Client Information

Client Rights

As a client of The Next Chapter each client is entitled to the following rights and privileges without limitation:

  1. To be treated with dignity and respect.

  2. To be free from abuse, neglect and exploitation; 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 provides privacy and promotes dignity.

  4. To receive treatment services free of discrimination based on the client’s race, religion, ethnic origin, age, disability 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 an attorney, personal physician, clergy, department of social and rehabilitation services staff or other individuals unless restricted 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 client participation in the development of the plan and 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 Next Chapter 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 grievance procedure as outlined in the policy and procedure manual for The Next Chapter.

  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 The Next Chapter, the Department of Social and Rehabilitation Services, or another entity

  19. To receive one’s own information regarding medical and psychiatric conditions including:

    1. prescribed medications including the risks, benefits, and side effects,

    2. whether medication compliance is a condition of treatment, and

    3. discharge plan 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 fees the client is required to pay and the refund policies and procedures. 

  22.  To receive treatment recommendations and referrals, if applicable, when the client is to be discharged or transferred. 

Informed Consent to Treat & Service Fees

Credentials:  We are licensed to practice in the State of Kansas as a licensed therapist in our field of specialty.  We are not medical providers or medical doctors and do not give medical advice or prescribe medication.

 

Hours:  By appointment only.  Appointments are generally available between 9am and 8pm Tuesday through Thursday; 10am to 4:30pm on Saturday and Sunday; closed on Monday and Friday. 

 

Confidentiality:  All information disclosed within sessions, including that of minors, is confidential and may not be revealed without written permission except as required by law.  Disclosure may be required in the following circumstances:

  1. Where there is a reasonable suspicion of child abuse or abuse to a dependent or elder adult.

  2. When the client communicates a threat of bodily injury to self or others.

  3. A medical emergency when the health of the client is in jeopardy.

  4. When the disclosure is ordered by a court.

 

Cancellation:  A scheduled appointment reserves a time slot specifically for you.  In a sense you are buying that time.  To avoid being charged for a missed session, please inform me of a cancellation at least 24 hours in advance.  Late cancellations may be charged at the full fee.  They are not reimbursed by insurance companies and therefore are out-of-pocket.

 

Use of Health Insurance:  Insurance coverage is an agreement between you and your benefit carrier to pay some of your bill.  You are responsible for the payment of your bill regardless of the status of your insurance claim.  We do not become involved in disputes between you and your insurance company or another party about payment of costs.

 

Referral:  If a referral from a primary care physician or lock-in provider is required for your insurance, it your responsibility to obtain this referral prior to services being provided.  Likewise, if a referral from an insurance or managed care company is required for services to be covered, it is your responsibility to obtain such referral or authorization.

 

Payment of Fees:  In order to provide therapeutic services for a reasonable fee, The Next Chapter does not utilize an outside billing service.  Our expectation is that patient fees will be paid at the time of service however we understand that life happens.  Continuity of care is important for your healing and growth so please talk to your clinician about payment arrangements if necessary.  All payments received from client, insurance or other funding resources will be applied as rendered to the corresponding outstanding charges.  Upon fulfillment of the outstanding balance due (including co-payments, deductibles, and non-covered services by insurance) any overage paid by the client or responsible party will be refunded in the form of a check within forty-five (45) days of completion of services. 

 

Fee Schedule:  The fees charged are typically the community average for psychotherapy services.  Your insurance carrier may have negotiated a discounted fee on your behalf.  We are willing to negotiate out-of-pocket fees for those who do not have insurance or do not wish to use it.

Notice of Supervision

In accordance with K.A.R. 102-2-8, you are hereby notified that this clinician, Janel R. Sanford, LMSW, LMAC, is practicing social work or participating in the delivery of social work services under supervision.   

Client confidentiality shall be upheld and respected by the supervisee and the supervisor unless as follows:  

  • The client consents in writing, OR 

  • The disclosure is allowed by court order, OR 

  • There is suspicion of harm, abuse, or neglect to self or others.   

