Client Rights

Your Rights and Responsibilities

Adapted from the Florida Patient’s Bill of Rights and Responsibilities, Florida Mental Health Law, and Directions for Living Policies and Procedures:

Your Rights

 To be treated with courtesy and respect, including appreciation of your individual dignity, and protection of your need for privacy

 To quality treatment

 To prompt and reasonable responses to questions and requests

 To know who is responsible for your care and his or her qualifications

 To know what client support services are available, including whether an interpreter is available if you do not speak English, or are Deaf or Hard of Hearing

 To know what rules and regulations apply to your conduct

 To be given information concerning diagnosis, recommended course of treatment, alternatives, risks, and prognosis, to guide in treatment decisions. In the case of prevention services, you have the right to be given information regarding the service being provided, expected outcome of that service and any risks related to participation in that service.

 To refuse any treatment, except as otherwise provided by law

 To be given full information regarding fees for services, available financial resources for your care, and an itemized bill upon request

 To impartial access to services or accommodations, regardless of sex, race, age, national origin, religion, sexual orientation, physical handicap, or resource of payment. If you believe you have been discriminated against in any way, please assist us in our commitment to providing impartial services by contacting the Director of Quality Improvement at (727) 524-4464 extension 1704.

 To give consent or refusal to participate in experimental research

 To express grievances regarding any violation of your rights, including abuse or neglect, as stated in Florida law, through the grievance procedure of Directions for Living. This information is provided during the orientation process and is posted in office reception areas. To express a violation of your rights, clients can also contact the Department of Children and Families at 813-337-5700 or Disability Rights Florida at 1-800-342-0823. To report abuse or neglect, contact the Florida Abuse Hot Line at 1-800-962-2873.

 To receive services in a safe and healthy environment

 To participate in the development and review of treatment/service and discharge planning

 To seek and/or receive services from the provider of your choice

Your Responsibilities

 To provide accurate and complete information to the best of your ability.

 To report changes in your condition, living arrangements, and financial/insurance status.

 To report whether or not you understand a suggested course of action and what is expected of you.

 To follow the treatment plan agreed upon by you and your service provider.

 To ask questions and discuss concerns regarding your treatment as they arise.

 To keep appointments regularly and to call and cancel any appointments you cannot keep at least 24-hours in advance. Failure to keep appointments regularly may lead to your case being closed and you will no longer be a client of Directions for Living. If your case is closed, you will have to re-apply for services.

 To accept any consequences that result from refusing treatment or not following the service provider’s instructions.

 To pay fees as promptly as possible. When there are difficulties meeting this responsibility, you can make arrangements with your service provider or a representative from the reimbursement department to pay as soon as possible. Failure to make arrangements for payment may lead to your case being closed.

 To treat all other people in the facility with courtesy and respect.

 To refrain from attending appointments when actively infectious or contagious and seek appropriate medical treatment before returning for services.

 To permit the Department of Children and Families, Juvenile Welfare Board, Central Florida Behavioral Health Network and other funding sources to review the information regarding your treatment or services if the help pay for your treatment or services provided by Directions for Living.

 To follow the facility rules regarding conduct as follows:

o Avoid being violent or threatening to staff, visitors, or other clients. You can be denied services if you become violent or threatening, or destroy property which does not belong to you. If you become violent, our staff may use crisis intervention techniques to protect you, themselves, others, and/or property.

o Do not bring unauthorized weapons into the building. If it is discovered that you have an unauthorized weapon, you will be required to leave immediately, and we will inform a law enforcement agency in the event of any threatening behavior.

o Avoid bringing any illegal substance in or around our property. If it is discovered that you have an illegal substance with you, you will be required to leave immediately and we may inform a law enforcement agency.

o Avoid exposing staff, visitors or other clients to contagious diseases or conditions such as lice, scabies, active tuberculosis, infectious hepatitis, or other contagious diseases. Services can be refused to anyone who has, or claims to have, a currently contagious disease or condition until appropriate medical attention has been initiated and the physical condition is no longer contagious.

o Directions for Living is a smoke-free environment. The designated smoking area for Directions’ guests is under the oak tree in front of the Clearwater location. A bench area at the side of the parking lot at the Largo facility is designated as the smoking area.

o Wear appropriate clothing when in or around our buildings


Your Privacy and Security

One of our five promises is to respect your privacy. This is part of our code of ethics. We are required by law to maintain the privacy of “protected health information” about you, to notify you of our legal duties and your legal rights, and to follow the privacy policies described in this notice. “Protected health information” means any information that we create or receive that identifies you and relates to your health or payment for services to you. All information about you is confidential and Directions is committed to protecting and securing your information. Directions for Living adheres to the rules and regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).


