Client Rights / Responsibilities and Grievance Procedures

Welcome to Family Services and Community Services for the Deaf

These Rights Apply to All Adults, Children, and Adolescents (And Their Parents and/or Guardians) Treated at Family Services and Community Services for the Deaf Programs.

Client Rights: Health care is a shared experience involving clients and those who give care. Recognizing the personal worth and dignity of each client at Family Services and Community Services for the Deaf, this statement of your rights is offered as an expression of our philosophy and commitment to you.

______ Your Rights:

⮚ The right to be treated with consideration and respect for personal dignity, autonomy and privacy;

⮚ The right to reasonable protection from physical, sexual or emotional abuse, neglect, and inhumane treatment;

⮚ The right to receive services in the least restrictive, feasible environment;

⮚ The right to participate in any appropriate and available service that is consistent with an individual service plan (ISP), regardless of the refusal of any other service, unless that service is a necessity for clear treatment reasons and requires the person’s participation;

⮚ The right to give informed consent to or to refuse any service, treatment or therapy, including medication absent and emergency;

⮚ The right to participate in the development, review and revision of one’s own individualized treatment plan and receive a copy of it;

⮚ The right to freedom from unnecessary or excessive medication, and to be free from restraint or seclusion unless there is immediate risk of physical hard to self or others;

⮚ The right to be informed of and refuse any unusual or hazardous treatment procedures;

⮚ The right to be advised and the right to refuse observation by others and by techniques such as one-way vision mirrors, tape recorders, video recorders, television, movies, photographs or other audio and visual technology. This right does not prohibit an agency from using closed-circuit monitoring to observe seclusion rooms or common areas, which does not include bathrooms or sleeping areas;

⮚ The right to confidentiality of communications and personal identifying information within the limitations and requirements for disclosure of client information under state and federal laws and regulations.

⮚ The right to have access to one's own client record unless access to certain information is restricted for clear treatment reasons. If access is restricted, the treatment plan shall include the reason for the restriction, a goal to remove the restriction and the treatment being offered to remove the restriction.

⮚ The right to receive an explanation of the reason(s) for denial of service;

⮚ The right not to be discriminated against for receiving services on the basis of race, ethnicity, age, color, religion, gender, national origin, sexual orientation, physical or mental handicap, developmental disability, genetic information, human immunodeficiency virus status, or in any manner prohibited by local, state or federal laws;

⮚ The right to know the cost of services;

⮚ The right to be verbally informed of all cli9ent rights, and to receive a written copy upon request.

⮚ The right to exercise one’s own rights without reprisal, except that no right extends so far as to supersede health and safety considerations;

⮚ The right to file a grievance;

⮚ The right to have oral and written instructions concerning the procedure for filing a grievance, and to assistance in filing a grievance if requested;

⮚ The right to be informed of one’s own condition; and

⮚ The right to consult with an independent treatment specialist or legal counsel at one’s own expense

______ You Have the Responsibility…..

⮚ To be honest about matters that relate to you as a client;

⮚ To participate in the development of your service plan (ISP) and treatment recommendations;

⮚ To give 24-hour notice of any appointment cancellations;

⮚ To know names of the staff who are caring for you;

⮚ To report changes in your condition to those responsible for your care and welfare;

⮚ To be considerate and respectful to the rights of other clients and staff;

⮚ To honor the confidentiality and privacy of other clients;

⮚ To notify staff or the Client Rights Officer if you feel your rights are being violated;

⮚ To assure that the financial obligations of your health care are fulfilled as promptly as possible;

⮚ To follow Family Services and Community Services for the Deaf rules and regulations affecting your care and conduct.

_____ PROGRAM RULES

⮚ Get involved in your / your child’s treatment. Following treatment recommendations is the basis for successful outcomes as well as for continued treatment with our agency.

⮚ Communicate your needs and concerns with the therapist. Ask questions.

⮚ Attend all scheduled sessions.

⮚ Please arrange for childcare during your scheduled sessions.

⮚ Each individual is responsible to pay for their services. Please present any form of insurance to the front desk staff and inform them of any changes in insurance coverage, or Medicaid or Medicare, as well as any changes in your address or phone number.

⮚ In the event of a mental health emergency situation, please call your therapist. If the therapist is unavailable or if the emergency occurs after normal working hours, please call 911 or go to your nearest hospital emergency room.

⮚ We advise you to not arrive for sessions under the influence of alcohol or intoxicating drugs. Illicit drugs may not be brought into our facilities.

⮚ We prohibit firearms or other weapons in our buildings.

⮚ For those clients who are mandated to participate in services, we expect that you follow through with all recommended services. We may be required to provide attendance information to those agencies mandating services.

⮚ We are a non-smoking facility. Please do not smoke in or near the entrances to our buildings.

______ Involuntary termination may result from any of the following behaviors/incidents:

o Violent behavior

o Carrying weapons into the sessions

o Misuse of medication and/or not following staff physician orders for medication administration

o Serious threats made to an employee

o Inappropriate use of multiple providers or systems for the same services

o No longer meeting admission or continuing stay criteria

o Not invested in treatment, as evidenced by numerous missed appointments

You may appeal involuntary termination decisions through the FS-CSD Grievance process.

In the event of a fire or other natural disaster / emergency Please follow the directions of FS-CSD staff in the case of an emergency or drill.

