TSI Outpatient Handbook

Welcome Statement

Welcome to Therapeutic Services, Inc., P.C. It is our desire to provide you with services and support in a manner that demonstrated hospitality, respect and choices. Our goal is to provide and/or have available to you informed outpatient mental health services.

Mission Statement

The mission of Therapeutic Services, Inc., Professional Company is to promote quality, value and an optimum outcome through a person-centered approach designed to enhance the lives of those served.

Vision Statement

Enhancing quality of life by promoting hope and dignity for all Oklahomans.

Introduction

Our desire to assure you receive the best possible services from Therapeutic Services. Inc., P.C. Therefore, we will provide information about our organization and the services you will receive. If you have any questions, please feel free to ask any Therapeutic Services, Inc., P.C. staff for assistance. We are interested in how best to help or improve our efforts to serve you.

Therapeutic Services, Inc., P.C., a private for-profit outpatient mental health agency was established in July 2006. We were accredited in May 2007, by CARF International (Commission on Accreditation of Rehabilitation Facilities), as an Outpatient Mental Health Provider. Therapeutic Services, Inc., P.C. was approved to provide mental health services in the state of Oklahoma in 2007. Our services offer behavioral health for children, adults and families. We are available to explain the CARF program, as needed.

Consumer Rights

In providing services for you, Therapeutic Services, Inc., P.C. intends to support and protect your fundamental human, civil and constitutional rights. Upon admission to Therapeutic Services, Inc., P.C., each person shall be notified of the Consumer Bill of Rights. If you are a minor, your parent or legal guardian shall also be informed of these rights. If you have a court ordered guardian, the guardian shall also be informed. Outlined below is a Synopsis of consumer bill of rights as set forth in OAC 450:15:3-27. The full Mental Health and Drug or Alcohol Abuse Services Bill of Rights, OAC 450: 15-3-6 through 450: 15-3-25 will be provided upon request. If you cannot understand the language in the Synopsis, an oral explanation of the Synopsis will be attempted with you in a language that may be understood and the provision of the Mental Health and Drug or Alcohol Abuse Services Bill of Rights shall be documented in the clinical record and sighed by the person providing the synopsis or attempting to explain the Synopsis.

As a Therapeutic Services, Inc., P.C. consumer, you have the following rights:

You have the right to be treated with respect and dignity and receive services conducted in a manner reflecting quality professional and ethical standards of practice.
You shall retain all rights, benefits, and privileges guaranteed by law except those lost through due process of law.
You have the right to receive services suited to you condition in a safe, sanitary and humane treatment environment regardless of race, religion, gender, ethnicity, age, degree of disability, handicapping condition or sexual orientation. If, in the opinion of clinical staff, outpatient services are not sage or an appropriate means for your care, every effort will be made to refer you to an appropriate level of care based on you resources and available community resources.
You have the right to not be neglected or sexually, physically, verbally, freedom from financial exploitation and humiliation or otherwise abused and freedom from financial exploitation and humiliation.
You have the right to be provided prompt, competent and appropriate treatment including an individualized treatment plan.
You have the right to participate in your treatment programs and may consent or refuse to consent to the prosed treatment. The right to consent or refuse to consent may be abridged for those adjudged incompetent by a court of competent jurisdiction and in emergency situations as defined by law.
You have the right to include your family in the treatment planning process.
Your clinical records shall be treated in confidential manner.
You shall not be required to participate in any research project or medical experiment without your informed consent as defined by law. Refusal to participate shall not affect the services available to you.
You have the right to assert grievances with respect to an alleged infringement on your rights.
You have the right to request the opinion of an outside medical or psychiatric consultant at your own expense or a right to an internal consultation upon request at no expense.
You shall not be retaliated against or subjected to any adverse change of conditions of treatment because you asserted your rights.
If you are an adult consumer of Therapeutic Services, Inc., P.C., you have the right to designate a family member or other concerned individual as a Treatment Advocate. The Treatment Advocate may participate in the treatment planning and discharge planning of the persons being served to the extent consented to by the person served and permitted by law.
You have the right to contact the Oklahoma Department of Mental Health and substance Abuse Consumer Advocacy Division, 2401 NW 23rd Street, Suite 82, Oklahoma City, Oklahoma 73107 Phone: (local) 405-52-.4279; (toll-free) 1-866-699-6605
You and/or your legally authorized representative have the right to access health information in your clinical record. The process to request access to read or receive a copy of your clinical record is as follows: You and/or your legally authorized representative must request and complete the Consent for Release of confidential Information form. You can obtain a Consent to Release Confidential Information form from your provider and/or any staff member of Therapeutic Services, Inc., P.C. The Consent for Release of Information form will be submitted to the Clinical Records department and reviewed by the Clinical Director. Therapeutic Services, Inc., P.C. has thirty (30) days to process the request of your clinical records. By law, a reasonable fee may be charged for making copies. Therapeutic Services Inc., P.C.’s current fee is $.25 per page.
You or your legally authorized representative have the right to request a review for a denial of access of medical records if the denial is made on the following basis.

