Your Rights - Solutions 4 Life Inc



Solutions 4 Life Inc.6727 1st Ave S. Ste 110St. Petersburg, FL 33707727-341-1000Client HandbookTable of ContentsPrivacy Practices3Confidentiality9Client Rights11Grievance Procedure13Fees Agreement16Application for Reduced Fees17What to expect in treatment19Program Rules/ Client Responsibilities22Infectious Disease/Infection Control25Admission Agreement27Helpful Telephone Numbers28Local Open AA Meetings29Group Days and TimesYour CounselorsJulius Sukhram, MS Sonja Kari-Platero, CAPWednesday: 6pm______ Tuesday: 2pm_____Saturday: 10:30am_____ Wednesday: 9am______ Individual Sessions:Cathy Coscia, LMHC__________ Julius Sukhram, MS _________________Kim Donat Ali, LCSW__________ Sonja Kari-Platero _________________Client Name:_____________________________________ Date of Admission:______________Your second individual counseling session date and time:______________________________This session must be completed within 30 days of your admission into the program. There is a penalty for not giving a 24 hour notice to change this appointment time.Your third individual counseling session date and time:________________________________Your fourth individual counseling session date and time: ______________________________Discharge/Exit session time and date:_______________________________________________Note: You will also be required to attend _____ AA/NA meeting, _____ within the first thirty (30) days of the program.Bus routes: PTSA #35, 79 and 90 provide services from South Pasadena, St Pete Beach, Treasure Island, Gulfport and central St. Petersburg. Solutions 4 Life Inc. is also in the process of obtaining licensing and insurance to provide transportation to our clients for an additional fee. When this option becomes available, we will notify all of our clients.Contact Information:Kim Donat Ali, LCSW, Executive Director, Privacy Officer, Ownerphone: 727-341-1000email: info@Our phones are staffed from 8:30-5:00 daily, excluding holidays and weekends. Solutions 4 Life Inc. closes our offices the Wednesday before Thanksgiving and will not open again until the following Monday. The offices are also closed from the 23rd of December until the 2nd of January.Client Signature: _________________________________Date:__________________________Counselor Signature:______________________________Date:__________________________Solutions For Life Inc.Notice of Privacy PracticesYour Information. Your Rights. Our Responsibilities.This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.Your RightsYou have the right to: Get a copy of your paper or electronic medical recordCorrect your paper or electronic medical recordRequest confidential communicationAsk us to limit the information we shareGet a list of those with whom we’ve shared your informationGet a copy of this privacy noticeChoose someone to act for youFile a complaint if you believe your privacy rights have been violatedYour ChoicesYou have some choices in the way that we use and share information as we: Tell family and friends about your conditionProvide disaster reliefInclude you in a hospital directoryProvide mental health careMarket our services and sell your informationRaise fundsOur Uses and DisclosuresWe may use and share your information as we: Treat youRun our organizationBill for your servicesHelp with public health and safety issuesDo researchComply with the lawRespond to organ and tissue donation requestsWork with a medical examiner or funeral directorAddress workers’ compensation, law enforcement, and other government requestsRespond to lawsuits and legal actionsYour RightsWhen it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.Get an electronic or paper copy of your medical record You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.Ask us to correct your medical recordYou can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.We may say “no” to your request, but we’ll tell you why in writing within 60 days.Request confidential communicationsYou can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.Ask us to limit what we use or shareYou can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.Get a list of those with whom we’ve shared informationYou can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.Get a copy of this privacy noticeYou can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.Choose someone to act for youIf you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.We will make sure the person has this authority and can act for you before we take any action.File a complaint if you feel your rights are violatedYou can complain if you feel we have violated your rights by contacting us using the information on page 1.You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting ocr/privacy/hipaa/complaints/.We will not retaliate against you for filing a complaint.Your ChoicesFor certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.In these cases, you have both the right and choice to tell us to:Share information with your family, close friends, or others involved in your careShare