R03-601. Client Rights

1. A licensee shall ensure at the time of admission or first appointment, the client and, if applicable, the client's parent, guardian, or designated representative receives a written copy of the client’s rights to include the following rights:
   1. To be treated with dignity and respect,
   2. To be free from:
      1. Abuse,
      2. Neglect,
      3. Exploitation,
      4. Restraint or seclusion, of any form, used as a means of coercion, discipline, convenience, or retaliation,
   3. To a safe, sanitary, and humane living environment that:
      1. Provides privacy, and
      2. Promotes dignity,
   4. To receive treatment services free of discrimination based on the client’s race, religion, ethnic origin, age, disabling or a medical condition, and ability to pay for the services,
   5. To privacy in treatment, including the right not to be fingerprinted, photographed, or recorded without consent, except for:
      1. Photographing for identification and administrative purposes, as provided by R03-602, or
      2. Video recordings used for security purposes that are maintained only on a temporary basis,
   6. To receive assistance from a family member, designated representative, or other individual in understanding, protecting, or exercising the client's rights,
   7. To confidential, uncensored, private communication that includes letters, telephone calls, and personal visits with:
      1. An attorney,
      2. Personal physician,
      3. Clergy,
      4. Department of Social and Rehabilitation Services Staff, or
      5. Other individuals unless restriction of such communication is clinically indicated and is documented in the client record,
   8. To practice individual religious beliefs including the opportunity for religious worship and fellowship as outlined in program policy,
   9. To be free from coercion in engaging in or refraining from individual religious or spiritual activity, practice, or belief,
   10. To receive an individualized treatment plan that includes the following:
       1. Client participation in the development of the plan,
       2. Periodic review and revision of the client’s written treatment plan,
   11. To refuse treatment or withdraw consent to treatment unless such treatment is ordered by a court or is necessary to save the client’s life or physical health,
   12. To receive a referral to another program if the licensee is unable to provide a treatment service that the client requests or that is indicated in the client’s assessment or treatment plan,
   13. To have the client’s information and records kept confidential and released according to R03-602,
   14. To be treated in the least restrictive environment consistent with the client’s clinical condition and legal status,
   15. To consent in writing, refuse to consent, or withdraw written consent to participate in research, experimentation, or a clinical trial that is not a professionally recognized treatment without affecting the services available to the client,
   16. To exercise the licensee’s grievance procedures,
   17. To receive a response to a grievance in a timely and impartial manner,
   18. To be free from retaliation for submitting a grievance to a licensee, the Department of Social and Rehabilitation Services, or another entity,
   19. To receive one’s own information regarding:
       1. Medical and psychiatric conditions,
       2. Prescribed medications including the risks, benefits, and side effects,
       3. Whether medication compliance is a condition of treatment, and
       4. Discharge plans for medications,
   20. To obtain a copy of the client’s clinical record at the client’s own expense,
   21. To be informed at the time of admission and before receiving treatment services, except for a treatment service provided to a client experiencing a crisis situation, of the:
       1. Fees the client is required to pay, and
       2. Refund policies and procedures, and
   22. To receive treatment recommendations and referrals, if applicable, when the client is to be discharged or transferred.
2. A licensee shall ensure that a client receiving treatment in a residential program, in addition to the rights listed in subsection (A), has the following rights:
   1. To receive visitors, and make telephone calls as established by program policy and posted conspicuously in the facility, unless:
      1. The program director or designee determines and documents in the client record, a specific treatment purpose that justifies waiving this right, and
      2. The client is informed of the reason the right is to be waived and the client’s right to submit a grievance regarding this treatment decision,
   2. To privacy in correspondence, communication, visitation, financial affairs, and personal hygiene, unless:
      1. The program director or designee determines and documents in the client record, a specific treatment purpose that justifies waiving this right, and
      2. The client is informed of the reason the right is to be waived and the client’s right to submit a grievance regarding this treatment decision,
   3. To maintain, display, and use personal belongings, including clothing according to program policy,
   4. To be provided with:
      1. Meals that meet the client’s nutritional needs,
      2. A referral to medical services to maintain the client’s health, safety, or welfare, if indicated, and
      3. Opportunities for social contact and daily social, recreational, or rehabilitative activities.
3. A licensee shall ensure that:
   1. At the time of admission, the client and, if applicable, the client’s parent, guardian or designated representative receives a written list and a verbal explanation of:
      1. Client rights,
      2. Grievance policy and procedure,
      3. Confidentiality policy, and
      4. Treatment service fees,
   2. The client and, if applicable, the client’s parent, guardian, or designated representative signs and dates a document indicating the receipt of the written list and the verbal explanation required in subsection (C)(1) or documentation of a refusal to sign, and
   3. Staff provides a verbal or other appropriate explanation that may be required to assist the client in understanding the client rights.

