CLIENT RIGHTS, RULES, AND GRIEVANCE PROCEDURES

FOR ALL PROGRAMS OF

PROFESSIONAL CARE SERVICES, INC.

Client Rights and Responsibilities: 

Persons accepted for treatment or related services by Professional Care Services, Inc. have the following rights.

Rights:

The right to be provided with information about the agency, its services, its practitioners, to be provided with the basic rights and responsibilities in a way which is easily understood.

The right to make recommendations regarding the agency’s client’s rights and responsibilities.

The right to be treated with respect, dignity, and compassion regardless of mind or condition.

The right to be provided equal treatment without regard to age, race, sex, religion, ethnic background, HIV status or LEP, Limited English Proficiency. PCS offers the same services to individuals who are physically, mentally challenged.

The right to privacy and confidentiality related to all aspects of care including, but not limited to, the unwarranted disclosure of medical records, whole or in part.

The right to be protected from neglect; to be protected from physical, emotional, or verbal abuse, and from all manner of exploitation.

The right to be informed of any proposed and/or alternative treatment methods; regardless of cost or benefit coverage.

To be informed about the risks, benefits, and side effects of his/her medication or proposed mediation.

The right to participate in the development of his/her individual service plan; to participate in all decision-making regarding his/her mental health and substance abuse care; to be involved in his/her discharge or aftercare planning.

The right to be provided quality treatment by competent staff members; to be afforded continuity of care from one service provider to another.

The right to refuse to participate partially of fully in treatment or therapeutic activities (unless participation is so ordered by the court).

The right to be provided treatment in the least restrictive setting feasible.

The right to refuse the use of any audio and/or visual techniques to record or observe the individual’s activities during treatment unless written and signed consent is given.

The right to participate in cultural, educational, religious, community service, vocational, and/or recreational activities; if offered and/or appropriate.

The right to be informed about fees and payment options for any treatment and/or classes.

The right to receive free language assistance.

The right to be able to choose practitioners within the limits of the agency; to be able to refuse care from specific practitioners.

The right to voice complaints, grievances and appeals about the care or services provided at the agency without fear of restraint, interference, coercion, discrimination, or reprisal.

The right to formulate advance directives.

The right to have access to his/her records.

The right to refuse to participate in experimentation including the right to a reasonable explanation of the procedure to be followed, the benefits to be expected, the relative advantages of alternative services, the potential discomforts and risks, and the right not to be denied appropriate and available treatment in reprisal for such refusal.

The right, if in a residential facility, to communicate with appropriate privacy with others from outside the facility. This includes convenient and reasonable access to telephone, mail service, and visitors during regular visiting hours.

The right not to be responsible for the care of other clients, clients have the right to be free of any requirement by the facility that they perform services which are ordinarily performed by facility staff.

The right not to be required to perform in public gatherings and the right to refuse use of client photograph without consent.

The right not to be required to make public statements expressing gratitude to the Center.

Responsibilities:

Clients must provide, to the extent possible, information needed by professional staff providing services to the consumer.

Clients must follow plans, instructions and guidelines for care that they have agreed upon with their practitioner.

Clients must participate, to the degree possible, in understanding their behavioral health problems and develop mutually agreed upon treatment goals.

 

INQUIRY, APPEAL AND GRIEVANCE PROCEDURES:

There is always the potential that the treatment received by a client may not be perceived by that client as fair or appropriate. To safeguard against any mis-treatment of a client, or any failure to provide quality care, or inaccurate accounting regarding client charges, Professional Care has established a grievance procedure whereby the client can make his or her concern known.

The basic procedure if you have a complaint or concern is as follows:

Client’s who express dissatisfaction will be instructed to talk to clinical or administrative staff regarding their complaint or grievance.

Client’s will be asked if they wish to write a formal grievance and they will be assisted by the Grievance Coordinator or Site Administrator.

Complaints and grievances will be investigated and resolved within 30 days.

Clients will be informed of their right to appeal with Professional Care Services,

Magellan, or other private or state agencies.

PROGRAM RULES FOR CLIENTS:

Clients may not bring weapons on premises.

Client may not bring alcohol on premises.

Intoxicated clients will not be seen for treatment (but may be screened for other services).

Clients must not be disruptive.

Clients must keep appointments as scheduled or cancel at least 24 hours prior to appointment.

Clients must assume appropriate financial responsibility for services.

 

CONFIDENTIALITY:

A basic right of every client is the right to confidentiality. Confidentiality is both an ethic and a law which prevents disclosures about clients and their care without their expressed permission, except in medical emergencies, cases of suspected child abuse, threat to the lives of self or others, or by Court Order.

If you have any further questions about confidentiality, please feel free to ask your treating clinician.

MENTAL HEALTH & SUBSTANCE ABUSE ADVOCACY NUMBERS

National Alliance for the Mentally Ill 1(800) 838-7880

Alcohol & Drug Services 1(800) 662-HELP

This notice describes information about privacy practices followed by our employees, staff and other office personnel. The practices described in this notice will also be followed by healthcare providers you consult with by telephone (when your regular healthcare provider from our office is not available) who provide “call coverage” for your healthcare provider.

