Client and Family Handbook

Tanager Place School Based Program

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Client and Family Handbook


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WELCOME TO TANAGER PLACE/ABOUT TANAGER PLACE ................................... 3 SCHOOL BASED SERVICES ........................................................................................ 4 Client Emergencies ......................................................................................................... 4 Satisfaction Surveys ....................................................................................................... 4

SERVICES ..................................................................................................................... 5 Intake and Orientation ..................................................................................................... 5 Mental Health Assessment ............................................................................................. 5 Therapy .......................................................................................................................... 5 Community Based Services ............................................................................................ 5 Psychological Testing ..................................................................................................... 5 Medication Management ................................................................................................. 5 Transition/Discharge ....................................................................................................... 5

CONSENT TO TREAT ................................................................................................... 6

FAMILY INVOLVEMENT ................................................................................................ 6 REQURIED REPORTING ............................................................................................... 6

TANAGER PLACE CLIENT AND CONSUMER RIGHTS ............................................... 6 GRIEVANCES, INVESTIGATION AND APPEAL ........................................................... 7 COMMUNICATION/REFERRALS TO PERSONS OUTSIDE THE AGENCY ................. 7

CARE MONITORING ..................................................................................................... 8 RECORD REQUEST ...................................................................................................... 8 RESEARCH .................................................................................................................... 8 FINANCIAL POLICY ...................................................................................................... 9 WELLIGENT PATIENT PORTAL ................................................................................. 10


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WELCOME! We are pleased that you chose Tanager Place to assist your child and family. It is our top priority that the services provided to you at Tanager Place are that of respect, healing, and hope. In this handbook you will find the answers to many of the questions you may have about Tanager Place and our services. We look forward to working with you! Thank you for choosing Tanager Place to join in your journey.

ABOUT TANAGER PLACE In 1879, before electricity lit the streets and homes of Cedar Rapids, Tanager Place opened its doors to children. The Industrial School, as it was first known, was founded by Eleanor Lund as a result of her work as a City Missionary in the community. After undergoing several different names between 1879 and 1990, the Children’s Home of Cedar Rapids changed its name to Tanager Place. The new name represents the beautiful scarlet tanager bird. The organization, like the scarlet tanager, is unique and beautiful to the children and families whom it serves.

Tanager Place is currently a multi-service agency serving youth and families in various programs, including Camp Tanager, Mentoring Programs, Inpatient Psychiatric Treatment, Behavioral Health Intervention Services, Pediatric Integrated Health Services, and Outpatient Clinical Services. The Behavioral Health Clinic provides the community with medication management, psychological assessment and testing, Autism Services, and various modalities of Therapy.

OUR MISSION

The mission of Tanager Place is to successfully serve children and families challenged by social and psychological needs.

OUR VISION

To be the industry leader of comprehensive, holistic, and integrated services for children and families.

GUIDING COMPASS


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SCHOOL BASED SERVICES

Tanager Place School Based Program provides prevention and treatment in the school setting. Tanager provides licensed mental health professionals in the school system to work with students, families, teachers and administration to encourage resilience, create awareness and promote wellness. With your consent, your child will be seen for therapy in the school setting, during the least restrictive time. Your therapist and you will develop a plan for communication and collaboration to ensure optimal success for your child. Your therapist will provide you with their email and phone number to ensure you can quickly access them if needed. You can also contact the program leaders below.

Maggie Hartzler LISW CTP, Program Manager: [email protected] ext.495

Emma Thompson LMFT, School Based Supervisor: [email protected] ext.343

Tawny Schafbuch LISW, School Based Supervisor/Therapist: [email protected] ext. 580

Cassie Kehoe LISW CTP, School Based Supervisor/Therapist: [email protected] ext. 477

CLIENT EMERGENCIES

Although we try to respond as promptly as possible to phone calls or messages left, if you are experiencing a mental health emergency and your therapist is not immediately available please call your:

Primary Care Physician or go to your local emergency room

Foundation 2 Crisis Line Phone Counseling - 319-362-2174

911

OUTCOME MEASURES AND SATISFACTION

From time to time during the treatment process, you will be asked to answer questions or complete surveys to measure your progress and evaluate your treatment plan. You will also be invited to provide feedback on how we can improve services during and after the treatment process is completed.

mailto:[email protected]