A licensed mental health processional has determined in the exercise of professional judgement that access to the medical record is reasonably likely to endanger the life or physical safety of you or another person.
The requested health information in the medical record makes reference to another person who such other person is a health care provider and a licensed mental health processional, in the exercised of professional judgment, that the access is reasonably likely to cause substantial harm to such other person.
The request for access is made by you and/or your personal representative and a licensed mental health professional has determined, in the exercise of professional judgement, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you and another person.

You and/or your legally authorized representative have the right to request an amendment of health information in your clinical record for as long as Therapeutic Services, Inc., P.C. has the information.
You and/or your legally authorized representative have the right to request confidential communication by alternative means or at alternative locations. (Alternative means may include contacting you by telephone, alternative location may include an alternative address, other than home address).
You or your legally authorized representative have the right to an accounting of disclosures of health information in your clinical record.

Consumer Responsibilities

Therapeutic Services, Inc., P.C. consumers shall receive a copy of the Consumer Handbook with the Consumer Responsibilities enclosed. Signature on the Consumer Consent form acknowledges receipt and understanding of the Consumer Responsibilities.

As a Therapeutic Services, Inc., P.C. consumer, you have the following responsibilities:

You shall treat other consumers and Therapeutic Services personnel with courtesy.
You shall participate at your highest ability to develop your treatment plan and in the services and activities that is included.
You are responsible for expressing your service needs and preferences to Therapeutic Services, Inc., P.C. staff.
You are responsible for making your concerns known to our staff. You may be contacted by the Clinical Director to answer questions about your services, providers and/or treatment at Therapeutic Services, Inc., P.C.
You shall not threaten violence or act violently with other consumers or agency personnel. Such actions will result in denial of services or restricted privileges for participation in services.
You shall not possess weapons of any kind while participating in agency services. Possession of weapons while participating in agency services are strictly prohibited and will result in discontinuation of services.
You shall not be intoxicated from the use of alcohol, illegal substances or misuse of prescription medications while participating in services at Therapeutic Services, Inc., P.C. If you drive yourself to Therapeutic Services, Inc., P.C. for services and appear to be intoxicated and impaired in the judgement of clinical staff, you will be restricted from participating in services at that time. Alternative transportation arrangements will be offered. In the event that alternative transportation arrangements are refused and you insist on driving yourself from Therapeutic Services, Inc., P.C., the police will be notified.
You shall not bring any animal into Therapeutic Services, Inc., P.C. facility unless the animal is a service animal.
You are responsible for paying the agreed upon fee at the time of services are rendered. You are responsible for a twenty-four (24) hour advance cancellation notice. You will not be rescheduled when a no show occurs or when missing two (2) consecutive appointments.
If you bring a child or youth under age eighteen (18) years with you to Therapeutic Services, Inc., P.C., you are responsible for supervising the child or youth at all times while the child or youth is at Therapeutic Services, Inc., P.C. It is strictly prohibited for children to be left unattended at Therapeutic Services, Inc., P.C.
If you are a parent/guardian with a child under the age of eighteen (18) years who is receiving services at Therapeutic Services, Inc., P.C., you are responsible for remaining in the Therapeutic Services, Inc., P.C. waiting area while the child is receiving services. This responsibility is for safety purposes. If the responsibility creates a burden the parent or guardian may consult the child or youth’s primary provider.
You shall acknowledge an understanding that in entering treatment, you must conduct yourself in such a way to protect yourself and others from exposure to, or transmission of, any infectious or communicable disease including sexually transmitted diseases.
You shall observe CDC (Centers for Disease Control) guidelines, at Therapeutics Services, Inc. P.C. facility, whether or not a state of emergency.