Supervisor contact information:  

        Kathleen J. Ruth, LSCSW 

        300 W. Douglas, Ave.  Suite 205 

        Wichita, KS  67202-2904 

        Phone:316-640-4261 

        Email: kjr_68@msn.com 

Confidentiality

NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION.  THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG & ALCOHOL RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

     GENERAL INFORMATION

Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) 42 U.S.C. §1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. §290dd-2, 42 C.F.R. Part 2. Under these laws The Next Chapter may not say to a person outside of The Next Chapter that you attend the program, nor may The Next Chapter disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law.

 

The Next Chapter must obtain your written consent before it can disclose information about you for payment purposes.  For example, The Next Chapter must obtain your written consent before it can disclose information to your health insurer in order to be paid for services.  Generally, you must also sign a written consent before The Next Chapter can share information for treatment purposes or for health care operations.  However, federal law permits The Next Chapter to disclose information without your written permission:

 

  • Pursuant to an agreement with a qualified service organization/business associate.

  • For example, The Next Chapter can discuss information without your consent to obtain legal or accounting services for our company’s business needs, as long as there is a qualified service organization agreement/business associate agreement in place.

  • For research, audit or evaluations.

    • For example, state licensing agencies conduct yearly reviews of our programs to ensure compliance with operating regulations.  This includes reviewing some of our client files.  Auditors conducting such reviews are required by law to maintain your confidentiality.

  • To report a crime committed on the premises of The Next Chapter or against The Next Chapter personnel.

    • For example, The Next Chapter may report you to the police if you commit a crime on The Next Chapter, or if you commit a crime against a The Next Chapter clinician (even if it occurs on property not owned or leased by The Next Chapter).

  • To medical personnel in a medical emergency.

    • For example, The Next Chapter call 911 should you need emergency medical assistance.  Only information pertinent to the emergency will be released.

  • To appropriate authorities to report suspected child abuse or neglect.

    • For example, The Next Chapter will contact state agencies involved in the investigation of child abuse and neglect should it appear that you or someone else is involved in or was recently involved in such behavior.

  • As allowed by court order.

    • For example, The Next Chapter will respond to a proper order from the court.  We will release only the information necessary to follow the order of the court and within the legal limits as set forth by federal confidentiality laws.

Before The Next Chapter can use or disclose any information about your health in a manner that is not described above, a specific written consent must be obtained from you allowing The Next Chapter to make the disclosure.  Any such written consent may be revoked by you in writing.

     YOUR RIGHTS

Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information.  The Next Chapter is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency.

 

You have the right to request that we communicate with you by alternative means or at an alternative location.  For example, you might want us to contact you by cell phone rather than your home phone, or, you might prefer that your invoices be mailed to a location other than your home.  The Next Chapter will accommodate such requests that are reasonable and will not request an explanation from you.  Under HIPAA you also have a right to inspect and copy your own health information maintained by The Next Chapter, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances.

 

Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in The Next Chapter records, and to request and receive an accounting of the disclosures of your health related information made by The Next Chapter direction during the six years prior to your request.  You also have the right to receive a paper copy of this notice.

 

      DUTIES OF THE NEXT CHAPTER

The Next Chapter is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information.   The Next Chapter is required by law to abide by the terms of this notice.  The Next Chapter reserves the right to change the terms of this notice and to make the new notice provisions effective for all protected health information it maintains.  In the event of this notice being revised, all current and active clients will be given a paper copy of the revised notice.  The revised notice will also be posted on our website: www.thenextchapterICT.org 

 

      COMPLAINTS AND REPORTING VIOLATIONS

You may complain to The Next Chapter and the Secretary of the United States Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA.  To file a privacy complaint with The Next Chapter please contact:

 

Janel R Sanford, LMSW, LMAC

300 W Douglas, Suite 205, Wichita, Kansas  67202

316-759-9136

 

To file a privacy complaint with the United States Department of Health and Human Services contact the office listed below:

Office for Civil Rights

Department of Health & Human Services

601 East 12th Street - Room 248, Kansas City, MO 64106

Phone:  (816) 426-7278, Fax (816) 426-3686

 

Violation of the Confidentiality Law by a program is a crime.  Suspected violations of the Confidentiality Law may be reported to the U.S. Attorney in the district where the violation occurs. 

 

You will not be retaliated against for filing a complaint.

