NOTICE OF PRIVACY PRACTICES

Client Rights & Responsibilities

PURPOSE: To assure basic rights of Clients and to preserve independent expression and decision-making.

AS A CLIENT, I HAVE THE RIGHT TO:
1. The least restrictive treatment that is available and medically indicated, regardless of race, creed, sex, national origin, sexual orientation, socioeconomic status, language and religion/spiritual beliefs.
2. Be treated with consideration, respect and full recognition of my dignity and individuality at all times and under all circumstances. This includes a professional relationship with all staff, free of psychological, physical, emotional abuse, retaliation, neglect or humiliation. Any believed breach of ethics may be reported following grievance procedures.
3. Be protected by the facility from physical, verbal and emotional abuse (including corporal punishment); and from all forms of misappropriation and/or exploitation.
4. Be free of any requirements to perform services ordinarily performed by staff.
5. Be assisted by the Facility to exercise my civil rights.
6. To know the identity and professional status of individuals providing services.
7. Participate in the development of the client’s individual program or treatment plans and to receive sufficient information about proposed and alternative interventions and program goals to enable them to participate effectively.
8. Clients have the right to have their personal information kept confidential in accordance with state and federal confidentiality laws. (see Privacy Practices).
9. To access and release (with written consent) pertinent treatment information to facilitate appropriate decision making.
10. Give informed consent, informed refusal or expression of choice regarding:
a. Service delivery
b. Release of information
c. Concurrent services
d. Composition of treatment team
e. Participation in research projects.
11. Voice grievances to staff, to the licensee and to outside representatives of my choice with freedom from restraint, interference, coercion, discrimination or reprisal. In addition, there will be a prompt investigation and resolution of alleged infringement of my rights (grievance/complaints) without fear of reprisal.
12. Obtain from the primary counselor complete and current information concerning diagnosis (to the degree known), treatment, and any known prognosis. If there is a time that it is not clinically advisable to give such information to me, the information shall be made available to a legally authorized individual.
13. Participate in decisions involving my treatment. This should include concise explanation of the condition and any proposed services. This should also include risks and side effects of all medications and treatment procedures used.
14. To refuse any specific medication or procedure to the extent of the law. Should this refusal prevent the provision of appropriate care in accordance with the ethical and professional standards, the facility’s relationship with me may be terminated upon reasonable notice. Note: if you are court or BOPP referred, you may be referred back to the court or probation/parole system.
15. To participate fully or to refuse to participate in community activities including cultural, educational, religious, community service, vocational services and recreational activities.
16. Review my individual chart by requesting a copy of the chart from my primary staff. I further understand that I can request to amend my record.
17. Complete explanation of the need for transfer to another facility and any continuing health care requirements following discharge.
18. Access or be referred to legal entities for appropriate representation.
19. Access self-help and advocacy support services.
20. An itemized and detailed explanation of total program fees for services rendered when appropriate, or to a legally authorized representation.
21. Clients shall be permitted to retain and use personal clothing and appropriate possessions including books, pictures, games, toys, radios, arts and crafts materials, religious articles, toiletries, jewelry and letters, as long as they do not interfere with diagnostic procedures or treatment.
22. Clients have the right to privacy while receiving services.
23. Have their personal information kept confidential in accordance with state and federal confidentiality laws.
24. Ask the Facility to correct information in their records, if the Facility refuses, the client may include a written statement in the records of the reason they disagree.
25. Be informed about their care in a language they understand.
26. To vote, make contracts, buy or sell real estate or personal property or sign documents, unless the law or court removes these rights.
27. (Refers to Residential only):
a. Associate and communicate privately with persons of their choice (including a spouse) including visitation by all concerned persons that have been clinically determined to be of utmost benefit to my treatment in accordance with the program’s policies and privilege requirements.
b. A suitable area in which to receive visitors.
c. Free use of common areas in the facility with due regard for the privacy, personal possessions and the rights of others. This includes the use of bathrooms at all hours.
d. Send personal mail unopened and to receive mail and packages which may be opened in the presence of staff when there is reason to believe that the contents may be harmful to the client or others.
e. Have telephone conversations unless contraindicated by clinical considerations and as dictated by policy and privilege requirements.
f. Have the right to be given privacy and freedom in the use of their bedroom/sleeping area.
28. Know that the Facility has certain responsibilities for your treatment, including discharge if you refuse or fail to comply with your treatment program. In the event that the clinical staff determines that you are a clear danger to yourself or others, we are obligated to seek assistance from Mobile Crisis or legal involvement if necessary.

I HAVE THE RESPONSIBILITY FOR:
1. Providing, to the best of my knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to my health. I must also report unexpected changes in my condition to the responsible program staff.
2. Making it known whether or not I clearly understand a contemplated course of treatment or prevention curriculum and expectations.
3. Following the treatment plan recommended including completing my agreed upon goals before successful completion of the program.
4. Keeping appointments and for notifying the proper persons if unable to do so. I understand that I am responsible to make up any missed sessions excused or not excused. I also understand that I am responsible for my own actions and for the consequences of my actions. I also understand that if there are three episodes of failure to keep scheduled appointments, I may be discharged from the program.
5. Provide urine samples for the purposes of laboratory analysis upon request of clinical staff or according to court ordered or BOPP agreement. I understand that the results of these tests will be incorporated into my medical record.
6. Assuring that the financial obligations of my care are fulfilled as soon as possible. If I do not have coverage, a payment agreement will be devised.
7. Following facility rules affecting my care, conduct and safety (including non-violent behavior, abstinence from drugs and/or alcohol, outside meeting attendance).
8. For being considerate of the rights of others and for assisting in the control of noise and regarding the smoking policy defined in either/both residential or outpatient treatment, as applicable.
9. To attend the group schedule assigned by my Case Manager.

CLIENTS ARE PROHITED FROM:
1. Assuming responsibility for the care of other clients.
2. Assuming responsibility for the supervision of other clients unless on duty/on-site staff are present.
3. Access to confidential information.