information in a disaster relief situationInclude your information in a hospital directoryIf you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.In these cases we never share your information unless you give us written permission:Marketing purposesSale of your informationMost sharing of psychotherapy notesIn the case of fundraising:We may contact you for fundraising efforts, but you can tell us not to contact you again.Our Uses and DisclosuresHow do we typically use or share your health information? We typically use or share your health information in the following ways.Treat youWe can use your health information and share it with other professionals who are treating you.Example: A doctor treating you for an injury asks another doctor about your overall health condition.Run our organizationWe can use and share your health information to run our practice, improve your care, and contact you when necessary.Example: We use health information about you to manage your treatment and services. Bill for your servicesWe can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: ocr/privacy/hipaa/understanding/consumers/index.html.Help with public health and safety issuesWe can share health information about you for certain situations such as: Preventing diseaseHelping with product recallsReporting adverse reactions to medicationsReporting suspected abuse, neglect, or domestic violencePreventing or reducing a serious threat to anyone’s health or safetyDo researchWe can use or share your information for health ply with the lawWe will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.Respond to organ and tissue donation requestsWe can share health information about you with organ procurement organizations.Work with a medical examiner or funeral directorWe can share health information with a coroner, medical examiner, or funeral director when an individual dies.Address workers’ compensation, law enforcement, and other government requestsWe can use or share health information about you:For workers’ compensation claimsFor law enforcement purposes or with a law enforcement officialWith health oversight agencies for activities authorized by lawFor special government functions such as military, national security, and presidential protective servicesRespond to lawsuits and legal actionsWe can share health information about you in response to a court or administrative order, or in response to a subpoena.Our ResponsibilitiesWe are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: ocr/privacy/hipaa/understanding/consumers/noticepp.html.Changes to the Terms of this NoticeWe can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.Other Instructions for NoticeMay 4, 2014 is the Effective Date of this NoticeKim Donat Ali, LCSW- Privacy Officer 727-341-1000 info@Office for Civil Rights – US Dept. of Health and Human Services200 Independence Ave. S.W. Room 509F, HHH BldgWashington, DC 20201We never market or sell personal information.Solutions 4 Life Inc.ConfidentialityThe notice of privacy practices is on the first pages of this booklet. It is also posted in the waiting area.Solutions 4 Life Inc. staff may not give anyone information about you or your treatment unless you sign a written consent to release treatment.The consent to release information:Must be dated at the time you sign;Give a date when the permission to release information expires;The information sent to another agency cannot be released by them to any other agency or person;You are entitled to a copy of any consent to release information that you sign;You may revoke consent to release information at any time. One exception is if the sharing of information is specifically related to your treatment;You may specify information you do not want disclosed as long as it is not specifically related to your treatment;You must never sign consents to release information if there are any blank lines. There are some limitations to confidentiality. All staff are mandated reporters and must respond accordingly in the following situations:If we have reason to believe you are in immediate danger of harming yourself or someone else;If we have evidence or belief that you are committing child or elder abuse or neglect;You have a medical emergency. We may tell medical staff the nature of the emergency;To report a crime committed on the Solutions 4 Life Inc. property or upon a staff member;As allowed by court. When we do release confidential information, we include the least amount possible.If you have a legal guardian, that person may have access to information and may participate in treatment planning.Solutions 4 Life Inc., professional staff works as a team and have access to your client information. Limited information will be shared. Any discussion about you will not occur at a time or place where others may overhear the conversation.Our licensing agency, The Department of Children and Families, has designated persons who will have access to your record. These individuals are mandated by federal laws to protect confidential information.You have the right to have reasonable