R03-602. Confidentiality

1. A licensee shall develop, implement, and comply with policies and procedures that ensure the confidentiality and security of client records and client-related information is maintained and address that:
   1. If maintained other than electronically, the client records and other written client- related information be stored in a locked container or area, or
   2. If maintained electronically, the client records and other written client-related information be protected from unauthorized access, and
   3. A staff member’s release and discussion of client-related information is conducted according to 42 CFR, Part 2 and the HIPAA of 1996.
2. Licensee shall ensure that a current active client record is maintained for each client and:
   1. Is protected at all times from loss, damage, or alteration,
   2. Is confidential,
   3. Is only released or disclosed as provided in:
      1. 42 U.S.C. § 290dd-2 (Supplement V 2002), incorporated by reference, and including no future editions or amendments, available at www.access.gpo.gov/uscode/uscmain.html and from the U.S. and Government Printing Office, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954, or
      2. Another applicable federal or state law that authorizes release or disclosure, or
      3. Accordance with written permission from the client and, if applicable, the client's parent, guardian, or designated representative, according to subsection (A),
3. A licensee shall ensure that written permission for release of a client record or information, as described in subsection (B)(3)(C) and (D), is obtained according to the following:
   1. Before a client record or information is released or disclosed,
   2. Is obtained in a language understood by the individual signing the written permission in subsection (D), and
   3. Is maintained in the client record.
4. A licensee shall ensure that written permission for release of a client record or information shall include:
   1. The name of the program or person disclosing the client record or information,
   2. The purpose of the disclosure,
   3. The individual, provider, program, or entity requesting or receiving the record or information,
   4. A description of the client record or information to be released or disclosed,
   5. A statement indicating client permission has been given and may be revoked at any time,
   6. The date or condition when the permission expires,
   7. The date the permission was signed, and
   8. The signature of the client and, if applicable, the client’s parent, guardian, or designated representative.

The policies R03-601 and R03-602 can be found here at the KDADS website.

4.9 Program Rules and Treatment Requirements

Urinalysis Drug Screening and Alco sensor Breath Tests

All patients must agree to submit to random drug screens and Alco sensor breath tests at the discretion of the clinical staff in order to assess progress in the program and the patient’s ability to remain abstinent from intoxicating substances. Refusal to submit to a breath or urine test will be interpreted as a clear indication that intoxicating chemicals have been used and the patient will be considered non- compliant with program requirements and may be discharged at the discretion of ARRI staff. An ARRI staff member will administer and observe the patient’s participation in urinalysis drug screens (see 4.5 Urinalysis and Alco sensor Testing Policy)

Utilizing Positive Urinalysis and Alco sensor Tests toward Treatment Goals

Patients will be informed of positive tests results by an ARRI Therapist, privately and respectfully. The therapist will inform the patient of the need to inform and utilize their treatment peers and other recovery supports toward developing a plan to aid the patient in the stabilization goal of abstinence. The patient is required to follow this abstinence-based plan (see 4.5 Urinalysis and Alco sensor Testing Policy).

