• Client Rights & Responsibilities Statement

  • Family Service Agency (FSA) is committed to providing competent and humane services in a manner that respects individual’s rights, protects their dignity and promotes their self-worth. Family Service Agency exists to strengthen people and communities through hope, healing, empowerment, and engagement. FSA strives to provide clients with a safe environment, regardless of culture or religious beliefs. Clients of FSA have the right to fair and equitable treatment, including but not limited to the right to receive services in a non-discriminatory manner and the consistent enforcement of program rules and expectations. In order to maintain FSA’s longstanding reputation in the community, this Client Rights and Responsibilities Statement has been established to specify expectations.


    Civil Rights and Non-Discrimination


    Ethnic background, personal or social creed, race, gender, sexual orientation, disability, religion or age will not affect the services provided to individuals. Physical barriers will not preclude anyone from receiving services provided by FSA. Upon commencement of services, individuals are entitled to have their rights explained to them using a preferred language or method of communication. Individuals retain all rights, benefits and privileges guaranteed by law. Services will not be denied, suspended or terminated for exercising their rights. Individuals have the right to be free from exploitation for the benefit or advantage of a staff member. If an individual feels their rights have been violated, they have the right to report complaints/grievances of FSA staff including the Executive Director without it affecting the quality of service. A description of how grievances will be handled will be provided with this document.


    Confidentiality

    All information concerning clients are held confidential and released only through procedures consistent with the law and professional ethics. This includes confidentiality guaranteed by the Mental Health and Developmental Disabilities Confidentiality Act and the federal Health Insurance Portability and Accountability Act of 1996. Individuals have the right to be informed of any limits on confidentiality as defined by state law. The records may be subpoenaed by the courts without permission. However, it is the policy of the Family Service Agency to notify the client of any subpoena and/or court order before appearing in court and the records are released. An individual’s rights must maintain a balance with society’s need for protection. FSA maintains a strict policy on the confidentiality of information (verbal, written or electronic form). All information individuals share, which FSA becomes aware of through work will remain confidential. There are some circumstances in which this policy becomes void and FSA is required by law to release information:

    • If FSA becomes aware that a client may be a danger to themselves or others.
    • If FSA becomes aware of or suspect child abuse or neglect.
    • If FSA becomes aware of or suspect abuse or neglect of a vulnerable adult.
    • If FSA is court ordered to testify or to submit records to the court.


    In the situations mentioned above, FSA would be required to advise appropriate authorities of the required information.

    • Clients have the right to refuse to release information, under applicable law. Clients have the right to have the consequences of this decision explained to them.
      Other situations in which information may be shared:
    • The following persons shall be entitled, upon request, to inspect a client’s record, or any part thereof:
      o The client, if they are 12 years of age or older.
      o The parent or guardian of a client who is at least 12 but under 18 years of age, if the client is informed and does not object (applicable procedures must be followed).
    •  FSA staff may disclose a record or communications without consent to:
      o Staff supervisors, a consulting therapist, members of a staff team participating in the provision of services, administrative staff responsible for recordkeeping.
      o Persons conducting a review of services being provided.
      o An attorney or advocate consulted by the agency which provides services concerning the agency’s legal rights or duties in relation to the client and services being offered.
    • Family Service Agency staff have a legal obligation to report fraud or misrepresentation involving government benefits and public assistance programs,
    • Representing attorneys and other advocates may be informed of client residence at the shelter, but only when reasonable precautions are taken.

    Client Responsibilities

    All clients of FSA are expected to treat FSA’s employees, volunteers, other clients and visitors with the utmost respect and dignity while on agency property.
    Clients are responsible for providing true and accurate information as requested/required in order to receive services.
    Family Service Agency strictly forbids discrimination or harassment of any kind, whether based on race, color, national origin, religion, creed, sex, age, physical, mental or developmental disability, marital status, sexual orientation, political ideology or any other reason. Harassment may include unsolicited or unwelcome remarks, gestures, or physical contact, as well as the display or circulation of inappropriate or derogatory written materials or pictures.


    The following is a list of behaviors that will not be tolerated in common areas or directed toward other clients, staff or volunteers:

    • Physical violence;
    • Verbal abuse and threatening language;
    • Profanity;
    • Any form of harassment;
    • Intimidation tactics and/or making threats;
    • Bullying;
    • Malicious or harmful statements about others;
    • Public disclosure of another person's private information;
    • Sexual language or discussion of any kind;
    • Possession of dangerous or unauthorized material, including firearms (with the exception of authorized law enforcement personnel);
    • Appearing to be under the influence of alcohol or illegal drugs;
    • Solicitation, purchase or selling of illegal substances or services;
    • Smoking and vaping are not permitted in areas restricted under Illinois Law
    • Smoking and vaping are not permitted by minors as restricted by Illinois Law
    • Excessive noise in waiting area (yelling, loud conversation, loud play, etc.); and
    • Cell phone use

    Clients and/or visitors who violate these responsibilities or act in a way deemed dangerous to other clients may be asked to leave the premises.