Consumer Grievance Policy

Therapeutic Services, Inc., P.C. is interested in knowing about your concerns, complaints and/or grievances. You are encouraged to speak to any staff of Therapeutic Services, Inc. P.C. if you are not satisfied with any aspect of your treatment by staff or the environment of services are provided.

If your concern is not satisfied after talking to a staff member, you or the agency staff member that is assisting you should contact the Clinical Director. The Clinical Director will respond to your concern within two (2) business days. If your concern is not resolved to your satisfaction after talking with agency staff, you are encouraged to use the Grievance policy and procedures outlined below.

You have the right and are encouraged to communicate your grievance to a Therapeutic Services, Inc., P.C. staff member or Clinical Director.
All consumers have a right to file a formal written grievance. You may request a form from any staff member.
If you are uncomfortable filing a grievance on your own, you may request any staff member to assist you.
Written grievances shall be forwarded to the Grievance Officer: Wakie I. Johnson, President. If you need assistance with the form or in composing the grievance, assistance may be provided by Grievance Officer or your provider.
In the instance where the Grievance Officer is the subject of a grievance, the grievance shall be forwarded Lori E. McGraw, Clinician.
At any point in this process, you may request an advocate for assistance with this process. Therapeutic Services, Inc., P.C.’s Grievance Officer, Wakie I. Johnson, will assist you in obtaining an advocate.
Time frame for resolution is no more than ten (10) days upon receipt of the grievance by Grievance Officer.
You will be mailed a written notice of the grievance outcome and steps for appealing the outcome from Wakie I. Johnson.
Throughout the process, you have the right to contact, make a complaint and/or appeal the grievance outcome to the Oklahoma Department of Mental Health and Substance Abuse Services Consumer Advocacy Division: 2401 NW 23rd Street, Suite 82, Oklahoma City, Oklahoma 73107 Phone: (local) 405.521.4279; 9toll-free) 1.866.699.6605. Wakie I. Johnson will assist you in contacting the Oklahoma Department of Mental Health and substance Abuse Services Advocacy Division, if needed.

Restriction of Privileges/Seclusion and Restraint

Several of our programs will sometime restrict privileges of their consumers because of problems with alcohol, drugs, or violence. If you are participating in our program, a staff member will provide specific information about restriction of privileges. It is the policy of Therapeutic Services, Inc., P.C. to not utilize Seclusion and/or Restraint. Therapeutic Services, Inc., P.C.’s Clinical Staff are training in managing aggressive behaviors.

Fee Agreement

Therapeutic Services, Inc., P.C.’s contractual obligation is to render screening, crisis intervention, and case management to individuals when Therapeutic Services, Inc., P.C. is capable of providing the service. Medicaid contract may pay for all services within the array of services allowed.

No Show/Cancellation Policy

If you fail to show for a scheduled appointment, you may be rescheduled at a later date when openings are available. An appointment not cancelled twenty-four (24) hours in advance will be considered a failed appointment. If you miss two (2) consecutive appointments, you will be required to completed a Screening process again prior to receiving a rescheduled appointment.

Employee Court Appearance Fee Agreement

Therapeutic Services, Inc., P.C.is a health facility and our clinicians serve a large number of consumers/patients just as a medical facility. Therapeutic Services, Inc., P.C. consumers schedule appointments with their clinician, as any medical facility schedules appointments. While Therapeutic Services, Inc., P.C. clinicians work with and cooperate with the District Attorney’s Office as well as individual judges, Therapeutic Services, Inc., P.C. clinicians will not render an opinion in custody or other kind of civil case for any party. A subpoena disrupts not only the schedule of the clinician who is subpoenaed, but also those consumers who had appointments set during the day of the subpoena and will require a complete rescheduling of all consumers on that court date’s calendar.

