As a program participant, you may choose to receive any of the above services. Bridges Healthcare will collect information on your clinical treatment through its electronic health record system. The data collected will help Bridges monitor your progress with treatment and health measures such as weight, body mass index and changes in mental health. Bridges will also work with the Medicaid authority to obtain data for things that aren’t collected through visits with other providers (encounter and claims data).
Additionally, we are conducting National Outcome Measures (NOMs) interviews with as many people as possible to learn about experiences with this new initiative. An interview specialist from Bridges’ Program Evaluation Team may reach out to you to ask if you would like to participate. This interview is completely voluntary, and should you choose to complete it, you may skip any question that you do not wish to answer. Your information will not be disclosed to any outside parties except for the Substance Abuse and Mental Health Services Administration, unless you were to report any instances of abuse or neglect. All data will be collected and reported in such a way that no one person could ever be identified. No names or identifying information will be used.
By signing below, you agree to receive services through the CCBHC project. This consent will expire two years from the date of signature below. You may revoke your participation in writing and submit it to your nurse care manager at any point or be discharged from the program if you feel you have fully benefitted from the services provided. Revoking participation WILL NOT affect enrollment in any other Bridges’ services (clinic, community support services, social rehabilitation…).