1 21Days2Change, LLC The Doorway to Change Family Welcome Guide Rev
3 Welcome To 21Days2Change, LLC We believe that you should have access to the best possible service within your own community. The information in this guide is meant to help you as you start services with our agency. While the information in the guide is helpful, it can also be difficult to read at times. We encourage you to contact the office any time if you need assistance clarifying any information located within this guide. The Guide contains not only information about our agency s practices and procedures, but has a family community resource listing for you to use to access resources within the community you may need. If you locate a resource within this guide that you feel would be helpful, but aren t quite sure how to access that resource, your therapist would be more than happy to assist you. We hope this guide will answer some of your questions regarding our services. Welcome! What is 21Days2Change, LLC? 21Days2Change, LLC is a private agency who provides counseling services to a wide variety of people within the community. The agency is committed to a high level of practice and only hires those professionals with experience and secured licensure. Mission: The doorway to a new perception, making the impossible possible one home at a time.
4 21 Days to Change, LLC Organizational Chart Board of Directors Operations Director Clinical Director Office Manager Clinical Staff: Team Leaders Counselors Quality Contro. Cord. Clerical Staff: Receptionist Billing Clerks Support Staff
5 What services are provided at 21Days2Change, LLC? Screening and Assessment Crisis Intervention Individual Counseling Family Counseling Prevention/Education Group Counseling Alcohol and Drug Referral Referrals Case Management This list is not inclusive and in the future, 21Days2Change hopes to add many more services to its agency. If you are need of any other type of service in the future, please feel free to contact the agency to see if that service has been updated. We expect to provide clients with excellent community services and continue to grow as an agency to meet the demands of the people within the community. What do services cost at 21Days2Change, LLC? At the current time, 21Days2Change, LLC accepts Medicaid and Sooner Care. Location: 21Days2Change, LLC is located at 3033 NW 63rd, Suite E-200 in The Jamestown Office Park. The office is available for services as scheduled. The office is located on the 2nd floor, has its own parking lot and has handicap parking places close to the front door. The building meets all handicapped requirements at this time. The office is equipped with a floor plan for the emergency exit, a First Aid Kit which is located in the main office and a Fire Extinguisher in the kitchen. Architectural: Even though we strive to have a hazard free environment, we have limited control on exterior features of our office building We have identified uneven cement pavers from the main parking lot. Sometimes these can be slick. Please use caution when entering our building.
6 Hours of Operation 21Days2Change, LLC open Monday through Friday, 8:00 a.m. to 4:00 p.m., with the exception of major Holidays. 21Days2Change, LLC is closed on the following holidays: New Year s Day (January 1st) Memorial Day (May) Independence Day (July 4th) Labor Day (September) Thanksgiving (November) Christmas (December 25th) After Hours Emergency Services The Therapist who has been assigned to your family for services should provide you with an after hours contact phone number in case of crisis. The following is a list of other emergency numbers that may be helpful in the event of an emergency. Oklahoma County Crisis Intervention Center: Oklahoma State Mental Health Hotline: (24 hours) Contact your local emergency room or call 911 in the event of a medical or psychiatric emergency Service Coordination After you complete the assessment process, you will be assigned to a primary therapist. The primary therapist is responsible for your service coordination. In the event of any issues communicating with your primary therapist, please contact Diane Holland, Clinical Director or James Hale, Operations Manager at
8 Assessment 21Days2Change, LLC must complete an assessment on each new person who shall receive services from the agency. The assessment was created in order to gather background information on you and your family that could be beneficial in knowing (such as allergies or medical conditions) and could be used during treatment services (such as past history, current stressors, etc.). The assessment process occurs in the beginning of the services, but the therapist will continually assess you and your family throughout services. Treatment Planning 21days2Change, LLC must complete a treatment plan as required by insurance providers. The treatment planning process is where you guide the way that your treatment is going to be provided. It allows you to list your problems, goals and objectives in terms that you can understand and in ways that the therapist can help you meet your personal goals. The treatment plan is submitted to your insurance company when services are requested and must be completed at a minimum of every six months. Changes to your treatment can be made at any time as services progress and there is a need for changes. Discharge The transition to discharge begins at the first session when you meet your therapist and complete the assessment. While the agency wants to be able to help you achieve your goals, we don t expect for you to be in therapy forever! The therapist will continue to work on your discharge plan with you as treatment progresses so that when the time comes, you are prepared for discharge and any referrals to other services that you may need are provided. You may discharge from the agency at anytime, but when possible, we ask that you work with your therapist to complete the discharge process. The therapist will complete a Discharge Form.
