CLIENT RIGHTS

Clients of Citrus Health Network have the right to:

Not be excluded from participation in, be denied the benefits of, or be subject to unlawful discrimination based on my race, color, age, national origin, sex, religion, marital status, familial status, disability, sexual orientation, genetics, gender identity, or source of payment.  I have the right to express my wishes with regard to my treatment.  When CHN cannot meet my request, or need for care, I will be referred to an available and appropriate facility. I have the right to be informed in a language that I understand, including hearing and/or visually impaired services. According to section 504 of the Rehabilitation Act of 1973, I have a right to appropriate auxiliary aids and services necessary to ensure effective communication at no cost. If I have a need for special services or accommodations, I may contact the Citrus Health Network ADA/Section 504 Coordinator at ext. 12353 or 305-424-3183 (TTY/TDD Relay 1-800-955-8771).  If I believe that I have been denied services, I may file a complaint with the U.S. Department of Health and Human Services, Office of Civil Rights, or the Department of Children and Families, Office of Civil Rights within 180 days of the alleged violation. 

Considerate, respectful care at all times and under all circumstances, with recognition of my personal dignity, cultural, spiritual, personal values, and belief systems.  I have the right to exercise my cultural and spiritual beliefs as long as they do not interfere with the well-being of others or my planned course of treatment.  My spiritual needs may be met at my request through arrangements with resources in the community as my treatment allows. 

Personal privacy and confidentiality of information as per Federal and State laws.  I understand these rights are outlined in Citrus Health Network’s Notice of Privacy Practices.

Necessary information, in a clear and concise explanation, to enable me to make treatment decisions that reflect my wishes.  CHN will make every effort to assure that I understand the following:  nature and goals of the individualized treatment plan, hours during which services are available, discharge plans along with plans following discharge, expected client conduct, and the types of infractions that can cause discharge from the facility. I have the right to know of experimental, research, or educational activities involved in my treatment. I also have the right to refuse to participate in any such activity without penalty.  I have the right to know the risks, side effects, and benefits of all medications and treatment procedures and available alternate treatment procedures.

Know the identity and professional status of all people involved in my care, including the identity of the individual who is primarily responsible for my treatment.  I have the right to know any change in the professional staff responsible for my care or the reason for any transfer within or outside the organization. 

Know that all persons acting in good faith, reasonably, and without negligence in relation to my care are free from all liability due to such acts. However, if a staff member were to violate or abuse my rights or privileges, they would be liable for damages under the law.

Accept medical care or to refuse treatment to the extent permitted by law and be informed of the consequences of such refusal.  I have the right to leave CHN against medical advice, but I will be asked to sign a form to that effect. 

To provide CHN with an Advanced Directive. The Advance Directive will be honored and documented in my medical record and communicated to staff.  I understand that if I presently do not have an Advance Directive, I have the right to create an Advance Directive and must ask CHN staff for more information.                

Contact people outside the CHN by means of visitors or through written or verbal communication, including the abuse registry and the DCF Substance Abuse and Mental Health Program Office at 305-377-5029.

A detailed, itemized explanation of my total bill for services, regardless of how these services will be paid.  If I need financial aid to pay this bill, I am entitled to information and assistance in securing such aid.

Know what rules and regulations apply to my conduct as a patient.  If I have any complaints, I have a right to access the CHN's system for answering patient complaints, by contacting the individual who is primarily responsible for my treatment.  My complaint will in no way affect the quality of care or compromise my future access to care.                   

Know that for my safety as well as others, seclusion, and restraints are used at CHN according to Federal and State Regulations and The Joint Commission.  It is the policy of CHN to keep clients safe from themselves or others while receiving treatment at CHN.  Restraint and seclusion use is limited to emergencies in which there is an imminent risk of an individual physically harming him/herself, staff, or others and non-physical interventions would not be effective.

CLIENT RESPONSIBILITIES

Clients of Citrus Health Network are responsible for:

• Providing my full name; proof of current address, such as rent receipt, voters registration, utility bill, etc.; date of birth; place of employment or proof of unemployment; Medicare/Medicaid cards or proof of private insurance; proof of income;

• Notifying CHN about any change in my address, telephone number, or any information I have given CHN;

• Providing accurate and complete information about the history of treatment or care including the name and address of other physicians recently seen and all medications I am currently taking;

• Reporting to CHN staff any perceived risks in my care.  I am responsible for asking questions when I do not understand what I have been told about my care or what I am expected to do while receiving treatment at CHN;

• Keeping my appointments.  If I cannot keep my appointment, I need to notify CHN as soon as possible. CHN will try to see me or make arrangements for an appointment as soon as possible;

• Following up with my care at CHN, within the time specified in the notice.  If I fail to contact CHN, my case will be closed without further notice. It is CHN’s policy to close behavioral health cases that are inactive over ninety (90) days and primary care cases when they have been inactive for 3 years, from the client’s last visit. 

meeting my financial obligations as agreed to.  I will be charged for services according to my income.