Client Grievance Policy and Procedure

The Next Chapter is established to provide therapeutic services to individuals and families that strive to move beyond those barriers that interfere with a quality of life.  While your investment is necessary to accomplish these goals, sometimes problems are encountered that need to be resolved before services can be utilized effectively.  Should you encounter a problem you believe should be addressed by The Next Chapter clinicians, please follow the steps as listed for efficient and timely resolution. 

Your concerns are important, and all grievances are taken seriously by The Next Chapter.  You will not be discharged or discriminated against as a result of the grievance. 

 

Contact your assigned clinician to discuss the issue of concern for assistance in resolving the barrier.  If a mediator is necessary, please feel free to request this assistance. 

If the problem continues or could not be resolved to satisfaction in discussion with the clinician and mediator, file a formal written grievance describing the complaint and mail it to:

 

The Next Chapter

Janel R. Sanford, LMSW, LMAC

300 W. Douglas, Suite 205, Wichita, KS  67202

 

The Next Chapter will review the grievance and respond to you in writing within 30 days. 

 

Should this response not resolve the problem to your satisfaction and you want to appeal the program team’s decision, please contact the Treatment Coordinator State of Kansas Department of Aging and Disability Services regarding your issue.  The Next Chapter clinicians will cooperate with KDADS in completion of any inquiries related to your grievance.

 

The Kansas Department of Aging and Disability Services

Alcohol and Drug Abuse Services

Clinical Services Coordinator

503 S. Kansas Ave., Topeka KS  66603

Phone:  785-296-6807

Fax:  785-296-0256

Contracted Service Providers

  • The Next Chapter provides mental health services outside of substance abuse services.  Each clinician housed within the office is independent of The Next Chapter, which may not be substance abuse service related, and further bound by confidentiality.  A full list will be posted in the office area for public review.  

 

  • Kathleen Ruth, LCSW, LCAC           Mental health service provider

  • Maland Silvio, MSW, LCAC             Addiction service provider

 

Other community services:

  • Thrive ICT                                        Abuse survivor support service

  • Culligan Water                               Water and coffee supply

  • Utility Consultants, Inc.                Drug testing facility

  • RapidCare Solutions, Inc               Billing service

  • Forshee Accounting & Tax             Accountant

Potential Barriers to Services

  • The Next Chapter does not have clinicians that are fluent in other languages.  Appropriate referrals will be made to a program that can accommodate language barriers.

  • The Next Chapter does not provide transportation to any client outside of the City of Wichita area.

  • The Next Chapter does not provide services for urine drug screening and any necessary testing is requested from an outside lab and at the client’s expense. 

  • The Next Chapter does not have male clinicians at this time. A referral will be made to an appropriate treatment provider should these deem necessary.

  • The Next Chapter has one clinician on staff and schedules are established by appointment only. 

Drug Testing Procedure

The Next Chapter will not complete onsite urine testing.  Should a urinalysis test be found necessary, the client will be referred to an area medical testing clinic and at the client’s cost.  Alternative to this referral can be a probation or parole office.  The client will have 24 hours to comply with the request.  Should the client choose not to comply; the request will be considered “declined by client”.  At that time, further assessment can be utilized to explore client barriers and further options for treatment.  Community professionals such as probation or parole officer, social worker and/or other pertinent agencies can be included in this assessment.  Any test results found positive in use will be used for further treatment planning.  The client can have opportunity to refute the initial test findings at the cost of the client. 

If illicit substance use is suspected, the client will be offered opportunity to address any use with counselor.  Admission to use will documented and entered into the client’s file.  Referral for urine drug testing can be deferred.

If urine drug screen is necessary, the client will be provided documentation of the request for screen to be complied with.  A release of information will be on file for the screening agency to obtain the results. 

Further options for treatment because of positive urine drug testing or admission of use can include:

  • Changes in treatment plan goals and tasks to include barriers in abstinence.

  • Changes in length of time in services. 

  • Increase in level of care to the least restrictive environment necessary to accomplish abstinence.

  • Referral to alternative program.

  • Referral to sober living environment.

300 W. Douglas, Suite 205

Wichita, Kansas 67202

Call Us:

316.759.9136

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