9 Follow Up Contact The agency also completes a follow up call to every family who discharges from our agency approximately three months after the discharge. The follow up contact occurs despite the reason for discharge and is completed to ensure your family is doing well and no new services are needed. Agency Termination Due to the nature of the services provided being home-based, the agency must ensure protection of its employees. If you or one of your family members exhibits the following behaviors, the agency will be forced to discharge you immediately but agrees to provide you with a referral to another agency so that you may continue your care. Continued verbal aggression towards staff Inappropriate sexual contact Destruction of staff or agency property Physical aggression towards staff Physical aggression towards one another during sessions when staff is present Uncontrolled animals in the home Threat of violence or harm either while in session or via the telephone Bringing a weapon of any kind into the agency Drug use in the space where sessions occur Drug related or gang related activity occurring in the home or in the close vicinity of the home where services occur Non-compliance with treatment If DHS opens an active investigation into individual or family actions, 21 Days reserves the right to terminate services so that 21 Days won t hinder further services from being provided by DHS. Service Restriction Any time the primary therapist feels it is necessary to do so, the therapist may impose restrictions on a person served due to behavior. The following would be acceptable restrictions made given certain behavior: Requiring services occur in the office as opposed to in the home Requiring services to occur in a public setting within a confidential area such as a local Department of Human Services office.
10 Readmission You may request readmission to the program if discharged or restricted by the above means. In order to request readmission or that restrictions be lifted, you must do so by calling or personally addressing the request with the Clinical Manager. The Clinical Manager will be responsible for reviewing the request with the treatment team and will make a decision to your request within fourteen (14) days. You will receive the decision in writing. Tobacco, Drugs and Weapons 21Days2Change, LLC forbids the possession of illicit drugs or weapons anywhere on the property. Prescription medications are allowed on the premises as long as they are kept in the original, child-proof containers and are kept out of the sight and reach of any other person on the premises. The agency is not responsible for storing, dispensing or collection any person s prescription drug medicine. 21Days2Change, LLC forbids the use of tobacco products in all locations where persons are served and all vehicles owned or operated by the agency. Clients who access the office for services are allowed to smoke in the permitted areas of the building only. Weapons are not allowed on the agency premises under any conditions. Should a staff member, client or any other person on site possess a weapon, the weapon should be confiscated if it does not pose a risk to staff or other clients. The decision on whether or not to call the police shall be made after staffing with one of the Directors or Managers. Seclusion and Restraint It is the policy of 21Days2Change, LLC NOT to seclude and/or restrain any person while in any service setting. If persons served are needing seclusion and restraint due to behavior, the agency staff or present therapist shall notify the authorities at once for assistance.
11 Sanctions/Incentives 21Days2Change, LLC does not impose sanctions or offer incentives of any value to its participants. Any gains or limitations received by persons who participate in services will only result from outside parties who have interest such as the courts, Department of Human Services, etc. Interventions provided by staff of 21Days2Change will be provided as necessary and shall be in the best interest of the person being served. Court Appearances 21Days2Change, LLC does not require its employees to appear in court on behalf of a client or family. While the agency encourages cooperation with court officials and systems, there is no guarantee that an independent contractor within the agency will provide continual court appearances for a person being served. It is expected that clients who completed a valid release of information can expect some type of communication to be made to the court on their behalf, most typically in writing. Financial Obligations Persons who receive services through 21Days2Change, LLC shall have to abide by the financial requirements of the agency. For those persons who have insurance coverage, you are required to contact the office immediately should insurance coverage change in any manner. You as a client are responsible for payment of co-pays, deductibles and those services provided by the agency that are not covered by insurance. You will not be denied services due to your inability to pay and often times the staff will assist you in regaining your insurance benefits if a termination of coverage occurs. For those who are qualified for services by private pay, all services must be paid for up front in cash or money order. Personal checks will not be accepted by the agency. In the event that a financial arrangement must be made, arrangements must be made with the Business Manager.