access to your records.You must request to see your record in writing and a time will be arranged for you to review your record with a professional staff member;You may request amendment or correction of information about you;You may request a listing of agencies or persons where information has been disclosed.Your client chart/record is stored in a locked filing cabinet in a locked room.Only professional staff members have access to your records.Your records are stored for seven years at which time they are shredded.It is a program rule that you keep all information about you and other persons in the program confidential. This means you may not give out other client’s names or circumstances.If you believe your confidentiality has been violated you may:Report and discuss the situation with the agency Privacy Officer, Kim Donat Ali, LCSWDistrict Alcohol, Drug Abuse and Mental Health Program Office813-558-5700727-542-0778Client RightsAll clients receiving treatment or other services from Solutions 4 Life Inc. have the right to:No discrimination against them on the basis of race, religion, age, creed, sex, sexual orientation, national origin, handicap, or source of financial petent and timely treatment delivered in a respectful way and dignified manner by staff that is free of alcohol and mood altering drugs.To have a complete orientation to programs providing you services and activities including explanation of all rules and regulations.Each client has the right to know the costs of treatment.Be assigned a primary counselor.Placement in the least restrictive treatment available based on your individual needs.Each client has the right to sufficient information to provide informed consent prior to the start of treatment. This shall include the specific nature and duration of treatment and the risks and benefits of any modality, and approximate length of time in treatment.Every client has the right to participate in developing an individual treatment evaluated regularly according to his/her needs. You may request family or friends to participate in treatment.Have information pertaining to your participation in treatment and client identifying information held confidential in accordance with Federal and State laws and regulations.Have the least amount of information disclosed. If a counselor determines the client may be at risk to harm him/her or others, or is suspected of committing child or elder abuse or neglect, a report to the agency, even in this case, the least amount of information possible will be disclosed.Be free from neglect, physical, or psychological abuse, exploitation of any form of corporal punishment by Solutions 4 Life Inc. staff.Have any search or seizure executed in a manner consistent with the program standards and only to ensure the safety and security of the clients and staff.The right to request the opinion of a consultant at personal expense or to request an in-house review of their individual treatment plan.Reasonable access to your client record, including the right to copies of some information and the right to attach amendments.Each client can expect assistance in planning an aftercare program following discharge from this treatment that will continue to the client’s continued recovery.The right to know of the existence of alternatives to this program’s care, and to have treatment in the least restrictive environment.Each client has the right to refuse treatment and to be fully advised of the risk and potential consequences of such refusal.Each client has the right to express opinions, recommendations, and grievances and to receive responses to such expressions.Each client has the right to call any of the following telephone numbers to report cases of client abuse:Local Florida Advocacy1-800-342-9154Abuse Hotline: 1-800-962-2873District Alcohol, Drug Abuse and Mental Health Program Office813-558-5700727-542-0778CLIENT GRIEVANCE POLICY INFORMATION FORMAs a client, or parents and/or legal guardians of a client, participating in one of Solutions 4 Life, Inc. treatment programs you have the right to file a complaint for any reason with cause, through the following grievance procedure without fear of discharge or reprisal.Grievance means any written complaint about treatment, including assessment, intervention, and decisions about placement and discharge as well as any complaint concerning staff or operations. Whenever such a complaint is filed, the President/CEO is notified via the designated management structure.The grievance procedure is considered part of the treatment process. Every attempt will be made to resolve the grievance.A client filing a grievance may choose other people to accompany him/her through the grievance process.The grievance process includes the following steps:You may want to consider writing your concerns/grievance on a piece of paper (grievance forms are in the lobby and/or reception area). The client talks about the complaint with the staff member involved or responsible for the area of concern. Together they try to solve the matter informally. The staff