The Mental Health and Recovery Services Board of Stark County requires each service provider agency to appoint a Client Rights Officer and alternate to be available to discuss concerns from consumers, family members or advocates regarding adherence to the following list of consumer's rights. As a Mental Health and Recovery Services Board provider, Community Services of Stark County, Inc. does adhere to the following list. Our appointed Client Rights Officer is Michelle Chaido. If you have any questions regarding your rights, you can contact Ms. Chaido at or by calling 330.455.0374.
Each person who receives services from a provider of the public mental health system has the following rights:
- The right to be treated with consideration and respect for personal dignity, autonomy and privacy;
- The right to service in a humane setting which is the least restrictive feasible as defined in the treatment plan;
- The right to be informed of one's own condition, of proposed or current services, treatment or therapies and of the alternatives;
- The right to consent or refuse any service, treatment, or therapy upon full explanation of the expected consequences of such consent or refusal. A parent or legal guardian may consent to or refuse any service, treatment or therapy on behalf of a minor client;
- The right to a current, written, individualized service plan that addresses one's own mental health, physical health, social and economic needs, and that specifies the provision of appropriate and adequate services, as available, either directly or by referral;
- The right to active and informed participation in the establishment, periodic review and reassessment of the service plan;
- The right to freedom from unnecessary or excessive medication;
- The right to freedom from unnecessary restraint or seclusion;
- The right to participate in any appropriate and available agency service, regardless of refusal of one or more other services, treatments or therapies, or regardless of relapse from earlier treatment in that or another service, unless there is a valid and specific necessity which precludes and/or requires the client's participation in other services. This necessity shall be explained to the client and written in the client's current service plan;
- The right to be informed of and refuse any unusual or hazardous treatment procedures;
- The right to be advised of and refuse observation by techniques such as one-way mirrors, tape recorders, televisions, movies, or photographs;
- The right to have the opportunity to consult with independent treatment specialists or legal counsel, at one's own expense;
- The right to confidentiality of communications and of all personally identifying information within the limitations and requirements for disclosure of various funding and /or certifying sources, state or federal statutes, unless release of information is specifically authorized by the client or parent or legal guardian of a minor client or court-appointed guardian of the person of an adult client in accordance with rule 5122:2-3-11 of the administrative code;
- The right to have access to one's own psychiatric, medical or other treatment records, unless access to particular identified items of information is specifically restricted for that individual client for clear treatment reasons in the client's treatment plan. "Clear treatment reasons" shall be understood to mean only severe emotional damage to the client such that dangerous or self-injurious behavior is an imminent risk. The person restricting the information shall explain to the client and other persons authorized by the client the factual information about the individual client that necessitates the restriction. The restriction must be renewed at least annually to retain validity. Any person authorized by the client has unrestricted access to all information. Clients shall be informed in writing of agency policies and procedures for viewing or obtaining copies of personal records;
- The right to be informed in advance of the reason(s) for discontinuance of service provision and to be involved in planning for the consequences of that event;
- The right to receive an explanation of the reasons for denial of service;
- The right to not be discriminated against in the provision of service on the basis of religion, race, color, creed, sex, national origin, age, lifestyle, physical or mental handicap, developmental disability or inability to pay;
- The right to know the cost of services;
- The right to be fully informed of all rights;
- The right to exercise any and all rights without reprisal in any form including continued uncompromised access to service;
- The right to file a grievance;
- The right to have oral and written instructions for filing a grievance.
The following information is available for you to understand how your medical information may be used and disclosed and how you can access your medical information as required by the Health Insurance Portability and Accountability Act.
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
At Community Services of Stark County, Inc., we understand that health information about you and your health is personal. We are committed to protecting health information about you and safeguarding that information against unauthorized use or disclosure. We are required by law to: 1) assure health information that identifies you is kept private; 2) give you Notice of our legal duties and privacy practices with respect to health information about you; and 3) follow the terms of the Notice that is currently in effect. This Notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of your health information. The Notice applies to all of the records that we have related to your care.
WHY WE COLLECT PERSONAL HEALTH INFORMATION
We collect personal information to:
- Determine eligibility for health care coverage
- Provide benefits and pay claims
- Conduct our service evaluation programs
- Provide other information for planning and improving mental health and substance abuse services in the community
We may also be required to collect and keep certain information so that we meet legal and regulatory requirements. We keep this information after a client's health care coverage ends.
PERSONAL INFORMATION WE COLLECT
We ask people seeking benefits to provide certain information when they complete an enrollment form. This information may include, for example:
- Name, Address, Phone
- Date of Birth
- Marital Status
- Social Security Number
- Family Income
We may also receive personal information about you from others, such as:
- Health care providers (doctors, clinics, hospitals)
- Business partners (companies with whom we have arrangements to assist us in providing products and services)
- Other government agencies (criminal justice system, child welfare, juvenile justice, etc.)
The information we collect from others may include, for example, eligibility, claims and payment information. From time to time, we also receive information from your treatment provider related to your diagnosis, treatment and progress in recovery, and any major unexpected emergencies or crises you may experience.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
If you have a guardian or a power of attorney, we will provide the information to your guardian or attorney in fact.
