CLIENT RIGHTS

Confidentiality Statement

TCN Behavioral Health Services, Inc. adheres to guidelines and regulations governing client confidentiality established by state and federal law (Ohio Revised Code, 42 U.S.C. 290dd-2, and 42 CFR Part 2). Drug abuse patient records are also protected under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 45 CFR parts 160 and 164.  Generally, no agency staff may disclose any information requiring a client’s authorization in the form of a signed “Authorization for Release of Information”.  Parents or other legal guardians must provide these when clients are under the age of eighteen.  Information may be disclosed in exceptional circumstances when a signed authorization for the release of information has not been obtained.  These include responding:

 

  1. To a valid court order;

  2. To medical personnel in a medical emergency;

  3. To research professionals for program evaluation or audits;

  4. To suspected child abuse or endangerment;

  5. To concerns over the immediate safety of the client or other individual.

 

The confidentiality of alcohol and drug abuse patient records maintained by this program is protected by Federal law and regulations.  Generally, the program may not say to a person outside the program that a patient attends the programs, or disclose any information identifying a patient as an alcohol or drug abuser except for the circumstances listed above in 1 through 5. 

 

Violation of the Federal law and regulations by a program is a crime.  Suspected violations may be reported to appropriate authorities in accordance with Federal regulations.

 

Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime.

 

Client information may be shared among TCN Behavioral Health Services, Inc. staff in the interest of coordinating and implementing treatment.

 

Per Section 5122.31(A5) of the Revised Code, client’s may have access to their own psychiatric, medical or other treatment records, unless access to particular identified items of information is specifically restricted from that individual client for clear treatment reasons in the client's treatment plan.  If access is restricted, the treatment plan shall also include a goal to remove the restriction.


 

MENTAL HEALTH AND SUBSTANCE USE CLIENT RIGHTS IN ACCORDANCE WITH OAC 5122-26-18

All consumers of TCN Behavioral Health Services, Inc. have rights, including, but not limited to, those bestowed by the Ohio Department of Mental Health and Addiction Services (ODMHAS) listed here.

 

CLIENT RIGHTS IN ACCORDANCE WITH OAC 5122-26-18

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

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

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

4.      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;

5.      The right to give informed consent to or to refuse any service, treatment or therapy, including medication absent an emergency;

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

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

8.      The right to be informed and the right to refuse any unusual or hazardous treatment procedures;

9.      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;

10.  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;

11.  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;

12.  The right to be informed a reasonable amount of time in advance of the reason for terminating participation in a service, and to be provided a referral, unless the service is unavailable or not necessary;

13.  The right to be informed of the reason for denial of a service;

14.  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;

15.  The right to know the cost of services;

16.  The right to be verbally informed of all client rights, and to receive a written copy upon request;

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

18.  The right to file a grievance;

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

20.  The right to be informed of one's own condition; and,

21.  The right to consult with an independent treatment specialist or legal counsel at one's own expense.

 

TCN Behavioral Health Services Civil Rights Policy

It is the policy of TCN Behavioral Health Services, Inc., to treat all clients without regard to race, color, national origin, age, sex, sexual orientation, or religion.  The same requirements are applied to all, and clients assigned without regard to race, color, national origin, disability, age, sex, sexual orientation or religion.  There is no distinction in eligibility for, or in the manner of providing client services.  All services are available without distinction to all clients and visitors regardless of race, color, national origin, disability, age, sex, sexual orientation, or religion.  All persons and organizations having occasion either to refer clients for services or to recommend TCN Behavioral Health Services are advised to do so without regard to the potential client’s race, color, national origin, disability, age, sex, sexual orientation, or religion.

 

Any person who feels they have been discriminated against because of their race, color, national origin, disability, age, sex, sexual orientation, or religion has the right to file a complaint.

 

GRIEVANCE PROCEDURES

The following staff members have been designated the Client Rights Officer /Advocate: 

Stacey Gough

 

This staff member is responsible for:  (1) Assuring compliance with client/consumer rights and grievance procedures; (2)  Assisting the client/consumer in preparing the grievance if such assistance is required; (3)  Explaining all aspects of the client/consumer rights and grievance procedures; (4) Ensure the client/consumer does not experience any form of reprisal or retribution consistent with #17 of Ohio Administrative Code (OAC) 5122-26-18 and #3 of OAC 5122-30-22.

 

A grievance is a written complaint which alleges that a client's/consumer’s rights were denied, violated and/or abused.  All grievances are required to be put into writing. Grievances may be filed at any time after the alleged violation by the client/consumer affected or by another individual or agency.  Persons wishing to file a grievance should prepare a written statement which includes the date and time of the alleged violation, a description of the circumstances, and the names of those involved (including witnesses). Grievances may be made verbally and the Client Rights Officer/Advocate shall be responsible for preparing a written text of the grievance. The written grievance must be signed and dated by the client/consumer, the individual filing the grievance on behalf of the client/consumer, or have an attestation by the Client Rights Officer/Advocate that the written grievance is a true and accurate representation of the client’s grievance.