12 What does confidentiality mean? It is the policy of 21Days2Change, LLC maintain all required confidentiality rules and regulations in the protection of protected health information. Confidentiality means that no one can obtain your personal information from 21Days2Change, LLC without your written permission. It means that no one employed by 21Days2Change, LLC can tell anyone anything you say or do in counseling, but will maintain a written file kept in the agency. The same confidentiality measures apply if you participate in a group setting. While others cannot release any information about you to anyone outside the group, you are not allowed under any circumstance to release any information pertaining to a fellow group member to anyone outside of the group as well. The limits to confidentiality There are some times when by law, a therapist must release your information to someone outside of the agency. The following are examples of when your information may be released without your written permission: There is the presence of clear and imminent danger to you or to others around you An emergency exists that requires medical treatment You make a threat to harm yourself or someone else You report that you have hurt or intend to hurt your children You report abuse by another party Electronic Communications Please keep in mind that communications via over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an can be intercepted and read by other parties besides the person to whom it is addressed. Please do not include personal identifying information such as your birth date, or personal medical information in any s you send to us. No one can diagnose your condition from or other written communications, and communication via our website cannot replace the relationship you have with a therapist or another healthcare practitioner.
13 Code of Ethics 21Days2Change, LLC operates under a written Code of Ethics that all staff members, employees, and contractors of the agency must adhere to in their relationships with persons served and other stakeholders. A written copy of the Code is given to all employees and can be requested by you in writing. Please address the written request to Diane Holland, Clinical Director. Grievance Procedure The following procedure must be used by any person who is receiving services at 21Days2Change, LLC who wishes to file a grievance with the agency: 1. If you have a grievance, you may discuss the complaint with your primary therapist. 2. If you and your primary therapist are unable to agree on a solution, you may present a written grievance to the Clinical Manager, Diane Holland. 3. The Clinical Manager will meet with you and the primary therapist, make a determination regarding your grievance and provide you with the results in writing, within fourteen (14) days of receiving your initial written grievance form. 4. If you are not satisfied with the result from the Clinical Manager, you may seek outside assistance from the Consumer s Advocate Office provided through the Oklahoma Department of Mental Health and Substance Abuse Services, Office of Advocate General. (405) The Office of the Advocate General will handle complaints and responses using their own procedural method. The agency and person served shall comply with the Advocate General s office and seek resolution of the grievance as quickly as possible. 6. Grievance Forms are available at all times and can be requested via mail, your primary therapist or any office staff during normal office hours.
14 Client Rights and Responsibilities As a client of 21Days2Change, LLC you have the right to Be treated with dignity and respect. Retain all rights, benefits, and privileges guaranteed by law except those lost through due process of law. Receive services suited to your condition in a safe, sanitary and human treatment environment regardless of your race, religion, gender, ethnicity, age, degree of disability, handicapped condition, sexual orientation or legal status. Never be neglected or sexually, physically, verbally or otherwise abused. Be provided with prompt, competent, appropriate treatment services and an individualized treatment plan. Be given the opportunity to participate in your treatment planning, and may consent or refuse to consent to the proposed treatment. With your permission, your family and/or significant others may be involved in your treatment and treatment planning. Have your records kept in a confidential manner. Refuse to participate in any research project or medical experiment without your informed consent, as defined by law. A refusal to participate in a research experiment will not affect the services available to you. Have the right to assert grievances with respect to alleged infringement on your rights. Request the opinion of an outside medical or psychiatric consultant, at your own expense, or request a new primary therapist be provided for an internal consultation at no cost. Not be retaliated against or subject to any adverse conditions or treatment services solely or partially because of having asserted your rights as stated above.
