Download Notice To NorServ Consumers Consumer Confidentiality, Privacy

Notice To NorServ Consumers
Consumer Confidentiality, Privacy Statement, Rights and Responsibilities
We would like to take this opportunity to inform you of your rights and responsibilities
while a consumer at the NorServ Group, Ltd. All consumers are scheduled by
appointment. As a consumer you are expected to keep the scheduled appointments you
have made. If you are not able to keep your appointment for any reason, we ask that
you provide us with 24-hour notice. A cancellation fee will be charged without notice.
YOUR CONSUMER RIGHTS:
The right to be treated with respect and dignity.
The right to privacy. No one can receive information about your mental health services
without your written consent.
The right to refuse service and to be informed of the consequences.
The right to information concerning the services provided.
The right to request change in your services.
If at any time you have a question, concern or complaint regarding services, we
encourage you to contact our Clinical Director OR our Program Director OR our
Recipient Rights Officer.
YOUR CONSUMER RESPONSIBILITIES:
To respect and keep your scheduled appointment times.
To be involved in the development of your plan of service and to carry out, to the
greatest extent possible, the provisions of that service plan.
If you are not satisfied with the service you have received, aggrieved consumers have
the right to make a complaint to file a recipient rights complaint. Our Recipient Rights
Officer is available to you and can explain the process of filing a complaint. Inform your
clinician or the receptionist if you want to request contact with the Recipient Rights
Officer.
CONFIDENTIALITY:
We place the highest value on the confidentiality of information that our consumers
share with us. Because of our legal and ethical responsibilities regarding this important
issue, we want to clarify the limits of confidentiality.
EXCEPTIONS TO CONFIDENTIALITY:
There are several important instances when confidential information may be released to
others:
1)
If we have reason to believe that you are abusing or neglecting your children, we
are obligated by law to report this to the appropriate state agency.
2)
If you communicate intent to harm either yourself or someone else, and we believe
your threat to be serious, we are obligated under the law to take whatever actions seem
necessary to protect people from harm. This may include divulging information to others
and would only be done under unusual circumstances where someone’s life appeared to
be in danger.
3)
If you are involved in litigation of any kind and inform the court of the services that
you received at our agency (making your mental health an issue before the court), you
may be waiving your right to keep your records confidential. You may want to consult
with your attorney regarding such matters before you disclose that you have waived your
rights.
4)
If you are utilizing an insurance policy for reimbursement of services: many
insurance companies request periodic information. Ask your therapist for additional
information.
5)
If, in the course of divorce proceedings, the custody of children is in dispute, the
Judge may order release of our records to aid in the decision to award custody.
In summary, we make every reasonable effort to safeguard the personal information you
share. There are, however, certain instances when we may be obligated under law to
release such information to others. If you have any questions regarding confidentiality,
please discuss them with your clinician.
The State of Health Privacy: Michigan
Michigan statutorily requires health facilities to have policies allowing patients access to
their medical records. The state does not have a general, comprehensive law prohibiting
the disclosure of confidential medical information. Rather, these privacy protections are
addressed in statutes governing specific entities or medical conditions.
Anti-Solicitation Rules:
In an effort to curb solicitation of personal injury claims, Michigan statutorily prohibits any
person, firm or corporation from selling and buying the identity of a patient or information
pertaining to the treatment of a patient. [ Mich. Comp. Laws § 750.410(2).] Treatment
information includes information in the files and records of a Restrictions on Disclosure
Information in the record of a recipient of mental health services is confidential and is not
open to public inspection. [ Mich. Comp. Laws § 330.1748.] The information may be
disclosed only as specifically provided for by law. [ Id. ] All disclosures are to be limited
to information that is germane to the authorized purpose for which the disclosure was
sought. [ Id. ] Confidential information may be disclosed upon the written consent of the
mental health services recipient (or his parent or guardian). [ Mich. Comp. Laws §
330.1748(6).] Disclosure without the recipient’s consent is permitted in a number of
circumstances, including: pursuant to court orders or subpoenas, unless the information
is privileged; to a prosecuting attorney as necessary for participation in a mental health
legal proceeding; as necessary for the purpose of outside research, with certain
restrictions; and others. [ Mich. Comp. Laws § 330.1748(5), (7) and (8).] A minor 14
years or older may request and receive outpatient mental health services without the
consent or knowledge of the minor’s parent, guardian or person on loco parentis. The
mental health professional may not inform the minor’s parent, guardian or person in loco
parentis of the services rendered without the minor’s consent unless the professional
treating the minor determines that there is a compelling need for disclosure and the
minor has been notified of the professional’s intent to disclose that information. [ Mich.
Comp. Laws § 330.1707.]
Substance Abuse:
Records of the identity, diagnosis, prognosis, and treatment of an individual maintained
in connection with the performance of a licensed substance abuse treatment and
rehabilitation service or prevention service are confidential and generally may be
disclosed only with the subject’s written consent. [ Mich. Comp. Laws §§ 333.6111 and
333.6112.] This consent may be revoked at any time by giving written notice. [ Mich.
Comp. Laws § 333.6112.] Disclosure may be made without the subject’s consent to:
medical personnel to the extent necessary to meet a bona fide emergency; to qualified
personnel for the purpose of conducting scientific research, financial audits, or program
evaluation, but the personnel may not identify individuals in any reports or otherwise
disclose an identity in any manner; to a court, but only information as to whether a
specific individual is under treatment by an agency; and for court hearings related to the
treatment of minors. [ Mich. Comp. Laws § 333.6113.]
WE VALUE CONFIDENTIALITY
INFORMATION ABOUT CONFIDENTIALITY AND YOUR INSURANCE
Many of us have insurance to cover our medical and mental health needs. What many
of us are not aware of is the amount of information our insurance company may have the
right to request before authorizing services and payment. Information frequently
requested includes:
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Your name and dependents
Address
Home and work telephone number
Place of employment
Social security number
Diagnosis
Previous treatment history
Medical history
Functioning level
Medications
Test results
Life history
Current stress
Detail of what is presently occurring in your life
Additional information may also be requested by your insurance provider. Before you
use your insurance benefits, we encourage you to contact your insurance company
regarding the information they may request, because we value your rights as a
consumer.
Our fees are based on many factors. They allow us to provide quality mental health
services and meet an accredited standard. We take pride in our ability to provide this
level of service to you.
Taking responsibility for your life is valuable. At least as valuable as the car you drive,
the food you eat, and the home you live in. If you are paying out-of-pocket for your
services, think about what you can afford based on our fee. Whether you schedule twice
a week or a couple of times a month, we will work with you to maximize the benefit you
receive from your sessions.