AERC Client Handbook

Clients who receive services through the ACCESS Evaluation and Resource Center (AERC), along with their families, must abide by the policies and procedures outlined below. If you have questions about any of these items, please contact the Director of Clinical Services.

Welcome

Welcome to ACCESS! We are excited you have chosen to become part of our ACCESS family. At ACCESS, we maintain a commitment in providing the best possible quality of care to every client. We strive for extraordinary results and offer state-of-the-art, innovative services for the clients we serve. We are committed to delivering a warm, friendly atmosphere and a person-centered service delivery model. Thank you for the opportunity to live out our mission with you and your family.

Our Mission

Expanding individual potential through innovative instruction.

Our Services

The ACCESS Evaluation and Resource Center provides a variety of outpatient mental health services to individuals seeking help for their emotional health and wellbeing. Services vary in type and level of intensity, depending on an individual’s need. Services include:

  • Comprehensive Diagnostic Interview
  • Person-Centered Treatment Planning
  • Individual and Group Therapy
  • Family Therapy
  • Psychiatric Evaluation and Medication Management
  • Crisis Intervention
  • Mental Health Extended Services (Case Management)
  • Psychological Evaluation
  • Psychoeducation

Eligibility

Clients referred for mental health services will receive a comprehensive diagnostic assessment by a Licensed Mental Health Professional. This assessment will include an interview with the client, interview with the parent/guardian when applicable, and clinical observation of behaviors. If therapy services are indicated, the Licensed Mental Health Professional will complete an individualized treatment plan with client and/or caregiver input. All services provided must be medically necessary. In addition, a prior authorization may be required for some services. If a prior authorization is required, ACCESS will obtain that authorization before those services may be provided. If additional services are recommended during the comprehensive diagnostic assessment, the Licensed Mental Health Professional will refer the client and their legal guardian when applicable to the admissions department for further assistance.

Clients that are ages birth to 18 may meet criteria established for Seriously Emotionally Disturbed (SED) if they are currently or at any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the DSM-5-TR and this disorder has resulted in functional impairment which substantially interferes with or limits the client’s role or functioning in family, school, or community activities.

Clients that are ages 18 and over may meet criteria established for Serious Mental Illness (SMI) if they are currently or at any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the DSM-5-TR and this disorder has resulted in functional impairment which substantially interferes with or limits the client’s role or functioning in one or more major life areas.

Individualized Treatment Planning

Each client who qualifies for services will have an individualized treatment plan which includes goals and objectives to be addressed. Each client’s treatment plan will be reviewed and updated every 180 days. The client’s Mental Health Professional will work in partnership with the client and/or parent/guardian to ensure that their input is included in the treatment goals established. In addition, client and/or parent/guardian input and evaluation of progress is required when completing treatment plan reviews in order to maximize success in treatment.

Appointments

The ACCESS Evaluation and Resource Center is open Monday-Friday from 7:30 am to 5:30 pm. Being on time and not missing scheduled appointments is absolutely critical to successful treatment. Clients or their legal guardians should contact the office as soon as they realize they will be late to an appointment or have become ill and are unable to attend. With notice, the therapist will wait for up to 15 minutes for the client to arrive. If the client is more than 15 minutes late, they will have to wait until the next scheduled appointment to be seen. If the client is more than five minutes late without notification, they will have to wait until the next scheduled appointment to be seen. Five late arrivals in a six-month timeframe may result in a discharge from services. Appointment cancellations must be made at least 24-hours in advance. Four unexcused absences in a six-month timeframe may result in a discharge from services.

Funding/Fees

ACCESS receives reimbursement for services from Medicaid, TEFRA, Private Insurance, and Private Pay. ACCESS will file with the client’s insurance for services rendered, however, this does not guarantee that the insurance company will pay for the services. If a client has private insurance, this insurance will be billed as primary. Any remaining balance will then be billed to Medicaid/TEFRA if applicable or invoiced to the client and/or parent/guardian. Fees are payable at the time services are rendered. When co-payments are applicable, they are payable at the time of services.

If the client is relying on Medicaid/TEFRA funding, it is the responsibility of the client and/or parent/guardian to ensure the status remains active. If Medicaid/TEFRA is inactive, the client and/or parent/guardian may be held responsible for the charges generated for services rendered. If funding remains inactive and/or services are unable to be paid for privately, then clients may be discharged and referred to another provider.

Third party payments such as Medicaid, TEFRA, and Private Insurance may be denied based on the policies or rules of their governing agencies.

Inclement Weather Policy

In case of inclement weather, clients should listen to local broadcasting for closings, late arrival or early dismissal. The broadcasting will be listed as ACCESS. ACCESS will also post this information at AccessGroupInc.org and on the ACCESS Facebook page. When ACCESS is closed due to weather, all offices will be closed, and outpatient services will be cancelled.

Check-In Process

Clients will be required to check in with the front office for assessment and therapy sessions. The mental health professional will meet their client in the lobby and will accompany them to the treatment area. For minor children, parents are allowed to leave during their child’s therapy only if they are accessible by phone and can return on time.

