Policies
Business policies, website terms, data usage and security.
Table of Contents
Website & Personal Data
Clinic Policies
Client & Provider
The DBT Clinic recognizes that the single largest determining factor for success in therapy is the therapeutic relationship between client and their provider. In light of that, it is important that both the client and the provider feel comfortable to have a say in determining the fit for treatment to be a success. We recognize that changes may need to be made to ensure the fit between clinician and client is a positive one. We also reserve the right to limit the frequency of such changes to avoid unnecessary disruption for our clients and staff members. This policy is designed to hold the dialectic between both of these needs.
The therapeutic relationship begins with an exploratory call between the client and potential provider. If that call goes well, the client and provider will meet for a number of sessions (no fewer than two no more than four) to determine the fit and desire of both parties to proceed with treatment.
- If after this intake time it is determined that the needs of the client and the strengths of the clinician are not a match, the client may be referred to another clinician at The DBT Clinic to move forward with treatment.
- If the client determines that the clinician is not a fit for them, they can request a change of providers at this time as well.
Once treatment has commenced, the client will be allowed to request a new clinician under the following circumstances.
- No more than once a year for any reason if requested by the client.
- If there is rupture that cannot be solved through mediation with the clinician and the clinical supervisor.
- If the clinician, through consultation with the clinical supervisor, determines that the needs of the client are beyond their scope of practice, the case may be transferred to a clinician with the requisite skills and experience.
Grievances & Appeals
The DBT Clinic is committed to providing quality treatment services designed to meet client needs and to respect clients’ rights. Compliant with OAR 309-019-0215, any individual or parent or guardian receiving services may file a grievance with the provider, the individual’s coordinated care plan, or the Division. A written grievance procedure will be provided to each individual or guardian at the initial intake session and any assistance that may be needed to understand the document will be given to the individual.
- The Grievance Statement is given to each new client during intake as well as posted next to the client’s rights poster.
- The intake clinician reviews the grievance statement with each new client and answers any questions regarding this process. In signing the Informed Consent, the client is acknowledging such actions have taken place.
- Formal grievances will be submitted to the clinical director. The Director will investigate as needed, consult when appropriate, and respond to the client as quickly as possible. Documentation of the grievance and the accompanying response will be documented in the client’s file.
Grievance Statement
The DBT Clinic is committed to providing quality services designed to meet clients’ needs and to respect clients’ rights. If you or any person acting on your behalf believes that your needs are not being met within the scope of treatment or that your rights have been violated, you may file a grievance with the provider, your coordinated care plan, or the Health Systems Division regarding any aspect of your treatment.
If you have a concern or complaint, ask your clinician to help you resolve the problem. If your clinician is not available, ask administrative staff to help you. If you are not satisfied with the resolution, write a formal grievance. These grievances can be submitted to the Practice Manager (Randy Brown, randy@thedbtclinicportland.com) and they are logged and forwarded the day they are received. An investigation by the Clinical Director will be conducted within 30 calendar days or sooner, if possible. The individual submitting the grievance will receive updates at least every 7 days and the final outcome within 45 days of the original grievance.
The written grievance must include a statement of the problem, the date(s) of occurrence, a list of persons involved, and any other pertinent details that will clarify the nature and circumstances of the grievance. You may suggest potential resolutions.
The clinical director will speak with you and all other appropriate parties in investigating your grievance within 30 calendar days. The clinical director will discuss possible resolutions with you and will then take action to resolve all valid aspects of the grievance. The resolution will be pursued in a timely manner. The clinical director will place in your record a copy of the grievance, a summary of investigation results, and a description of actions taken. You have a right to review this information. Aspects of this information that could violate the privacy rights of staff or other clients may be withheld from your record.
Expedited Grievances
In circumstances in which the matter of the grievance is likely to cause harm to the individual before the grievance procedures outlined in these rules are completed, the individual, or guardian of the individual, may request an expedited review. The Clinical director will review and respond in writing to the grievance within 48 hours of receipt of the grievance. The written response must include information about the appeal process.
Retaliation
A grievant, witness, clinician, supervisor, or staff member of The DBT Clinic must not be subject to retaliation by a provider for making a report or being interviewed about a grievance or being a witness. Retaliation may include, but is not limited to, dismissal or harassment, reduction in services, wages or benefits, or basing service or a performance review on the action.
Immunity
The grievant is immune from any civil or criminal liability with respect to making or the content of a grievance made in good faith.
Appeals
Individuals and their legal guardians have the right to appeal entry, transfer, and grievance decisions as follows:
- If you are unsatisfied with the decision, you can file an appeal in writing within 10 working days of the date of the clinical director’s response to the grievance or notification of denial for services.
- If your treatment is paid for by public or private insurance, you can also file an appeal with your insurance company. If you are covered by Multnomah County Mental Health, your appeal must be submitted to the Health Systems Division at the Oregon Health Authority.
- The DBT Clinic will be available to assist in responding to the appeal, if requested.
- The Health Systems Division must provide a written response within 10 working days of the receipt of the appeal.
- If the individual or guardian is not satisfied with the appeal decision, they may file a second appeal in writing within 10 working days of the date of the written response to the Health Systems Division at the Oregon Health Authority.