member will schedule a meeting with the client within two working days of the grievance being filed and provide a written response as well as an opportunity to discuss all concerns.If the grievance is not resolved, you may request a meeting with the Executive Director and all parties involved in Step A. The Executive Director will schedule and hold the meeting within five working days of your request.The Executive Director and all parties involved will address the grievance and a final decision issued.Depending upon the nature and/or severity of the complaint, the Executive Director may recommend eliminating one or more steps in order to resolve the complaint more quickly.The staff member hearing the complaint or a designated agency recorder must document each step of the grievance process.The problem and its resolution will be documented in writing and included in the patient’s clinical record.Written notification of the decision will be given to the individual filing the grievance. Solutions 4 Life, Inc.CLIENT GRIEVANCE FORMClient’s Name: _______________________________________Time/date/location of the incident _______________________Details of the complaint (what happened, who was involved?)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ (Use the reverse side of this paper if you need more space.)What correction would like to happen?Client’s Signature: __________________________________________________Staff Signature:_____________________________________________________Time and Date Received by staff member:_______________________________Solutions 4 Life Inc.Fee Agreement(rev. 04/01/14)Client:_______________________________________ Number: ________________________You are scheduled to attend __________ sessions over a period of __________ weeks.In order to be successfully discharged, the last six weeks of treatment must be consecutive (1 session a week) and you must have a negative saliva or urine test for alcohol and/or other substances at last session.FeeService$55.00Initial Assessment, Intake and Orientation. (Instant saliva testing for alcohol is included and for the duration of treatment.)$55.00 (within 30 days of intake)Individual Session$30.00Group Session (per session fee)$30.00 (within 60 days of intake)Individual Session$30.00 (within 90 days of intake)Individual Session$30.00 (within 120 days of intake)Individual Session$55.00Discharge processing$30.00Instant substance abuse testing from drugs (saliva or urine)$25.00Urinalysis sent to a lab for drug testing$50.00Urinalysis sent to lab for alcohol use- tests for use up to previous 80 hours$25.00Failure toprovide 24 hours’ notice of cancellation of appointment. If you miss due to emergency- you are required to provide documentation.To accommodate your transportation and time restrictions, we make every attempt to schedule your individual sessions on the same day you are here for the group. If you need to reschedule your individual session, you must give 24-hour notice. You will be tested for alcohol and/or substance use. The fees associated with each test are listed in the table above.All fees must be paid in full at the time of your exit session.Solutions 4 Life Inc.WHAT TO EXPECT IN TREATMENTThe Solutions 4 Life Inc. program is a combination of group and individual counseling.About the Counselors:At the time of your intake (first appointment), you will be assigned a primary counselor who will provide you with individual counseling. You will also have a group counselor. This may or may not be the same person. Whenever possible, the group and individual counselor will be the same person. All staff is trained to provide you high quality and individualized treatment. The counselors have advanced degrees and many years of experience working with alcohol and other substance abuse treatment. A licensed Mental Health or Addiction Professional closely supervises the staff.Individual (Private) Counseling:Individual counseling offers you an opportunity to speak privately with your counselor. These sessions help us meet your individual needs and customize your treatment.You will have a minimum of:Initial intake and development of your Master Treatment Plan;Within 30 days of your initial appointment to update your Master Treatment Plan;Every 30 days after your Master Treatment Plan is developed to update your progress;At the end of treatment.You may have additional individual sessions to update your treatment plan or to address any special needs or issues. If you would like other types of personal counseling you should ask your counselor to schedule sessions or to make an appropriate referral. You may ask for a private session at any time. There is an additional fee charged for individual therapy sessions outside of the required one meeting per month.Group Therapy:Group therapy sessions are held one time a week and last 75 minutes. Under some circumstances your counselor may allow you to attend more than one group per week. You may not attend more than one group per week without permission, but are required to attend at least once per week. The