Please have your Legal Counsel contact Therapeutic Services, Inc., P.C.’s President to arrange for witness testimony at least one (1) week prior to the requested subpoena date and to pay for the applicable full day rate for any Therapeutic Services, Inc., P.C. staff at least two (2) days in advance of any subpoenaed court appearance. Further, if another party subpoenas a Therapeutic Services, Inc., P.C. staffing a case in which you are involved, because of custody or guardianship, and utilized Therapeutic Services, Inc., P.C. services, you shall agree and guarantee that your legal counsel will recognize such subpoenaed Therapeutic Services, Inc., P.C. staff as a witness and move to protect the subpoenaed staff by filing a Motion to Quash such subpoena, informing all other parties and attorneys about Therapeutic Services, Inc., P.C.’s Court Appearance policy and taking any other steps necessary to protect the subpoenaed staff. You shall pay for all such legal serves. In the event that Therapeutic Services, Inc., P.C. staff is required to appear in court, the daily rates below shall apply. The party who caused the subpoena to be issued is reasonable for payment in full. Public entities, including court systems, are exempt from fee assessment. Payment much be made at least two (2) business days prior to the appearance date, in the form of a certified or cashier’s check or money order.

Court-Staff Fees -

Staff Time Per Day

Parking & Travel Per Day

Total Rate Per Day

Licensed Clinician (LPC, LMFT, LBP, LCSW)

$684.00

$40.00

$724.00

Candidate for License Clinician (LPC, LMFT, LBP, LCSW)

$584.00

$40.00

$624.00

Nicotine Policy

Therapeutic Services Inc., P.C. is committed to providing a safe and healthy environment and to promoting the health and well-being of its consumers and staff. Therapeutic Services, Inc., P.C. is further committed to protecting visitors at Therapeutic Services, Inc., P.C. from exposure to nicotine products.

As required by the Oklahoma department of Mental Health and Substance Abuse Services and in commitment to a healthy environment, Therapeutic Services, Inc., P.C. prohibits possession and use of any nicotine product by consumers, staff, and visitors on the premises inside and outside within 25 feet of Therapeutic Services, Inc., P.C. facility entrances and exits. Staff shall not use nicotine products in a consumer’s home or on any other premises while providing services.

Therapeutic Services, Inc., P.C. is committed to providing support to all Therapeutic Services, Inc., P.C. consumers who desire to stop using nicotine products. Therapeutic Services, Inc., P.C. is committed to informing you of available assistance, including but not limited to the following:

Educational information regarding the health impact of prolonged nicotine use
Evidence-based behavioral interventions for nicotine use cessation provided by Therapeutic Services, Inc., P.C.
Referral assistance to 1-800-QUIT NOW (1-800-784-8669), Oklahoma’s Nicotine Helpline, a free service for all Oklahomans wishing to stop the use of nicotine products. Through Helpline, participants receive one-on-one coaching and may receive free nicotine patches or gum.

Animal Policy

The only animals allowed inside Therapeutic Services, Inc., P.C. facility are “service animals”. Pursuant to the Americans with Disabilities Act (ADA), “Service animals mean any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability. Other species of animals whether wild or domestic, trained or untrained, are note service animals for the purposes of this definition. The work or tasks performed by a service animal must be directly related to the individual’s disability.” As instructed by the ADA, dogs that are not trained to perform tasks that mitigate (make less severe) the effects of a disability, including dogs that are used purely for emotional support, are not service animals.

Any person presenting with an animal other than a dog will be reminded of Therapeutic Services, Inc., P.C.’s policy and be asked to remove the animal from the premises. If an individual present to Therapeutic Services, Inc., P.C. with a dog whom the individual identifies as a service animal, he/he may be aske three (3) questions:

Whether the service animal is required because of a disability: and/or
What work or task the service animal has been trained to perform
To provide veterinarian records evidencing all required vaccination and/or inoculations are current. The evidence will be required each time the animal is present on Therapeutic Services, Inc., P.C. premises. Failure to provide said evidence will cause service animal to not be allowed access to the property reverenced above.