Your Privacy Rights

 To confidentiality.

 To determine the amount of information to be released either to or from anyone outside Directions by signing a Release of Information.

 To determine the length of time that information may be released.

 To revoke a written Authorization for us to use or disclose your protected health information. The revocation will not affect any previous use or disclosure of your information.

 To review and copy your record. You have the right to see records used to make decisions about you, unless a clinical professional determines that disclosure would create a substantial risk of physical harm to you (for example, disclosure to your personal representative may create a risk of physical harm to you if there is an abusive relationship). If requested and with your written permission, we will forward a complete copy of your health record to a subsequent treating provider. If another person provided information about you to our clinical staff in confidence, that information may be removed from the record before it is shared with you. We will also delete any protected health information about other people. We will charge a reasonable fee for this service as appropriate.

 To “amend” your record. If you believe your records contain an error, you may ask us to amend it. If there is a mistake, a note will be entered in the record to correct the error. If not, you will be told and allowed the opportunity to add a short statement to the record explaining why you believe the record is inaccurate. This information will be included as part of the total record and shared with others if it might affect decisions they make about you.

 To a paper copy of this Notice. You have the right to a paper copy of any Notice of Privacy Practices.

 To file a complaint with Directions for Living’s Compliance Officer, at (727) 524-4464, extension 1704, if you feel that Directions for Living has not been compliant with the privacy and security of your protected health information. You can also submit a complaint to the United States Department of Health and Human Services by calling OCR Hotlines-Voice: 1-800-368-1019 or by sending your complaint to:

Office for Civil Rights U.S. Department of Health and Human Services

200 Independence Avenue, S.W. Room 509F, HHH Building Washington, D.C. 20201

We will never retaliate against you for filing a complaint. You can also contact the Directions for Living Quality Management Department at (727) 524-4464 ext. 1716 if you have any questions about your privacy and security, policies and procedures, requests to exercise individual rights.

Our Use and disclosure for treatment, payment and health care operations

 We will use your protected health information and disclose it to others as necessary to provide treatment to you, based upon the consent you provided in your registration form or releases of information that you sign. Here are some examples:

o Various members of our staff may see your clinical record in the course of our care for you. This includes, but is not limited to medical assistants, case managers, nurses, physicians, and other therapists.

o Your record may be reviewed for quality improvement purposes.

o It may be necessary to send blood or urine samples to a laboratory for analysis to help us evaluate your medical condition.

o We may provide information to your health plan or another treatment provider in order to arrange for a referral or clinical consultation.

o We will contact you to remind you of appointments.

o We may in some cases use another organization to transcribe the medical progress notes to provide a clear and legible record of your treatment.

 We will use or disclose your protected health information as needed to arrange for payment for service to you. For example, information about your diagnosis and the services we render is included in the bills that we submit to your health insurance plan. Your health plan may require health information in order to confirm that the services rendered are covered by your benefit program and medically necessary. A health care provider that delivers service to you, such as a clinical laboratory, may need information about you in order to arrange for payment for its services.

 It may also be necessary to use or disclose protected health information for our health care operations or those of another organization that has a relationship with you. For example, our quality assurance staff reviews records to be sure that we deliver appropriate treatment of high quality. Your health plan may wish to review your records to be sure that we meet national standards for quality of care. Additionally, your record may be reviewed by our licensing or accrediting agencies.

 It is our policy to obtain a general written permission to use and disclose your protected health information for treatment, payment or health care operations purposes. Your registration form includes your authorization for the release of medical information necessary to process payment or related claims and for the release of statistical and demographic information to certain local, state, and/or federal agencies.

 Beyond this, it is our policy to obtain specific written permission for every other disclosure of protected health information to third parties except as noted below. You will be asked to sign an Authorization form for disclosure to each person or organization that receives the information.