number of people per group will be 10-15 persons. The number of weeks or sessions you must attend to complete treatment will depend upon your history of alcohol/drug use, your arrest record and other problems caused by substance use.The type of counseling we offer is called Motivational Therapy and Cognitive Behavior Therapy. This type of treatment offers you the opportunity to learn new ways of thinking about your problems and your lifestyle. This process will help you identify problems in your life and make healthier decisions. Each week a different topic will be introduced by the group leader and the members will discuss their thoughts, beliefs, experiences and feelings with other people in the group. Some topics are directly related to drugs and alcohol and some with other life skills.Some topics are:Ways to help you remain abstinent from drugs and alcoholRelapse prevention strategiesHow drugs and alcohol effect your body, mind, family, employment and societyCommunications SkillsStress ManagementAnger ManagementHIV/AIDS and other contagious diseasesUsing self-help and other community support groupsSetting GoalsGrief and LossFluid Testing:One of the primary rules of the program is that you do not drink alcohols or use drugs that are not prescribed for you while you are in the program. If you believe you may not be able to abstain from alcohol or drugs without having withdrawal symptoms or without getting ill, you must let your counselor know.You will be tested for both alcohol and drug use and most will be on a random basis. They could be saliva, urine or blood samples. A positive result will add sessions to your treatment. The cost for instant saliva alcohol testing is included in the intake fee; there is a fee of at least $30.00 for an instant drug test, the fee for urine test is $30.00 for drug use and $50.00 for alcohol use. You should plan to have at least 2 drug tests during treatment.Benefits of Therapy:An increased ability to make better decisions; this leads to fewer problems in personal, professional and financial life.Improved self- esteem.Decreased emotional stress. Excessive stress increases your risk for physical illness and self –defeating behavior.Feel relief that other people are in the same situation as you.Improve relationships.Replace negative thoughts and fears with confidence, hope and peace of mind.Potential difficulties that may be experienced during therapy:Some topics raised in therapy may be uncomfortable to think or talk about.It may be difficult at first to talk and share feelings in a group setting.You may be asked to make change or try new behaviors that will feel uncomfortable.As you make changes in your life and thinking, your friends and family may not support those changes. You may need to make some new friends who will support your changes and limit time spent with your old friends.If you are experiencing problems, please discuss them with your counselor.How to get the most out of the group experience:Confidentiality- what goes on in group stays in group. You must respect and maintain confidentiality of all group members. You do not want information about you taken out of the agency, so extend this right to others. Breaking confidentiality is cause for immediate termination from the program.Participate- as fully as possible. The more you put in, the more you will take out.Feedback- give constructive feedback to other group members.Use “I” statements.Share- your feelings, not just your thoughts.Safety- see the group as a safe place for you to learn and grow.Keep- an open mind.Do not have side conversations.Remember- group is what you make it. You will be spending several weeks in treatment, make the best of it.A staff member will be happy to answer your questions at any time during your treatment.Solutions 4 Life, Inc.PROGRAM RULESYou are expected to remain alcohol and drug free throughout treatment, Solutions 4 Life, Inc., tests for use of alcohol and drugs on a random basis.Consequences of use during treatment will be an extension of treatment when a test result is positive. Continued use of alcohol or drugs may require a referral to a higher level of care.Everyone has a different treatment plan and schedule depending upon their individual needs. This includes the number of weeks or sessions assigned, frequency of attendance, number of individual sessions and number of community support groups. If you have questions about your treatment plan, please discuss them with a counselor.You are expected to be on time for all sessions. You are required to verbally participate in group sessions. If homework is assigned you are expected to complete it within the allotted time. Twenty – four (24) hour notice is required if you need to miss an individual session. Failure to properly notify the agency staff will result in an additional charge.If you have an emergency or contagious illness you must call the agency as soon as possible. You will be required to provide documentation of the problem.Unacceptable Absences:A telephone call while at work or after you have already been