NOTE:  I may have other specific rights if I become a resident in one of the CHN's facilities.  Consult with Admissions staff.

• For downloadable Client Rights and Responsibility forms in English and Spanish, please click here.

IMPORTANT NOTICE TO PATIENTS CHN serves all patients regardless of ability to pay. You may apply for a discounted rate at the front desk. Discounts for essential services are offered depending upon family size and income. Once you receive a percentage discount based on information provided by you, that percent will be used to determine how much you will be charged for each service. The established fee is due at the time of your visit. Please speak with our receptionist if you have any questions. Thank you Citrus Health Network, Inc. and its covered individuals have medical malpractice coverage under the Federal Tort Claims Act.

``````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````AVISO IMPORTANTE PARA PACIENTES CHN ofrece servicios esenciales a todos los pacientes sin considerar la capacidad de pago. Usted puede solicitar un descuento con nuestra recepcionista. Descuentos por estos servicios son calculados de acuerdo al tamaño familiar y el nivel de ingreso. El costo del servicio después de aplicarse el descuento, si califica, debe ser pagado al momento de la visita. Por favor hable con nuestra recepcionista si tiene preguntas. Gracias Citrus Health Network, Inc. y sus personas cubiertas tienen cobertura de negligencia médica bajo la Ley Federal de Demandas por Agravio.

NOTICE OF PRIVACY PRACTICES SUMMARY

THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice is provided in two layers: This top layer briefly summarizes how we use and disclose your protected health information, known as PHI, and the attached bottom layer provides further details of our privacy policies and procedures regarding the uses and disclosures of your PHI.

How we may use and disclose your PHI. We use your PHI for treatment, to get paid for treatment, for administrative purposes, and to evaluate the quality of care that you receive. For example, your PHI may be shared with other providers to whom you are referred. Information may be shared by paper, mail, electronic mail, fax, or other methods. We may use or disclose your PHI without your authorization for several reasons allowed by federal and state laws. We will ask for your written authorization before using or disclosing any of your PHI for any other use. If you sign an authorization to disclose information, you have the right to revoke the authorization from any future uses and disclosures.

Your rights. In most cases, you have the right to look at or receive a copy of your PHI. If you request copies, we may charge you a fee not to exceed $1 per page. You also have the right to request a list of certain types of PHI disclosures that we have made. If you believe your PHI is incorrect or information is missing, you have the right to request an amendment to your PHI.

Our legal duty. The Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). We are required to protect your PHI; provide you with this notice; comply with the privacy practices as described in our notice; and seek your acknowledgment of receipt of this notice. We reserve the right to modify the terms of this notice by first posting the revised notice in prominent locations throughout CHN’s service sites and posting the revised notice on our web site: www.citrushealth.org. You may request a copy of our notice at any time. For more information about our privacy policies, contact CHN’s Privacy Officer.

Privacy complaints. If you believe that your privacy rights have been violated or if you disagree with a decision we made about access to your PHI, you may file a written complaint with us and/or the U.S. Department of Health and Human Services. For more information about how to file a complaint, contact CHN’s Privacy Officer.

For the complete Notice of Privacy Practices document, please click on the pdf below.

DOWNLOAD PDF

This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

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Este centro de salud recibe financiamiento del HHS y tiene un estatus otorgado por el Servicio de Salud Pública Federal (PHS) en relación con ciertas reclamaciones de salud o relacionadas con la atención médica, incluidas las reclamaciones por negligencia médica, para sí mismo y para sus individuos cubiertos.

Joint Commission

Citrus Health Network Inc. has been accredited by the Joint Commission since 1987. We strive to provide you with good quality care and services. If there is a concern about patient care and safety at any of our facilities, please first contact the Program Administrator or Administration at (305) 825-0300.