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SERVICES Intake and Orientation Clerical staff will gather information from you regarding your concerns, health information, and billing information. Insurance cards are photocopied or scanned and placed in the client chart. Assessment (Intake) A licensed clinician or certified staff member will ask you and your child about current concerns, experiences, and needs, helping you choose the services to best meet your goals. You will be asked about your child and family’s strengths, abilities, and preferences for treatment. At the completion of your assessment, your clinician and you will discuss recommendations and your clinician will make referrals for services. Tanager Place has an array of services that can benefit your child and family. Some of these services have a waitlist due to the high volume of interest in Tanager’s services. If your child happens to be put on a waitlist you will be given contact information in order to check in and verify where your child is on the waitlist. Once your child’s name comes up on the waitlist you will be contacted and provided with current availability. It is important to respond timely in order to receive services. The spot your family will be offered will be the same day and time each week. Tanager schedules in this fashion in order to ensure that your child has consistent, reliable services with the greatest probability of optimal results. If additional referrals are needed throughout treatment, the clinician will be responsible for ongoing assessment of client needs and link to appropriate services for optimal outcomes. Therapy Our job as clinicians is to guide clients where they want to go. This occurs in a collaborative manner between the clinician and the client. The most important factor that makes therapy successful is the relationship between the therapist and client. It is the value set of Tanager to build relationships with our clients while collaboratively joining with you toward your goals. You will join with your clinician to create treatment plan goals for optimal outcomes. The desire is for therapy to assist your child and family with healing and promote hope and well-being for ongoing success. Sessions range from 40-50 minutes unless otherwise indicated. Community Based Services Tanager has several different community based services. A clinician may recommend these services for your child and family. These services include Pediatric Integrated Health Home (PIH), Behavioral Health Intervention Services (BHIS), Mentoring Programs, and Camp Tanager. You can also find brochures in the clinic waiting area.

PIH PIH services offer a care team that can be an advocate for your child and family. With as much, or as little involvement as the family desires, a PIH worker can assist with: helping find community resources, connect families with needed medical services, support educational needs, and serve as a support for caregivers. This is a free service for children with Medicaid. BHIS BHIS can help children who find it difficult to manage their behaviors and need encouragement with anger management, problem solving, conflict resolution, communication skills, social skills, etc. Services are provided in the home and are free for children with Medicaid.

Psychological Testing Psychological assessment is a process of testing that uses a combination of techniques to help arrive at some hypotheses about a person and their behavior, personality, and capabilities. If you feel your child needs psychological testing please discuss this service with your therapist. Medication Management If you and your clinician decide medications may be helpful, psychiatric services are provided at Tanager Place. Transition / Discharge When your child and family have met treatment plan goals or you no longer choose to participate in Tanager Place services, your clinician will help guide your child and family members in developing a plan to maintain or improve the gains you made while in treatment.


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CONSENT TO TREAT As a general rule, minors should not be treated without the consent of the parent or legal guardian. Iowa law defines the period of minority to extend to the age of 18 years. A guardian is generally an individual who has been appointed by a court or juvenile court having jurisdiction over the minor child to make important decisions for the minor, including decisions concerning medical treatment. The authority of the guardian ends, unless otherwise ordered by the court, when the minor reaches the age of 18. Tanager Place requires that appointed caretakers demonstrate paperwork to identify themselves as the legal guardian before services can be rendered.

Unless appointed as guardian or ordered by the court, grandparents, stepparents, foster parents, or other family members do not have authority to consent to treatment.

FAMILY INVOLVEMENT

Tanager Place requests parents/guardians to be actively involved in their child’s treatment. The treatment plan is developed jointly by the child, parent/guardian, and Tanager Place staff. We will review treatment plans every 3 months to ensure both satisfaction and client outcomes are being achieved. If parent cannot attend their scheduled appointments with their child we ask the parent/guardian to ensure good communication is occurring with the therapist as we know family involvement is vital for optimal outcomes.

MANDATORY REPORTING

State Law and Professional Ethics require all mental health professionals to protect your confidentiality except for the following situations, in which we are required by law to file a report with the appropriate agency or authority:

1. If there is suspected child abuse or dependent adult abuse. 2. If there is a serious threat of physical harm or injury to a reasonably well-identified victim. 3. When a client communicates a threat to injure or kill himself/herself. 4. When a client is in foster care and the Foster Care Review Board requests updates.

