Any information you share with a staff member is considered confidential, even the fact that you are a client at Chilton-Shelby Mental Health Center. When there is a need to release information about you, you will be asked to sign a "Release of Information" form. A staff member will tell you what information will be requested or released. Clinical information, either written or verbal, will not be released by this center without your written permission except in the following instances:
- If there is evidence of abuse or neglect or suspected child abuse or neglect.
- If the center is ordered by a judge.
- If you express intent to harm yourself or others.
- If you have a medical emergency.
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Payment for services is expected at the time of the service. The center will file your insurance (Blue Cross/Blue Shield, United Behavioral Health, Medicare, Medicaid, etc.) for you if you provide us with all the necessary information to do so. If you have insurance that would cover our service but choose not to file, you will be responsible for the full fee. Some healthcare plans may require a call from you before sessions are approved. If you fail to do this prior to your scheduled appointment, you will be expected to pay full fee for the service you receive.
Application for Discounted Fee
If you are not covered by an insurance plan and you are contract eligible, you may wish to apply for discounted fees based on your total income and size of your family. To qualify for discounted fees, it is necessary for you to provide the following information for verification of income:
- Most recent year's tax return, or
- Paycheck stubs for one month, or
- Statement from the Foods Stamp Office
You are requested to notify the Center if there is a change in the income or size of your family since this may affect your fee.
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It is important you keep every appointment to ensure the best progress toward your treatment goals. If you are unable to keep an appointment, please notify the Center as soon as possible. Check our Directory for the phone number of the office you need to reach.
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In Case of an Emergency
In case you have a mental health related emergencies in the evenings, on weekends, or on holidays, call the 24 hour emergency number:
- Shelby County 205-663-1252
- Chilton County 205-755-5933 or 205-755-8803
Your call will be directed to our Answering Service and a professional counselor will be contacted to help you deal with your emergency. Since the counselors are "on-call" on a rotating basis, the counselor that you reach may not be your regular counselor. Therefore, problems which are not emergencies should be discussed with your regular counselor during your scheduled appointment time.
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Consumer Rights for Persons Enrolled in Chilton-Shelby Mental Health Center Services
- Right to Privacy
- Right to Confidentiality
- Right to Access Information
- Right to Access Compliance/Grievance Procedures
- Right to be informed of financial aspects of treatment
- Right to be fully informed of need for parental or guardian consent
- Right to be fully informed of services provided
- Right ti give informed consent prior to being involved in research projects
- Right to be protected from harm including any forms of abuse, neglect, exploitation and mistreatment
- Right to access courts and attorneys
- Right to be informed of commitment status if legally committed
- Right to be accorded adequate services, humane respect and dignity, regardless of the source of financial support
- Right to refuse mental health services, except when refusals are not permitted under applicable law
- Right to be informed of means of accessing advocates or rights protection services
- Right to be free from seclusion, restraint, drugs or other interventions administered for punishment, discipline or staff convenience
- Right to be included in the community with appropriate and adequate supports on completion of, or in conjunction with, the terms of commitment
- Right to be advised when special equipment, such as two-way mirrors, cameras, and tape recordings are used
- Right to enforce rights through courts or appropriate administrative procedures
- Right to receive quality treatment and care from trained professionals regardless of your race, religion, gender, sexual orientation, ethnicity, age or disability
- Your plan of treatment of habilitation should be designed just for your individual needs and abilities.
- You should be allowed to actively participate in your treatment plan. There will be a periodic review of the treatment or program plan.
- The right to individualized treatment providing services within the least restrictive environment possible
- Right to care that is considerate and respects the consumer's personal values and belief systems
- Right of the individual served and the individual's family to be informed of their rights in a language they understand
- Right to be informed of the organization's rules and regulations concerning the conduct of the individuals served
- Right to adequate number of competent, qualified, and experienced professional clinical staff to supervise and carry out the treatment or program plan
These rights are available to you as a consumer of mental health services, although there may be some limitations based upon your circumstances.
