Any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or other person responsible for the child's welfare is a mandatory reporter. § 39.201(1a), Florida Statutes.

The abuse hotline is the phone number and links you can use to report abuse, neglect and/or mistreatment for all children and vulnerable adults.

TEL: 1-800-962-2873 TTY: 711 or 1-800-955-8771 FAX: 1-800-914-0004

CHILD: https://reportabuse.dcf.state.fl.us/Child/ChildForm.aspx

ADULT: https://reportabuse.dcf.state.fl.us/Adult/AdultForm.aspx

If an emergency situation occurs where an indi-vidual appears to face immediate risk of abuse or neglect likely to result in death or serious harm;

CALL 911 First/ Abuse Line Second

While receiving treatment at a facility, your rights as a consumer of services are guaranteed to you under Florida law. When you request or receive services, the network provider should give you written information regarding your rights. Your rights are as follows:

Be treated with respect at all times

Be free from abuse and neglect

To receive quality service, given in a qualified, professional and timely manner.

Be free from exploitation, retaliation and humiliation

To understand the availability of the services you need, what

Have freedom of movement, unless it has been re- stricted as a part of your treatment or by a judge.

Have freedom of religion and practice.

Appropriate treatment

To be informed in writing, to know and to agree to any fees

Receive treatment in the least restrictive setting.

• Consent or not consent to treatment, unless restricted by a judge or in an emergency. If you are under 18 years of age, your guardian must also be asked to give
• expressed and informed consent.

Question the cause and legality of your being detained.

Ask the circuit court to order your release.

• Be informed about the reason for your admission, your proposed treatment, any potential side effects of any treatment, your approximate length of stay, and other possible treatments.
• Take back any consent to treatment, either verbally or
• in writing, by you, your guardian or guardian advo- cate.

Have reasonable access to your own records.

Authorize release of information to people or agencies.

Have your records kept confidential.

If necessary, to be provided, though court, a guardian advocate to make decisions regarding your treatment.

Designate a person to receive any required notices.

Receive services that are skillfully, safely, and hu- manely administered.

Right to Participate in Treatment and Discharge Plan- ning:

Receive appropriate medical, vocational, social, edu- cational, and rehabilitative services.

Help make decisions about your treatment and provide written comments on your treatment plan. Informed consent or refusal of expression of choice regarding the composition of the service delivery team. Help make plans for your discharge.

OPTIMUM HEALTH OUTCOMES, L.L.C follows laws and regulations regarding privacy and protection of health information.

“Informed consent” means that you or your legal guardian will know exactly what you are agreeing to do.

"Confidential information" includes drug, alcohol, and/or mental health information about you.

If OPTIMUM HEALTH OUTCOMES, L.L.C needs confidential information from another agency or provider,  OPTIMUM HEALTH OUTCOMES, L.L.C staff member will:

Review, what information is needed and why, with you and/or your legal guardian

• Information" indicating that you agree to have the necessary information released

The client or their legal guardian will be asked to sign the "Consent to Release/Request

OPTIMUM HEALTH OUTCOMES, L.L.C cannot get your confidential information without the "Consent to Release/Request Information"

You are eligible for services based on your needs. You may receive services from the agency based on availability.

OPTIMUM HEALTH OUTCOMES, L.L.C will seek staff to match your needs. If you stop receiving services and later return, we will try to assign the same staff to your case.

OPTIMUM HEALTH OUTCOMES, L.L.C will go over any changes in your treatment plan with you and/or your parent or guardian. If you or your parent/guardian are not able to participate in treatment planning, you will be told in advance about the benefits, risks, and alternatives to planned services or treatment to be administered by

 

You have the right to review the information collected during your treatment time with OPTIMUM HEALTH OUTCOMES, L.L.C and can do so by making a formal request of OPTIMUM HEALTH OUTCOMES, L.L.C staff.

OPTIMUM HEALTH OUTCOMES, L.L.C wants to work with you to find solutions to problems when they happen. We seek solutions that both you and the agency find satisfactory.

You, your family, your guardian, or primary caretaker have the right to appeal if you are not satisfied with the service or decisions made by an OPTIMUM HEALTH OUTCOMES, L.L.C staff member. The worker will make every effort to resolve your problem. In the event that a solution is not found, you or your representative may file a written grievance.

