MLTSS Member Rights and Responsibilities
You deserve the best health care. As a member of Horizon NJ Health, you have a partner who will help you get the care you need. Horizon NJ Health will treat you with respect, and there are certain rights you can expect from Horizon NJ Health. There are also responsibilities that Horizon NJ Health expects you to live up to.
You will get a copy of the following Member Rights and Responsibilities when you join Horizon NJ Health. You must sign and return this form, so we can be sure you have read and understand these guidelines.
You have the right to:
- Ask for and receive information on the choice of services and providers available to you.
- Have access to and choice of qualified service providers.
- Be told about all of your rights before receiving chosen and approved services.
- Get services no matter what your race, religion, color, creed, gender, national origin, political beliefs, sexual orientation, marital status or disability.
- Have access to all services that are best for your health and welfare.
- Make your own decisions after being assisted to understand the risks and possible effects of the decisions made.
- Make decisions about your own care needs.
- Help develop and change your own Plan of Care.
- Ask for changes in services at any time, including adding, increasing, decreasing or discontinuing them.
- Ask for and receive from your Care Manager a list of names and duties of any people assigned to provide services to you under the Plan of Care.
- Receive support and direction from your Care Manager to resolve concerns about your care needs and/or grievances about services or providers.
- Be told about a list of resident rights, and receive a copy in writing, upon admission to an institution or community residential setting.
- Be told of all the covered/required services you are entitled to, required by and/or offered by the institutional or residential setting, and of any charges not covered by Horizon NJ Health while in the facility.
- Not to be discharged or transferred out of a facility unless it is medically necessary; to protect your welfare and safety as well as the welfare and safety of other residents; or because of failure, after reasonable and appropriate notice, to pay the facility from available income as reported on the statement of available income for NJ FamilyCare payment.
- Have Horizon NJ Health protect and promote all your rights that are outlined in this document.
- Have all rights and responsibilities outlined here shared with your authorized representative or court-appointed legal guardian.
Along with rights come responsibilities. Here are some of the key responsibilities for MLTSS members:
- Provide all health and treatment-related information, including but not limited to, medication, circumstances, living arrangements, and informal and formal supports, to the Care Manager to identify care needs and develop a Plan of Care.
- Understand your health care needs and work with your Care Manager to develop or change goals and services.
- Work with your Care Manager to develop and/or revise your Plan of Care to facilitate timely authorization and delivery of services.
- Ask questions when you need more information.
- Understand the risks that come with your decisions about care.
- Develop an emergency backup plan for care and services with your Care Manager.
- Report any major changes about your health condition, medication, circumstances, living arrangements, informal and formal supports to the Care Manager.
- Notify your Care Manager should any problems occur or if you are not pleased with the services being provided.
- Pay your room and board in a nursing facility or community residential setting and your cost share on time each month (if applicable).
- Treat service workers and care providers with dignity and respect.
- Keep all Horizon NJ Health documents, such as your Plan of Care, emergency backup plan, etc., for your personal records and future reference.
- Follow Horizon NJ Health’s rules and/or those rules of institutional or community residential settings.