Client Rights and Responsibilities

This section sets out the standing under which this policy is issued, who owns it, who is bound by it, and how it is kept current. It is not itself a procedure. The obligations begin at Section 1.

This policy makes sure every client of Sample Agency, LLC (the "Agency") knows their rights and responsibilities before services start, that staff respect those rights on every visit, and that clients know how to raise a concern inside and outside the Agency. Michigan does not license non-medical home care agencies and has no statute that gives home care clients a list of rights. The rights in this policy come from the Michigan Medicaid program rules that bind the Agency for Home Help and MI Choice services and from federal law, and the Agency applies them, as its own standard, to every client including private-pay clients.

This policy applies to every client and every service the Agency offers (companion or sitter services and personal care services), in the client's home and in the community, and to every employee and volunteer who has contact with clients or their information.

For the purposes of this policy:

"Each waiver agency or direct provider of home-based services must notify each participant, in writing, at the initiation of service of their right to comment about service provision or appeal the denial, reduction, suspension, or termination of services. Such notice must also advise the participant that they may file complaints of discrimination with the respective waiver agency, the Department of Health and Human Services Office of Civil Rights, or the Michigan Department of Civil Rights. The MI Choice Participant Handbook meets this requirement." (MPM MI Choice Waiver §9.9)

The Home Help program is designed to "Encourage and support the client's right and responsibility to make informed choices" and to "Empower the client to manage their services, respecting the client's right to determine what services are necessary, when they are completed, and how they are performed." (MPM Home Help §1.1) "The client has the right to terminate services with the provider at any time." (MPM Home Help §8)

As the Agency's own standard, every client, whatever the payer, receives the Agency's written rights and responsibilities notice (Form MI-HC-CR-01-A) at or before the first visit, has it explained in a language and format the client understands, and is never treated less favorably for exercising any right in this policy.

1. At or before the first visit, the staff member who completes the start-of-service visit (Policy MI-HC-ADM-01) gives the client, and any representative, Form MI-HC-CR-01-A and the other documents in the client information packet listed on Form MI-HC-CR-01-B.
2. For an MI Choice participant, the written notice under MPM MI Choice Waiver §9.9 is given "at the initiation of service". The waiver agency's MI Choice Participant Handbook meets that requirement, but the Agency still gives its own Form MI-HC-CR-01-A so the participant knows how to reach the Agency and how the Agency handles concerns.
3. The staff member explains each right and responsibility in plain language, in the client's preferred language, using a qualified interpreter or an accessible format when needed (Policy MI-HC-CR-02). Reading the form aloud is offered to every client.
4. The client or representative signs Form MI-HC-CR-01-B to show what was received and explained. If the client cannot or will not sign, the staff member writes the reason and the date on the form and signs it. Signing is never a condition of receiving services.
5. The client keeps the originals of Forms MI-HC-CR-01-A and MI-HC-CR-02-A in the home. A copy of the signed Form MI-HC-CR-01-B goes in the client record.
6. When the rights notice changes, the Agency gives every current client the new version at the next supervisory visit or by mail, as the Agency's own standard, and records the date on Form MI-HC-CR-01-B.

Every client of the Agency has the following rights. Where a right comes from a program rule the source is shown; the others are the Agency's own standards and apply to every client.

• "Each waiver agency and direct service provider must comply with the Federal Home and Community Based Services Settings Requirements as specified in 42 CFR §441.301(c)(4)" (MPM MI Choice Waiver §9.8). Among other qualities, the setting "Ensures an individual's rights of privacy, dignity and respect, and freedom from coercion and restraint", "Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact", and "Facilitates individual choice regarding services and supports, and who provides them." (42 CFR §441.301(c)(4)(iii) to (v))
• In practice, workers support the participant to take part in community life, to keep control of their own money and belongings, to choose their daily routine and visitors, and to decide how services are delivered. Workers do not set rules for the participant's home.
• Any limit on a participant's choices must come from the person-centered service plan prepared by the supports coordinator, never from a worker or the Agency. A worker who thinks a limit is needed for safety tells the supervisor, who contacts the supports coordinator (Policy MI-HC-SP-03).
• The Agency completes any HCBS settings survey a waiver agency asks for and corrects any finding within the time the waiver agency sets (MPM MI Choice Waiver §9.8).

