(a) If a person has the ability to choose a CCO on his or her own, or with the assistance of supported decision making, the person may:

(b) If a person lacks the ability to enroll in a CCO, disenroll from a CCO, or act in the CCO review process, but has a guardian lawfully empowered to enroll him or her in a CCO, the guardian may take any of the actions enumerated in subdivision (a) of this section.

(c) If a person lacks the ability to choose a CCO and does not have a guardian lawfully empowered to enroll him or her in a CCO, then any of the following parties, in the order stated, may take any of the actions enumerated in subdivision (a) of this section:

(d) If the first surrogate on the list in subdivision (c) of this section is not reasonably available and willing to make enrollment decisions and enroll the individual in a CCO or act in the CCO review process, and is not expected to become reasonably available and willing to make an enrollment decision and enroll the individual in a CCO or act in the CCO review process, the surrogate who has the highest priority on the list and who is willing and available shall have the authority to make enrollment decisions and enroll the individual in a CCO or act in the CCO review process.

(e) If more than one party exists within a category in subdivision (c) of this section utilizing the standard of active involvement, consent shall be sought first from the party with a higher level of involvement or, when the parties within a category are equally actively involved, consent shall be sought from any of such parties.

(f) If a person lacks the ability to choose a CCO, does not have a guardian lawfully empowered to enroll him or her in a CCO, and there are no parties identified in subdivision (c) of this section, then the chief executive officer (CEO) (see section 635-99.1 of this Part) of the agency operating the person’s residential facility or sponsoring the family care home, or a designee of the CEO, may take any of the actions enumerated in subdivision (a) of this section. For the purposes of this subsection only, if the person’s residential facility is operated by OPWDD, the CEO of the agency is the director of the DDSOO that operates the residential facility.

(g) If a party specified in subdivisions (a) through (e) of this section, in the order so specified, makes a decision to enroll in a CCO; not to enroll in a CCO; or to disenroll from a CCO; that decision shall be considered the final decision of the affected individual and any party in a subordinate position, as specified in subdivisions (a) through (e) of this section, may not change that enrollment decision. The party that enrolls the individual shall also be the party authorized to act in the CCO review process.

(h) If the CEO enrolls the person in the CCO or acts in the CCO review process, he or she shall give written notice of such enrollment and/or action to:

(i) For each individual eligible to enroll in a CCO, the individual’s care management provider for OPWDD-certified services shall identify a decision-maker who has the authority to make enrollment decisions for the individual pursuant to this section. If there is no care management provider assigned to the individual at the time of the eligibility, the DDRO director for the region encompassing the person’s current residence, or his or her designee, shall identify a decision-maker pursuant to this section.

(j) The care management provider or DDRO director shall notify the following parties of the decision-maker identified to make enrollment decisions:

(k) The care management provider or DDRO director shall maintain documentation of the current decision-maker identified pursuant to this section, including documentation of attempts to reach unavailable individuals, and shall confirm the identification of the current decision maker as necessary, but at least annually.