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Residential Services Consumer Rights
- Right to adequate food and shelter in residential programs
- Right to access medical services in residential programs
- Right to wear your own clothing and keep your own personal possessions
- Right to privacy of mail, telephone communications and visitors, unless legally restricted
- Right to management of personal funds to the maximum level of each consumers ability
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Other Consumer Rights
Consumers have the same rights afforded to all citizens.
- Right to receive a free and appropriate education if you are of school age
- Right to exercise freedom of religion
- Right to be paid the value of work performed
- Right to exercise rights as a citizen of the United States and the state of Alabama
- Right to be served through general services available to all other citizens
- Right to choose to live, work, be educated and recreate with persons who do not have disabilities
- Right to be presumed competent until a court of competent jurisdiction, abiding by statutory and constitution provision, determines otherwise
- Right to vote and otherwise participate in the political process
- Right to own and possess real and personal property (Nothing in this section shall affect existing laws pertaining to conveyance of personal property.)
- Right to make contracts
- Right to exercise rights without reprisal
- Right to obtain a driver's license on the same basis as other citizens unless excluded due to violation of the law
- Right to marry and divorce
- Right to sexual interaction with members of either sex (Romantic relationships between active group therapy members are discouraged for therapeutic reasons.)
These rights may be limited based upon an individual's specific circumstances
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Realizing the freedom to exercise rights carries the need to accept some responsibilities. The following list of responsibilities is expected of each person who receives services from the Chilton-Shelby Mental Health Center.
- To provide, to the best of your knowledge, accurate information regarding your mental health and medical history including: present and past illnesses, medications, hospitalizations, etc.
- To be responsible for your actions should you refuse treatment or do not follow instructions
- To be familiar with and follow rules and regulations governing your care and conduct
- To attend scheduled activities and keep appointments
- To be considerate of the rights of others
- To be respectful of the property of others and of the facility
- To take an active part in planning for your treatment/habilitation program
- To ask questions when you do not understand instruction, treatment, etc.
- To help take care of and clean up your service area as appropriate
- To obey the laws which apply to all citizens
- To pay for services as per agreement
There may be other specific rules and responsibilities as outlined within services.
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Any person or agency who applies for or receives any service from Chilton-Shelby Mental Health Center may file a complaint/grievance.
Informal complaints may be given to any staff member or supervisory personnel. Those staff members may resolve the complaint quickly, in an informal manner. In the event the person with a complaint is not satisfied with the resolution of the complaint, the person may file a formal complaint/grievance.
The informal complaint process will not apply in cases where there is alleged abuse or neglect of a client. Such complaints will be handled as formal complaints and should be reported to the Chief Executive Officer immediately.
A formal complaint/grievance may be filed in the event the informal methods do not satisfy the person with a complaint. This complaint should be directed to the Chief Executive Officer's Office. Such companies should identify the problem and state the relief desired, if any.
The Chief Executive Officer may assign supervisory personnel to investigate and resolve the formal complaint/grievance, if possible. The Chief Executive Officer will be informed of the resolution of the formal complaint/grievance.
In the event that the person with a complaint is not satisfied with the resolution, the person may request that the Chief Executive Officer review the complaint and reconsider the relief desired. If the decision is that the relief desired will not be granted, the person with a complaint will be notified of the decision.
This procedure may be carried out in accordance with the Community Advocacy Program of the Alabama Department of Mental Health and Mental Retardation.
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Rights and Protection Services
If you want to find out more about your rights or how to file
a complaint when you feel your rights have been violated...
Chief Executive Officer’s Office
Chilton-Shelby Mental Health Center
P.O. Drawer 689
Calera, Alabama 35040
Contact the Alabama Department of Mental Health
and Mental Retardation Advocacy Office
Other Advocacy/Protection Services
Alabama Disabilities Advocacy Program
Alliance for the Mentally Ill of Alabama
|Department of Human Resources
| Chilton County
Mental Health Consumers of Alabama
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