Program Rules
• Please be on time for appointments with BCFS HHS Staff.
• Call the center at least 24 hours ahead of time if you are not able to keep an appointment.
• Please Do Not bring weapons (firearms, explosives, knives or sharp objects of any kind), illegal drugs, synthetic drugs, street drugs, drug paraphernalia, over the counter drugs, prescribed drugs, herbs or alcohol at the center.
• Our centers are SMOKE FREE BCFS HHS CSD facilities.
• Please do not bring chewing tobacco, shisha, and nicotine gum, vapes, electronic and green cigarettes into BCFS HHS CSD facilities.
• Please leave all bags, backpacks, purses, satchels etc. in lockers located in the reception area, prior to entering transition center.
• Please respect all BCFS Property, do not damage or break any equipment.
• No cursing, disrespectful, or foul language allowed in the transition center.
• Please respect all BCFS Staff, visitors, and transition center guest.

 

Consequences
• You will be asked to leave the center and our appointment will be canceled and postponed.
• Your guardian/placement will be informed of the violation.
• Repeated violations of the rules listed above can result in your discharge from the program.
• If necessary a call to Security or Local Police Dept. will be made for assistance.

BCFS Health and Human Services
San Antonio Transition Center
4346 NW Loop 410
San Antonio, Texas 78232

Hello and welcome to San Antonio Transition Center. We encourage you to read this information carefully. We have provided information about your rights and responsibilities as a client receiving services at our center. Please ask any questions about the information below or about any other concerns you may have.

CONFIDENTIALITY:
It is important for us that you understand your rights to confidentiality. Discussions with your case manager, intake coordinator, or any other representative with our agency will remain confidential. We will not discuss your case with anyone outside our agency without your permission. Legal and ethical guidelines, however, require the sharing of information with other professionals when incidents of threat to self or others and/or abuse has been disclosed. This includes, but is not limited to, child, spousal, and elderly abuse. Also, should your records be subpoenaed by the court, we are required to oblige by these requests.

DESCRIPTION OF SERVICES:
We provide a wide range of services to include support groups, mentoring, education and vocation assistance, and counseling. Please speak with your case manager about other services which interest you and we may be able to connect you with appropriate resources.

Clients are also welcomed to simply visit our center during business hours to use the computer, rest between appointments, or even watch television.

GRIEVANCES:
In order to provide you with the best quality services, we invite you to share your perception about the work we do with you. If, at any time, you would like to file a formal complaint about services, please ask any staff member for a Grievance Report Form. You are free to report your concerns about any of our staff members or policies used at the Transition Center. Your grievance report will remain confidential to the extent possible. Furthermore, we understand that clients may also want to transfer to a case manager from one he or she has been originally assigned. It is your right to be able to do so and we will honor that right.

CLIENT RESPONSIBILITIES:
Our staff will be as dedicated as you are in your effort to successfully transition into independent living. It is your responsibility to follow-through with service plans you develop with your case manager. If you feel that a service plan is not appropriate for you at any point, it is your duty and right as an adult to discuss changes you believe may be more effective for you.

FINANCIAL AGREEMENT:
Although clients must meet certain eligibility requirements, our clients will not be charged for services offered through our center. The quick reference sheet you were given is an overview of the benefits you may be eligible for.

HOURS OF OPERATION & EMERGENCY SERVICES:
The San Antonio Transition Center is open from 8:30 a.m. to 5:30 p.m. Monday through Friday. While our hours are normally set during the week we can accommodate after hours and weekend appointments, if needed. The best way to ensure a meeting with your case manager/counselor/facilitator is to schedule an appointment. In addition, you are asked to contact your case manager if you will be late for or need to cancel a scheduled meeting.

TERMINATION OF SERVICES
The Transition Center serves young adults from ages 14 to 25 years of age. As a client, you always have the right to terminate services with the Transition Center at any time. We hope, however, to create with you a lasting sense of support that positively influences your transition into independent living.

 

I have read, understand, and discussed with the Youth Advocate the rights and responsibilities outlined in this document. I understand that I can ask questions about my rights and the services offered through the Transition Center at any time. I also understand that I can terminate services at any time.

This form will be utilized in the event that BCFS HHS ConnectED program has to reach out to 3rd party in order to advocate on your behalf. 

1. I understand that, unless withdrawn, this authorization will expire at discharge from program. A photocopy of this form will be considered as valid as the original.