• Every client may make a complaint to the Agency at any time, orally or in writing, to any staff member or directly to Pat Sample, Administrator, on (517) 555-0111 or person1@example.com. The Agency acknowledges a complaint within 5 business days and aims to resolve it within 30 business days (Policy MI-HC-GRV-01).
• Outside the Agency: Michigan does not license non-medical home care agencies, so there is no state licensing complaint office for this service. Home Help clients may contact their MDHHS adult services worker or local MDHHS office. MI Choice participants may file a grievance, orally or in writing, with their MI Choice waiver agency. Michigan does not license non-medical home care, so there is no state licensing office for home care complaints; staff never refer a home care client to a licensing agency for a complaint about the Agency.
• MI Choice participants: "Participants may file a grievance orally or in writing when they are dissatisfied with the quality of services received. A grievance may be submitted to the waiver agency at any time." (MPM MI Choice Waiver §11.1) A participant who disagrees with a waiver agency decision to deny, reduce, suspend or terminate services may appeal to the waiver agency; "Participants have 60 calendar days from the date of the Adverse Benefit Determination to request an internal appeal." (MPM MI Choice Waiver §11.2) If the waiver agency upholds its decision, the participant may request a State Fair Hearing (MPM MI Choice Waiver §11.3).
• Home Help clients: "A client or their authorized hearing representative may appeal an eligibility determination, service approval or negative action by requesting an administrative hearing. A provider cannot request an administrative hearing on behalf of a client." (MPM Home Help §9.1) Staff may tell the client where to find the hearing request information on the MDHHS notice and give the Michigan Office of Administrative Hearings and Rules number listed in the MPM Directory Appendix (800-648-3397), but never file for the client.
• Discrimination complaints may also be filed with the waiver agency (MI Choice), the U.S. Department of Health and Human Services Office for Civil Rights, or the Michigan Department of Civil Rights (MPM MI Choice Waiver §9.9; Policy MI-HC-CR-02).
• Suspected abuse, neglect or exploitation: MDHHS Centralized Intake for Abuse and Neglect, 855-444-3911. Suspected Medicaid fraud: 1-855-MI-FRAUD (1-855-643-7283), www.michigan.gov/fraud. Questions about Medicaid coverage: the MDHHS Beneficiary Help Line, 800-642-3195.
• No client is threatened, refused service, given less service or discharged because the client or anyone on the client's behalf complained, grieved, appealed or reported a concern to anyone (Agency standard).

The Agency asks every client, or the client's representative, to meet the following responsibilities, as the Agency's own standard. They are explained at the start-of-service visit and listed on Form MI-HC-CR-01-A. They are requests, not conditions that take away any right in Section 6.

• Give the Agency accurate information about health, needs, medicines the worker will remind about, allergies and anything in the home that could affect safety.
• Tell the Agency as soon as possible about a hospital stay, a move, a change in the program that pays for services, a new representative, or when the client will not be home for a scheduled visit.
• Ask workers only for tasks on the care plan. Requests for other help go to the office, which will contact the adult services worker or supports coordinator if the authorization needs to change.
• Treat workers with respect and keep the home reasonably safe for them, including keeping pets secured if asked and not smoking near the worker where possible.
• Confirm visits in the electronic visit verification system or on the daily service log as the Agency explains (Policy MI-HC-BUS-03).
• Not offer workers money, gifts, tips or loans, and tell the office if a worker asks for any (Policy MI-HC-ETH-01).
• For private-pay clients, pay invoices as agreed in the service agreement (Policies MI-HC-ADM-01 and MI-HC-BUS-04).
• Tell the Agency about any concern, so it can be put right.

• Workers knock or ring and identify themselves, wear the Agency picture identification on every visit (Policy MI-HC-HR-06), and ask the client's permission before starting each task.
• If a client refuses a task, the worker does not insist, explains any risk calmly, offers again later in the visit if appropriate, records the refusal on the daily service log and tells the supervisor before the end of the shift if the refusal could affect the client's health or safety. The supervisor follows Policy MI-HC-SP-03.
• If a client asks a worker to do something that is not on the care plan, unsafe or against Agency rules, the worker politely declines and tells the office.
• Workers do not smoke in clients' homes, do not use personal cell phones in the home except in an emergency, and never threaten or coerce a client (MPM MI Choice Waiver §9.12.E, applied to all clients by Policy MI-HC-ETH-01).
• A worker who sees any sign that a client's rights are not being respected, by anyone, tells the supervisor the same day and, where abuse, neglect or exploitation is suspected, makes the report required by Policy MI-HC-ANE-01.

Accountability under this policy is allocated as follows.

The signed Form MI-HC-CR-01-B and any notes about how rights were explained are kept in the client record for 10 years for MI Choice participants (MPM MI Choice Waiver §9.12.C) and seven years from the last date of service for all other clients, as the Agency's own standard. Each quarter, as the Agency's own standard, the Administrator checks a sample of at least five new client records (or all, if fewer) for a signed Form MI-HC-CR-01-B dated on or before the first visit and reviews the complaint log (Form MI-HC-GRV-01-B) for any rights issue; findings go to the quality management program (Policy MI-HC-QM-01).

All staff learn client rights and responsibilities at orientation, before working with any client, and review them at least once a year in in-service training (Policy MI-HC-HR-05). Staff who complete start-of-service visits are trained to explain the notice, use interpreters and record refusals before doing so.

This policy implements the following authorities.

• Michigan Medicaid Provider Manual, MI Choice Waiver chapter (October 1, 2026), Sections 9.5, 9.6, 9.7, 9.8, 9.9, 9.11, 9.12.E, 9.16, 11, 11.1, 11.2 and 11.3
• Michigan Medicaid Provider Manual, Home Help chapter (October 1, 2026), Sections 1.1, 8, 8.6.C, 8.6.E.3, 8.9 and 9.1
• Michigan Medicaid Provider Manual, General Information for Providers chapter (October 1, 2026), Sections 8.1 and 13.1; Directory Appendix (Appeals)
• 42 CFR §441.301(c)(4) (home and community-based settings)
• MCL 400.11a (adult abuse reporting) and MCL 400.111b (payment in full)
• 45 CFR Part 92 (Section 1557) and 45 CFR §§164.520, 164.524 (HIPAA)

The following documents are read together with this policy.

This policy is adopted by the governing body of Sample Agency, LLC. The effective date, the person who approved it, and the date of approval are shown in the header block and recorded in the signature lines below.

Every version of this policy, the date it took effect, a summary of what changed, and who approved it is recorded below. Where a law, rule or manual chapter cited in Section 14 is amended, the amendment is recorded in this table and a new version of this policy is issued.