out of townCalling in during or after the group session with any excuseMissing because you oversleptTransportationForgettingVisiting friends or relativesIf you have a cold or flu symptoms, an infectious disease, contagious skin conditions such as poison ivy or parasites , or an open wound, you must notify a staff member of this condition. You may be required to present documentation of treatment.If you miss 3 consecutive sessions and do not notify the agency staff, you will be discharged from the program and the agency that referred you will be notified of this change of status. a. If you have three unexcused absences, you will be charged an additional $10.00 per group beginning at the time of the third unexcused absence.If you do not complete the program within three weeks of your initial completion date, the cost of group sessions increases to $40.00. Once you are discharged, if you want to re-enter the program you will be charged a fee and one session deducted for each month you are not in attendance.You are expected to pay all fees on time. If you need a financial arrangement, you must meet with the Agency Director for approval. Firearms, weapons and sharp objects are not permitted on the premises.Appropriate dress is required. All clients are expected to dress in a modest fashion. No one will be permitted into the group wearing clothing promoting the use of alcohol or drugs. Sunglasses are prohibited, except with medical documentation.No energy drinks may be consumed at the agency or prior to coming to the agency. Even though alcohol is not listed as an ingredient, many contain small amounts of alcohol or metabolize into alcohol.Do not wear perfume cologne or aftershave. These interfere with alcohol testing and many people are allergic or have sensitivities and cannot tolerate being in a closed room with the odor.Cell phones must be turned completely off and kept out of sight. Violation of this rule may result in dismissal from the group session.You are expected to honor all aspects of the Client ResponsibilitiesAll clients will be required to attend a minimum number of AA/NA or other community support groups. The number of groups will be determined when you develop your treatment plan with your counselor.Solutions 4 Life Inc.CLIENT RULES AND RESPONSIBILITIESAnd the Criteria for Involuntary TerminationAs a participant in this treatment program, I understand that I will be expected to:Read, understand and obey the program rules. Provide full information regarding any treatment I am receiving or have received including all types of counseling/therapy, medications and/or hospitalization. Actively participate in the treatment planning and counseling process. Attend all activities as agreed upon with staff and indicated on my treatment plan. Keep scheduled appointments or cancel at least 24 hours in advance. Pay assessed fees as agreed in a timely manner. Provide a fluid and/or breath sample for substance screening upon request (per my treatment plan). Maintain the confidentiality of the program and of other clients at all times. Inform staff of any medications being taken. Refrain from possessing or using weapons with said weapons to be defined by staff. Refrain from illegal activity. Refrain from the use of any illicit drugs, alcohol, other substances or medications not approved by staff. Refrain from sexual involvement with other clients. Refrain from violent or abusive behavior including physical or verbal threats or acts toward other clients, staff, or property. Pay for any intentional damages to property that I may cause.Reasons for Dismissal from Group and No attendance creditOwing more than $30.00Wearing cologne, perfume or aftershaveWearing revealing clothing or clothing with a drug/alcohol logo. Wearing sunglasses if they are not medically necessary and you cannot provide the doctor’s prescription.Having possession of a weapon or weapon like objectNot having your cell phone on silent and out of sightBringing food or beverage into the group room. The only beverage allowed is waterBringing an energy drink to groupComing to the agency under the influence of drugs and alcoholTesting positive on a drug/alcohol screenAttending a group that you are not scheduled for without permissionBeing lateInvoluntary Program TerminationBreaking confidentialityExcessive absencesConsistent rudeness to staff or other clientsDerogatory remarks about any racial, ethnic, religious groups or anyone’s sexual orientationAggressive behavior or threats- implied or actual. This includes yelling at others.Intentional property damageCommitting a crime on Solutions 4 Life Inc.’s property. This includes driving to the center without a driver’s license.Solutions 4 Life Inc.Solutions 4 Life Inc. is committed to promoting good physical and mental health. In keeping with this commitment we feel it is important to address infectious diseases that are prominent in today’s society. The following information is presented to help prevent spread of these diseases and encourage you to seek appropriate medical treatment if you have