Suspected child abuse can include, but is not limited to, domestic violence, sexual abuse, physical abuse, mental injury and neglect. The clinician is not responsible for investigating or authenticating any allegations and it is not their role to determine if the reported abuse meets qualification for reception of an investigation by the Department of Human Services

CLIENT AND CONSUMER RIGHTS

Rights Children, adolescents, and families are serviced by Tanager Place programs regardless of age, color, creed, gender identity, national origin, race, religion, sex, sexual orientation, or, to the extent possible, differently abled. As clients and families of clients, you have the right to:

o Respect as individuals o Individualized services o Timely services o Self-determination o Confidentiality o Privacy


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You have the right to refuse any service, treatment or medication, unless mandated by law or court order. You also have the right to be informed about the consequences of such refusal, which can include discharge. You have the right to be free from coercion, abuse, retaliation, humiliation, neglect, and financial or other exploitation.

Responsibilities Tanager Place staff are responsible for respecting the personal dignity and positive social identity of clients, consumers, and their families.

GRIEVANCES

If you believe your rights have been violated or believe that Tanager Place staff has violated standards of professional behavior, you are encouraged to contact your clinician, supervisor, director, or administrator to file a written grievance or request a review of their treatment plan. The clinician, supervisor, director, or administrator will investigate the grievance and/or arrange a care review by a panel or person as indicated.

Tanager Place staff shall not interfere or retaliate when client/family or guardian makes a complaint or grievance. When possible, the complainant is encouraged to talk to the individual first to see if the issue can be resolved. If this is unsatisfactory, the complainant is directed to the next level, either supervisor or administrative staff. For a complaint to be considered a grievance there has to be a perception that one or more of the individual’s rights, listed in the “Tanager Place Client and Consumer Rights” statement (and including denial of services) was violated. A complaint may also be considered a grievance when there are important inconsistencies in program functioning. Grievances may start out as either verbal or written. Once the determination is made that the complaint meets criteria as a grievance, the complaint will be written either by the complainant or by the investigating staff. The investigation will begin as soon as possible. The investigator gives/sends complainant written notification of resolution and explanation of any further appeal, rights, or recourse within fourteen (14) days of investigation completion. The complainant may appeal in writing the outcome of the investigation to the next level. The administrator, or designee, then reviews the investigation and notifies the complainant in writing of the agency’s decision within thirty (30) days of date of receipt of appeal. Documentation of grievance process, including appeals, is kept in a program grievance/incident notebook by the appropriate program designee. Documentation includes, but is not limited to, the written notification sent to the complainant [e.g., issue(s), process for resolving complaint, corrective action taken, and signature of the investigating/reviewing staff]. Anonymous grievance information is reported quarterly to the QI (Quality Improvement) designee for risk management report to the Board and Administrative Cabinet.

COMMUNICATION AND REFERRALS TO PERSONS OUTSIDE THE AGENCY Communication with collateral parties and non-guardian family members are often recommended and/or necessary during treatment. In order for any clinic staff to communicate with persons outside the agency, and non-guardian family members, a valid release of information signed by the client and/or their guardian must be on file.

CARE MONITORING


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Supervision As a means of our continued development as therapists, we regularly participate in supervision. As a part of supervision, therapists discuss cases with peer therapists to receive feedback for optimal clinical results. We may also ask you for permission to audio or video tape a session for this purpose. We will not publish, communicate, or otherwise disclose any of this material to anyone other than our staff and supervisors without your written consent. Training Tanager is an agency dedicated to training and growing upcoming professionals in the field of mental health. At times clinicians may request from you that an intern be present for sessions involving your child/ your family. You have the option to decline this request. In addition, there may be times in which your therapist may have to attend trainings for continued professional growth. Your therapist will do their best to reschedule your appointment so that any missed appointments can be made up. Litigation Clinicians will not voluntarily participate in any litigation or custody dispute. Should a clinician be subpoenaed to appear as a witness in an action involving a client, the client agrees to reimburse Tanager for time spent for preparation, travel, court appearances, etc. at the hourly rate set by administration. Quality Improvement Outpatient Clinical Services engages in ongoing processes and procedures addressing quality improvement.

RECORD REQUESTS All requests for records must be in writing. Tanager Place will attempt to fulfill all eligible requests within three (3) to five (5) business days. However, Tanager reserves the right to complete the request within the thirty (30) day time frame outlined under HIPAA. If your request cannot be honored within thirty (30) days, Tanager will notify you by mail of our thirty (30) day extension request. As the person requesting the records, you will be responsible to pay a charge of $0.25 per page plus any postage charges incurred.

