Creative Counseling Services, Inc.
SUBSTANCE ABUSE ORIENTATION
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.
NATURE AND GOALS OF THE PROGRAM
Creative Counseling Services, Inc. (CCS) is committed to providing the most comprehensive care in the least restrictive environment on an outpatient basis. CCS’s goal is for clients to experience a relief of mental health/substance abuse symptoms as a result of services.
NOTICE OF PRIVACY PRACTICES
Creative Counseling Services, Inc. must collect timely and accurate health information about you and make that information available to members of your health care team in this agency, so that they can accurately diagnose your condition and provide the care you need. There may also be times when your health information will be sent to service providers outside this agency for services that this agency cannot provide. It is the legal duty of Creative Counseling Services, Inc. to protect your health information from unauthorized use or disclosure while providing health care, obtaining payment for that health care, and for other services relating to your health care.
The purpose of this Notice of Privacy Practices is to inform you about how your health information may be used within Creative Counseling Services, Inc. as well as reasons why your health information could be sent to other service providers outside of this agency.
This Notice describes your rights in regards to the protection of your health information and how you may exercise those rights. This Notice also gives you the names of contacts should you have questions or comments about the policies and procedures Creative Counseling Services, Inc. uses to protect the privacy of your health information. Please contact CCS staff for questions or comments on policies and procedures.
There are some times when the laws require us to use or share your information. For example: 1) When there is a serious threat to your or another’s health and safety or to the public. We will only share information with persons who are able to help prevent or reduce the threat. 2) When we are required to do so by lawsuits and other legal or court proceedings. 3) If a law enforcement official requires us to do so. 4) For workers’ compensation and similar benefit programs. 5) As mandatory reporters, we can report suspected child or dependent adult abuse as required under mandatory reporting law. 6) In other rare situations (ex: government sanctioned public health investigations).
Please keep in mind that communications via email over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. Please do not include personal identifying information such as your birth date, or personal medical information in any emails you send to us. No one can diagnose your condition from email or other written communications, and communication via our website cannot replace the relationship you have with a physician or another healthcare practitioner. By Signing the Intake Form and leaving the designated box unmarked you give CCS staff consent to contact you by utilizing your phone number, email address, or physical address.
ELECTRONIC COMMUNICATION All electronic devices utilized by CCS staff are password protected in order to help ensure confidentiality. Even though CCS counselors may have an email address or a cell phone that utilizes both texting and calling, there is no guarantee that messages are checked on a daily, or even weekly basis. In the event of an emergency, please call 911. For other communication, please contact CCS at 233-1699.
FOLLOW UP
Clients will be contacted 6 months after discharge for a follow up interview. This will be scheduled at the last session. If you drop out of services, this will be done via telephone.
ASSESSMENTS
In order to serve your needs most effectively, assessments need to be current. We consider a substance abuse assessment current for 90 days. If treatment is recommended, it needs to be started within 90 days or the assessment will need to be redone.
AFTER HOURS RESOURCES
Occasionally incidents occur outside of office hours. If this is an emergency or you or a loved one are having suicidal thoughts please call 9-1-1 immediately! If this is not an emergency, but services are needed outside office hours, refer to the following list of resources. Mary Greeley Medical Center is available 24 hours/day 7 days/week.
●Eyerly Ball- 515-290-3642
●National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
●First Nurse: 515-239-6877 or 1800-524-6877
●Mary Greeley Medical Center: 515-239-2011
●McFarland Clinic: 515-239-4400
●Ames Non-Emergency Police?: 515-239-5133
●Rosedale Shelter (adolescents only): 515-233-2330
●Crisis Childcare: 515-460-2423
●Child Abuse Reporting: 515-268-7000 or 1-866-474-5366
●ACCESS (Domestic Violence/Sexual Assault): 515-292-5378 or 1-800-203-3488
●Emergency Residence Project: 515-232-8075
●Story County Sheriff: 515-382-6566
CLIENT RIGHTS
●Every client involved with Creative Counseling Services, Inc. has the right to be treated with respect and dignity.
●Every client has the right to know by name and credential, those who are providing services to him/her.
●Every client has the right to be informed of current information regarding their dx and progress, in common terms they can understand. If staff feel it is not in the best interest to share this information with the client, the staff may give this information to an appropriate family member on his/her behalf.
●Every client has the right to privacy and confidentiality as it relates to his/her treatment and involvement with Creative Counseling Services, Inc.
●Every client has the right to his/her privacy and individuality regarding his/her physical, social, psychosocial, spiritual, and sexual well being.
●Every client has the right to be free of sexual harassment.
●Every client has the right to be free from physical or emotional abuse.
●Every client has the right to participate, or refuse to participate in his/her treatment plan and request a copy of that plan.
●Every client has the right to expect Creative Counseling Services, Inc. to make a reasonable response to his/her request within a reasonable time frame.
●Every client has the right to express grievances or complaints related to treatment, services, or facilities of Creative Counseling Services, Inc.
●Every client has the right to privacy and confidentiality of treatment records. Information regarding substance abuse can be released to other persons or agencies only with written consent in accordance with Federal Regulation - 42 C.F.R., Part 2.
●Every client has the right to information regarding the relationships Creative Counseling Services, Inc. has to other health care institutions and agencies, so far as care and referral are concerned.
CLIENT RESPONSIBLITIES
Client is responsible for providing updates to contact information and any change in insurance/billing information. Clients are expected to display responsible/appropriate behavior. The following behaviors may constitute dismissal from services.
●Bringing contraband onto the premises, including drugs, alcohol, or weapons.
●Failure to pay treatment costs.
●Excessive cancellations or no shows. Please give 24 hours notice in the event of a cancellation.
●Harassment or negative treatment/behavior towards staff or other clients.
●Failure to maintain confidentiality of other clients.
●Failure to participate in TB screening if determined to be high risk
OFFICE HOURS
Office hours are by appointment. .In case of inclement weather, the office may be closed. Our call center, KASA, is open Monday-Friday from 9am-5pm.
TB/HIV
Community Health Services offered by HOMEWARD Health Services of Mary Greeley Medical Center, (515) 239-6730 or (800) 529-4610, provides a variety of services including:flu shots, TB testing, and adult immunizations for tetanus/diphtheria, hepatitis B, and hepatitis A.
Planned Parenthood, located at 2530 Chamberlain Street, Ames, (877) 811-7526, offers HIV testing and counseling. In some cases these services may be subsidized for those uninsured. Testing is open on a walk in basis during office hours. Call Planned Parenthood for hours. Results must be given in person.
Current Fee Schedule (1/14/14)Substance Abuse / Mental Health / Group Session / Supervised Visit / Drug/Alcohol Screen / Court testimony/prep/travel
Assessment $125.00 / Assessment $175.00 / $55.00/hr / $110/hr Staff / $45.00 / $150.00/hr mental health clients
Ongoing session $110.00 / MH session $150.00 / $85/hr Intern / $110.00/hr substance abuse clients
08232016AHCCS#15