    Clients will advise FSA support staff of any personal situations or problems that arise that may affect their services.


    Clients will be present and on time for appointments with staff or volunteers. If they will be late or must cancel the appointment, they must give 24 hours’ notice or may be subject to a no show/late cancel fee.


    Rights of Persons with Disabilities


    Individuals’ rights are protected in accordance with Chapter 2 of the Mental Health and Developmental Disabilities Code. Individuals have the right to have disabilities accommodated as outlined in the Americans With Disabilities Act, section 504 of the Rehabilitation Act and the Human Rights Act. The following resources are available to persons with disabilities at their own discretion:

    • Individuals have the right to contact the Illinois Guardianship and Advocacy Commission, which protects the rights and promotes the welfare of persons with disabilities.
      o Address: 4302 N Main St # 108, Rockford, IL 61103
      o Phone: (815) 987-7657
    • Individuals have the right to contact Equip for Equality, Inc, which protects the civil and human rights of people with disabilities through self-advocacy assistance, legal assistance, public policy, monitoring, and training.
      o Address: 20 N Michigan Ave suite 300, Chicago, IL 60602
      o Phone: (312) 341-0022
    • Individuals have the right to contact the Human Rights Authority, which investigates alleged violations of the rights of persons with disabilities by providers of services
      o Address: 4302 N. Main St., Suite 108, Rockford, IL 61103
      o Phone: (866) 274-8023

    Rights Pertaining to All Agency Clients

    • Clients have the right to refuse to participate in, or be interviewed for, any research studies/projects.
    • Clients have the right to be provided with services in an environment that is free from exploitation, the imminent or potential threat of physical, emotional, sexual or other types of abuse or neglect, and intentional mistreatment.
    •  Clients have the right to ethical and equitable treatment.
    •  Clients have the right to reasonable accommodations and communication suppors.
    • Clients have the right to receive services in a non-discriminatory manner.
    • Clients have the right to receive inclusive services that are respectful of, and responsive to, cultural and linguistic diversity.
    • Clients have the right to be free from physical restraint.
    • Clients have the right to receive service in a manner that is non-coercive and that protects Clients right to self-determination
    • Clients have the right to request services; however, implementation of that service is at the discretion of Family Service Agency.
    • Clients have the right to refuse or terminate services to the extent allowed by law and to be informed of any consequences related to service delivery should they refuse services, which can include discharge from services.
    • Clients have the right to be provided with services in the least restrictive setting possible.
    • Clients have the right to participate in all service decisions. A parent or legal guardian has the right to participate in all service decisions on behalf of a minor client.
    • To consent to or refuse any service, treatment, or therapy upon full explanation of the expected benefits, risks, side effects, alternatives to planned services, and consequences of such consent or refusal. A parent or legal guardian may consent to or refuse any service, treatment, or therapy on behalf of a minor client.
    • Clients have the right to informed consent regarding all aspects of services provided by Family Service Agency.
    • Clients have the right to review, and if they wish, have copies of materials in their case records that pertain to the services Clients have received at Family Service Agency.
    • Clients have the right to consistent enforcement of program rules and expectations.

     

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  • Program Addendums

    Children’s Advocacy Center
    Responsibilities
    • Clients are expected to return phone calls and e-mails to CAC and FSA staff for the purpose of case management.
    Rights
    • Recorded forensic interviews will only be released as allowed by law.

    Center for Counseling
    Responsibilities
    • Clients have the right to know the costs of program services.
    • Clients have the right to insert into their case record written statement(s) about their treatment issues or about the services they are receiving, or wish to receive, at the Agency. Clients will also be informed of any written responses to their statement(s) that may be included in their case record.Program Addendums

    •Clients have the right to have services provided to them with their input according to an individualized treatment or service plan developed.
    • Clients have the right to have their treatment or service plan reviewed periodically, but at least every six (6) months.
    • Clients have the right to participate with their service provider and other staff in any meeting at which their treatment / service plan is reviewed.
    • Clients may review, upon written request, any case records created on their behalf by Family Service Agency.
    • Clients have the right to contact their public payer or its designee and to be informed of the public payer’s process for reviewing grievances.
    • Clients have the right to contact HFS or its designee and to be informed by HFS of their healthcare benefit and the process for reviewing grievances.

    Community Action Program
    Responsibilities
    • Clients are expected to maintain confidentiality regarding other participants’ disclosures.
    • Clients are responsible for supplying complete, accurate, and truthful information necessary to determine eligibility and develop service goals.
    • Clients are responsible for submitting required documentation or attend scheduled appointments, failure to do so may result in delays or closure of a financial assistance request.
    • Clients are responsible for participating in the development of their service goals and for taking an active role in the services they and/or their family receive, including attending meetings and participating in activities.
    • Clients are responsible for using benefits and services as intended and in compliance with program rules and applicable laws.
    • Clients are responsible for using financial assistance solely for its approved purpose, as outlined by Family Service Agency and the applicable funding source.
    Rights
    • Clients have the Right to understand eligibility, limits, and funding constraints.
    • Clients have the right to be informed that financial assistance is limited, time-restricted, and subject to the availability of grant funding.
    • Clients have the right to understand that financial assistance is not guaranteed, even if eligibility criteria are met.
    • Clients have the right to receive an explanation of assistance amounts, frequency, and allowable expenses as determined by funding source rules and agency policy.

