Client Rights at RCG

Your rights are guaranteed by law.

Unless you have been declared incompetent by a court, you have the same basic civil rights and remedies as other citizens, including the right to buy or sell property, sign a contract, register and vote, sue others who have wronged you, and marry or get a divorce. You also have other rights guaranteed by North Carolina General Statutes 122C, Article 3, including the right to dignity, privacy, humane care, and freedom from physical punishment, abuse, neglect, and exploitation. It is the responsibility of the person\program that you are receiving services from to provide you or your legally responsible person a written summary of your rights within your first three visits to the agency (or your first 72 hours if you are in a 24‐hour facility).

You have the right to a treatment plan.

A written treatment plan, based on your individual needs, must be implemented within 15 calendar days of admission. You have the right to treatment in the most normal, age‐appropriate and least restrictive environment possible. You have the right to take part in the development and periodic review of this plan. You are entitled to review your treatment plan and to understand how to obtain a copy of it from your therapist or the Medical Records Department. In order to review your treatment plan, request a copy from your assigned clinician. The Medical Records Department will then provide the treatment plan via email or scheduled office pick up.

You have the right to be informed about medications.

You have the right to have medication administered in accordance with accepted medical standards and upon the order of a physician. When medication is needed, you have the right to receive it in the lowest possible therapeutic dose. You cannot be treated with experimental drugs or procedures without your written permission and without being informed of the risks, benefits and alternatives. You may refuse to take medication; however, you will be informed of the risks of doing this. Medication cannot be used for punishment, discipline or staff convenience. The Relief Counseling Group office is does not hold, administer, or prescribe medication.

You have the right to refuse treatment.

Before you agree to your plan, you will be informed of the benefits or risk involved in the services you will receive. You have the right to consent to treatment and may withdraw your consent at any time. You have the right to refuse treatment as described in the statute without threat or termination of services except as outlined in the statute. If you have asked to receive services, you always have a right to agree to or refuse any specific treatment. The only time you can be treated without your consent is in an emergency situation, or when it has been court‐ordered, or if you are a minor and your parents have given permission. A minor may seek and receive periodic services from a physician without parental consent for the prevention, diagnosis and treatment of (1) venereal disease and other diseases reportable under G.S. 130A-135, (2) pregnancy, (3) abuse of controlled substances or alcohol, and (4) emotional disturbance. In the event that a minor and a guardian are in disagreement regarding treatment services at Relief Counseling Group (RCG), the assigned clinician RCG clinician will work to deescalate, mediate, defuse any misunderstandings. Family sessions and sessions without the patient are welcome and recommended when necessary.

You have the right to treatment, including access to medical care and habilitation, regardless of age or degree of MH/IDD/SA disability.

You have the right to confidentiality.

The confidentiality of your care and treatment is protected by law. Except as allowed by law and agency regulations, your records and other information about you will not be released without your written permission. Circumstances under which we may be required to share information with another about the services you receive include:

• If you give permission, we may share information with any person that you name.
• Your next of kin may be informed that you are a consumer, if it is in your best interest. With your permission, your next of kin, a family member with a legitimate role in your service, or another person whom you name may be given other information about your care.
• A consumer advocate may review your record when assigned to work on your behalf.
• The court may order us to release your records.
• Our attorney may need to see your file because of legal proceedings.
• Request from the funding source, or an audit
• Additionally: Another facility or HIPAA Covered Entity may need to receive your files when your care is transferred.
• If you become imprisoned we may share your file with prison officials.
• In an emergency another professional who is treating you may receive your records.
• A physician or other professional who referred you to our facility may receive your files.
• If we believe that you are a danger to yourself or to others, or if we believe that you are likely to commit a crime, we may share information with law enforcement.

Special rules may apply if you have a legal guardian appointed, are a minor, or are receiving treatment for substance abuse.

You have the right to see your own records except under certain circumstances, specified by law. You have the right to have those circumstances explained to you.

Review the agency Notice of Privacy Practices for further information.

You have the right to be informed of the rules.

You have the right to be informed of the rules that you are expected to follow in a particular facility or practice and possible penalties for violation of the rules. This information will be provided when you enter the program. You have the right to be free from un‐warranted suspension or expulsion from programs and services. If you are discharged from a facility or practice, you are entitled to a copy of your discharge plan.

You have the right to know your treatment costs.

