WestBridge is committed to providing you with the best service possible and to do so with full respect for your rights, feelings, perceptions and opinions that will ensure your personal privacy, individuality and dignity. You have the right to exercise the following rights without fear of reprisal, including reprisal in the form of denial of any appropriate, available treatment
- You will not be discriminated against because of race, color, national origin, religion, sex, age, sexual orientation, gender identity, political affiliation/belief or degree of ability/disability.
- If you need legal counsel, you have the right to obtain that service;
You have the right to be treated with consideration, respect, and full recognition of your dignity and individuality;
- You have the right to be informed of the name, licensure status, and staff positions of all those with whom you have contact;
- You have the right to information pertinent to facilitate decision making and have the freedom to make decisions and act independently on them, unless you have a guardian to make financial and/or treatment decisions, or in certain emergency situations specified by law;
- Personal privacy will be maintained at all times to the greatest extent possible. For example, matters related to treatment and finances will be discussed in a private setting. You will not be fingerprinted, photographed or recorded without your permission. Please understand that privacy is also everyone’s responsibility; please pay attention to how loud you speak and your choice of location for the discussion, as the content of what you are discussing may be heard by others;
- Drug screens will be conducted in a manner which preserves your dignity. Participants may incur an expense if the drug screen requires external validation or if there is a medically confirmed inability to give urine requiring an alternative means of screening, such as an order for a blood test;
- Professional boundaries between staff and participants will be maintained at all times. For example, it is never appropriate for a staff member to have a romantic or sexual relationship with a current or former participant;
- Freedom from physical, sexual or emotional abuse, financial or other exploitation, retaliation, humiliation, neglect and/or coercion;
- You have control over your bodily appearance, provided, however, on program premises, WestBridge has the right to prohibit attire and personal decoration which it deems to interfere with treatment, examples of which include but is not limited to clothing which depicts violence, drugs, alcohol or the glamorization of such;
- You have the right to convenient and reasonable (as defined in the Participant Handbook) unmonitored access to the telephone and mail, and to see visitors during regularly scheduled visiting hours, unless a treatment team member determines it is necessary to restrict your access to certain visitors for treatment purposes or safety. It is the responsibility of residents to share access and time on the participant phone and be aware and mindful of the community setting and potential impact of your personal conversations on others;
- Services provided to you will be in keeping with accepted clinical and professional standards. You have the right to be informed of the services available and decide on services in which you want to participate, but clinical and professional standards may require the administration of a mode or course of treatment without your consent in emergency situations. The courts may also order a certain mode or course of treatment without your permission;
- You have the right to practice the religion or faith of your choice;
- You have the right to receive an individualized, written recovery plan, which is based on an initial and ongoing evaluation of your needs and the goals that you want to reach. The plan will include disclosure of any diagnosis unless clinically inadvisable. You have the right to services which promote independence and least restrict your freedom while still enabling you to meet your treatment goals. You have the right to receive referrals to other providers of mental health services upon discharge, as appropriate;
- You have the right to informed consent regarding release of information, concurrent services, and composition of the service delivery team and to receive an explanation of your general condition, treatment objectives, the nature and significant adverse effects of recommended treatments, the reasons why a particular treatment is considered appropriate, the reasons why access to certain visitors may not be appropriate and any available alternative treatment services;
- You have the right to be free from chemical or physical restraints. WestBridge does not utilize these interventions and if clinically indicated, referral to a higher level of care would be initiated;
- You have the right not to participate in any research unless you have provided voluntary written consent. If you choose to participate in research, you have the right to protections in connection with your participation, including adherence to research guidelines and ethics and the right to revoke your consent;
- You have the right to have an advance directive for medical care (living will and durable power of attorney for healthcare). If you are determined to be legally incapable of exercising your rights or making decisions for yourself, your designated representative may exercise your rights or make decisions on your behalf;
- You have the right to seek out a second opinion or consult with another service provider at your own cost;
- You have the right to access legal entities for appropriate representation, self-help and advocacy support services;
- You have the right to be treated in a safe and humane environment; therefore, no alcohol, drugs or weapons may be brought to WestBridge facilities;
- You may terminate your treatment at any time. Treatment is routinely terminated based on a joint decision made by you and your treatment team. Either of you, however, can terminate care independently, the basis of which will be documented in your clinical record. If WestBridge decides to terminate services because of endangerment to participants/staff, you have the right to an appeal of this decision. While appeal is pending, service to you will not be terminated unless a safety risk is present;
- Your records will be kept confidential. As a health care provider, WestBridge is required by federal and state law (including HIPAA and 42 CFR Part 2) to maintain the privacy of Protected Health Information (PHI) and to provide you an explanation of our legal duties and privacy practices.
