Rights and Responsibilities

Your Rights

You have the right to choose the Brokerage you work with.
There are currently six (6) Brokerages serving customers in the Portland Metro area. They include:

  1. Independence Northwest (Washington, Clackamas and Multnomah)
  2. Self Determination Resources Inc. (Washington)
  3. Mentor Oregon Brokerage (Washington, Clackamas and Multnomah)
  4. Inclusion Inc. (Clackamas and Multnomah)
  5. Community Pathways (Clackamas and Multnomah)
  6. UCP Connections (Clackamas and Multnomah)

You are currently receiving services from Independence Northwest, but you have the right to choose to transfer to one of the other brokerages. Just let us know and we can help you switch agencies.

You have a right to choose your Personal Agent
Now that you have been referred to Independence Northwest, you have been assigned a Personal Agent (PA) who will assist you in developing your plan.  If you are unsatisfied with this arrangement for any reason, you can always choose to switch to an available PA who you feel more compatible with.  To switch PAs, contact your Personal Agent’s supervisor. Call our front desk and you’ll be redirected to the appropriate person.

You have the right to a written plan within 60 days of entering brokerage services
Your plan of support must be written and include specific information such as your name, your goals, the support you need and how you will get it.  Your written plan will also include a budget for expenditures you plan to use with your support service funds.  Once your PA assists you in creating this plan and you or your legal guardian have signed it to indicate you agree with what is written, it must then be approved by a brokerage administrator before any plan dollars can be spent.  Once approved, your PA can assist you in implementing the plan.

You have the right to a Person Centered Plan
Your plan is about you and what you want and need.  Your PA will utilize “person-centered” planning techniques in her/her discussions with you to make sure that your plan is truly for and about you. If you would like a formally facilitated Person Centered Plan, speak with your PA and we will arrange one for you.

You have the right to review and revise your plan
Once completed and approved, your PA will give you a copy of your plan.  You have the right to review and change your plan at any time.

You have a right to work with providers who are qualified
Once you decide what you need on your plan, you have the option of choosing from a pool of providers to meet those needs.  You have the right to make sure the people who are helping you meet your needs are qualified to do the job.  Your PA will assist you in making a proper service agreement (job description or contract) with your provider.  The service agreement is a document signed by you and your provider that outlines your expectations of that provider and how they will best work with you.  In addition, providers must go through a qualification process to assure the following:

  1. Anyone (including a relative) that is being paid through your plan must complete a Criminal History Records Check and must pass the check through Oregon’s Department of Human Services Criminal Records Unit.
  2. They must confirm their understanding of their responsibilities as a Mandatory Abuse Reporter.
  3. They must be able to legally work in the United States.
  4. If driving, they must have proof of car insurance on record as well as a current and valid driver’s license.  If they are not planning on driving you somewhere as part of their services, they must sign a driving waiver.
  5. They must sign a confidentiality statement, meaning they cannot discuss anything about you or your family without your written consent (Release of Information).
  6. If the caregiver or provider is a licensed professional (such as a Speech Therapist or Psychologist), we must obtain a copy of their license.
  7. They must be able to effectively help you get the services you want.
  8. They must report any and all injuries and accidents that may happen while working with you ( via Incident Report) to your PA.

You have the right to direct your services
As a customer of Independence Northwest, you are in control of what your plan says, how much your providers get paid and how to best monitor the services being delivered.  You, or a representative of your choosing, may initiate and engage in direct contact with your Personal Agent at any time to address any issue that is important to you.

You have the right to be safe from abuse
All Independence Northwest staff and the providers who work for you are Mandatory Abuse Reporters according to Oregon’s law.  This means that if we witness, suspect or receive a report of someone hurting you physically, verbally, sexually or financially, we are obligated to report the abuse to the county protective services office or to the local authorities.

