A. CLIENT RIGHTS

Individuals receiving services from Kokua have the same rights enjoyed by other individuals in the community. All new clients will be informed of their rights and will sign a Statement of Rights.

B. KOKUA STATEMENT OF RIGHTS

All individuals receiving services from Kokua are informed of their rights as consumers of state-paid services. If the services you are receiving are not meeting your needs, you have the right to ask for changes to be made. You may speak to your staff, your Service Coordinator, the Executive Director or the Director of Client Services, or to your DDD Case Manager to let them know your concerns.

Individuals receiving services from Kokua are encouraged to give feedback on the quality of the services provided. If you believe that you are being treated unfairly or if you have a problem with your staff, you have a right to file a grievance. You may call the Kokua office on your own to ask for help or you may ask a friend or relative to assist you to do so.

Making Decisions in Your Own Home

  • The place where you live is your home. You have the right to determine your own daily schedule. (What time you get up, what food you eat, what shows to watch on TV, etc.) If you have roommates, you may need to talk with your roommates to help make decisions that will work out for everyone.
  • You have the right to privacy. Staff should knock before entering the bathroom or your bedroom. You may spend time alone in your room if that is your choice.
  • You have the right to open your own mail. No one should open your mail unless you give staff permission to do so.
  • The telephone in your home belongs to you. You may use it whenever you please. If a staff person needs to use the phone, he or she should ask your permission to do so.
  • You have the right to invite friends or family to your home.
  • You may decide how you would like to decorate your own room. You may put up pictures, posters or any other items that you enjoy. If you prefer, you may lock your room when you are not at home.

Making Decisions About Activities.

  • You can decide what activities you want to do for fun. You may take a class, join a club, visit with friends, take a trip, go to watch a football game or any other activity that seems interesting to you. You should be able to do any activity that interests you and fits within your budget. You may also save up money for a more expensive activity, such as taking a vacation. Please tell your staff if you have an activity you are interested in.
  • You are free to choose your own friends. You have the right to have your friends visit you at home or you may go to their home for a visit.
  • You may attend any church or religious activity of your choice. Your staff will provide transportation for you if you need it.

Decisions About Your Money

  • If you are not required to have a representative payee, you have the right to manage your own money. If you want some help with managing your finances, your staff may assist you in learning to budget your money and pay your bills.
  • If you have a representative payee, you still have the right to make decisions about your own spending money and any other money that you earn on your own. You may have a checking account or a savings account in your own name to handle your personal money.
  • If Kokua is your representative payee, you have the right to see how money is being spent on your behalf. You also have the right to review and approve your Individual Financial Plan.

Reporting Abuse or Neglect:

  • If anyone hurts you, steals from you, yells at you or forces you to do something you do not want to do, you have a right to ask for help and protection.
  • You may call the following numbers to ask for help:

 

___________________________, your DDD case manager __________________________ Name Phone

Residential Care Services, 1-800-562-6078

I have read or have had this Statement of Client Rights read to me. I understand that I may call the Kokua office at any time if I have a question or a concern.

_________________________________________________ _______________________

Client Signature Date

_________________________________________________ ________________________

Witness Signature Date

Revised November, 2009