Your Consumer Rights and Responsibilities

When you contact us about services we begin a two-way relationship with you as the consumer and us as the treatment provider. We want this relationship to be productive. We want the best care for you or your family. We will work together toward the best possible result for you and your situation. We also know that you will expect things from us. We expect certain things of you as well. Your “Rights” are the things that you can count on getting from us. Your “Responsibilities” are things we need from you. With everyone doing their part and trying their best to work together, we will promote and protect your health and safety and the health and safety of your family and our community.

YOUR RIGHTS

RESPECT

1. To be treated with dignity and respect by WVCW staff;

ACCESS TO SERVICES

1. To give informed consent in writing prior to the start of services (except in a medical emergency or otherwise permitted by law);
2. To seek outpatient services on your own if you are age 14 or older, emancipated, or under age 18 and legally married;
3. To seek services for a minor if you are the legal guardian;
4. To be treated in the same manner as any other individual seeking behavioral health services;
5. You do not need a referral from a doctor to get our services;
6. You will get care that is right for your condition;
7. You will get care that is approved for your condition;
8. You will get behavioral health services in a timely manner equal to access available to any other individual seeking the same services;
9. You will be notified in a timely way if we have to cancel your appointment;
10.  You can get help or “Protected Services” if you are being abused;
11. You can get crisis care 24 hours a day, 7 days a week;
12. You have access to Peer Delivered Services

 INFORMATION

1. You will be given information about your rights and responsibilities;
2. You will be given information about services;
3. You will be given information about behavioral health services covered or not covered by your health care plan and WVCW will work with you to ensure finances are not a barrier to receiving care;
4. You can choose the service options covered by your health care plan that works for you;
5. You can have services explained, including expected outcomes and possible risks;
6. You can have free written materials in a form you can understand;
7. You can have us explain written materials to you;
8. You can have a free interpreter if you are hearing impaired or if your primary language is not English.
9. You can have information about “The Declaration for Mental Health Treatment” and “Advance Directive” for health care decisions and what is involved in those processes;
10. You will be informed before you receive a service not covered by your health care plan;
11. You will get information about fee agreements before you receive a service;
12. You will receive prior notice of transfer, unless in circumstances necessitating transfer pose a threat to health and safety;

DIRECT YOUR CARE

1. We will give you our best effort to understand your condition;
2. We will give you details about your condition;
3. We will try our best to set up services that most closely meet your needs;
4. You can accept or decline services offered to you (except those required by court order);
5. We will inform you of how your decision to accept or not accept a service could affect your health;
6. We will not use the practice of “restraint” or “isolation” to punish you;
7. We will not “restrain” or “isolate” you to make you do something you don’t want to do;
8. You can get a second opinion about your diagnosis and treatment;
9. You may be referred to another provider if you need covered specialty care we do not provide;
10.  You will be actively involved in making your plan for treatment;
11. You will be involved in making your child’s plan for treatment, if you are a parent or guardian;
12. You can have a friend, family member, or advocate with you at appointments;
13. You will be involved in decisions about your care;
14. You can change your provider or treatment agency, with a good reason;
15. You can choose whether or not you wish to take part in any new forms of treatment offered;

CONFIDENTIALITY

1. Your personal information will be kept private;
2. What you say to your provider will be kept confidential unless required by law;
3. You will have a record kept with information about your condition, services you received, and referrals that were made for you;
4. Your record will be kept private and confidential according to the law;
5. You can get a copy of your record unless it is restricted by law;
6. You can ask to change or correct the information in your record;
7. You can ask us to give information from your record to another provider;
8. No research information gathered will identify your personal information;
9. You can withdraw a release at any time;

EXERCISE YOUR RIGHT

1. You have religious freedom, freedom from seclusion and restraint;
2. You will be given information about our complaint process;
3. You will not be discriminated against in any way for making a complaint;
4. You will not be discriminated against for exercising your rights;
5. You will not be discriminated against or restricted from services based on race, age, gender, ethnic or national origin, language spoken, disability, sexual orientation, political or religious beliefs, or marital status;
6. You can make a complaint about WVCW, and will get a timely answer;

YOUR RESPONSIBILITIES

RESPECT

1. Treat your provider and treatment agency staff with respect;

INVOLVEMENT

1. Be actively involved in creating your plan of care;
2. Ask questions about anything you don’t understand;
3. Use information you have received to decide about your care before care is given;
4. Follow plans of care you have agreed to, or ask for them to be changed;

COMMUNICATION AND INFORMATION

1.  Keep appointments with your provider;
2.  Be on time for your appointment, If you arrive more than 15 minutes late your appointment may be rescheduled;
3. Call ahead when you are going to be late or can’t keep the appointment;
4.  Give your provider correct information about your behavioral health situation;
5. Give accurate information for your record;
6. Help your provider get previous behavioral health records;
7. Keep your address, phone number and insurance information up to date;

HONORING GUIDELINES

1. Use services from your assigned provider except in an emergency;
2. Use urgent and emergency services appropriately;

PAYMENT

1. Show your insurance card to your treatment agency before your receive services.
2. Pay all fees when they are due;
3. Sign papers to confirm you have been informed of how much any services not covered by your insurance will cost, should you choose to use them;
4. Provide proof of income documents if requested;
5. Sign forms to verify you have been informed who is responsible for paying for services if you choose to get services that are not covered by your insurance. You can get this document in a larger print size or in a different format. You can also get this document in some languages other than English. Contact us at 541-426-4524 and request languge services.