Any such service animal must remain under the control of its handler at all times while at Therapeutic Services, Inc., P.C. A services animal shall have a harness, leash or other tether would not interfere with the service animal’s safe, effective performance of work or tasks, in which case the service animal must be otherwise under the handler’s control (e.g., voice control, signals, or other effective means). Therapeutic Services is not responsible for the care or supervision of a service animal.

A person with a disability and a service animal may be asked to remove the service animal from the premises if:

The dog is out of control and the dog’s handler does not take effective action to control it; or
The animal is not housebroken
The animal poses a direct threat to the health or safety of others.

Decisions on these matters will be made by representative of the above referenced property.

The only animals allowed into Therapeutic Services, Inc., P.C. facility are “service animals”. Pursuant to the Americans with Disabilities Act (ADA), “services animals are animals that are individually trained to perform tasks for people with disabilities such as guiding people who are blind, alerting people who are deaf, pulling wheelchairs, alerting and protecting a person who is having a seizure or performing other special tasks. Service animals are working animals, not pets”.

Code of Ethics

Therapeutic Services, Inc., P.C. expects all of its staff to conduct themselves at all times in a professional manner. We require each employee to sign a statement that they agree to follow out Code of Ethics and Conduct. The Code covers such items as discrimination, maintaining the privacy of out consumers, relationships with consumers and how staff represent themselves to consumer. Therapeutic Services, Inc., P.C. is committed to a high standard of ethical behavior by our staff. Standards include but are not limited to:

Therapeutic Services, Inc., P.C. staff will treat all consumers with dignity and respect
Therapeutic Services, Inc., P.C. staff shall not subject consumers to harassment of any kind
Therapeutic Services, Inc., P.C. staff shall not discriminate on any basis
Therapeutic Services, Inc., P.C. staff shall respect the privacy and confidentiality of persons served
Therapeutic Services, Inc., P.C. staff shall not commit fraud
Therapeutic Services, Inc., P.C. staff shall not engage in social or sexual relationships with consumers

Therapeutic Services, Inc., P.C.’s Code of Ethics is posted at our facility. A complete copy of Therapeutic Services, Inc., P.C.’s Code of Ethics is available upon request. If you have questions regarding Therapeutic Services, Inc., P.C.’s Code of Ethics, please inquire at your convenience. You may report a suspected ethics violation through the Grievance process. Violation of any part of Therapeutic Services, Inc., P.C.’s Code of Ethics is sufficient for personnel action up to and including termination of employment.

Partners in Recovery: Naming a Treatment Advocate

What is a Treatment Advocate? It is a person who is identified and named by any adult consumer of mental health services to serve as a partner in his or her recovery. The Treatment Advocate may be a family member, a spouse or partner, a friend, someone from a self-help organization or anyone else a consumer wishes to name. Choosing a Treatment Advocate is completely voluntary. No consumer can be forces or coerced in any way to name or not name a Treatment Advocate or choice of a Treatment Advocate or level of involvement of the Treatment Advocate.

What can a Treatment Advocate do? Any designated Treatment Advocate shall at all times act in the best interest of the consumer and comply with all conditions of confidentiality. Ideally, a Treatment Advocate knows the consumer’s wishes and preferences and advocates for in that manner. The Treatment Advocate may participate in the treatment planning and discharge planning of the consumer being served to the extent consented to by the consumer and permitted by law. Therapeutic Services Inc., P.C. will notify the consumer and the Treatment Advocate of treatment and discharge planning meetings at least twenty-four (24) hours in advance.

Designation of a Treatment Advocate - Therapeutic Services, Inc., P.C. utilized a Designation of a Treatment Advocate form. When a consumer elects to utilize a Treatment Advocate, on the Designation of Treatment Advocate form the consumer will indicate his or her decision to:

Choice of individual to serve as a Treatment Advocate
The level of involvement the identified Treatment Advocate shall have

A Treatment Advocate – will indicate on the form his or her intention of serving according to the consumer’s specifications and acknowledgement that the Treatment Advocate will comply with all standards of confidentiality. Signatures from both the consumer and Treatment Advocate must be on the Designation of Treatment Advocate form. Verbal confirmation of written information processed in the form hall be permitted until such time as the Treatment Advocate can be present to sign the Designation of Treatment Advocate form.