Contact information for appeals:
- Healthshare of Oregon: 503-416-8090
- Oregon Health Plan: 503-947-5804
- Disability Rights Oregon: Voice: 503-243-2081; TTY users: dial 711
- HSD of Oregon Health Authority: 503-945-5763
- Governor’s Advocacy Office: 503-945-6904
Rights
The DBT Clinic has an essential responsibility to protect and uphold the rights of each person served at the clinic. Clients are active participants in the treatment planning, implementation, and ongoing evaluation of their services. The DBT Clinic’s client rights policies and procedures comply with the requirements of federal, state, and local laws, including OAR 309-019-0115, and will be provided to each client at intake.
- At enrollment, a copy of the client rights and responsibilities forms are made available on the The DBT Clinic website. The clinician(s) conducting the intake and the client review these rights and responsibilities.
- The DBT Clinic services are provided to clients who voluntarily consent to these services. Services are provided at the least restrictive level of care. At admission, each client signs a written Informed Consent form that includes the limits to confidentiality. The client also signs a Receipt of Rights form. The intake clinician documents in the progress note that the forms were signed and that the client understands them.
- The DBT Clinic policies ensure each client’s rights as listed on the client Rights form, following this Policy. Further detail on some of these rights is listed below.
- Nondiscrimination and allowable restrictions: No person shall be denied services or discriminated against based on age, diagnostic, or disability category.
- Refusal of treatment: The client shall have the right to refuse service, including any specific procedure. If consequences may result from refusing the service, such as termination from other services or referral to a person having supervisory authority over the client, the fact must be explained verbally and in writing to the client.
- Informed participation in treatment planning: clients and sometimes important people in the client’s lives are included in the treatment-planning process. Goals and anticipated outcomes are collaboratively determined between the clinicians, client, and, when appropriate, support people.
- Informed consent to fees for services: The amount and schedule of any fees must be disclosed in writing and agreed to by the client prior to services being provided.
- Client Work Policy: Current and former clients are not employed at The DBT Clinic. There is no ability to trade work or to barter for treatment.
- Voter Registration: The DBT Clinic can provide voter registration on-site. Program staff must not seek to influence an applicant’s political preference or party registration.
- All staff review copies of the Client Rights and the Grievance Statement in their initial orientation and receive training on client rights as needed.
The business manager posts copies of client’s’ rights in all waiting rooms in the facility and are accessible to clients and staff.
Client Rights
All clients of The DBT Clinic are entitled to the following rights:
- Nondiscrimination: The DBT Clinic will not discriminate against you on the basis of your race, color, national origin, duration of residence, religion, ancestry, sex, gender, disability, sexual orientation, political affiliation, marital status, or age.
- Spiritual and religious freedom: You have the right to your religious beliefs and spiritual practices. The DBT Clinic staff will demonstrate compassion and provide support for you to practice your chosen religion or form of spirituality.
- Respect and Dignity: You have the right to treatment that is considerate and respectful of your dignity and individuality.
- Exercise of rights: Your civil and human rights are the same as if you were not in treatment, including the right to vote and political views.
- At the start of treatment: You have the rights to
- be informed of the policies and procedures, service agreements and treatment fees for services provided
- have a custodial parent, guardian, or representative, assist with understanding any information presented.
- have family and guardian involvement in service planning and delivery
- make a declaration for mental health treatment, when you are legally an adult
- give informed consent in writing, except in a medical emergency or as otherwise permitted by law. Minor children may give informed consent to services if age 14 or older for outpatient services only.
- file grievances, including appealing decisions resulting from the grievance
- exercise all rights set forth in ORS 109.610 through 109.697
- exercise all rights described here without any form of reprisal or punishment.
- While in treatment: You have the right to:
- choose from available services and supports that are consistent with the Service Plan, culturally competent, provided in the most integrated setting in the community and under conditions that are the least restrictive and intrusive to you and that provide you the greatest degree of independence.
- participate in the development of a written Service Plan, receive services consistent with that plan and participate in periodic review and reassessment of service and support needs, assist in the development of the plan, and to receive a copy of the written Service Plan.
- confidential treatment of your records and to consent to disclosure in accordance with ORS 107.154, 179.505, 179.507, 192.515, 192.507, 42 CFR Part 2 and 45 CFR Part 205.50. Except as required by a medical emergency, no information will be released to or sought from any other agency or significant other (spouse, parent, etc.), unless you have signed a Release of Information form or are under age 14. Statistical data reported to funding and monitoring agencies shall be processed in a way that protects your identity.
- referrals to/for medication management services.
- be notified in advance of changes in your care team and if you are being transferred to a new clinician, except in emergency situations or if there are concerns about health and safety.
- ask for and receive, from appropriate staff members, information about your diagnosis, individual plan and treatment methods, prospects for recovery and outcomes, potential risks, and alternative choices for treatment in understandable terms.
- refuse to participate in research and experimentation.
- not be abused or neglected by any representative of The DBT Clinic. Physical punishment and mental, sexual, and physical abuse are prohibited. Clients are not permitted to discipline other clients. Sexual contact between clients and The DBT Clinic employees is strictly prohibited. If you are concerned about this guideline, speak with a clinical director. There will be no retaliation from making a report of potential abuse or neglect.
- be free of restraint or seclusion at The DBT Clinic. Physical and chemical restraints, or seclusion in a locked room, are prohibited.
- not perform services for The DBT Clinic that are not included for therapeutic purposes in the program or in the individual plan.
- formally or informally express concerns and complaints. You have a right to information regarding the grievance process.
- review your service records within five days of your written request to do so in accordance with ORS 179.505.
- terminate services at any time. You also have the right to refuse treatment and to be informed of the consequences of your refusal. However, if your refusal prevents The DBT Clinic staff from giving appropriate, ethical care, The DBT Clinic may terminate your services.