RESEARCH Tanager Place continuously evaluates its programs and work to provide services that are as effective as possible. Tanager Place may participate with outside organizations in research studies to improve services. Information submitted for studies will not identify client information. In the event that there is a need for any research to include any identifying information about a child or family, the client and family’s permission will be obtained first and the client and family will be fully informed of the procedures to be followed and any risks associated with the research. The client and family will be given the opportunity to have any and all questions answered. The client and family may decline to participate in research and withdraw at any time without any negative consequences. This in no way affects the services received.

FINANCIAL POLICY If you are covered by health insurance with Mental Health benefits, we will be happy to bill your insurance. Please provide your insurance information and we will be happy to verify your coverage. As a courtesy to our patients with insurance, we will file your claims for all services rendered.


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Commercial Insurance Patients

You are responsible for paying any deductible, copay and/or coinsurance payment at the time of service.

If you do not know your co-pay and/or coinsurance, a flat $20 will be collected. At the conclusion of your visits with us you may be billed for any outstanding balances. If at any time there is a credit, it will be applied to future visits or you can request a refund at any time.

Accepting your insurance does not place all financial responsibilities unto Tanager Place, and you will be held accountable for any unpaid balances by your plan. Although we are contracted with most insurance carriers, our services may not be covered by your particular insurance plan. Being referred to our clinic by another physician does not guarantee that your insurance will cover our services. If your insurance does not include Tanager Place as an in-network provider, you may be billed for non-covered charges or be responsible for Private Pay rate. In the event you do not want your insurance company billed, patients must accept liability for, and pay full cost of care at the Private Pay rate.

Private Pay or High Deductible Patients

Some providers and services are not covered by insurance. We will discuss this with you prior to your first session. If you choose to enter into financial agreement for services at Tanager Place you are responsible for payment in full at the time of service, unless other arrangements are made in advance.

Prior to your first visit we will go over your specific Financial Agreement. At the conclusion of your visits with us you may be billed for any outstanding balances. If at any time there is a credit, it will be applied to future visits or you can request a refund at any time.

Medicaid, State, or County Funded Patients

Some providers and services may not be covered by your funder. We will discuss this with you prior to your first visit. If at any time you experience a lapse in coverage, you will be responsible for all services rendered. You may choose to enter into a Private Pay Financial Agreement, or discuss alternative treatment arrangements with your clinician at that time.

Delinquent Accounts

Statements are sent to the Responsible Party to advise them of balances due. An account shall be considered delinquent if Tanager Place has not received any payments on the account, or a Responsible Party has made a payment less than the amount agreed. Failure to make payment arrangements may result in termination of services. Any account greater than $500 or over 120 days past due will be subject for review. If you are not able to pay your balance in one payment, Tanager Place offers no-interest payment options.


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TANAGER PLACE

PORTAL ACCOUNTS Using Welligent to Manage Required Documents

GETTING STARTED

If you would like a portal account, you will

need to give an email address to your clinician.

You will then receive an email to the address

you provided that will outline the details and

instructions to log into your Welligent Portal

account. Follow the instructions to sign in and

update your password and information.

FINDING DOCUMENTS

Signatures are required on several

documents in order to receive treatment. The

portal allows you to view and sign these

needed documents electronically. Once

logged into the Portal, use the menu on the

left-hand side of the screen to navigate to

"Review and Sign" and to see the list of

documents available for you to sign.


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VIEWING DOCUMENTS

Once you have found the list of documents to

sign, click on the "View/Sign" icon. Once

selected, a new screen will appear which will

show you the entire document that you are

about to sign.

SIGNING DOCUMENTS

After viewing, you can sign by clicking the box

on the top right corner that says "Sign

Document". This will open another window,

Select signature of Parent/Guardian, and

ensure "Mouse Signature" is selected. Next

type your full name. Then, click into the

signature box and use the mouse to sign your

name on the line. You can clear and sign as

many times as needed to capture your

signature. Once done, select "Save Signature".

F O R S U P P O R T W I T H Y O U R W E L L I G E N T P O R T A L

A C C O U N T E M A I L U S A T :

T H E R A P Y R E F E R R A L @ T A N A G E R P L A C E . O R G

O R C A L L 3 1 9 - 2 8 6 - 4 5 4 5

Our Uses and

Disclosures

Your Choices

Your Rights

Your Information. Your Rights. Our Responsibilities.

