Bridges Healthcare, Inc. will follow the statutes of the State of Connecticut, Section 17a-540(formerly Sec. 17-206a) to 17a-550 (formerly Sec.17-206k), that outline rights of clients at facilities such as Bridges Healthcare, inc. These rights include:

 1. The right to be treated with respect and dignity.

 2. The right to privacy and maintenance of confidentiality.

 3. The right to participate in voluntary treatment, the right for a specialized treatment plan and the right to refuse treatment recommended by the staff.

 4. The right to seek a psychiatric consultation or the right to refuse such a recommendation. In addition, clients may refuse to take medication recommended by a psychiatrist. If client chooses to receive medication, it will only be with informed consent.

 5. The right to receive treatment that is based upon a sliding fee scale determined by the client’s income.

6. The right to treatment regardless of race, religion, national origin, age, sex or other attributes.

7. The right to access the grievance procedure if a client feels any of the above rights were violated. If this process does not remedy the situation, the client has the right to formal legal action.

In addition to the statutes above, clients’ rights include protection from abuse, financial or other exploitation, retaliation, humiliation and neglect.

Any client believing that his or her rights have not been fully considered may use the grievance procedures outlined on the next page. Agency Ethics and Grievance Policies are posted in our waiting rooms.

I CONSENT TO TREATMENT and I agree to participate in my treatment, which may consist of one or more of the following:

Assessment
Individual
Family
Marital/Couples
Group
Case Management Services
Psychiatric Evaluation/Medication Management 

Other details of my treatment contract are indicated on the treatment plan.

 

IN ADDITION, MY SIGNATURE BELOW INDICATES THAT I HAVE READ AND UNDERSTOOD:

1. Rights and responsibilities described above
2. Confidentiality regulations (on the next page of this form)
3. Grievance procedures (on the next page of this form)
   
4. Fire and Emergency procedures (on the next page of this form)
5. Bridges Healthcare, Inc. and its staff do not administer medication to child clients.
6. Bridges Healthcare, Inc. and its staff have the responsibility of reporting suspected abuse or neglect under CT General Statute 17a-101.

    

CONFIDENTIALITY PROCEDURES

Bridges Healthcare, Inc. adheres to State and Federal regulations of confidentiality. The agency will not give out any information to anyone without your written authorization, except under the following circumstances:

• Your clinician could be subpoenaed to testify about you in court.
• If you indicate that you intend to harm someone or yourself, the agency is required to take action to prevent that harm from occurring, including alerting the authorities and alerting the person being threatened.
• The agency is also required to report any suspected child/elderly abuse or neglect.
• In an emergency situation where information is required to stabilize the situation
• In event of a crime committed on program premises, or against program personnel or threats to do so.
  
  

CONSUMER INPUT

Bridges is committed to the full inclusion of consumers in the design, implementation, modification, and evaluation of its programs and services. All persons served by the agency will have the opportunity to participate in these activities, and to express their satisfaction with the services they receive.  Please ask your service provider about our Consumer Advisory Committee, scheduled Client Satisfaction Surveys, and other ways to gather your feedback.  YOUR OPINION MATTERS to us!

GRIEVANCE/COMPLAINT PROCEDURES

If you have a grievance or concern, you should follow these steps:

1. State your concerns to the staff member providing services to you.
2. If not resolved, you may request to speak to that person’s supervisor.
3. If not resolved at that level, you may file a written grievance with the Consumer Rights Officer.

All grievances regarding client’s rights should be put in writing (complaint forms are available from the receptionist). All communications will be kept confidential.

The Agency’s policies regarding client grievance procedures are available upon request.

 

FIRE & EMERGENCY & MEDICAL EMERGENCY PROCEDURES
 

1. In the event of a fire or emergency, audible fire alarms and a recorded voice evacuation message will be heard on both the lower and upper floors.
2. Check the Fire Emergency Exit Plans posted on the wall in the waiting room and EXIT the building IMMEDIATELY , using the routes outlined in those plans.
3. If you are waiting for a child who is being seen by a staff member in an office at the time of a fire emergency, DO NOT attempt to go to the office to get the child. EXIT the building immediately and assemble in the front of the building. All staff are responsible for getting their clients out of the building, including children. No matter what exit route they use to do so, they will all assemble in the parking lot area of the building.
4. Administration of first aid to children is the responsibility of the parent/guardian.  Staff that are providing services to a child will direct the parent/guardian to the location of the first aid box as indicated above.  If the parent/guardian of the child is unavailable, the staff providing services will administer first aid and if necessary follow Medical Emergency policy/procedures posted at the first aid boxes.