concerns. This information is not all-inclusive and we encourage you to get more information. This information may be obtained at the following agencies:_____________________________________________________________________________________________Pinellas County Health Department727-824-6900205 9th/Dr. MLK ST NSt. Petersburg, FL 33701Testing for HIV, STD’s and TB are availableNational Centers for Disease Control and Prevention (CDC) 404-332-4555Planned Parenthood727-898-819921-A Dr. MLK Jr. St SSt. Petersburg, FL 33701Testing for STD’s, HIVAgency PolicySolutions 4 Life Inc. has a policy and procedure for infection control. In summary, the policy states that the agency will identify and handle potential and actual infectious disease of both employees and clients. Infectious diseases are those illnesses capable of being transmitted from person to person by body fluids, aerosol droplets (sneezing or coughing) or bodily contacts such as cold, flu and any contagious skin condition.The medical director will receive all reports of infectious illness, both clients and employees and make recommendations to the Agency Director for the handling of these cases. All agency responses to employees and clients with infectious diseases will comply with applicable Federal, State and other relevant guidelines including notification of proper authorities.Clients will remain in treatment unless or until their behavior or physical condition deteriorates to the point where their health may be jeopardized, mental health becomes problematic or they become a health risk to others.Confidentiality policy/procedure will be followed. Unauthorized disclosure of sensitive information and discrimination in decision making regarding client will not be permitted.Colds and Flu:We strongly advise that all staff and clients obtain an annual flu vaccination and TB test.If you believe you have flu-like symptom, you must identify an agency employee to make arrangements for you when you are no longer contagious.The “risk” of catching a cold or flu can be minimized by washing hands properly and frequently.Use hand sanitizer. Hand sanitizer and facial tissue are in each office and group room. You are free to use these at any time.You are expected to use tissue to cover your nose and mouth when you cough or sneeze. The tissue must be disposed of properly.Skin conditions, parasites and open wounds:If you have a parasite such as ringworm, scabies, lice, etc. you must notify a staff member and you will not be permitted to attend group or an individual session until the condition is cleared.If you have an open wound or sore, it must be covered with an appropriate bandage.You may be required to bring documentation from your doctor that you are no longer in a contagious state.Universal PrecautionsHelp prevent infection through the use of:Protective barriers such as gloves, gowns, masks and protective goggles.Safe work practices such as proper disposal of needles as an infectious waste.Steps you can take to protect yourselfWear protective gloves at any time you may have contact with blood or other infectious bodily fluidsWash your hands and other skin surfaces with soap and water immediately after direct contact with blood or bodily fluidsCover up open wounds and broken skinIf the agency work area becomes contaminated with blood:Notify your counselor immediatelyClose off the area until the area has been decontaminated and clean up materials are removed.If you are exposed to blood or other infectious fluids:Wash the exposed area immediatelyReport the incident to your counselor or agency directorFollow procedures for testing and treatmentSolutions 4 Life Inc.Consent for Counseling and Program OrientationAdmission to the program:Acceptance and participation in the program are the same for everyone without regard to race, religious, ethnicity, age and sexual orientation. It is Solutions 4 Life Inc.’s policy to provide reasonable accommodations to clients with disabilities to ensure their access and opportunity to the same quality and care as other clients without disabilities. All clients will be treated with dignity and respect.All clients have individualized treatment plans developed during individual sessions. The length of time in treatment and frequency of visits will vary depending upon needs.Prior to admission there is a client orientation that offers you the opportunity to be informed about the agency and your treatment. All questions about treatment will be answered to the best of the staff’s ability.Orientation TopicsMy condition/diagnosisThe name of my primary counselor and contact information for the agency/counselorWhat to expect in treatment including: types of intervention, possible risks and benefits, and qualifications of the counselorsThe cost of treatment and financial responsibilityProtected Health InformationConfidentiality and the limits of confidentialityClient rights and responsibilities including telephone numbers for reporting problems or concerns.Internal grievance procedureProgram rules and Criteria for Involuntary TerminationInformation