Enrollees and individuals applying for, eligible for, or receiving Great Rivers Behavioral Health Organization (Great Rivers) services shall have the right to receive information in accordance with applicable federal and state laws that pertain to individuals’ rights. These include, but are not limited to, CFR Sections 438.100 (Enrollee Rights) and 438.10 (Information Requirements).

You have the responsibility to:

  1. To supply information (to the extent possible) that the BHO and its BHA/practitioners and providers need in order to provide care;

  2. To follow treatment plan and instructions for care that you have agreed to with your treatment team; and

  3. To understand your behavioral health needs and participate in developing mutually agreed upon treatment goals, to the degree possible.

You have the right to:

  1. Be treated with respect with due consideration for individuals, dignity and privacy, except that staff may conduct reasonable searches to detect and prevent possession or use of contraband on the premises;

  2. Help your provider to develop a plan of care with services to meet your needs;

  3. Participate in decisions regarding enrollee/individual’s behavioral health including the right to refuse treatment;

  4. Receive services in a barrier-free location (accessible);

  5. Receive the name, address, telephone number, and any languages offered other than English of providers in your BHO yearly or when you request it;

  6. Receive the amount and duration of services you need;

  7. Receive a written Notice of Adverse Benefit Determination from the BHO if services are denied, limited, reduced, suspended, or terminated;

  8. Receive information about the structure and operation of the BHO;

  9. Receive emergent or urgent care or crisis services;

  10. Receive post-stabilization services after you receive emergent or urgent care or crisis services that result in a hospitalization;

  11. Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation, as specified in other Federal regulations of restraints and seclusion.  Great Rivers requires all outpatient providers to ensure enrollee/individuals are free from use of seclusion or restraints;

  12. Receive age and culturally-appropriate services;

  13. Be provided a certified interpreter and translated material at no cost to you;

  14. Receive information you request and help in the language or format of your choice;

  15. Receive information on available treatment options and alternatives, presented in a manner appropriate to the enrollee/individual’s condition and ability to understand, regardless of cost or benefit coverage; 

  16. Refuse any proposed treatment;

  17. Receive services without regard to race, creed, national origin, religion, gender, sexual orientation, age, type of illness or disability;

  18. Practice the religion of choice as long as the practice does not infringe on the rights and treatment of others or the treatment service. Individual participants have the right to refuse participation in any religious practice;

  19. Be reasonably accommodated in case of sensory or physical disability, limited ability to communicate, limited English proficiency, and cultural differences;

  20. Be free of exploitation including physical and financial exploitation;

  21. Be free of any sexual harassment;

  22. Have all clinical and personal information treated in accord with state and federal confidentiality regulations;

  23. Review your clinical record in the presence of the administrator or designee and be given an opportunity to request amendments or corrections;

  24. Receive an explanation of all medications prescribed and possible side effects;

  25. Make a mental health advance directive that states your choices and preferences for mental health care;

  26. Receive information about medical advance directives.  For more information about advance directives use the links below:

    For information about Mental Health Advance Directives

    For information about Medical Advanced Directives from the Aging and Long-Term Support Administration

    If you feel your mental health or medical health advance directive was not followed, you can receive information or file a complaint with the Washington State Department of Health (DOH): 

    ·    You may call DOH at 1-360-236-2620;

    ·    You may email DOH at HSQAComplaintIntake@doh.wa.gov; or

    ·    You may go online to DOH at www.doh.wa.gov

  27. Receive quality services, which are medically necessary;

  28. Receive medically necessary services in accordance with the early periodic screening, diagnosis, and treatment (EPSDT) under WAC 182-534-0100, if you are twenty years of age or younger;

  29. Receive a second opinion from a mental health or substance use professional in the Great Rivers area if you disagree with your provider;

  30. Receive medically necessary behavioral health services outside of the BHO if those services cannot be provided adequately and timely within the BHO;

  31. Choose a behavioral health provider for yourself and your child (if your child is under 13 years of age);

  32. To receive information about the BHO or BHA, its services, its practitioners and providers and member rights and responsibilities;

  33. Change behavioral health providers at any time;

  34. Request and receive a copy of your behavioral health treatment records. You will be told the cost for copying;

  35. Be free to exercise rights, and that the exercise of these rights does not adversely affect the way the BHO or BHA treat the enrollee/individual.  Free from retaliation;

  36. Request and receive policies and procedures of Great Rivers and Behavioral Health Agencies (BHAs) as they pertain to your rights;

  37. Receive a copy of BHA and BHO grievance system procedures according to WAC 182-538D-0654 through 182-538D-0680 upon request and to file a grievance with the agency, or behavioral health organization (BHO), if applicable, if you believe your rights have been violated;

  38. Submit a report to the department when you feel the agency has violated a WAC requirement regulating "behavioral health agencies”;

  39. Voice complaints/grievances or appeals about the BHO, BHA, or care the BHA provides;

  40. Receive a Notice of Adverse Benefit Determination so that you may appeal any decision by Great Rivers that denies or limits authorization of a requested service, that reduces, suspends, or terminates previously authorized service, or that denies payment for a service, in whole or in part;

  41. File an appeal if Great Rivers fails to provide services in a timely manner as defined by the state;

  42. Request an administrative (fair) hearing if your grievance or appeal is not resolved within the timelines as described in WAC 388-877-0660;

  43. Request services by the behavioral health Ombuds office to help you file a grievance or appeal, or request and administrative hearing;

  44. Request and receive a copy of these Rights; and

  45. Make recommendations regarding the BHO’s enrollee rights and responsibility policy.