Exceptions to Confidentiality

There are several important instances when confidential information may be released to others:

  • Emergencies: If there is an emergency, we will disclose your protected health information as needed to enable people to care for you.
  • Disclosure to health oversight agencies: We are legally obligated to disclose protected health information to certain government agencies, including the Department of Children and Families or the Managing Entity of Directions’ contract with the Department, and the federal Department of Health and Human Services.
  • Disclosures to child, elder, and disabled adult protection agencies: We will disclose protected health information as needed to comply with state law requiring reports of suspected incidents of child, elder, or disabled adult abuse or neglect. We will disclose protected health information as requested as part of an investigation by a law enforcement agency of an abuse or neglect report.
  • Other disclosures without written permission: There are other circumstances in which we may be required by law to disclose protected health information without your permission. They include disclosures made:
    • If you invite another person into your treatment session
    • If we are court ordered by a judge to release information
    • If you present a threat of danger to yourself or to someone else
    • If you have a communicable disease that we are required by law to report to public health authorities
    • If you are a minor and your parent or legal guardian requests information regarding your care
    • If you file a formal complaint or take legal action against an employee of Directions
    • If you take other legal action in which you make your mental health an issue
    • To law enforcement officials in some circumstances, for example if you commit a crime while on Directions’ property
    • To correctional institutions regarding inmates
    • To federal officials for lawful military or intelligence activities
    • To coroners or medical examiners
    • To researchers involved in approved research projects
  • We share the social security number, name, and address of clients whose services are funded in whole or in part by the Juvenile Welfare Board (JWB) to that agency for the following purposes:
    • To research, track, and measure the impact of JWB-funded programs and services in an effort to maintain and improve such programs and services for the future (individual information will not be disclosed)
    • To identify and match individuals and data within and among various systems and other agencies for research purposes
    • If applicable, to share information with the Florida Department of Health for purposes of Medicaid funding
      • As otherwise required by law
    • Disclosures with your permission: No other disclosure of protected health information will be made unless you give written Authorization for the specific disclosure.

Personal representative: A “personal representative” of a client may act on their behalf in exercising their privacy rights. This includes the parent or legal guardian of a minor. In some cases, adolescents who are “mature minors” may make their own decisions about receiving treatment and disclosure of protected health information about them. If an adult is incapable of acting on his or her own behalf, the personal representative would ordinarily be his or her spouse or another member of the immediate family. An individual can also grant another person the right to act as his or her personal representative in an advance directive or living will.

Disclosure of protected health information to personal representatives may be limited in cases of domestic or child abuse.

Advance Directives

The Florida Legislature has recognized that every adult has the right to decide what medical and mental health treatment he or she will receive, including the right to refuse treatment. It has enacted the Florida Health Care Advance Directive Law (Chapter 765). This allows you to make decisions about your treatment while you are able to do so – before a crisis.

This is done through a document called an Advance Directive, which lets you write down what you want to have happen later. It also allows you to name a trusted friend or family member, called a Health Care Surrogate, to carry out your wishes.

A Mental Health Advance Directive is a legal document that allows you to state your preferences regarding mental health treatment before a crisis occurs, when you might not be able to understand treatment choices or make decisions.

Upon admission to services, when appropriate, you may be asked by staff if you have an Advance Directive. You may also be asked to complete a form called a Personal Safety Plan / Mental Health Advance Directive. This form lets your treatment team know how you want us to respond if you start feeling badly. We want to prevent a crisis before it starts.

We at Directions strongly encourage you to think about this issue. If you would like more information about Mental Health Advance Directives, or how to name a Health Care Surrogate, ask someone on your treatment team. If you have an Advance Directive documenting a Living Will and/or the appointment of a Health Care Surrogate, it is your responsibility to present a copy of the forms to Directions’ staff. Client choice and preferences identified via your Advance Directive will be respected and implemented according to applicable laws.

Deaf & Hard of Hearing: Our services, activities, programs, and facilities are provided without regard to age, race, religion, national origin, handicap, impairment, veteran status, or political opinions or affiliations as provided by law and in accordance with Directions for Living’s respect for personal dignity. All of our services and facilities are accessible to disabled persons, including persons who are deaf, hard of hearing, blind, or who have other sensory impairments. We serve a variety of clientele and will make translator and/or interpreter services or other assistive communications devices available free of charge to clients. If possible, please provide 24 hours notice if a translator or interpreter is needed. To request assistance with our facilities, an interpreter, translator, other assistive devices, or if you would like this Handbook in an alternate format, or to receive a copy of our Auxiliary Aids Plan, please speak with your provider, a Customer Service Representative, or contact the Quality Department at (727) 524-4464, ext. 1716.