Behavioral Addiction Policy

All patients must agree to abstain from participating in any type of behavioral addiction (i.e., gambling, shopping, internet usage, cutting, pornography, exercise, video gaming, etc.). Should a patient return to participating in a behavioral addiction(s) the patient must meet with clinical staff to assess his/her treatment needs and to discuss his/her participation in addictive behaviors with his/her treatment group(s) and follow all recommendations made by clinical staff and/or treatment peers regarding his/her treatment needs.

12- Step Meeting attendance

ARRI is a 12-Step oriented treatment program. As such, patients must attend at least ten 12-Step meetings as assigned by their primary therapist. Non-attendance at 12-Step meetings may result in suspension or discharge from treatment.

Personal Effects/Property Liability/Safety and Contraband

Patients should not bring unnecessary personal possessions into treatment. ARRI and any staff member employed by ARRI are not responsible for replacing any of a patient’s personal possessions that may be lost or stolen during the course of treatment.

Cell Phones

Patients may not use cell phones in group or in individual sessions. Patients will be permitted to use cell phones during designated break periods. If a patient is expecting an emergency phone call, they must make arrangements with the staff member facilitating group and/or individual session prior to the beginning of session. In those instances, the staff member facilitating group may make an exception to allow the patient to have their cell phone on during session.

Clinical Environment

In order to maintain an optimal clinical environment which ensures the safety and health of all patients and staff at ARRI patients must agree not to bring any type of intoxicating substance, drug paraphernalia or weapon onto ARRI property. Patients must also agree to allow ARRI staff to search personal belongings including but not limited to any bags, purses or outerwear and clothing at random and/or based on reasonable suspicion. Failure to comply with ARRI staff’s request to search will result in immediate, unsuccessful discharge from treatment. Participation in any of the below listed behaviors can result in immediate discharge from treatment services and if necessary, the involvement of local law enforcement.

• Possession of weapons, including pocketknives, on the premises - inside the building, on the property outside of the building and/or in a vehicle including pocketknives
• Coming to treatment under the influence
• Driving while intoxicated to or from our facility.
• Initiating or engaging in physical altercations
• The use of direct and/or implicit threatening language
• Making derogatory comments about a group of people
• Promiscuity and/or sexual relations with treatment peers inside and/or outside of the treatment facility
• The use of direct or implicit use of sexually suggestive language and or behavior
• The use of cell phones during group or individual sessions
• Attempting to triangulate or split staff.
• Criminal activity inside or outside of the treatment facility
• Attempt ARRI to substitute alter or otherwise falsify a urinalysis sample.
• Use, disclosure and/or any other dissemination of another patient or participant’s confidential information.

Dress Code

All patients must comply with the following dress code with the understanding that ARRI staff is ultimately responsible for determining the appropriateness of a patient’s appearance.

• No midriff baring shirts
• No bathing suit tops or tube tops.
• No clothing depicting obscene/foul language.
• No clothing depicting or advertising alcohol, drugs, paraphernalia, gambling, or any establishment primarily known for selling alcohol or other drugs such as liquor stores and/or bars.
• No clothing depicting sexual content or violence.
• No excessively short shorts or skirts
• No gang-related clothing or accessories
• No see-through clothing
• No hats, scarves, or Doo-Rags
• No excessive “sagging” or display of undergarments.

4.11 Financial Policies and Procedures

Each patient will be presented with a copy of ARRI’s Financial Policies and Procedures at the time of admission. The below information will be included in the Informed Consent Document presented to each patient at the time of admission.

As a courtesy to our patients, a staff member at ARRI will verify the substance abuse and/or mental health benefits available through the patient’s private insurance carrier or other third-party payer.