2. I understand that I may revoke this authorization at any time by notifying BCFS, in writing, and this authorization will cease to be effective on the date notified except to the extent action has already been taken in reliance upon it.

3. I understand that information used or disclosed pursuant to this authorization may be subject to re-disclosure by the recipient and no longer be protected by federal privacy regulations. However, other state or federal law may prohibit the recipient from disclosing specially protected information, such as substance abuse treatment information and mental health information.

4. I understand that my refusal to sign this Authorization will not jeopardize my right to obtain present or future treatment for psychiatric disabilities except where disclosure of the information is necessary for the treatment.

5. My mental health care and or services will not be affected if I do not sign this form.

6. I understand that I can request a copy of this form after I sign it. 

I, _(sign below)____ request BCFS HHS to provide professional services to achieve the goals I have set with my Youth Advocate.

CONFIDENTIALITY
The privacy and confidentiality of our sessions are extremely important to BCFS HHS. Statements provided below should be viewed as an extension of the information provided in the Notice of BCFS Practices to Protect the Privacy of Your Health Information and the Professional Services Acknowledgment Form.

BCFS HHS client information is entered into a secure database for data collection purposes and is monitored by funding or oversight agencies. BCFS HHS service providers have access to the same documentation system containing client information however, each provider holds an ethical obligation to refrain from viewing any unassigned client information without client’s permission.

Consent for media release, transportation, releases of liability and information may be revoked in writing by the person who gave authorization. If not earlier revoked, this consent shall terminate in one year from the above date without written notice.

1. COMPLAINTS
If you have any complaints or questions, please contact the office Director. Should you feel further assistance is needed, you may contact a Program Director, Noel Martinez at (210) 246-3309. You may also submit a grievance form provided by BCFS HHS.

2. OFFICE POLICIES
BCFS HHS requests the courtesy of a 24-hour advance notice of cancellation of an appointment, if you are unable to attend. After 30 days if you have been unable to contact and/or not attended scheduled appointments, your case will be closed. If you return within 90 days of case closure your services will be resumed.

3. HOURS OF OPERATION AND EMERGENCIES

Mon – Fri 8:30am – 5:30pm
Advocate/Case Managers at BCFS HHS are not crisis counselors. The Advocate/Case Managers are not available for immediate client emergencies or crises. If in a crisis and need help immediately, please proceed to your nearest emergency hospital for evaluation or dial 911 or contact the Program Director at (210) 246-3309

National Suicide Prevention Hotline 1 (800)273- TALK (8255)
Texas Runaway Hotline 1 (888) 850- HELP (4357)
Information and Referral 2-1-1
Texas Foster Youth Justice Project 1 (877) 313-3688
Resiliency Through Healing (18 – 24yo): 1-800-295-7884

In addition, your assigned youth advocate may not work weekends, from time to time will take vacations, or may be absent due to training, family emergencies, etc. Due to the nature of the job, your assigned youth advocate is not always available and therefore another staff member for the ConnectEd program will assist. For any emergency issues please utilize the hotline.

In the event that your youth advocate becomes incapacitated and cannot practice, all client files and records will be stored with and can be accessed by the remaining BCFS HHS youth advocate or other authorized BCFS HHS staff. All client files and records of any BCFS HHS youth advocate, are the responsibility of BCFS HHS.

Your signature below means that you have read and agree to participate in ConnectED services voluntarily, without force.

Furthermore, your signature means that you understand all of the information in this documents and hold harmless all entities for legal, financial, and/or other compensation for results which do not meet your stated expectations.

I have read, understand, and have been advised by a ConnectEd representative concerning the contents of this document.
I hereby grant my permission for all services list above.