Examples of how we use your information include:
Health Care Operations
We use personal information to train staff, manage costs, conduct required business duties, and make plans to better serve you and other community residents who may need mental health or substance abuse services.
Other Services We Provide
We may also use your personal information to:
- Review and evaluate the quality, effectiveness, and efficiency of the services you have received;
- Conduct program and fiscal audits of programs that have provided you with services;
- Investigate major unusual incidents, report these kinds of incidents and take steps to protect your health and safety;
- Prepare reports required by the Ohio Department of Alcohol and Drug Addiction Services, the Ohio Department of Mental Health, and the Ohio Department of Job and Family Services;
SHARING YOUR PERSONAL INFORMATION
There are limited situations in which we are permitted or required to disclose personal information without your signed authorization. These situations are:
- To protect victims of abuse, neglect or domestic violence;
- To reduce or prevent a serious threat to public health and safety;
- For health oversight activities such as investigations, audits, and inspections;
- For local, state, federal agencies to monitor your services;
- For lawsuits and similar proceedings;
- For public health purposes, such as reporting communicable diseases, work-related illnesses or other diseases and injuries, as permitted by law; reporting births and deaths and reporting reactions to drugs and problems with medical devices;
- When required by law;
- When requested by law enforcement as required by law or court order, except as limited by laws regarding disclosure of alcohol and other drug treatment;
- To coroners, medical examiners and funeral directors;
- For organ and tissue donation;
- For workers’ compensation or other similar programs, if you are injured at work and are covered by workers’ compensation or other similar programs;
- For specialized government functions such as intelligence and national security.
All other uses and disclosures not described in this notice require your signed authorization. You may revoke your authorization at any time with a written statement.
SAFEGUARDING YOUR PERSONAL INFORMATION
We maintain physical, electronic and procedural safeguards that comply with applicable federal and state laws and regulations to guard your personal information against unauthorized use or disclosure. Any third party processor or consultant used by Community Services has signed an agreement with us requiring such entity to maintain the confidentiality of your personal information. We also restrict access to your personal information to those employees who need to know the information in order to perform their job duties. Community Services maintains policies and procedures that prohibit employees and agents of Community Services from using, disclosing, transferring, providing access to or otherwise divulging client health information to any person or entity other than to the individual who is the subject of the information.
INDIVIDUAL CLIENT RIGHTS
You have the following rights regarding the health information we maintain about you:
- 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 payment or health care operations. We will consider all requests for restrictions carefully but are not required to agree to any requested restrictions.*
You also have the right to request a limit on the health information we disclose about you to a family member who is involved in your care if you are receiving alcohol or other drug services and have previously agreed to limited disclosure to such a family member. We will comply with any restrictions you request regarding disclosure to such a family member.*
- Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we contact you only at work or by mail.
- Right to Inspect and Copy. You have the right to access the personal information we collect, upon request. Under certain circumstances, we may not share information that we collected for example, if the information is the subject of a lawsuit or legal claim, or if information may present a danger to you or someone else. Fees may apply to copied information.*
- Right to Amend. You have the right to request corrections or additions to your personal information. You must give the reasons for wanting the change.*
- Right to An Accounting of Disclosures. You have the right to request an accounting of disclosures made of your personal information that were not related to our business operations or your authorization. Under certain circumstances, we may not share information that we collected; for example, if the information is the subject of a lawsuit or legal claim, or if release of the information may present a danger to you or someone else. Your request must state the period of time desired for the accounting, which must be within the six years prior to your request. The first accounting is free, but a fee will apply if more than one request is made in a 12-month period.*
- Right to a Paper Copy of Notice. You have the right to a paper copy of this Notice. Although this Notice is available at our web site you may obtain a copy of the Notice by contacting our offices.
Requests marked with a star (*) must be made in writing. Contact the Client Rights Officer of Community Services with your request. To exercise any of your rights described in this paragraph, please contact the Client Rights Officer at the address or phone number listed below.
Community Services of Stark County, Inc.
625 Cleveland Avenue, NW
Canton, OH 44702
CHANGES TO THIS NOTICE
We reserve the right to change this Notice at any time. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice at the offices of Community Services. The Notice will contain, on the first page in the top center, the effective date.
If you have a complaint about our privacy policies and procedures or you believe your privacy rights have been violated, you may file a complaint with Community Services or with the Secretary of the Department of Health and Human Services. To file a complaint with Community Services, contact the Clients Rights Officer at the address below. We will investigate all complaints and will not retaliate against you for filing a complaint. If you wish to file a complaint with the Secretary, you may send the complaint to:
7500 Security Blvd., C5-24-04
Baltimore, MD 21244
OTHER USES OF PERSONAL HEALTH INFORMATION
Other uses and disclosures of your personal health information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your health information for the reasons covered by your written permission. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the services that we provided to you.
Community Services of Stark County, Inc.
625 Cleveland Avenue, NW
Canton, OH 44702