The confidentiality of substance use disorder records is specifically protected by Federal law and regulations, 42 CFR Part 2. This includes a prohibition, with very few exceptions, on informing anyone outside the program that you attend the program or disclosing any information that identifies you as having a substance use disorder.
Listed below are examples of the uses and disclosures that WestBridge may make of your PHI. This list is not exhaustive and describes types of uses and disclosures that may be made. We will attempt to inform you when we are required to report or disclose any information about you. It is important to understand that there are specific times when state, local or federal law or audits requires staff to report or provide certain information. We have listed the most common situations and exceptions below:
- Release to a legally authorized representative: guardian, durable power of attorney, etc. upon presentation of a written authorization.
- Release to your insurance company to comply with billing requirements.
- Outside agencies periodically review a sample of WestBridge’s records to be sure we are meeting their standards of care. Examples include accrediting organizations, State Division of Public Health, and those WestBridge has established a Qualified Service Organization Agreement (QSOA) with.
- WestBridge’s clinical care and records may periodically be reviewed by other WestBridge staff for quality assurance measures, evidence-based practice fidelity reviews, billing and supervision to ensure proper adherence to protocols, policies and procedures. In the instance the reviewer is external to WestBridge, a Business Associate Agreement (BAA), QSOA, or confidentiality agreement will be in place between the external party and WestBridge.
- Every staff member is a mandated reporter which means they are required by law to report any suspicion of abuse or neglect of children, the elderly and/or incapacitated adults to the appropriate agencies.
- Information related to the commission of a criminal act or threat to commit a criminal act on the premises of WestBridge and/or against WestBridge personnel are not protected by HIPAA and 42 CFR Part 2.
- By Court Order.
- The Office of Attorney General shall have access to all records and information pertaining to a participant when that participant is the subject of an involuntary commitment hearing, or a guardianship proceeding.
- WestBridge legal counsel will have access to all records and information pertaining to a participant when the participant has instituted legal action against WestBridge in regard to care and treatment provided by WestBridge and when required for the purpose of providing legal consultation to WestBridge.
- Information regarding the medical treatment of a participant may be released to law enforcement, emergency services or health facility personnel if an emergency situation exists involving a serious threat of harm to the health and safety of self or others. Only specific information necessary to the relief of the emergency may be released without the participant’s consent.
- You are able to view and obtain a copy of your records at a mutually agreeable time. This includes a copy of disclosures up to six years. Under certain circumstances, some information may not be provided to you, such as information provided by third parties that restrict re-disclosure and if your clinical team determines viewing certain materials would be detrimental to your health or recovery. No part of the record can be removed or changed however, you have the right to request, in writing, that WestBridge amend your record by inserting a signed letter of correction. The charge for the copying of records shall not exceed $15 for the first 30 pages or $.50 per page, whichever is greater;
- If you are dissatisfied with the services you have received, or if you believe the rights outlined in this document have been violated, you have the right to have your complaint respectfully heard and any failure corrected;
- You should first talk with your point person/team regarding any complaint.
- If you are not satisfied by the team’s response to your complaint or should you prefer to talk with someone else, you may directly contact:
Clinical Director: 603-634-4446
Residential Director (Residential/Respite Care): 603-606-3791
WestBridge Complaint Investigator: 603-634-4446
Anonymous Lighthouse Hotline: 833-401-0002 or www.lighthouse-services.com/westbridge
- Any problem having to do with charges or billing should first be discussed with the Family Benefits Team at 603-634-4446.
- If at any time you are not satisfied with WestBridge’s resolution of your complaint, you can ask a staff member to provide you with a Complaints/Concerns/Suggestion form in accordance with Compliance Policy: Reporting Complaints, Concerns and Suggestions and submit this complaint in writing to the WestBridge Complaint Investigator and/or Chief Executive Officer. You may also make an anonymous report to Lighthouse (see above). A copy of the complaint procedure is included in the Participant Handbook.
- The names and contact information for our state licensing entity and where to file any complaints are:
NH Department of Health & Human Services
Health Facilities Licensing Unit
129 Pleasant Street, Concord, NH 03301
Phone: 603-271-4592, Email: email@example.com
State of New Hampshire, Office of the Ombudsman