Client Rights

1. You have the right to accept or refuse services.
2. If you agree to services, you have the right to change your mind at any time.
3. You have the right to a humane environment that provides reasonable protection from harm and appropriate privacy for your personal needs.
4. You have the right to be free from abuse, neglect, and exploitation.
5. You have the right to be treated with dignity and respect.
6. You have the right to appropriate services in the least restrictive setting available that meets your needs.
7. You have the right to be told about the program rules and regulations before you are enrolled, including the rules and policies related to restraints and seclusion.
8. Your legally authorized representative, if any, also has the right to be and shall be and shall be notified of the rules and policies related to restraints and seclusion.
9. You have the right to be told before admission:       
   • The services you are eligible for.
   • The proposed plan of action for services.   
   • The risks, benefits, and side effects of all services, if applicable.       
   • The probable health and mental health consequences of refusing services, if applicable.       
   • The other services that are available and which ones, if, any, might be appropriate to you       
   • The expected length of services.
10. You have the right to a service plan designed to meet your needs, and you have the right to take part in developing that plan.
11. You have the right to meet with staff to review and update the plan on a regular basis.
12. You have the right to refuse to take part in research without affecting your regular care.
13. You have the right to have information about you kept private and to be told about the times when the information can be released without your permission.
14. You have the right to receive an explanation of your services or your rights if you have questions while you are an active participant.
15. You have the right to make a complaint and receive a fair response from the organization within a reasonable amount of time.
16. You have the right to complain directly to the Executive Director or the funder (Department of Family Protective Services, Bexar County Juvenile Probation, etc…) at any reasonable time. The funder information will be provided directly to you upon request.
17. You have the right to get a copy of these rights before you are start services, including the address and phone number of BCFS HHS Executive Director – Community Services.
18. You have the right to have your rights explained to you in simple terms, in a way you can understand within 24 hours of your intake.

Inquiries & Grievance Contacts:
By Mail:
Celeste Garcia, BCFS HHS Executive Director
BCFS Health and Human Services, CSD
4346 NW Loop 410
San Antonio, TX. 78229

The Privacy Act of 1974 establishes practices to help ensure the confidentiality of individuals and their personally identifiable information. For the Healthy Marriage and Responsible Fatherhood (HMRF) programs, this means that HMRF program staff will offer all clients the opportunity to review a description of their privacy rights at enrollment to the program, before taking client surveys, and when personal information is requested during service contacts. Following is the description of privacy rights for all clients in HMRF programs. Please raise any questions you have about your rights with HMRF program staff.

Thank you for participating in this program. Throughout the program we will ask you to provide information so that we can better support you and to help monitor the program’s performance. We hope you will answer all the questions asked by program staff or in surveys, but you may skip any questions you do not want to answer. Your answers will be kept private as required by law.

PRINCIPAL PURPOSE: The information you provide will be used primarily to (a) provide you with services, (b) monitor and help improve the performance of Healthy Marriage and Responsible Fatherhood (HMRF) programs, and (c) help understand HMRF services and participants across programs.

ROUTINE USES: Your information will be kept private and cannot be used against you in any law enforcement action. Your information may be combined with information from other individuals, but you will not be personally identifiable. However, there may be circumstances where disclosure of your personal information may be requested; in these cases, processes are in place to further protect your information for such requests. These requests may include: (a) by a congressional office if you ask that office to help obtain a copy of your records; (b) to coordinate and respond to a data security breach; (c) for research or evaluation purposes; (d) for administrative or legal actions; or (e) by contractors supporting the purpose and uses described here, but only on a must know basis in order to perform their duties. Please see the sources below for more information about these routine uses.

DISCLOSURE: This request is voluntary. The relevant SORN is 09-80-0361, OPRE Research and Evaluation Project Records.

AUTHORITY: 42 U.S.C. 613 - Research, evaluations, and national studies; 42 U.S.C. 628b - National random sample study of child welfare; 42 U.S.C. 1310 - Cooperative research or demonstration projects; 42 U.S.C. 9836 - Designation of Head Start agencies; 42 U.S.C. Subchapter II-B - Child Care and Development Block Grant; and Pub L. No. 110-161, Division G, Title II, Payments to States for the Child Care and Development Block Grant (121 STAT. 2179).

THIS NOTICE DESCRIBES HOW MEDICAL/MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date of Compliance: April 26, 2019

I. Use and Disclosures for Treatment, Payment, and Health Care Operations

BCFS Health and Human Services provides counseling and case management services for mental health needs and creates and maintains treatment records that contains individually identifiable health information, herein referred to as protected health information (PHI). These records, known as medical records or mental health records and this notice concerns the privacy and confidentiality of those records and the information contained therein.

State and federal laws allow BCFS Health and Human Services to use or disclose your PHI for treatment, payment, and other health care operation purposes with your consent. Providing treatment services, collecting payment and conducting healthcare operations are necessary activities for quality care. Your signature on the acknowledgement form indicates your consent for such use.

