Client Notices

It is Community Choice Behavioral Health’s policy to treat all protected healthcare information and records as confidential, and not to disclose such information unless authorized to do so. Community Choice Behavioral Health will use client information for the purposes of treatment, securing payment and other usual operations. It should be understand that this information may be available to people working on behalf of Community Choice Behavioral Health, who are subject to the same duty of confidentiality with respect to any of my information. Members understand that they have certain rights with respect to disclosure of my health care information, subject to certain disclosures that are permitted or required by law(as fully described in the Notice), for example:

Members have specifically authorized the disclosure
The disclosure is permitted or required by law
Reports of homicidal or suicidal intent with a plan
Mandated reporting of suspected or known abuse or neglect of a child or incapacitated or dependent adult

Members understand that if Community Choice Behavioral Health holds certain sensitive information related to: alcohol and drug abuse treatment programs, mental health treatment, and/or diagnosis or treatment for HIV or AIDS; then special authorization will be required to disclose this information to others. Members understand that they may refuse to allow the sharing of some or all such information, but the refusal may result in improper diagnosis or treatment or other adverse consequences.

Community Choice Behavioral Health has an electronic health record, and understand that all involved providers through Community Choice Behavioral Health will have access to the services/treatment being received across programs. Members also understand that they have rights to restrict access for involved providers, in which case a note will be made in their record and this will be audited regularly to ensure only those authorized will access individual program records.

Records will be maintained for six (6) years beyond discharge (or 6 years after the age of 18 after discharge). Members can request copies of their record during the time their record is maintained.

Members must acknowledge that services are provided through Community Choice Behavioral Health, a licensed behavioral health agency. Should a provider discontinue working through Community Choice Behavioral Health, Community Choice Behavioral Health will arrange for continuation of services through another provider, if desired. Members further understand that Community Choice Behavioral Health is responsible for the services that are provided  and  can contact Community Choice Behavioral Health at any time with questions or concerns about treatment at (207) 640-4400 or info@ccbhmaine.com.

The following is a summary of your rights as a recipient for community based services under the Rights of Recipients of Mental Health Services. Community Choice Behavioral Health has provided a full copy to you and you can request a copy from DHHS anytime, by contacting DHHS at 11 State House Station, Augusta, ME 04333

• For Adults 207-287-8901
• For Children (http://www.maine.gov/dhhs/ocfs/cbhs/policy/rights.shtml) or
• TTY 711 for Maine Relay

If you are deaf or do not understand English, an interpreter will be made available to assist you understanding your rights.

Basic Rights. You have the same civil, human and legal rights, which all citizens are entitled. You have the right to be treated with courtesy, respect and dignity. You cannot be secluded or restrained in a community setting.
Right to Confidentiality and Access to Records. You have the right to have your records kept confidential and only be released with your full informed consent. You have the right to review your record at any reasonable time and to add written comments to clarify information you believe is inaccurate or incomplete. No one else can see your record except under circumstances outlined in the rights book.
Right to an Individualized Treatment Service Plan. You have the right to a written service plan, developed by you and your worker, based on your actual needs and goals. The plan must be in writing and detail what everyone will do, the time frames in which the tasks and goals will be met, and identify how success is determined. The plan must identify how a need will be met if the service is not available. You have the right receive a copy of your plan and a right to a second opinion if you do not agree with the plan.
Right to Informed Consent& Protection of Rights. No service or treatment can be provided to you against your will. You have the right to be informed of possible risks and anticipated benefits of all services and treatment. You may designate a representative who is authorized to help you understand and exercise your rights, help you make decisions, or to make decisions for you. This must be requested in writing and can be changed or canceled at any time, unless under court appointed representation.
Right to File a Grievance and Appeal. You have the right, without retribution, to grieve any violation of your rights or a questionable practice. You have the right to a written response, including reasons for the decision. You may appeal any decision to the Department of Health and Human Services.

For assistance contact:

• Adult Grievances – Office of Behavioral Health, 41 Anthony Ave, 11 SHS, Augusta, ME 04333 or (207) 287-2595.
• Children Grievances – Children’s Grievance Coordinator, 207-462-4436 or or TTY 711- at 11 State House Station 2 Anthony Ave, Augusta Maine 04333; or
• The Disability Rights Center, 24 Stone St. Ste. 204, Augusta, Maine 04330 (1-800-452-1948).

This Client Complaint Policy serves as notification that all complaints must be submitted in writing, and that the Client Rights Representative is available to assist the complainant in preparing a written complaint as may be necessary.

All written client complaints are to be submitted to the Client Rights Representative and should include the following information:

• The date, time and location at which the complaint or alleged violation of client rights occurred.
• The names or description of individuals involved in the incident or situation being grieved.
• A brief narrative of the incident or complaint.
• The name of the client filing the complaint.
• The date of complaint filing verified by the signatures of both the complainant and the Client Rights Representative.  If a third-party files the complaint on behalf of the client, the signature of that third party should also be included with the date of complaint filing.

The Client Rights Representative shall investigate the complaint and provide the complainant with a signed and dated summary of any findings and the proposed resolution within twenty-one (21) days of the written filing.  A copy of any such findings will also be provided to the Executive Director.  Any extenuating circumstances indicating extension of this twenty-one (21) day time period must be documented with written notice of such extension provided to the complainant.

If the proposed resolution is not satisfactory to the complainant, they, accompanied by the Client Rights Representative, will meet with either the Executive Director to promote resolution of the complaint.  Such meeting must be requested within five (5) working days of the notification of findings and will be scheduled within five (5) working days of the request. Following this meeting, the Executive Director will investigate the complaint and will render a decision within five (5) working days from the time of the meeting.

Following receipt of a complaint from a client or another person acting on behalf of a client of CCBH, within three (3) working days the Client Rights Representative will acknowledge receipt of the complaint in writing to the person responsible for the filing.  The written acknowledgment will include, at minimum, the following information:

• Date the complaint was received.
• Summary of the complaint.
• An overview of the complaint investigation process.
• The timetable for completing investigation of the complaint and notifying the complainant of proposed resolution.
• The contact name, address, and telephone number of the Client Rights Representative.

In addition to this initial acknowledgment, written notification, and explanation of the disposition of any complaint will be supplied to the client at each stage of the complaint process within the time frames specified in this policy.

Non-Retaliation

If a complaint is filed either internally within CCBH or with an outside organization, it is the strict policy of CCBH that the complaint will not result in retaliation toward the complainant, create a barrier to the provision of services, or the refusal on the part of CCBH employees to provide the availability or assistant of the complainant seeking an advocate.