You have the right to move within the state of Oregon without losing services
Oregon has Support Service Brokerages covering the entire state.  If you move or are planning to move to a new county, your PA can assist you in transferring your plan and services to a brokerage serving your new county of residence

You have the right to withdraw from services
You have the option of declining services if you decide you don’t want them.

You have the right to be notified of termination of services
If, for some reason, services must cease (budget cuts, closure of programs, you lose eligibility) you will be notified in writing.

If your PA cannot get in touch with you for your annual plan renewal (for example, the PA receives no response from you or your family), they are required to send you a letter requesting communication within 30 days of receiving the letter.  If they do not receive a response after 30 days, your file will be closed and you will be exited from our services.

You have the right to file a complaint with Oregon Office of Developmental Disabilities Services.
If you are ever unhappy with any of your services through the brokerage, you can always file a formal Complaint with the Oregon Office on Developmental Disabilities Services.  Your PA can give you a form to fill out and assist you in finding the appropriate person to talk to.

You have a right to file a grievance or concern with Independence Northwest
If you have a problem with your services at Independence Northwest, you should:

  1. First, contact your Personal Agent.
  2. If your PA can’t help you or you don’t feel comfortable addressing the issue with him/her, you can contact your PA’s direct supervisor.
  3. If you are dissatisfied with this outcome, you can contact Independence Northwest’s Executive Director. The Executive Director will investigate the facts supporting or disproving the grievance and will take appropriate actions on grievances within five working days following the receipt of the grievance.  The Executive Director will then review the grievance and provide a written response within fifteen days following the receipt of the grievance.
  4. If you are not satisfied with the outcome, you may file a formal complaint with the Oregon Office on Developmental Disabilities Services.


Your Responsibilities

You have the responsibility to direct the development of your individual support plan
Your PA will assist you by giving you information, but you are the one who should decide what goals and support needs are included in your plan.

You have the responsibility to participate in your services
You have the responsibility to be actively involved in Support Services on at least a monthly basis.  You can do this by receiving planned services (such as a service from a provider) and/or by staying in touch with your Personal Agent.   In addition, you must participate in direct contact (phone or in person) with your Personal Agent at least twice a year.

You have the responsibility to understand the limitations of the plan
The brokerage system is governed by rules set forth by Medicaid and the state of Oregon.  There are some things your plan cannot pay for according to those rules.  Your PA will help you learn what can and cannot be paid for through your plan and help you find other ways to get your needs met in the circumstances a need cannot be funded through plan dollars.

You have the responsibility to authorize services being delivered to you
In addition to authorizing your plan by signing it, you will be expected to sign off on all timesheets or invoices your providers submit for payment. Your signature verifies that your provider worked with you on the dates and times they claim on their invoices and allows you and your PA to monitor their work to ensure they are fulfilling their obligations agreed upon in the service agreement. We strongly suggest developing a system of signing in and out with your providers each time you visit together.

You have the responsibility to ensure that services being provided to you are considered a social benefit
All plan dollars spent must be a social benefit. A social benefit describes a service intended to assist an adult with disabilities to function in society on a level comparable to that of an adult who does not have such disability.  Services must be essential and are linked to your unique disability-related needs.

You have the responsibility to be aware of the funding in your plan and ensure it is being used properly
Your PA will explain to you how much support money you are eligible for and your options for meeting your needs.  You are responsible for letting your PA know what you need and whether or not you feel your plan dollars are adequately meeting those needs.

You have the responsibility to let your Personal Agent and any providers you work with know about any health issues you might have that require special supports.
If you have any serious medical risks such as diabetes, seizures, aspiration, constipation or dehydration, you will be responsible for working with your Personal Agent, your healthcare provider and your providers to develop protocols so you are receiving the best care possible in case of emergency.

You have the responsibility to be available for your annual ISP (Individual Support Plan) planning and signing.

You have the responsibility to let Independence Northwest know if you are dissatisfied with your services.
We want to serve you in the best way possible.  If you are unhappy with the way things are going with your plan or services, please let us know.

Updated 07.2013

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