15 As a client of 21Days2Change, LLC you have the responsibility to... Participate in the planning of your treatment. Be courteous to other clients and staff. Be on time for all appointments. Provide a 24 hour notice for all cancelled appointments. Pay any required fee for your services at the time services are received. Notify your primary therapist as soon as possible of any changes in your demographic information such as name, address, phone number, insurance, etc. Ask questions about any part of your treatment plan that you do not agree with or understand. Notify your primary therapist if you need any special assistance to be able to participate in services. Notify your primary therapist if you wish to discontinue services. If you fail to attend an appointment or make contact with your therapist for more than thirty (30) days, you will receive written notification of discharge. Not carry weapons, illegal drugs, or alcohol onto the property of 21Days2Change, LLC Attend services Alcohol and Drug Free. Smoke only in designated smoking areas.
16 Client Satisfaction 21Days2Change, LLC has implemented routine surveys during treatment and follow up surveys during the year following treatment. These surveys allow 21Days2Change, LLC to access your opinion, suggestions and input on how services have been provided and can be improved. Follow up surveys will allow 21Days2Change, LLC to check on how you are doing at the end of treatment and will assist in measurement of the effectiveness and efficiency of 21Days2Change, LLC Treatment does not depend on your agreement to participate in random surveys. Participation is strictly voluntary and you are free to withdraw or decline at any time. We have included a Client Discharge Questionnaire for your convenience. Client Input In addition to surveys 21Days2Change, LLC encourages its participants to contact the Clinical Manger at any time for complaints/questions/ compliments, etc. Participants who wish to speak with the Clinical Manager may provide their contact information or remain anonymous with the exception of filing grievances. Benefits of Reducing Physical Risk Regular physical activity is one of the most important things you can do for your health. It can help: Control your weight Reduce your risk of cardiovascular disease Reduce your risk for type 2 diabetes and metabolic syndrome Reduce your risk of some cancers Strengthen your bones and muscles Improve your mental health Improve your ability to do daily activities and prevent falls, if you re an older adult Increase your chances of living longer Eliminate Alcohol and/or Drug use Reduce and eliminate smoking Reduce Stress
17 HIV/AIDS Testing 21Days2Change recommends HIV/AIDS testing, as well as other sexually transmitted diseases (STD) testing, to all consumers and consumers s significant other, especially those who are considered to be high risk. HIV is a virus which never leaves the body once it has been contracted. Many viruses stay in the body for only a few days but once a person has tested positive for HIV, he/she will always be positive. HIV actually stands for Human Immunodeficiency Virus and over time it infects and kills white blood cells which help the body fight off certain types of infections and cancers, leaving the body highly susceptible to other illnesses. Once HIV has progressed far enough that it effectively weakens the body and immune system, the carrier usually becomes ill from one of several infections, such as pneumonia or tuberculosis, that their body and immune system are no longer strong enough to fight. When the HIV virus has progressed this far it is called AIDS, which stands for Acquired Immune Deficiency Syndrome. The time it takes for HIV to progress into AIDS varies and may take up to 10 years or more. As is often the case with many sexually transmitted diseases, it is often impossible to tell if someone else has HIV and many carriers do not know that they are infected. Initial symptoms