Grievances should be sent to: 

Stacey Gough

TCN Behavioral Health Services, Inc.

1825 Commerce Center Blvd.

Fairborn, OH 45324                        

(937) 306-1209

 The agency will provide assistance in preparing/filing the grievance if such assistance is needed.  The Client Rights Officer / Advocate is responsible for assisting the griever and should be contacted for assistance.  If you desire assistance, please contact the appropriate Client Rights Officer based on your location via the phone number identified above during normal business hours (Mon. - Fri. 8:00 a.m. – 4:30 p.m.).  The caller should note that a grievance is involved.  If unavailable at the time of call, the Client Rights Officer / Advocate will return the call by the end of the next business day.

 

In the event, the Client Rights Officer/Advocate is unavailable (e.g., on sick leave, vacation); the agency's Alternate Client Rights Officer or designee shall fulfill the role of the Client Rights Officer during the absence.  Grievances involving the Client Rights Officer / Advocate should also be filed with the Alternate Client Rights Officer.  The Alternate Client Rights Officer is Charles Tipton. Mr. Tipton can be reached by phone at (937) 376-7038 or at the following location: 452 West Market Street, Xenia, OH 45385.

 

Written acknowledgement of receipt of the grievance will be provided to each grievant within three (3) business days from receipt of the grievance. The written acknowledgement shall include, but not be limited to, the following: (1) Date the grievance was received; (2) Summary of the grievance; (3) Overview of the grievance investigation process; (4) Timetable for completion of investigation and notification of resolution; and (4) Treatment provider contact name, address and telephone number.

 

The Client Rights Officer shall conduct an investigation of the grievance and shall determine appropriate actions, if any, to take. The griever (or the griever if other than the resident, with the resident’s permission) shall receive a written response from the Client Rights Officer within 20 business days of the receipt of the written grievance. Any extenuating circumstances indicating that this time period will need to be extended must be documented in the grievance file and written notification will be given to the client/consumer.

 

If the client disagrees with the written response they may file an appeal with Tom Otto, Associate CEO. To file an appeal, please request the appeal in writing and address it to Tom Otto, 1825 Commerce Center Blvd., Fairborn, OH 45324. If desired by the griever or determined necessary or appropriate during the appeal process, a Client Rights Committee may be formed. 

 

If a Client Rights Committee is utilized, it is comprised of the Client Rights Officer and other staff designated by the Chief Executive Officer. To ensure impartiality, members of the committee who are involved in the allegation shall be replaced with another staff member. When appropriate, given the nature of the grievances, individuals external to the agency may be asked to serve on the committee with the client’s consent. The Client Rights Officer shall represent the griever throughout the process, including agency hearings, and shall insure that agency procedures are followed.

 

The Client Rights Committee shall conduct an investigation of the complaint and shall determine appropriate actions to take.  A report stating the committee's findings and a summary of the recommendations will be submitted to the Chief Executive Officer.  The Chief Executive Officer will review all grievances and the actions taken by the committee including those involving the alleged client/consumer abuse and neglect. 

The griever (or the griever if other than the client/consumer, with the client/consumer’s permission) shall receive a written response to an appeal within 20 business days of receipt of the written appeal.

Allegations involving client/consumer abuse and neglect shall be reported to the appropriate county Board (ex. Mental Health and Recovery Board of Clark, Greene, and Madison Counties or the Montgomery County ADAMHS Board) and the Department of Mental Health and Addiction Services within 24-hours of receiving the grievance.  In such cases, the Board and the Department shall be notified of the investigative findings and actions taken.  Allegations involving child abuse and adult abuse shall be reported to the appropriate authorities and law enforcement agencies required by law.

 

TCN Behavioral Health Services, Inc. will maintain records of written grievances for at least three years.  The Client Rights Officer / Advocate is responsible for maintaining records of all Client/Consumer Rights / Grievance complaints and actions. The record will include (1) A copy of the grievance, (2) Documentation of the grievance process used and resolution/remedy, (3) A copy of the letter to the grievant reflecting the resolution, and (4) Documentation, if applicable, of extenuating circumstances for extending the time period for resolving the grievance beyond twenty business days. 

Each griever shall be provided with a list of organizations other than the agency to which grievances may be directed. All relevant information about the grievance will be forwarded to one or more of these organizations upon the griever’s request.

