{"ref":"MO-HC-CR-03","title":"Participant Choice, Representatives, Consent, and Advance Directives","category":"Client rights","summary":"Protects the participant's choice of provider and direction over services within the authorized care plan; explains who may act for a participant and how the Agency confirms a representative's authority; sets how the Agency obtains the participant's agreement to services and handles refusals; and requires that, before services start, each participant is told of his or her rights under Missouri advance directive law and the record shows whether the participant has executed an advance directive (PC Manual §2.5).","inShort":["Participants choose their provider. If one wants to change, tell your supervisor the same day.","Take instructions only from the participant, or from someone the office has confirmed can act for them.","Explain each task before you start. If the participant says no, do not push. Write it down and tell your supervisor before the end of your shift.","Never witness, fill in or give advice about an advance directive. Refer the participant to the supervisor.","In an emergency, call 911 first. Give the responders any do-not-resuscitate (OHDNR) form or identification the participant has."],"primaryCitation":"19 CSR 15-7.021(18)(O)3","citations":["19 CSR 15-7.021(4)(B)","19 CSR 15-7.021(9)","19 CSR 15-7.021(15), (15)(C)","19 CSR 15-7.021(18)(I)12, (18)(K)","19 CSR 15-7.021(18)(O)3","13 CSR 70-91.010(1)(B)2, 4","13 CSR 70-91.010(3)(B)","MMAC In-Home Services Program Requirements 5.1","MO HealthNet Personal Care Provider Manual §§2.5 (Participant Case Record), 3.5","RSMo 404.800 to 404.865 (Durable Power of Attorney for Health Care Act)","RSMo 459.010 to 459.055 (declarations)","RSMo 190.600 to 190.621 (Outside the Hospital Do-Not-Resuscitate Act)"],"federalCitations":[],"surveyorAsks":["Show me where this participant's record documents that, before services began, the participant was informed of advance directive rights and whether one was executed.","A daughter says she has power of attorney and wants services changed. What do you do?"],"forms":[{"ref":"MO-HC-CR-03-A","title":"Advance Directive Information and Acknowledgment"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 15-7.021(18)(O)3)","5. Choice of Provider","6. Direction Over Services Within the Care Plan","7. Representatives","8. Agreement to Services and Refusals","9. Advance Directive Information Before Services Start","10. What Workers Do About Advance Directives and OHDNR Orders","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"mo-hca","state":"Missouri","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}