    Youth Programming
    Responsibilities
    • Clients are expected to maintain confidentiality regarding other members’ disclosures.
    Rights
    • Clients (and guardians, when applicable) have the right to understand the nature of services, including goals, activities, and potential benefits or discomforts.
    • Clients participating in group sessions have the right to expect confidentiality from other group members regarding personal disclosures.
    • Clients and guardians have the right to receive updates on progress and provide feedback about services.
    • Clients are advised of policies regarding personal belongings during sessions to prevent loss or damage.
    • Clients have the right to know and understand program rules, schedules, and behavioral expectations

    • (e.g., attendance, dress code, conduct).
    • Clients in programs have the right to meet with a mental health professional for screening and receive appropriate recommendations.

    Roots to Rise Shelter and Transitional Living
    Responsibilities
    • Clients are expected to adhere to all program rules and expectations.
    • Clients are expected to maintain confidentiality regarding other clients.
    • Clients are responsible for supplying accurate information necessary to determine eligibility and develop service goals.
    • Clients must respect the rights of staff members and other clients. Failure to do so can result in the suspension or termination of services.
    • While participating in services, Client must be free from the influence of any substance not prescribed by a physician. Clients must understand that staff can request a urine drop at any time.
    • Clients are responsible for helping to create and support a safe and welcoming environment. FSA does not allow illegal activity, violence, or weapons. Violation of this responsibility may result in suspension or termination of services and legal consequences.
    • Clients are responsible for participating in the development of their service goals and for taking an active role in the services they and/or their family receive, including attending meetings and participating in activities.
    • Clients are responsible for asking questions to make sure they understand the program, services and any other information related to themselves or FSA.
    Rights
    • Clients have the right to have services provided to the with their input according to an individualized treatment or service plan developed.
    • Clients have the right to a comprehensive age-appropriate assessment.
    • Clients have the right to participate with their service provider and other staff in any meeting at which their treatment / service plan is reviewed.
    • If clients are a member of a well-recognized denomination, they may choose spiritual healing services.
    • Client’s personal belongings shall be returned to them upon discharge
    • Unless a client is a minor or prohibited by court order, they may use their money as they chose, including depositing it in a financial institution.
    • All personally owed money shall be returned to me upon discharge.
    • No service provider or agency employees shall be made a representative payee without the client’s informed consent.
    • Unless restricted to prevent harm from self or others, clients shall be permitted to receive, possess and use personal property with the provision of reasonable storage, only personal property allowed by FSA guidelines will be allowed on FSA property. Items brought that are not allowed will be confiscated and stored until time of discharge.
    • Clients must understand that they may be searched upon their return to the shelter from any unsupervised activity.
    • Clients may work as part of the program but must be paid at least monthly if there is any consequential economic benefit to FSA. Clients must understand that they will be expected to be responsible for any debts incurred during their stay. This can include financial restitution, or restitution achieved through community service work hours.
    • Clients shall be allowed unimpeded and uncensored communication with persons by mail, telephone and visitation. Any arrangements which are necessary for making communications available, shall be convenient and reasonable. Consent for a client’s guardian will be required for minors.

    • All phone calls are monitored by staff as an extension of services. Any questionable behavior will result in increased supervision. Any suspect correspondence will be discussed with the program coordinator and Director of Youth Programming and may require the client to open in the presence of staff so that the contents may be examined for contraband.
    • Clients shall have available to them, written and oral communication tools if they have difficulty understanding or reading the primary language used at FSA.
    • Except in emergencies, no medical or dental services will be provided to Clients without their informed consent.

    Senior Services
    • Use of cell phones is permitted at the Senior Centers
    • Recurrent and/or habitual offenses may prohibit the individual from Activity Center activities

  • Violations

    Of paramount importance to FSA is the safety and security of its employees, volunteers, clients and visitors. This policy is strictly enforced, and non-compliance will result in corrective measures being undertaken.


    Violations of a serious nature will require law enforcement intervention. The Executive Director and staff of Family Service Agency reserve the right to exclude any person from accessing services as a consequence of violating this policy.


    I have read and agree to the terms of this Rights and Responsibilities Statement and understand the consequences of not abiding by it.

  • Staff Use Only

    I have explained these rights to the individual (or the guardian of the individual, if applicable) and have provided them with a copy of it. A copy of this form has been filed in the individual's client record.

     

     

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                              Staff Signature                                                                           Date

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