This notice applies to the information and records we have about your health, health status, and the healthcare and services you receive at this office.

We are required by law to maintain the privacy of protected health information and to give you this notice. It will tell you about the ways in which we may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.

We must have your written, signed consent to use and disclose health information for the following purposes:

For Treatment. We may use health information about you to provide you with medical treatment or services. We may disclose health information about you to doctors, nurses, technicians, office staff or other personnel who are involved in taking care of you and your health.

For example, your doctor may be treating you for a heart condition and may need to know if you have other health problems that could complicate your treatment. The doctor may use your medical history to decide what treatment is best for you. The doctor may also tell another doctor about your condition so that doctor can help determine the most appropriate care for you.

Different personnel in our office may share information about you and disclose information to people who do not work in our office in order to coordinate your care, such as phoning in prescriptions to your pharmacy, scheduling lab work and ordering X-rays. Family members and other healthcare providers may be part of your medical care outside this office and may require information about you that we have.

For Payment. We may use and disclose health information about you so that the treatment and services you receive at this office may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about a service you received here so your health plan will pay us or reimburse you for the service. We may also tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.

For Healthcare Operations. We may use and disclose health information about you in order to run the office and make sure that you and our other patients receive quality care. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also use health information about all or many of our patients to help us decide what additional services we should offer, how we can become more efficient, or whether certain new treatments are effective.

Appointment Reminders. We may contact you if we need to reschedule an appointment.

Treatment Alternatives. We may tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Products and Services. We may tell you about health-related products or services that may be of interest to you.

Please notify us if you do not wish to be contacted for appointment reschedules, or if you do not wish to receive communications about treatment alternatives or health-related products and services. If you advise us in writing that you do not wish to receive such communications, we will not use or disclose your information for these purposes.

You may revoke your Consent at any time by giving us written notice. Your revocation will be effective when we receive it, but it will not apply to any uses and disclosures that occurred before that time.

If you do revoke your Consent, we will not be permitted to use or disclose information for purposes of treatment, payment or healthcare operations, and we may therefore choose to discontinue providing you with healthcare treatment and services.

We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations:

To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety of the public or another person.

Required By Law. We will disclose health information about you when required to do so by federal, state or local law.

Military, Veterans, National Security and Intelligence. If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority.

Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injures, reactions to medications or problems with products.

Health Oversight Activities. We may disclose health information to a health oversight agency for audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the healthcare system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.

Law Enforcement. We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements.

Coroners, Medical Examiners and Funeral Directors. We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.

Information Not Personally Identifiable. We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Family and Friends. We may disclose health information about you to your family members or friends if we obtain your verbal agreement to do so or if we give you an opportunity to object to such disclosure and you do not raise an objection. We may also disclose health information to your family or friends if we can infer from the circumstances, based on our professional judgment that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse with you into the exam room during treatment or while treatment is discussed.

In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person’s involvement in your care. For example, we may inform the person who accompanied you to the emergency room that your suffered a heart attack and provide updates on your progress and prognosis. We may also use our professional judgment and experience to make reasonable inferences that is in your best interest to allow another person to act on your behalf to pick up, for example, filled prescriptions, medical supplies, or X-rays.

We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, signed Authorization. We must obtain your Authorization separate from any Consent we may have obtained from you. If you give us Authorization to use or disclose health information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose information about you for the reasons covered by your written Authorization, but we cannot take back any uses or disclosures already made with your permission.

If we have HIV or substance abuse information about you, we cannot release that information without a signed, written authorization from you. In order to disclose these types of records for purposes of treatment, payment or healthcare operations, we will have to have both your signed Consent and a special written Authorization that complies with the law governing HIV or substance abuse records.

You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy your health information, such as medical and billing records, that we use to make decisions about your care. You must submit a written request to PCS, Inc. in order to inspect and/or copy your health information. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other associated supplies. We may deny your request to inspect and/or copy in certain limited circumstances. If you are denied access to your health information, you may ask that the denial be reviewed. If law requires such a review, we will select a licensed healthcare professional to review your request and our denial. The person conducting the review will not be the person who denied your request, and we will comply with the outcome of the review.

Right to Amend. If you believe health information we have about you is incorrect or incomplete, you may ask to amend the information. You have the right to request an amendment as long as the information is kept by this office. An amendment request must be made in writing and must include a reason to support the request.

In addition, we may deny your request if you ask us to amend information that:

1- We did not create, unless the person or entity that created the information is no longer available to make the amendment.

2- Is not part of the health information that we keep.

3- You would not be permitted to inspect and copy.

4- Is accurate and complete.

Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment and healthcare operations. To obtain this list, you must submit your request in writing to PCS, Inc. It must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). We may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. To request restrictions, you must submit your request in writing to PCS, Inc. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

We must comply with the provisions of this notice, although we reserve the right to change this notice and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice in the office with its effective date in the top right hand corner. You are entitled to a copy of the notice currently in effect. You can always request a copy of our most current privacy notice at the front desk.

Send mail to Charlee.McCommon with questions or comments about this web site.
Copyright © 2006 Professional Care Services of West TN, Inc.
Last modified: April 25, 2008