If you experience a mental health after-hour emergency go directly to the nearest hospital emergency room or call 911.

Thank you for choosing our outpatient therapy services.

Our mission is to provide you with results-focused care that is accessible and involves you throughout your treatment process. We have

designed our treatment programs to provide you and/or members of your family with the necessary skills and solutions to cope with problems of daily living.

______ Procedures

A copy of the Client Rights, Responsibilities and Grievance Policies will be given to each service applicant at the time of intake or, in unusual

circumstances, by the next subsequent appointment. Clients with limitations that may preclude full understanding will also have the policy

explained to them. Distribution will occur as part of the financial counseling process except in a crisis/emergency situation where the applicant

shall be verbally advised of the immediately pertinent rights, e.g., the right to consent or to refuse any service upon full explanation of the

consequences of that agreement or refusal, etc. A copy of the policy shall be provided at the next subsequent appointment, if scheduled.

Persons receiving "indirect" services (consultation, education, prevention, training, etc.) may have a copy and explanation of the Client Rights and Responsibilities Policy upon request.

A copy of this policy is posted in a conspicuous location in each space providing services by Family Services & Community services for the Deaf.

It is expected that every staff person will be familiar with all Client Rights and Responsibilities and the Grievance Procedures and will explain any and all aspects of the rights and the grievance procedures upon request.

A Client Rights Officer (CRO) has been assigned to help assure clients of their rights and responsibilities. He will accept and oversee the process of any grievance filed. The CRO is readily accessible by telephone or in person.

The Client Rights Officer/Advocate is:

Tim Alldredge, LPCC-S Family Services and Community Services for the Deaf

Chief Operations Officer 2211 Arbor Blvd. Dayton, Ohio 45439

talldredge@fsadayton.org Monday through Friday (8:30 am – 5:00 pm)

. Day Phone: (937) 222-9481 Fax: (937) 222-3710

Grievance Procedures

Grievances must be in writing, signed and dated by the client. The grievance may be made verbally and the client advocate shall be

responsible for preparing a written text of the grievance. Grievances must include information of the date, time, location, names of the

person(s) involved and a description of the incident/situation and the treatment provider to include contact name, address and telephone

number. The client has the option of filing a grievance with an outside agency. Should a client, or another party on behalf of a client, have a

grievance, that person may file the grievance at any time. Assistance will be given to help file the grievance. A client grievance form will be used.

All grievances are to be settled within the following steps:

1. The Client Rights Officer (CRO) will provide a written acknowledgment of receipt of the grievance to include:

(a) Date grievance was received; (b) Summary of grievance; (c) Overview of grievance investigation process

(d) Timetable for completion of investigation and notification of resolution; and, (e) Treatment provider contact name, address and telephone number.

2. The Client Rights Officer (CRO) will review the grievance within three (3) business days, interview the client as necessary and appropriate, conduct any investigation deemed necessary, and render a judgement within 20 business days of receipt of the written grievance.

3. The Client Rights Officer (CRO) will make a resolution decision on the grievance within twenty (20) business days of receipt of the grievance. Any extenuating circumstances indicating that this time period will need to be extended must be documented in the grievance file and written notification given to the client.

4. If not resolved, the matter will be referred to the Executive Director of Family Services. The client and the CRO will meet with the

Executive Director to review the grievance. A written statement of the results will be given to the client. The entire process will be completed within twenty (20) business days of the receipt of the grievance.

5. If not resolved, the client will be advised and referred to outside agencies. The CRO may assist the client in contacting any resource.

6. The administration of Family Services and Community Services for the Deaf will give whatever support is required for the CRO to fulfill his role in assuming that the agency is in compliance with the Grievance Procedure.

7. Upon their request, and with their signed Release of Information (ROI), information about the grievance will be provided to any outside agency(ies) to which the client has been advised and referred for resolution of the grievance. The agencies usually included are:

Alcohol, Drug Addiction and Mental Health

Services Board for Montgomery County

409 E. Monument Avenue, Suite 102

Dayton, Ohio 45402

(937) 443-0416

Tri-County Mental Health and

Recovery Board

1280 N County Rd 25A, Troy, OH 45373

(800)351-7347

Ohio Department of Mental Health and Addiction Services

30 E. Broad Street, 7 th Floor

Columbus, Ohio 43215

(614) 466-2596

TDD (614) 752-9696

Ohio Counselor, Social Worker, and Marriage

and Family Therapist Board

77 S. High Street, Room 2468

Columbus, Ohio 43215-6108

(614) 466-0912

TDD/TTY Not available

U.S. Department of Health and Human Services Disability Rights Ohio

233 North Michigan Avenue, Suite 240 200 South Civic Center Drive, Suite 300

Chicago, Illinois 60601 Columbus, Ohio 43215

1-800-368-1019 1-800-282-9181

Emergency Interpretation

In a crisis or emergency situation, the client or applicant shall be verbally advised, at a minimum, of the client's immediate pertinent rights, including but not limited to the client's rights to consent or refuse the treatment offered, and the consequences of such agreement or refusal. Clients who are deaf will have such emergency information communicated by a professional interpreter in American Sign Language or in another medium (e.g. C-Print) acceptable to the client. Clients who do not speak English will have such emergency information communicated in their own language whenever feasible.