Fees for services should be discussed with you at your first visit. If this does not occur, please let us know. Although it is your responsibility to make arrangements to pay your bill, you will never be denied services because of inability to pay. Fees for services should be discussed with you at your first visit. If this does not occur, please let us know. Although it is your responsibility to make arrangements to pay your bill, you will never be denied services because of inability to pay. In accordance with 10A NCAC 22J .0106, a provider may refuse to accept a patient as a Medicaid patient and bill the patient as a private pay patient only if the provider informs the patient that the provider will not bill Medicaid for any services, but will charge the patient for all services provided. Acceptance of a patient as a Medicaid patient by a provider includes, but is not limited to, entering the patient's Medicaid number or card into any sort of patient record or general record-keeping system, obtaining other proof of Medicaid eligibility, or filing a Medicaid claim for services provided to a patient.

A provider who accepts a patient as a Medicaid patient shall agree to accept Medicaid payment plus any authorized deductible, co-insurance, co-payment and third-party payment as payment in full for all Medicaid covered services provided, except that a provider shall not deny services to any Medicaid patient on account of the individual's inability to pay a deductible, co-insurance or co-payment amount.

Providers may bill a patient accepted as a Medicaid patient only in the following situations:

• For allowable deductibles, co-insurance, or co-payments;
• Before the service is provided the provider has informed the patient that the patient may be billed for a service that is not one covered by Medicaid regardless of the type of provider or is beyond the limits on Medicaid services;
• The patient is 65 years of age or older and is enrolled in the Medicare program at the time services are received but has failed to supply a Medicare number as proof of coverage; or
• The patient is no longer eligible for Medicaid as defined in 10A NCAC 21B.

When a provider files a Medicaid claim for services provided to a Medicaid patient, the provider shall not bill the Medicaid patient for Medicaid services for which it receives no reimbursement from Medicaid when:

• The provider failed to follow program regulations; or
• The Division denied the claim on the basis of a lack of medical necessity; or
• The provider is attempting to bill the Medicaid patient beyond the situations stated in Paragraph (c) of 10A NCAC 22J.0106.

You have the right to privacy.

You have the right to be free from any unwarranted search of your person or property. At the time of admission to a 24‐hour facility, staff may search you and your belongings to prevent dangerous or illegal substances from being brought into the facility. The facility itself may be searched if dangerous or illegal substances are reasonably believed to be present, and staff may search consumers who are minors.

Should search and seizure apply to a program from which you are receiving treatment, the specific procedures will be explained when you enter the program.

You have the right not to be abused.

At the time of admission to a specific program, you will be informed of the types of interventions that are approved for use by that program. The program cannot administer any potentially painful procedure or stimulus to reduce the frequency or intensity of a behavior, and at no time is corporal punishment allowed. Employees must protect consumers from harm and report any form of abuse, neglect or exploitation.

In an emergency situation, if your behavior is dangerous to yourself or others, or property, or if we determine -that it is necessary for your care, an RCG staff may notify law enforcement assistance or initiation of involuntary commitment procedures. Relief Counseling Group upholds a strict "no touch or restrain" policy. RCG staff are not to touch or restrain clients.

You have a special right if you have intellectual disabilities.

If your primary need is related to the fact that you have intellectual disabilities and are placed in a residential facility, you are entitled to assistance in finding another place to live if your original placement can no longer serve you. This right exists unless you have broken the rules you agreed to follow or if we offer another place that can meet your needs and you refuse that offer. The facility must give you, your legal guardian and Alliance Behavioral Healthcare 60 days advance notice if it intends to discharge you. This right does not apply if you live in a privately‐operated ICF‐MR facility.

You have the right to make instructions for your treatment in advance.

In the event that you become incapacitated and unable to make decisions about your treatment, you may prepare a document which outlines your intentions for your treatment, and a person to make decisions based upon your instructions.

You have the right to make a complaint.

If you are dissatisfied with a Mental Health, Intellectual Developmental Disabilities or Substance Abuse service delivered through Relief Counseling Group PLLC or a Network Provider through an insurance company, you have the right to state a complaint or file a grievance at any time. Before stating a written complaint, we urge you to first discuss the matter with staff of the program providing the service and allow them an opportunity to help resolve it. If attempts to rectify a complaint are unsuccessful, contact the grievance department of your insurance company. [Client's with Alliance Behavioral Healthcare dial: 1-800- 510-913].

You Have Certain Appeal Rights

If you have Medicaid, you have the right to request an appeal hearing if you are denied a requested service, or if current services are reduced, suspended or terminated.

If you have questions or problems contact:

Relief Counseling Group PLLC
1135 Kildaire Farm Rd., St 20
Cary, NC, 27511
(919) 438-3206

Disability Rights NC

This statewide agency is designated under federal and state law to protect and advocate for the rights of persons who have disabilities.

Disability Rights NC
3724 National Drive
Suite 100
Raleigh, NC 27612

Toll Free: 877‐235‐4210

Local: 919-856‐2195
TTY: 888-268-5535
Fax: 919‐856‐2244

www.disabilityrightsnc.org