about infection control and universal precautions and fluid screening processVoluntary Consent for Treatment/Client AgreementI hereby give my voluntary consent for treatmentI have received a copy of the Solutions 4 Life Inc. Client Handbook and agree to read it and ask any questions I may have during the course of my treatmentI will complete the client orientation quiz and return it at my next appointmentI agree to:Abide by the program rulesAbstain from alcohol and all mood altering drugs that are not prescribed to me.Keep appointments and arrive on timeMake prior arrangements if a schedule change is necessaryProvide staff with a copy of probation requirementsNotify staff of medical and mental health treatment and provide documentation of medicationsNotify staff of medication changesTurn off cell phone while in individual or group sessionsNot wear perfume, cologne or aftershaveNot bring food or drink to sessionsNot bring energy drinks or drink energy drinks prior to sessionsMaintain the confidentiality of all other clients. I will not reveal information about any person or their disclosures to anyone outside of this agency.I hereby give voluntary consent to provide fluid samples (urine/saliva/blood) when requested by the staff. I agree to pay for costs of treatment and fluid testing according to the financial agreement. Initials___________________Helpful Telephone NumbersCommunity Information and ReferaalsDial 211Crisis Intervention and Suicide Prevention727-791-3131Abuse Hotline1-800-962-2873Florida Domestic Violence Hotline1-800-500-1119CASA, Community Action Stops Abuse1-77-544-3900 x 152Rape Crisis727-530-7233Elder Abuse727-570-9696Poison Control1-800-282-3171St. Petersburg Police Department727-893-7780Pinellas County Sheriff’s Office727-582-6200Pinellas County Health Department727-824-6900Violation of Client Rights by Treatment Agencies Local Florida Advocacy800-342-9154District Alcohol, Drug Abuse813-558-5700Mental Health Program Office727-542-0778Alcoholics Anonymous- Pinellas County 24 hour Help Line- 727-530-041524 Hour Hot Line Spanish (Espanol)727-209-0523Narcotics Anonymous727-547-0444Cocaine Anonymous727-742-2216Al-Anon or Al-A Teen alanon-727-548-6811Adult Children of Alcoholics727-347-4522CoDA Pasadena Community Church Life Ring Secular Recovery of Tampa Bay tshelley@tampabay.727-866-6797Celebrate Recovery 727-894-4661Smart Recovery (Mike Carson) and 727-822-4981Solid Rock Ministries727-329-9930National Hotline Problem Gambling1-800-522-4700Local Gamblers Anonymous727-954-3908Sex and Love Addicts Anonymous727-896-7522Overeaters AnonymousSuggested AA MeetingsLEGEND - Types of MeetingsOpen?- Any one may attend, whether or not they are an alcoholic.Closed?- Only those people who have admitted they are an alcoholic may attend.Click here for more definitions.aABBBBCDGGVAMAs Bill Sees ItBeginnerBig BookClosedDiscussionGayGrapevineINTLMNOSSMZInterpreter providedLast WeekMenNoonOpenSpeakerSmokingNon Smoking During MeetingSpStTrW?*#WCAYPGSpanishStepTraditionsWomenAlanonAlateenWheelchair AccessYoung People's MeetingALL MEETING TIMES ARE P.M. UNLESS INDICATED OTHERWISEALL MEETINGS ARE NON-SMOKING UNLESS INDICATED OTHERWISEDISCLAIMER: Meetings listed in our directory or website appear at their own request. An AA meeting listing does not constitute or imply approval or endorsement of a group's approach to or practice of the AA program by Pinellas County Intergroup. This list is confidential for persons needing to find AA and is not to be used for any other purpose.?Meetings by Area -?Gulfport/PasadenaGroup Number: 00010-37-06BAIGISPasadena Community Church112 70th Street SouthPasadena, FL?33707Hamilton AuditoriumSunMonTueWedThuFriSatOSt?8:00 PM?FREE THINKERSGulfport Library5501 28th Ave. So.Gulfport, FL?33707SunMonTueWedThuFriSatOD?5:45 PM?Group Number: 00013-14-38GULFPORT ALL AGES GROUP - WCASenior Center5501 27th Avenue SouthGulfport, FL?33707-5553SunMonTueWedThuFriSatOLS?7:30 PM?OD?7:30 PM?GULFPORT SUNSET - SM - WCAPavilion #7Next to the Rec CenterGulfPort , FL?33707SunMonTueWedThuFriSatCD?8:00 PM?CD?8:00 PM?CD?8:00 PM?CD?8:00 PM?CBB?8:00 PM?CD?8:00 PM?NEW FREEDOM / NEW HAPPINESSScout Hall (except Sat/Sun)5315 28th Avenue SouthGulfport, FL?33707-5535Sat/Sun: Pavilion 7SunMonTueWedThuFriSatOBB on beach07:30 AM?OD?07:30 AM?OD?07:30 AM?OD?07:30 AM?OD?07:30 AM?OD?07:30 AM?OD on beach07:30 AM?NOT SO LATE NITE - SM - WCAGulfport Beach?Pavilion #6Gulfport, FL?33707SunMonTueWedThuFriSatODSM?10:00 PM?ODSM?10:00 PM?OD?10:00 PM?ODSM?10:00 PM?OD?10:00 PM?SISTERHOODGulfport Library5501 28th Ave SGulfport, FL?33707SunMonTueWedThuFriSatCDSGW?5:45 PM?STEP GROUP OF GULFPORTUnited Methodist Church2728 53rd Street S.Gulfport, FL?33707-5444SunMonTueWedThuFriSatCSt?7:30 PM?Group Number: 00010-32-24SUNSHINE CITYPasadena Presbyterian Church100 Pasadena Avenue NorthSt. Petersburg, FL?33710SunMonTueWedThuFriSatOD?7:00 PM?OSL?7:00 PM?WOMEN IN STEP - WCAPasadena Presbyterian Church100 Pasadena Ave NPasadena, FL?33707SunMonTueWedThuFriSatCStW?7:00 PM? ................
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