You have the right to:

Get a copy of your paper or electronic medical record

Correct your paper or electronic medical record

Request confidential communication

Ask us to limit the information we share

Get a list of those with whom we’ve shared

your information

Get a copy of this privacy notice

Choose someone to act for you

File a complaint if you believe your privacy

rights have been violated

You have some choices in the way that

we use and share information as we:

Tell family and friends about your condition

Provide disaster relief

Include you in a hospital directory

Provide mental health care

Market our services and sell your information

Raise funds

We may use and share your information as we:

Treat you

Run our organization

Bill for your services

Help with public health and safety issues

Do research

Comply with the law

Respond to organ and tissue donation requests

Work with a medical examiner or funeral director

Address workers’ compensation, law enforcement,

and other government requests

Respond to lawsuits and legal actions

This notice describes how medical information about you

may be used and disclosed and how you can get access

to this information. Please review it carefully.

➤ See page 2 for

more information on

these rights and how

to exercise them

➤ See page 3 for

more information on

these choices and

how to exercise them

➤ See pages 3 and

4 for more

information on these

uses and disclosures

Notice of Privacy Practices • Page 1

NOTICE OF PRIVACY PRACTICES

Your Rights

When it comes to your health information, you have certain rights. This

section explains your rights and some of our responsibilities to help you.

Get a copy of this

privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Get an electronic or • You can ask to see or get an electronic or paper copy of your medical record and

paper copy of your other health information we have about you. Ask us how to do this.

medical record • We will provide a copy or a summary of your health information, usually within 30

days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct • You can ask us to correct health information about you that you think is incorrect

your medical record or incomplete. Ask us how to do this.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential • You can ask us to contact you in a specific way (for example, home or office phone)

communications or to send mail to a different address.

We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment,

payment, or our operations. We are not required to agree to your request, and we

may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to

share that information for the purpose of payment or our operations with your health

insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those

with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

We will include all the disclosures except for those about treatment, payment, and

health care operations, and certain other disclosures (such as any you asked us to

make). We’ll provide one accounting a year for free but will charge a reasonable,

cost-based fee if you ask for another one within 12 months.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal

guardian, that person can exercise your rights and make choices about your health

information.

We will make sure the person has this authority and can act for you before we take

any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information on page 1.

You can file a complaint with the U.S. Department of Health and Human Services

Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W.,

Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/ privacy/hipaa/complaints/.

We will not retaliate against you for filing a complaint.


http://www.hhs.gov/ocr/

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the

situations described below, talk to us. Tell us what you want us to do, and we will follow

your instructions.

In the case of fundraising: • We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and

Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

We can use and share your health

information to run our practice, improve

your care, and contact you when necessary.

We can use and share your health information to bill and get payment from health plans or other entities.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Example: We use health information about you to manage your treatment and services.

Example: We give information about you to your health insurance plan so it will pay for your services.

Treat you • We can use your health information and share it with other professionals who are treating you.

Run our organization

Bill for your services

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care

Share information in a disaster relief situation

Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we

may go ahead and share your information if we believe it is in your best interest. We

may also share your information when needed to lessen a serious and imminent

threat to health or safety.

In these cases we never share your information unless you give us written permission:

Marketing purposes

Sale of your information

Most sharing of psychotherapy notes

continued on next page


Respond to lawsuits

and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.


Respond to organ and

tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.

We have to meet many conditions in the law before we can share your information for these purposes. For more

information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

Preventing disease

Helping with product recalls

Reporting adverse reactions to medications

Reporting suspected abuse, neglect, or domestic violence

Preventing or reducing a serious threat to anyone’s health or safety

Do research • We can use or share your information for health research.

Comply with the law • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

For workers’ compensation claims

For law enforcement purposes or with a law enforcement official

With health oversight agencies for activities authorized by law

For special government functions such as military, national security, and

presidential protective services

Tanager Place does not manage a hospital directory.

Tanager Place will never share any records regarding substance abuse or psychotherapy notes and will not

disclose AIDS or HIV related information without your written permission. If you provide written permission,

you may revoke it at any time by giving us notice. Your revocation will not be effective for uses and disclosures

made prior to such notice received.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security

of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in

writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you

change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice We can change the terms of this notice, and the changes will apply to all information we have about you.

The new notice will be available upon request, in our office, and on our web site.


This Notice of Privacy Practices applies to the following organizations.

Effective October 2017

This notice applies to all Tanager Place locations including Camp Tanager as well as the Training and

Education Center.

Tanager Place Privacy Officer | Quality Improvement Department

319-365-9165 ext. 307

http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Client and Family Handbook

Documents

Transcript of Client and Family Handbook