Patient Rights and Responsibilities

THE MENTAL HEALTH CENTER OF GREATER MANCHESTER PATIENT’S RIGHTS AND RESPONSIBILITIES

The Mental Health Center of Greater Manchester (MHCGM) is committed to providing you with the best service possible and to do so with full respect for your rights, feelings and opinions that will ensure your personal privacy, individuality and  dignity.

1. You will not be discriminated against because of race, color, age, national origin, sex, gender identity and sexual orientation, marital status, familial status, religion, disability or source of income. If you need legal counsel, you have the right to obtain that service.

2. Under Title VI of the Civil Rights Act, which is a U.S. Law, you have a right to competent language services if you have limited ability to speak English, and under the Americans with Disabilities Act, you have the same right if you are Deaf or Hard of Hearing.
3. Unless you have a guardian or activated Durable Power of Attorney (DPOA), who makes financial and/or treatment decisions, or in certain emergency situations specified by law then you have the right to make decisions and act independently on them. You have the right to refuse all forms of medications, treatment, or services except emergency treatment under the terms and conditions prescribed by law or by rules adopted by the commissioner under RSA 541-A. You have the right to be advised of the consequences of your decisions/actions. You have the responsibility to participate in your treatment plan.

4. Personal privacy will be maintained at all times, for example: you may talk to someone alone or, you will not be fingerprinted, photographed or recorded without your permission. As part of your care and treatment and MHCGM’s efforts to promote and enhance integrated care, The Mental Health Center may electronically transmit or receive your Protected Health Information, including substance use information, in a secure and confidential manner with other healthcare providers involved in your care, through MedAllies or other secure health information exchange.

5. For Cypress Center (in accordance with RSA 151:21 XXII and XXIII):
   1. You will not be denied admission to Cypress Center solely based on your vaccination status;
   2. While receiving care at Cypress Center you will be entitled to designate a spouse, family member, support person, or caregiver who may visit you during your admission unless it is determined that:
      1. The visitation would be harmful to you or others (due to disruptive, threatening or violent behaviors), or;
      2. The visitation would interfere with the care of or rights of you or others, or;
      3. The visitor is in non-compliance with Cypress Center

Upon request, you or your legal representative shall be provided the reason for denial or revocation of visitation rights outlined above.

1. You will have the right to communicate freely and privately by mail and telephone with persons outside the (Note: phone access may be reviewed if you engage in harassment and/or abusive or threatening communications during calls).

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6. You have the right to be informed of and to give consent before administration of any treatment. Services provided to you will be in keeping with accepted clinical and professional standards provided by qualified staff which may include the use of telemedicine. You have the right to information regarding your provider’s professional code of ethics, education and practice limitations. You have the right to be referred to other providers when appropriate. You have the right to be informed of your diagnosis, purpose, goals, techniques, risks and benefits of treatment. You have the right to be informed of the services available and decide on services in which you want to You may withhold or withdraw your consent for telemedicine services – it will not affect your right to care and treatment to which you are otherwise entitled.

7. You have the right to an individualized treatment plan which is based on an initial and ongoing evaluation of your needs and the goals you want to reach. You have the right to services, which promote independence and least restrict your freedom while still enabling you to meet your treatment You have the right to clear information addressing time of sessions, fees, third party requirement procedures, absences and emergency procedures. You have the right to request, through your clinician, a treatment plan conference. MHCGM is comprised of a number of programs, e.g., Bedford Counseling Associates, The Cypress Center, and that one medical record will be kept, which may be accessed by MHCGM providers, treatment team member and other MHCGM individuals as allowed under HIPAA.
8. Federal law 42CFR Part 2 provides confidentiality protections for records that might identify an individual directly or indirectly as having a substance use disorder.

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9. You have the right to advance directives for medical care (living will and durable power of attorney for healthcare).

10. You have the right to seek out a second opinion or consult with another service provider at your own

11. You have the right to be free from seclusion or physical or pharmacological restraint except in an
12. You have the right to be treated in a safe environment; therefore, no pets (except for service animals, pets in HUD residences; or by special exception), alcohol, drugs, weapons or ammunition are to be brought into MHCGM facilities, or in a staff member’s or MHCGM vehicle.

13. Treatment is routinely terminated based on a joint decision made by you and your therapist. Either of you, however, can terminate treatment independently, the basis for which will be documented in your clinical If The Mental Health Center decides to terminate services because of endangerment to patients or staff, you have the right to appeal. While the appeal is pending, service to you will not be terminated unless a safety risk is present.

14. Treatment shall not be suspended unless prior written notice was This notice may be given as an item in the individual service plan or in written rules of the program or service. The maximum length of a suspension shall be five program days. You have the right to appeal.
15. If you are dissatisfied with the service you have received, you have the right to have your concern respectfully heard and any failure corrected.
    1. You may discuss the concern with your current treatment

1. If you are not satisfied by their response, or should you prefer to talk with someone else, you may directly contact:

• your therapist’s director
• MHCGM’s Complaint Manager for informal resolution
• the NH Bureau of Mental Health Services Office of Client and Legal Services for a formal resolution

1. You are financially responsible for all charges related to your care. You have the right to request evaluation for a discount for the cost of your services not covered by You may request the evaluation through the Patient Benefits representative at your program location.

Payments made may be applied to the oldest balance first.

Any problem having to do with charges or billing should first be discussed with Revenue Cycle Management staff. If the problem is not resolved, you may contact the Director of Revenue Cycle Management.

16. Your medical records are only guaranteed to be retained by us for the duration required by current

PATIENT RIGHTS/MEDICAL1 (04/07/23) (PSO 02.01.00, 03.03.00)