The written grievance should contain the following information:Name of Staff Member Date of Occurence

Explanation/Details of Greivance Desired Outcome

The written grievance should be given to the worker's Supervisor. It may be emailed at optimumhealthoutcomes@outlook.com or delivered to 5104 N Orange Blossom Trail. St 220 Orlando, FL 32810.

The supervisor will try to find a solution that is acceptable to you. If a solution is not found, the supervisor of the program will send the grievance to the Chief Executive Director for final decision. The decision of the Chief Executive Director is final and shall be in writing.

If the services you receive are being paid by a government contract, the funder will be notified of the filing of a grievance. They will also be notified of the outcome. Implementation of this procedure does not prevent OPTIMUM HEALTH OUTCOMES, L.L.C from taking any necessary action to protect an individual from physical or mental harm, neglect or abuse.

You may also submit your complaint to the Department of Children’s and Families Substance Abuse and Mental Health Office at 407-317-7010.

As required by the Privacy Regulations Promulgated Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR IDENTIFIABLE HEALTH INFORMATION.

PLEASE REVIEW THIS NOTICE CAREFULLY.

OUR COMMITMENT TO YOUR PRIVACY: Our organization is dedicated to maintaining the privacy of your identifiable health information. In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and privacy practices concerning your identifiable health information. By law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

2.Payment. Our organization may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your identifiable health information to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your identifiable health information to bill you directly for services and items.

3.Health Care Operations. Our organization may use and disclose your identifiable health information to operate our business. As examples of the ways in which we may use and disclose your information for our operations, our organization may use your health information to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice. Some health care operations services provided in our organization are through contracts, referred to as business associate agreements. To protect your health information, we require the business associate to appropriately safeguard your information.

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

1. Public Health Risks. Our organization may disclose your identifiable health information to public health authorities authorized by law to collect information for the purpose of:

Maintaining vital records, such as births and deaths.

Reporting child abuse or neglect.

Preventing or controlling disease, injury, or disability.

Notifying a person regarding potential exposure to a communicable disease.

Notifying a person regarding a potential risk for spreading or contracting a disease or condition.

Reporting reactions to drugs or problems with products or devices.

Notifying individuals if a product or device they may be using has been recalled.

• of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information.

Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect

Notifying your employer under limited circumstances related primarily to workplace injury or illness or

2.Health Oversight Activities. Our organization may disclose your identifiable health information to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions, civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

3.Lawsuits and Similar Proceedings. Our organization may use and disclose your identifiable health information in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your identifiable information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

 

4. Law Enforcement. We may release identifiable health information if asked to do so by a law enforcement official:

Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement.

Concerning a death we believe might have resulted from criminal conduct.

Regarding criminal conduct at our offices.

In response to a warrant, summons, court order, subpoena or similar legal process.

To identify/locate a suspect, material witness, fugitive or missing person.

• identity or location of the perpetrator

In an emergency, to report a crime (including the location or victim(s) of the crime, or the description,

5.Serious Threats to Health or Safety. Our organization may use and disclose your identifiable health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

6.Military. Our organization may disclose your identifiable health information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities.

7.National Safety. Our organization may disclose your identifiable health information to federal officials for intelligence and national security activities authorized by law. We also may disclose your identifiable health information to federal officials in order to protect the President, other officials, or foreign heads of state, or to conduct investigations.

8.Inmates. Our organization may disclose your identifiable health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary:

(a) for the institution to provide health care services to you; (b) for the safety and security of the institution, and/or; (c) to protect your health and safety or the health and safety of other individuals.

9. Workers Compensation. Our organization may release your identifiable health information for workers’ compensation and similar programs.

E. YOUR RIGHTS REGARDING YOUR IDENTIFIABLE HEALTH INFORMATION

You have the following rights regarding the identifiable health information that we maintain about you:

 

4. Law Enforcement. We may release identifiable health information if asked to do so by a law enforcement official:

Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement.

Concerning a death we believe might have resulted from criminal conduct.

Regarding criminal conduct at our offices.

In response to a warrant, summons, court order, subpoena or similar legal process.

To identify/locate a suspect, material witness, fugitive or missing person.

• identity or location of the perpetrator

In an emergency, to report a crime (including the location or victim(s) of the crime, or the description,

5.Serious Threats to Health or Safety. Our organization may use and disclose your identifiable health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

6.Military. Our organization may disclose your identifiable health information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities.

Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your

5. “accounting of disclosures” is a list of certain disclosures our organization has made of your identifiable health information. In order to obtain an accounting of disclosures, you must submit your request in writing to , Privacy Officer, Community Health Centers, Inc., 110 South Woodland Street, Winter Garden, Florida 34787, phone 407-905-8827. All requests for an “accounting of disclosures” must state a time period, which may not be longer than seven (7) years and may not include dates before April 14, 2003. The first list you request within a 12- month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our organization will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures”. An

6. practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice contact the Receptionist or a Manager at the Health Center.

Right to a Paper Copy of this Notice. You are entitled to receive a paper copy of our notice of privacy

7. written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the same reasons described in the authorization. Please note, we are required to retain records of your care. Most uses and disclosures of psychotherapy notes, uses and

Right to Provide an Authorization for other Uses and Disclosures. Our organization will obtain your

disclosures of protected health information for marketing purposes, and disclosures that constitute a sale of protected health information, require authorization.

8. complaint with our organization or with the Secretary of the Department of Health and Human Services. To file a complaint with our organization, contact , Privacy Officer, Optimum Health Outcomes, L.L.C. 5104 N. Orange Blossom Trail. Orlando, FL 32810. Phone number 407-394 7181. To file a complaint outside our organization contact, Secretary, U.S. Department of Health and Human Services, 200 Independence Avenue S.W., Room 509 F, HHH Building, Washington, D.C. 20201. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a written

Communicable diseases, sometimes called infectious diseases, are illnesses caused by organisms such as bacteria, viruses, fungi, and parasites. Communicable diseases may be transmitted from one person to another. Transmission may occur from one infected person directly to another, from an animal to a human, or from an inanimate object such as a doorknob to a person.

The State of Florida has over 90 diseases that are mandated by Florida Administrative Code to be reported to the local County Health Departments. Sexually transmitted diseases or infections (STD/STI) are among the most common of reportable diseases. STD/STI’s spread from person to person through sexual contact.

Human body fluids (cerebrospinal, peritoneal, synovial, pleural, pericardial, amniotic fluid, semen, vaginal secretions) Other body fluid visibly contaminated with blood i.e. saliva, vomit All body fluids where it is difficult to differentiate between body fluids i.e. emergency response situation

Other reportable diseases include:

Human immunodeficiency virus (HIV) ~ AIDS Hepatitis B virus (HBV) ~ Hepatitis B Hepatitis C virus (HCV) ~ Hepatitis C Malaria Syphilis Brucellosis

Clients of OHO are responsible for telling their OHO Staff member if they have a reportable disease during client assessment.

To have your rights to confidentiality and privacy respected and upheld within the limits of the law, and to obtain your agreement before information is given to another agency or person outside OPTIMUM HEALTH

To know that your record may be reviewed for quality and compliance and that persons from the Council on Accreditation, program staff and funder staff also may review your record.

To participate in setting up and reviewing your service plan.

To understand rules and conditions related to OPTIMUM HEALTH OUTCOMES, L.L.C stopping services.

To refuse services, unless law or court order has limited your rights, and to be informed of what will happen if you refuse.

To file a grievance and to be given a copy of the OPTIMUM HEALTH OUTCOMES, L.L.C consumer grievance procedure.

To be honest in giving information that is requested by OPTIMUM HEALTH OUTCOMES, L.L.C in order to be accepted for service and set up a treatment plan.

To comply with all OPTIMUM HEALTH OUTCOMES, L.L.C rules, policies and requests.

To work towards treatment plan goals.

To respect the privacy/confidentiality of others receiving services.

To not behave in any way that threatens or endangers another person and to understand that such activity could cause OPTIMUM HEALTH OUTCOMES, L.L.C to stop services.

To promptly pay agreed upon fees or other charges.

Please read and discuss these Consumer Rights and Responsibilities with a OPTIMUM HEALTH OUTCOMES, L.L.C STAFF, and take this time to ask questions. When you are satisfied that you understand your rights and responsibilities, please sign the receipt form offered by the OPTIMUM HEALTH OUTCOMES, L.L.C worker to indicate you have received the OPTIMUM HEALTH OUTCOMES, L.L.C Consumer Handbook.