Verification of benefits on ARRI’s part in no way guarantees payment by the insurance company or other third-party payer, including AAPS/Value Options. Payment by any third-party payer, including AAPS/ Value Options, depends on the patient’s eligibility for benefits at the time that claims are processed.

Block Grant/Value Options Patients

Eligibility for AAPS Block Grant funding and/or SB6 funding is based on a number of variables including, but not limited to income, residency and whether or not the patient has private insurance or other third-party payer options. It is possible that eligibility for Block Grant funds may change during the treatment process based on any of the aforementioned variables. It is the patient’s responsibility to notify ARRI if they have private insurance or any other third-party payment option.

The patient is ultimately responsible for verifying substance abuse and/or mental health benefits with their insurance carrier or other third-party payer (including AAPS/Value Options), determining whether ARRI is contracted and in-network with their insurance carrier or other third-party payer and for paying all treatment expenses not covered by their insurance carrier or other third-party payer.

If the patient determines that ARRI is an out-of-network provider for their insurance carrier and the patient would like to determine if their insurance carrier will make an exception for their participation in treatment services at ARRI it is the patient's sole responsibility to negotiate that exception with their insurance carrier.

Staff at ARRI will obtain all necessary precertification for services following but not including the patient's initial appointment. If precertification for the patient's initial appointment is required, it is the patient's responsibility to obtain that authorization and provide proof of that authorization to ARRI staff.

Based on the benefits received from your insurance carrier or other third-party payer a staff member at ARRI will estimate the total out-of-pocket expense the patient will be expected to pay for services rendered.

During the initial portion of the patient’s primary treatment process the patient will be given a form titled “Notice of Financial Responsibility” reflecting the patient's estimated out-of-pocket expense for their primary treatment process. The patient will also be given documentation of the benefit information received from their insurance carrier or other third-party payer. If the patient does not have any anticipated treatment cost, they will not receive a “Notice of Financial Responsibility.”

• For estimates at or below $250.00 the entire amount is due at the beginning of the treatment process.
• For estimates over $250.00 – a down payment equal to 30% of the total estimate is required at the beginning of the treatment process.

Failure to pay the specified amount due at the beginning of the treatment process will result in you being discharged from services at ARRI.

ARRI will submit claims to the patient’s insurance company or other third-party payer on their behalf, sometimes directly and in some cases through the clearinghouse ARRI employs.

ARRI bills the patient for services as they are rendered. A monthly statement will be sent to the patient after ARRI receives a response from your insurance or other third-party payer.

Failure to pay the balance and/or failure to make alternative arrangements with ARRI staff may result in the patients account being turned over to ARRI’s attorney for collections and may also result in the patient being discharged from services at ARRI.

The patient’s insurance company or other third-party payer may be given information about the type(s), cost(s), dates and providers of any services or treatment that is received. Payment from the patient’s insurance carrier or other third-party payer will be made directly to ARRI.

All patients are directly and personally responsible for certain out of pocket expenses including but not limited to urinalysis drug screens, late cancellation charges and continuing care treatment charges regardless of funding source - including patients accessing funding from a third-party payer such as SB6, AAPS Block Grant, or SB123.

Written reports including, but not limited to, evaluation results, and/or reports on progress and attendance in treatment must be requested at least 14 calendar days prior to the date the report is due. Patients failing to make a request for a written report without more than 14 days’ notice prior to the due date will be charged an out-of-pocket “convenience fee” of $100.00 at the time that the request is made and prior to the report being released from ARRI

Readmission

Patients who initiate readmission to ARRI for any reason following discharge will be required to pay the entire balance in full for any services that were rendered and unpaid for during their previous treatment episode(s) before they will be allowed readmission.

It is the patient’s responsibility to provide ARRI with the most accurate and up to date billing information. If there is a change in your insurance or other third-party payer coverage it is your responsibility to notify ARRI of that change(s) and to provide ARRI with all information required to submit claims on your behalf. It is also the patient’s responsibility to keep ARRI informed of their current mailing address.