II. Uses and Disclosures Requiring Authorization

If BCFS Health and Human Services needs to use or disclose PHI for purposes other than treatment, payment, and health care operations, we must obtain your authorization before releasing information. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. You may revoke all such authorizations of PHI at any time, provided each revocation is in writing and we have not already released the information. 

 

III. Use and Disclosures Not Requiring Authorization or Consent

You may be required or permitted to disclose your personal health information (e.g., your mental health records) without your written authorization. The following circumstances are examples of when such disclosures may or will be made:

• Abuse and/or Neglect: If there is disclosure of or suspected abuse or neglect of a child, an adult who iselderly, or disabled, we must make a report to the Texas Department of Protective and RegulatoryServices.

• Serious threat to Health or Safety: If we determine that there is a serious threat to your health or safety, orthe health and safety of others, we may disclose relevant confidential mental health information to medicalor law enforcement personnel.

• Judicial or Administrative Proceedings: If information about you is requested as part of a court proceeding,such information may be privileged under state law, and we will not release information without yourwritten authorization, unless ordered by the court.

• Health Oversight: If a complaint is filed against us with a state licensing board, they may have the authorityto subpoena confidential mental health information relevant to that complaint. If funding or oversightagencies monitor our programs, they may have access to confidential information as it relates to theirmonitoring.

• Worker’s Compensation: If you file a worker’s compensation claim, we may disclose records relating toyour diagnosis and treatment to your employer’s insurance carrier.

 

IV. Client’s Rights

• Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosuresof protected health information about you, and we will honor your request if possible.

• Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – Youhave the right to request and receive confidential communications of PHI by alternative means andalternative locations. For example, you may request we send mail correspondence to another address.

• Right to Inspect and Copy – You have the right to inspect or obtain a copy of PHI in our mental healthand billing records used to make decisions about you for as long as the PHI is maintained in the record.We may deny your access to PHI under certain circumstances, and on your request, we will discuss withyou the details of the request and denial process. This right to inspect and copy is not absolute – in otherwords, BCFS Health and Human Services is permitted to deny access for specified reasons. For instance,you do not have this right of access with respect to “psychotherapy notes.” The term “psychotherapynotes” means notes recorded (in any medium) by a health care provider who is a mental health professionaldocumenting or analyzing the contents of conversation during a private counseling session or a group,joint, or family counseling session and that are separated from the rest of the individual’s medical (includesmental health) record. The term excludes medication prescription and monitoring, counseling session startand stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and anysummary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis,and progress to date.

• Right to Amend – You have the right to request an amendment in writing of PHI for as long as the PHI ismaintained in the record. We may deny your request. If the provider has an electronic health recordssystem capable of fulfilling the request, your records must be provided to you no later than the 15thbusiness day after you submit your written request. Once you have made such a request, the provider orhealth plan must respond and if they do not agree with your requested corrections, must notify you inwriting and explain why your request was denied. You have the right to submit a statement ordisagreement that the provider or plan must add to your record.

• Right to Accounting – You generally have the right to receive an accounting of the disclosures of PHI forwhich you have neither provided consent nor authorization (as described in Section III of this notice). Onyour request, we will discuss with you the details of the accounting process.

• Right to a Paper Copy – You have the right to obtain a paper copy of this notice upon request.

 

V. BCFS Health and Human Services Duties

• We are required by law to maintain the privacy of PHI and to provide you with a notice of our legal dutiesand privacy practices with respect to PHI.

• We reserve the right to change the privacy practices described in this notice. Unless we notify you of suchchanges, however, we are required to abide by the terms currently in effect.

• If we revise our practices, we will provide you with a revised notice by mail or in person at your nextscheduled meeting.

 

VI. Complaints

• If you are concerned that we have violated your privacy rights, or you disagree with a decision we have about access to your records, you may contact Celeste Garcia, Executive Director, 1-800-830-2246. You may file a complaint with Texas Health and Human Services Commission by calling 2-1-1 or 877-541-7905 (toll-free). If you are hearing or speech impaired, you may call 7-1-1 or 800-735-2989
  (TTY).

• You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, Region VI, 1301Young St., Suite 1169, Dallas, TX 75202. You can call 800-368-1019 (toll-free), fax 214-767-0432 or visit www.hhs.gov/ocr/privacy/hipaa/complaints. If you are hearing or speech impaired, you may call 800-537-1697 (TTY).