Sycamore Participant- Individual Rights and Responsibilities

AUDIO/ASL – PARTICIPANT INDIVIDUAL RIGHTS AND RESPONSIBILITIES

INDIVIDUAL RIGHTS AND RESPONSIBILITIES

It shall be the policy of Sycamore Services, Inc. to have a statement of individuals’ rights to preserve the human rights, dignity, and safety of individuals receiving services through Sycamore Services, Inc. Sycamore Services, Inc. shall ensure that an individual’s rights as guaranteed by the Constitution of the United States and the Constitution of Indiana are not infringed upon.  These rights will be made available to all individuals and shall be explained to all individuals in their mode of communication or, when appropriate, their parents/guardians/provider.

Procedure:

All individuals receiving services through Sycamore Services, Inc. shall have the following rights:

  1. To be informed, in writing, before or at admission and on an annual basis of his/her rights and responsibilities while receiving services through Sycamore Services. If the individual is unable to read the document, the document shall be interpreted to him/her and/or parent/guardian/advocate in a manner that is understandable to the individual. A written acknowledgment must be witnessed by a third person. If an individual has a guardian, the guardian shall also be required to sign the form to indicate his/her receipt, review and understanding of the information. When changes or additions are made to the above rights and responsibilities, the participant shall be likewise informed.
  2. To active and ongoing participation in the selection of relevant services available through Sycamore Services that are habilitative and supportive toward his/her chosen lifestyle and projected level of independence as documented in his/her Individual Service Plan. Each individual shall be given the opportunity to participate in planning his/her individual services, including program goals and objectives. Each individual and/or guardian has a right to a copy of that plan and any subsequent documentation of changes to that plan.
  3. To advance notification prior to the transfer to any other program within Sycamore
  4. To refuse treatment and services, and be informed of all risks of treatment and services.
  5. To be encouraged and assisted throughout receipt of any services to exercise his/her rights as a citizen including individual rights as set out in Indiana Code are not infringed upon and an individual has the ability to exercise those rights as provided in Indiana code. Individual is  free from discrimination in the provision of Right to have alleged violations of rights investigated, to voice grievance and recommend changes in policies, procedures, and services to facility staff and/or outside representatives of his/her choice free from restraint, interference, coercion, discrimination or reprisal.  (See Grievance and Appeal policy and Investigation Policy).
  6. To regularly see a doctor, at their own expense, and to proper medical care including but not limited to be free from unnecessary medications and restraints, reduction of individual’s dependence on medications and restraints as agreed by physician and/or (Individual Support Team (IST).
  7. To be free from abuse, neglect and exploitation. (See Abuse & Neglect policy).
  8. To be free from any restrictive behavioral procedures including physical, medical and chemical restraints, removal of personal property, or seclusion. (See HRC, Restrictive Interventions, and Behavioral Emergency – Imminent Danger Policies).
  9. To be free from exclusion of services except:
    1. When authorized by the IST as described in an approved
      intervention strategy with the informed consent of the individual and/or his/her guardian or in accordance with Sycamore Services’ suspension policy.
    2. When necessary in an emergency to protect the individual from injury to
      himself/herself or to others. The agency shall not use any restraint as punishment or for the convenience of staff.
  10. Ensured confidential treatment of all information contained in his/her records. His/her written consent shall be required for the release of information to persons not otherwise authorized to receive it.
  11. To be treated with consideration, respect, and full recognition of his/her dignity and
  12. To communicate, associate, and meet privately with persons of his/her choice unless to do so would infringe upon the rights of other individuals. (Including sending and receiving unopened mail, access to a telephone with privacy for incoming and outgoing local and long distance calls at the individuals expense).
  13. To participate in activities of social, religious, and community activities of their choosing..
  14. To achieve full community inclusion within every aspect of daily living to include the activities associated with work, leisure, and home environment.
  15. To retain and use appropriate personal possessions and clothing.
  16. To terminate his/her involvement with services provided by Sycamore Services. If the individual has a legal guardian, the authorization to terminate services must be obtained from that guardian. To petition the committing court for consideration of any services you are being involuntarily committed to.
  17. To advocate for themselves and/or to a qualified advocate and/or guardian when this is required to protect his/her personal well being and interest. Right to contact and consult privately with an attorney of their choice, at their own expense.
  18. To the respect of all who work, advocate, or associate with him/her.
  19. Not to participate in experimental research or treatment without your informed, voluntary written consent. Individuals have the right to withdraw consent at any time.
  20. Not compelled to provide services for a provider or to complete work or chores benefiting others without pay or pay below minimum wage unless:
    1. Provider has obtained a certificate from the United States Department of Labor authorizing the employment of workers with a disability at special minimum wage rates and the individual works voluntarily for a provider with compensation at the prevailing wage and commensurate with the individual’s abilities. Individual shall voluntarily work for a provider compensated at the prevailing wage and commensurate with the individual’s abilities.
    2. Services are being performed by an Individual in the Individual’s own residence as a normal and customary part of housekeeping and maintenance duties.
    3. Individual desires to perform volunteer work in the community.
  21. To regular developmental and behavioral assessments. To be informed on a regular basis as specified by the individual’s plan of their Medical condition, Developmental status and Behavioral status.  (See Individual Service Plan Policy, Individual Support Plan and Individual Support Team meeting form).
  22. The opportunity for personal privacy.
  23. To have funds and property protected from misuse or misappropriation.

Participant Responsibilities:

  1. To participate in planning of your services.
  2. To choose the provider of your services.
  3. To work toward achieving your goals and objectives.
  4. To keep your appointments.
  5. To inform your identified team members about changes that are pertinent to your plan of care and your participation in your program.
  6. To advocate for yourself or designate someone to advocate for you.
  7. See also “Code of Conduct”.

These rights will be reviewed with you when you enroll in a Sycamore program. You will be asked to sign a page that documents that you received and understand your rights and responsibilities. If you have any questions, please ask the Sycamore representative assisting you.

Contact Us

Sycamore Services, Inc.
Corporate Office & Work Center

1001 Sycamore Lane
P.O. Box 369
Danville, IN 46122-1474

PH: (317) 745-4715
TOLL FREE: 866-573-0817
FAX: (317) 745-8271

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