right to:

• Be informed of our policies and practices that relate to your care and services.
• Voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment, and services.
• Be informed about resources for resolving disputes and grievances. If your concerns are not resolved with EBCI Tribal Option, you may report them to the NCDHHS Department of Civil Rights.
• Contact the NC Medicaid Ombudsman any time you feel you have not been treated fairly.

Right to an interpreter

You have the right to:

• An interpreter, translation services, or other forms of communication if you do not speak English or if you have trouble reading or hearing.
• A minister/spiritual advisor of your choice.
• Present your concerns, receive spiritual care, and receive advice concerning ethical issues related to care, discharge planning, and money matters concerning care. You can also receive help with protection from abuse, discrimination, and neglect. You can report your concerns to your Primary Care Provider, your Care Manager, EBCI Tribal Option Member Services, or by visiting EBCI Tribal Option’s website.

Your Responsibilities:

• Provide correct and complete reports about your health.
• Let your doctor and Care Manager know if you do not understand the plan for your care and services or your role in that plan.
• Participate in your plan of care and services prepared by you, your PCP, and your care team.
• Understand the fact that you may cause your health to become worse if you refuse treatment or do not follow your care plan.
• Report changes in your health and keep your appointments.
• Consider the needs and feelings of other patients and members of your care team.
• Provide an Advance Directive (Five Wishes, Living Will, or Healthcare Power of Attorney) if you have one.

Rights and responsibilities for pediatric members and their families:

In addition to the rights and responsibilities listed above, the following rights and responsibilities apply to pediatric patients (individuals under 18 years of age):

You have the right to:

• Receive timely reports about your care that you can understand.
• Emotional support.
• Grow, play, and learn.
• Make your own choices when you are able.

Families’ Responsibilities:

• Provide correct, complete reports about your child’s health.
• Give your child the care he or she needs.
• Think about and respect the rights of other patients, families, and other members of the care team.