Client Rights & Responsibilities

• Not be excluded from participation in, be denied the benefits of or be subject to unlawful discrimination based on my race, color, age, national origin, sex, religion, marital status, familial status, disability, sexual orientation, genetics, gender identity or source of payment.  I have the right to express my wishes with regard to my treatment.  When CHN cannot meet my request, or need for care, I will be referred to an available and appropriate facility. I have the right to be informed in a language that I understand, including hearing and/or visually impaired services. According to section 504 of the Rehabilitation Act of 1973 I have a right to appropriate auxiliary aids and services necessary to ensure effective communication at no cost. If I have a need for special services or accommodations, I may contact the Citrus Health Network ADA/Section 504 Coordinator at ext. 12353 or 305-424-3183 (TTY/TDD Relay 1-800-955-8771).  If I believe that I have been denied services, I may file a complaint with the U.S. Department of Health and Human Services, Office of Civil Rights or the Department of Children and Families, Office of Civil Rights within 180 days of the alleged violation. 
• Considerate, respectful care at all times and under all circumstances, with recognition of my personal dignity, cultural, spiritual, personal values and belief systems.  I have the right to exercise my cultural and spiritual beliefs as long as they do not interfere with the well-being of others or my planned course of treatment.  My spiritual needs may be met at my request through arrangement with resources in the community as my treatment allows. 
• Personal privacy and confidentiality of information as per Federal and State laws.  I understand these rights are outlined in Citrus Health Network’s Notice of Privacy Practices.
• Necessary information, in a clear and concise explanation, to enable me to make treatment decisions that reflect my wishes.  CHN will make every effort to assure that I understand the following:  nature and goals of the individualized treatment plan, hours during which services are available, discharge plans along with plans following discharge, expected client conduct, and the types of infractions that can cause discharge from the facility. I have the right to know of experimental, research, or educational activities involved in my treatment. I also have the right to refuse to participate in any such activity without penalty.  I have the right to know risks, side effects and benefits of all medications and treatment procedures and available alternate treatment procedures.
• Know the identity and professional status of all people involved in my care, including the identity of the individual who is primarily responsible for my treatment.  I have the right to know any change in the professional staff responsible for my care or the reason for any transfer within or outside the organization. 
• Know that all persons acting in good faith, reasonably and without negligence in relation to my care are free from all liability due to such acts. However, if a staff member were to violate or abuse my rights or privileges, they would be liable for damages under the law.
• Accept medical care or to refuse treatment to the extent permitted by law and to be informed of the consequences of such refusal.  I have the right to leave CHN against medical advice, but I will be asked to sign a form to that effect. 
• To provide CHN with an Advanced Directive. The Advance Directive will be honored and documented in my medical record and communicated to staff.  I understand that if I presently do not have an Advance Directive, I have the right to create an Advance Directive and must ask CHN staff for more information.                
• Contact people outside the CHN by means of visitors or through written or verbal communication, including the abuse registry and the DCF Substance Abuse and Mental Health Program Office at 305-377-5029.
• A detailed, itemized explanation of my total bill for services, regardless of how these services will be paid.  If I need financial aid to pay this bill, I am entitled to information and assistance in securing such aid.
• Know what rules and regulations apply to my conduct as a patient.  If I have any complaints, I have a right to access the CHN's system for answering patient complaints, by contacting the individual who is primarily responsible for my treatment.  My complaint will in no way affect the quality of care or compromise my future access to care.                   
• Know that for my safety as well as others, seclusion and restraints are used at CHN according to Federal and State Regulations and The Joint Commission.  It is policy of CHN to keep clients safe from themselves or others while receiving treatment at CHN.  Restraint and seclusion use is limited to emergencies in which there is imminent risk of an individual physically harming him/herself, staff or others and non-physical interventions would not be effective.

CLIENT RESPONSIBILITIES

Clients of Citrus Health Network are responsible for:

• providing my full name; proof of current address, such as rent receipt, voters registration, utility bill etc.; date of birth; place of employment or proof of unemployment; Medicare/Medicaid cards or proof of private insurance; proof of income;
• notifying CHN about any change in my address, telephone number, or any information I have given CHN;
• providing accurate and complete information about the history of treatment or care including the name and address of other physicians recently seen and all medications I am currently taking;
• reporting to CHN staff any perceived risks in my care.  I am responsible for asking questions when I do not understand what I have been told about my care or what I am expected to do while receiving treatment at CHN;
• keeping my appointments.  If I cannot keep my appointment, I need to notify CHN as soon as possible. CHN will try to see me or make arrangements for an appointment as soon as possible;
• following-up with my care at CHN, within the time specified in the notice.  If I fail to contact CHN, my case will be closed without further notice. It is CHN’s policy to close behavioral health cases that are inactive over ninety (90) days and primary care cases when they have been inactive for 3 years, from the client’s last visit. 
• meeting my financial obligations as agreed to.  I will be charged for services according to my income.

NOTE:  I may have other specific rights if I become a resident in one of the CHN's facilities.  Consult with Admissions staff.

For downloadable Client Rights and Responsibility forms in English and Spanish, please click the PDF below.