If you believe the concern has not been resolved, you may notify The Joint Commission in writing at the Office of Quality Monitoring, One Renaissance Blvd., Oakbrook Terrace, IL 60181; by fax at 630-792-5636; by e-mail at complaint@thejointcomission.org; or call 1-800-994-6610.

A complaint may also be made via email at complaints@citrushealth.com.

Notice of Rights Under Title VI

Citrus Health Network operates its programs without regard to race, color, and national origin in accordance with Title VI of the Civil Rights Act. Any person who believes she or he has been aggrieved by any unlawful discriminatory practice under Title VI may file a complaint with Citrus Health Network. The complaint form is available below and may be returned to Quality Improvement Officer Carmen Cantero at our Administrative offices located at 4175 W 20th Ave, Hialeah, FL 33012, or via email at complaints@citrushealth.com.

Notificación al Público de los Derechos del Título VI

Citrus Health Network opera sus programas y servicios sin distinción de raza, color y origen nacional de acuerdo con el Título VI de la Ley de Derechos Civiles. Cualquier persona que crea que él o ella ha sido agraviada por alguna práctica discriminatoria ilegal bajo el Título VI puede presentar una queja ante Citrus Health Network. El formulario de quejas esta disponible a continuacion y se le puede entregar a la Oficial de mejora de calidad Carmen Cantero en nuestra oficina administrativa en 4175 W 20 Avenue, Hialeah, Florida 33020 o por correo electrónico a complaints@citrushealth.com.

Avize Piblik la Sou Dwa Dapre Tit VI

Citrus Health Network opere pwogram li yo ak sèvis san yo pa konsidere ras, koulè, ak orijin nasyonal an akò ak Tit VI nan Lwa sou Dwa Sivil la. Nenpòt moun ki kwè ke li te agrave li ak nenpòt pratik diskriminatwa ilegal nan Tit VI ka depoze yon plent ak Citrus Health Network. Fòm plent lan disponib anba a epi yo ka retounen li nan Ofisye Amelyorasyon Kalite Carmen Cantero nan biwo Administratif nou yo ki nan 4175 W 20th Ave, Hialeah, FL 33012 oswa via imèl nan complaints@citrushealth.com.

This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

English:

CHN will investigate the complaint within 90 calendar days of the filing of the complaint. If CHN needs more information to resolve the case, CHN will contact the complainant. The complainant has 10 business days from the date of the letter requesting additional information to send the requested information to CHN. If the complainant does not reply within the allotted time, CHN will administratively close the case. A complaint can also be administratively closed if the complainant no longer wishes to pursue the case. CHN will provide a written response to the complainant.

Spanish:

CHN investigará la denuncia dentro de los 90 días del calendario desde que se presentó la denuncia. Si CHN necesita más información para resolver el caso, CHN se comunicará con el denunciante. El denunciante tiene 10 días hábiles a partir de la fecha de la carta solicitando información adicional para enviar la información solicitada al CHN. Si el denunciante no responde dentro del tiempo asignado, CHN cerrará administrativamente el caso. Una denuncia también puede cerrarse administrativamente si el denunciante ya no desea continuar con el caso. CHN proporcionará una respuesta por escrito al denunciante.

Creole:

CHN gen pou l mennen ankèt sou plent lan nan entèval 90 jou sivil ki swiv depo plent lan. Si CHN bezwen plis enfòmasyon pou l rezoud ka a, CHN ap kontakte moun ki depoze plent lan. Moun ki depoze plent lan genyen entèval 10 jou ouvrab apati dat li resevwa lèt ki mande l plis enfòmasyon an pou l voye enfòmasyon yo mande l yo bay CHN. Si moun ki pote plent lan pa reponn nan entèval tan yo bay la, CHN ap fèmen dosye a sou pwen administratif. Yon plent kapab rive fèmen sou pwen administratif tou si moun ki pote plent lan pa anvi kontinye avèk dosye a ankò. CHN ap voye yon repons alekri bay moun ki te pote plent lan.

Citrus Health Network’s Ryan White Program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant numberH89HA00005, CFDA#93.914 - HIV Emergency Relief Projects grants, as part of a Fiscal Year 2023 award totaling $271.874, as of 03/01/2023 with 22 % financed with non-governmental sources. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government.

Resources:

• Medicare Marketing Toolkit

• Website Medicare Services Checklist

• Verbiage to Promote Medicare Services

Open Enrollment Timelines:

• Medicare Open Enrollment: October 15, 2024 – December 7, 2024

• Marketplace Open Enrollment: November 1, 2024 – January 15, 2025