  

You also have the right to file a grievance at any time with the following organizations:

Montgomery County ADAMHS Board

409 E. Monument Avenue, Suite 102

Dayton, OH 45402
937-853-4307

Fax: 937-461-2204

Mental Health & Recovery Board of Clark, Greene and Madison Counties

1055 E. High Street

Springfield, OH 45505

937-322-0648 or 800-435-7968



Tri-County Board of Recovery & Mental Health Services

1100 Wayne St., Suite 4000

Troy, Ohio 45373

937-335-7727

Mental Health, Drug & Alcohol Services Board of Logan & Champaign Counties

1521 N. Detroit St. (P.O. Box 765)

West Liberty, Ohio 43357

937-465-1045


Ohio Department of Mental Health and Addiction Services

30 E. Broad St., 36th Floor

Columbus, OH 43215-3430

614-466-2596   

Toll-free Bridge Line  1-877-275-6364

Text telephone 614-752-9696

Disability Rights Ohio

Attn: Intake

200 Civic Center Drive, Suite 300

Columbus, OH  43215

614-466-7264 or 800-282-9181

 

Office for Civil Rights

U.S. Department of Health & Human Services

200 Independence Ave., SW

Room 509F, HHH Building

Washington, D.C. 20201

Voice Phone: 800-368-1019

TDD: 800-537-7697

Ohio Civil Rights Commission

Dayton Regional Office

Point West III

3055 Kettering Blvd, Suite 111
Dayton, Ohio 45439

937-285-6500

 

State Medical Board of Ohio

30 E. Broad St., 3rd floor

Columbus, OH  43215

614-466-3934

Fax: 614-728-5946

Attorney General’s Office

Health Care Fraud Unit

30 East Broad Street, 14th Floor

Columbus, OH  43215

614-466-4986 or 800-282-0515


Ohio Board of Nursing

17 S. High St. Suite 660

Columbus, OH 43215

614-466-3947

Fax: 614-466-0388

State Board of Psychology (Ohio)

77 S. High Street, Suite 1830

Columbus, OH  43215

614-466-8808 or 877-779-7446

Fax: 614-728-7081

Ohio Counselor, Social Worker, and Marriage and Family Therapist Board

77 S. High St., 24th Floor, Room 2468

Columbus, OH 43215

614-466-0912

Fax: 614-728-7790

Ohio Chemical Dependency Professionals Board

77 S. High Street, 16th floor

Columbus, OH 43215

614-387-1110

Fax: 614-387-1109


For legal assistance in regard to your rights, contact:

Legal Aid of Western Ohio, Inc.

130 W. Second St, Suite 700 West

Dayton, Ohio 45402

1-877-894-4599 or 937-228-8088

www.legalaidline.lawolaw.org

SECTION 504 GRIEVANCE PROCEDURES

 

Section 504 of the Rehabilitation Act prohibits discrimination based on disability.  In accordance with Section 504 Regulation, any program participant (patient, resident, etc.), participant representative, prospective participant or staff member who has reason to believe that he/she has been mistreated, denied services or discriminated against in any aspect of services or employment because of disability may file a grievance.  In order to implement this policy, this agency/facility has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by the U.S. Department of Health and Human Services Regulation (45 CFR Part 84) implementing Section 504 of the Rehabilitation Act of 1973 as amended (29 USC 794).  Section 504 states, in part, that “no otherwise qualified disabled individual... shall, solely by reason of his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance...”  The law and regulations may be examined in the office of the Client Rights Officer at TCN Behavioral Health Services, Inc., 1825 Commerce Center Blvd, Fairborn, Ohio, 45324. Stacey Gough has been designated as the Section 504 Coordinator.

 

1. A grievance must be in writing, contain the name and address of the person filing it, and briefly describe the action alleged to be prohibited by the regulations.

 

2. A grievance must be filed in the office of the Section 504 Coordinator within 30 days after the person filing the grievance became aware of the action alleged to be prohibited by the regulations.  This time frame may be waived by the Coordinator if extenuating circumstances exist which justify an extension.

 

3. The Coordinator, or his designee, shall conduct such investigation of a grievance as may be appropriate to determine its validity.  These rules contemplate thorough investigations, affording all interested persons and their representatives, if any, an opportunity to submit evidence relevant to the grievance.  Under Section 504 of the Rehabilitation Act, 45 CFR 84.7(b), the agency/facility need not process complaints from applicants for employment.

 

4. The Section 504 Coordinator shall issue a written decision determining the validity of the grievance no later than 15 days after its filing.

 

5. If the grievance has not been resolved at this point, the Section 504 Coordinator should forward it to the Chief Executive Officer who shall have an additional 15 days to resolve the grievance.  The Chief Executive Officer shall notify the grievant in writing of the decision and list the evidence on which the decision is based.

 

6. If the complaint is still unresolved, the grievant may request in writing that the Chief Executive Officer submit the grievance to the Board of Directors.  The Board shall have 30 days to resolve the grievance.  If the grievance is then unresolved, the grievant will be advised in writing of the right to file a complaint with the appropriate local, state and federal civil rights offices and will be provided with the names and addresses of such offices, including the Office of Civil Rights of the U.S. Department of Health and Human Services at 233 N. Michigan Ave., Suite 240 Chicago, IL 60601.