are non-specific, often resembling symptoms of common cold or flu viruses, and may include: Fatigue Fever Rash Headache Swollen lymph nodes Sore throat These symptoms are not a reliable way to diagnose HIV as they will only occur within days or weeks of the initial exposure. Testing for HIV antibodies is the only way to know whether you have been infected. The HIV antibody test only works after the immune system of the infected person has been able to develop antibodies. The window period between the initial infection and when antibodies are detectable may be from 2 weeks to 6 months. The average window period lasts about 3 months and standard HIV testing during this time is ineffective. It is
18 recommended that persons who test negative have additional testing in 6 months in order to rule out this window period and obtain an accurate result. Persons who are engaging in at risk behaviors are more likely to contract HIV and other sexually transmitted diseases than persons who are not. If you or your sexual partner(s) have engaged in any of the following behaviors you are at risk and should be tested. Any type of unprotected sexual contact Sex with an IV drug user History of STDs such as herpes, Chlamydia, gonorrhea or hepatitis. Unplanned pregnancy Victim of sexual assault Passed out after drinking or getting high or been unable to remember what happened Shared needles or other equipment which pierces the skin If you are interested in contacting confidential testing sites at which you and/or your significant other can receive testing for HIV/AIDS and other STDs as well as further education please contact your county Department of Human Services office. If you, your spouse, significant other, or other sexual partners would like to receive educational counseling sessions regarding HIV and other STDs then please notify your primary clinician. Oklahoma HIV/AIDS Hotline (TDD Available) National HIV/AIDS Hotline (TDD Available) CDC (Centers for Disease Control) National HIV/STD Hotline (TDD Available) Native American HIV/AIDS Hotline Spanish Language HIV/AIDS Hotline (TDD Available) STD National Hotline (TTY Available) Oklahoma State Medical Association: For access to Medical services including; testing, dental, medical case management and transportation
19 Family Community Resource Listing Medical Facilities Cedar Ridge:* 6501 N.E. 50 th, OKC, OK Child Study Center: 1100 N.E. 13 th, OKC, OK Deaconess Hospital: 5501 N. Portland, OKC, OK Deaconess Bethany:* 7600 N.W. 23 rd, OKC, OK Edmond Regional Medical Center: 1 S. Bryant, Edmond, OK Family Medicine Center: 900 N.E. 10 th, OKC, OK Griffin Memorial Hospital:* 900 E. Main, Norman, OK Integris Health Center: 3300 N.W. Expressway, OKC, OK Mary Mahoney Health Center: N.E. 36 th, OKC, OK Med Presbyterian:** Suite 700, Presbyterian Professional Building Mercy Health System: 4300 W. Memorial Road, OKC, OK Midwest City Regional Hospital:* 2825 Parklawn Drive, Midwest City, OK Norman Regional Hospital:* 901 N. Porter, Norman, OK
20 Oklahoma City Crisis Intervention Center:* 1200 N.E. 13 th, OKC, OK Oklahoma County Health Services:** 1025 Straka Terrace, OKC, OK Oklahoma County Pharmacy:** 7401 NE 23 rd, OKC, OK Oklahoma Youth Center:* th Ave NE, Norman, OK Red Rock Children s Unit:* 4400 N. Lincoln Blvd., OKC, OK Red Rock Adult Unit:* 900 Main Norman, OK Saint Anthony s Hospital:* 1000 N. Lee, OKC, OK Saint Anthony s South:* 2129 S.W. 59 th, OKC, OK SW Integris Hospital: 4401 S. Western, OKC, OK University Medical Center: * 800 N.E. 13 th, OKC, OK US Veteran s Medical Center:* 921 NE 13 th, OKC, OK Willow View, Integris:* 2601 Spencer Road Spencer, OK Key: *= Medical Facilities with Inpatient Mental Health Treatment Services **= Facilities that offer free/reduced cost prescriptions 24-Hour Toll Free Hotlines Alcoholics Anonymous: Reachout Hotline: (for assistance with issues related to mental health and substance abuse) The Gambling Helpline: (for assistance with problems of compulsive gambling) Teenline: TEEN (for young people looking for a concerned listener. NOTE: Teenline is not always staffed 24 hours per day, call for a current listing of staffed hours). Mobile Assessment Team:
21 Community Mental Health Services Moore Alcohol and Drug Center: 624 N.W. 5 th, Moore, OK Central Oklahoma Community Mental Health Center: 909 E. Alameda, Norman, OK Norman Alcohol Information Center: 215 W. Linn, Norman, OK Norman Alcohol and Drug Treatment Center: P.O. Box 151, Norman, OK A Chance to Change Foundation:* 5228 Classen Circle, OKC, OK Drug Recovery, Inc.: 415 N.W. 7 th, OKC, OK Eagle Ridge Institute: 601 N.E. 63 rd, OKC, OK Hope Community Services: 105 S.E. 15 th, OKC, OK Latino Community Development Agency: 420 S.W. 10 th, OKC, OK NorthCare Center: 6300 N. Classen, OKC, OK Red Rock Behavioral Health Services: 4400 N. Lincoln Boulevard, OKC, OK Referral Center: 1215 N.W. 25, OKC, OK Turning Point: 1607 S.W. 15 th, OKC, OK Youth Services for OK County, Inc.: 201 N.E. 50 th, OKC, OK Center for Positive Change: 1500 Professional Circle, Yukon, OK
22 Other Helpful Phone Numbers NAMT-OK Chapter: 500 N. Broadway, Suite 100, OKC, OK (National Alliance for the Mentally ill, for resources, support groups, etc.) Baptist Mission Center: 1215 Exchange Avenue, OKC, OK (free health clinic, must have an appt.) Baptist Community Clinic: 1201 N.W. 10 th, OKC, OK (free/reduced cost dental, medical and vision services) Care Point: 1200 N. Walker, Suite 500, OKC, OK (HIV/AIDS testing, counseling, referral, etc.) Catholic Charities: 1501 N. Classen Boulevard, OKC, OK Children s Hospital Clinic: 420 S.W. 10th OKC, OK (Pediatric services children newborn to age 18; accept Medicaid or no insurance, office visits for no insurance are $20.) City Church: 136 N.W. 10 th, OKC, OK (Free meals Mon. - Fri. 6:30 a.m. to 7:30 a.m.) Community Action Agency: 319 S.W. 25 th, OKC, OK (variety of social services, including housing, treatment, infant services, etc.) Crossing Community Church: N. Portland, OKC, OK (variety of community support services) Goodwill Industries: 410 S.W. 3rd OKC, OK (employment) Good Shepherd Ministries: 222 N.W. 12 th, OKC, OK (medical services) Grace Rescue Mission: 2205 Exchange Avenue, OKC, OK (Homeless shelter)
23 Healing Hands Health Care Services: 411 N.W. 11 th, OKC, OK (appointment preferred, homeless only) Infant Crisis Services: 1933 N.W. 39 th, OKC, OK (Infant supplies such as clothing, diapers, formula, etc.) Jesus House: 1335 W. Sheridan, OKC, OK (Homeless shelter) Neighborhood Services Organization: (multiple social services including housing and dental) Oklahoma Housing Finance Authority: (For Section 8 and low income housing applications) Oklahoma County Health Department: 921 N.W. 23 Street, OKC, OK (For WIC, immunizations, Venereal Disease testing, etc.) Parent s Assistance Center: 415 N.W. 5th Street, OKC, OK (For individual and group classes) Social Security Administration: Sunbeam Family Services: 616 N.W. 21 st, OKC, OK (Variety of family related social assistance) Salvation Army: 2041 N.W. 7 th, OKC, OK (Homeless shelter) Salvation Army: 501 S. Harvey, OKC, OK (food bank, clothing bank, utility assistance) Traveler s Aid & Homeless Assistance Center: United Way Helpline: Voc-Rehab:
24 Local Department of Human Services Offices Oklahoma County-Southwest Oklahoma County: 401 W. Commerce, OKC, OK Oklahoma County-Midwest: 9901 S.E. 29 th, MWC, OK Oklahoma County-Kelley: 2409 N. Kelley, OKC, OK Oklahoma County-Juvenile Justice: 5905 N. Classen Court, OKC, OK Oklahoma County-Children s Hospital: 940 N.E. 13th OKC, OK Oklahoma County-Juvenile Justice: 2409 N. Kelley OKC, OK Oklahoma County-Mayfair: 2821 N.W. 50 th, OKC, OK Oklahoma County-Rockwell: N.W. 10 th, OKC, OK Oklahoma County-Crossroads: 1115 S.E. 66 th, OKC, OK Cleveland County-Moore: 2507 N. Shields, OKC, OK Cleveland County-Norman: 631 E. Robinson, Norman, OK Cleveland County-Noble: 1600 N. Main, Suite 2, Noble, OK