A copy of the completed Designation of Treatment Advocate form shall be given to the consumer and the Designation of Treatment Advocate. The original shall be maintained in the consumer’s clinical scanned chart record. The consumer may change or revoke the designation of a Designation of Treatment Advocate at any time for any reason. The Designation of Treatment Advocate form shall be reviewed with the consumer at each point of treatment planning and treatment planning review to afford the consumer an opportunity for review and amendment.

Consent to Receive Services

Each consumer shall acknowledge an understanding that his/her communication with Therapeutic Services, Inc., P.C. staff and his/her treatment records are confidential and may not be released except under the following conditions or circumstances or where otherwise provided by federal and state regulation, such as:

Upon express written consent to enable and ensure collection of third part payment for services rendered and other purposes for which the consumer gives consent
Upon the need to disclose information or protect the rights and safety of the consumer or others if:

The consumer presents a clear and imminent danger to self and refuses explicitly or by behavior to voluntarily accepts appropriate treatment; or if the consumer communicates an explicit threat to kill or inflict serious bodily injury upon an identified person with the intent and ability to carry out the treat; or if the consumer has a known history of physical violence and the treatment staff has a reasonable basis to believe that there is a clear and imminent danger that the consumer will attempt to kill or inflict serious bodily injury upon and identified person.

As required for supervision review by funding sources and/or accreditation groups in order to verify and evaluate the provision of services.
As required by state laws in the reporting of alleged acted of child abuse and/or neglect.

Your Treatment Team and Individual Plan

As a recipient of Therapeutic Services, Inc., P.C., you will decide the type of services and what you hope to change or accomplish. This is documented in what we call a treatment plan. This plan describes what you hope to accomplish from receiving our services and how this will occur. Everyone who participated in developing the plan is called the treatment team. The staff person that is providing your services will work with you in designing this plan. You will be encouraged to keep a copy of this plan. If at any time you have questions about this plan, please let us know.

Notice of Privacy Practice

Therapeutic Services, Inc., P.C. is committed to protecting information about you that we create as a part of our services. We desire to be fully informed about this information, how we protect it and how we use that information. When you start services with Therapeutic Services, Inc., P.C, you will be informed of our Notice of Privacy Practices. A paper copy of Therapeutic Services, Inc., P.C.’s Notice of Privacy Practice is given to each individual presenting for the first face-to-face screening and/or intake. The Notice of Privacy Practice is posted at our facility. If you would like a more detailed explanation of these rights, or if you would like to exercise one or more of these rights, contact: Wakie I. Johnson, 5569 South Lewis Avenue, Tulsa, Oklahoma, 74105, 918-742-6050.

Input – As was stated at the beginning of this handbook, we are interested in assisting you and improving the quality of care and our services for you. We have a suggestion box in our facility and we would like to hear from you at any time. We hand out and/or mail surveys several times a year and encourage you to fill out and return surveys.

If you would like specific or additional information from Therapeutic Services, Inc., P.C.’s Annual Performance Improvement Report or if you would like to call or write us please contact: Therapeutic Services, Inc., P.C., 5569 South Lewis Avenue, Tulsa, Oklahoma, 74105, 918-742-6050.

Call 2-1-1 to connect people with important community services and volunteer opportunities. Also, 2-1-1 provides callers with information about and referrals to human services for every day needs and in times of crisis.

Therapeutic Services, Inc., P.C. is accredited by CARF International (Commission on Accreditation of Rehabilitation Facilities) as an Outpatient Mental Health Center providing services to children, adolescents and adults.

Therapeutic Services, Inc., P.C. is committed to three ideas that embrace our philosophy of helping: collaboration, compassion and commitment. Our Slogan is:

"A person's a person, no matter how small."

Horton Hears A Who! By Dr. Seuss