Behavior Management and Expectations

ACCESS believes in building positive relationships with clients. When people are paid attention to, they feel validated and important, which in turn builds trust and decreases negative behaviors. Employees use positive approaches to engage clients in working together to maintain a safe environment. When stressful situations occur which do result in negative behaviors, ACCESS staff are trained to address the behaviors using de-escalation strategies. If these strategies are not effective, an individualized behavior management plan may be developed. ACCESS does not allow physical and/or verbal abuse of staff, clients, or families.

The ACCESS Evaluation and Resource Center does not perform therapeutic holds as part of its behavioral management program.

Client and/or Parent/Guardian Involvement and Input

Client and/or Parent/Guardian involvement is a vital part of the ACCESS Mental Health program. When treatment is provided to minor children, ACCESS requires each parent/guardian to be an active participant in the treatment provided. Because one of ACCESS’ goals is to support and enhance the family and client, we offer involvement opportunities frequently. These opportunities include, but are not limited to, the following:

  • Admissions and Assessment Process: These processes begin during the first contact with ACCESS. Admissions Coordinators serve as Program Coordinators and will assist clients and/or their families with all the possible services and/or programs which may be available. During this process, services may include standardized testing, as well as information gathering for clients regarding medical and social history. It is extremely important that ACCESS receives accurate information since this information will help determine whether a potential client qualifies for the enrollment process.
  • Enrollment Process: During this process, clients and/or parents/guardians are encouraged to become acquainted with ACCESS staff, particularly with the treatment team members assigned to provide services. ACCESS team members are eager to learn about each client’s interests and needs.
  • Individualized Treatment Planning: Each client has an individualized treatment plan which includes goals and objectives to be addressed. Each client’s treatment plan will be reviewed and updated every 180 days. The client’s Mental Health Professional will work in partnership with the client and/or parent/guardian to ensure that their input is included in the treatment goals established. In addition, client and/or parent/guardian input and evaluation of progress is required when completing treatment plan reviews in order to maximize success in treatment.
  • Family Therapy Services: If a minor child receives mental health services through ACCESS, family involvement will be a mandatory part of treatment. This is completed by participating in monthly family therapy sessions.
  • Providing Feedback: Clients and/or parents/guardians are encouraged to give staff constructive feedback at any time and to discuss any problems with therapists and/or Program Directors.
  • Satisfaction Surveys: Satisfaction surveys will be emailed when first enrolled, at random times during enrollment, at discharge, and at post discharge. These are optional, but feedback is very important and will help ACCESS to continuously improve services.
  • Suggestion Boxes: Each campus maintains a suggestion box. Please feel free to make suggestions/comments by filling out the form and placing it in the suggestion box. Input is valuable to ACCESS.
  • Parent Workshops and Family Events: ACCESS occasionally hosts community and/or parent workshops, family events, demonstrations, and discussion groups. These programs serve to reinforce the partnership between clients/families and ACCESS staff. They also offer opportunities to provide input into ongoing quality improvement activities, meet other parents/guardians, develop a much-needed support system, and learn more about the services provided by ACCESS.
  • Educating the Community About ACCESS Programs and Services: This is accomplished through sharing with friends, family, doctors, and others in the community. Visitors are welcome and can be provided with organization information.

Medications

ACCESS only prescribes medications as a part of a client’s treatment as it relates to the plan of care for the ACCESS Evaluation and Resource Center mental health program. The AERC mental health program does not control or perform medication administration. Staff or clients/families who feel that a client may benefit from an appointment with the psychiatrist should discuss with their Mental Health Professional. Depending on the psychiatrist’s schedule and the urgency of the client’s needs, the appointment will either be scheduled at the AERC or may be referred out for consultation regarding medication management.

Court Services

Unless specifically contracted to do so, in writing prior to the first scheduled appointment, ACCESS’s mental health staff will not make custody recommendations regarding clients, even if therapy services have been provided to all parties involved in the divorce. In the event an ACCESS mental health staff member is requested to produce his or her records, give a deposition or attend court to provide testimony, there will be a legal retainer fee of $2,000 charged per day, per staff person, payable in advance. This includes, but is not limited to, any type of court trials (including divorce or custody cases), depositions, mediations, etc. This fee will be charged to the client or their guardian even if another attorney, without client or guardian authorization, subpoenas any mental health staff member regarding records or testimony. This fee must be paid prior to the staff member’s appearance in court.

Advance Directives

ACCESS believes in the right for individuals who are their own legal guardian to make decisions for themselves. One important area in which a client exercises independence is in choosing the mental health treatment received. Unfortunately, clients may become unable to make informed choices about their care in an emergency situation. These choices can be made ahead of time by utilizing an advance directive. Advance directives are documents that enable a client to make decisions now about their mental health care in the future. They offer guidance to their family and doctors when they cannot speak for themselves and help to assure that their values and important wishes are carried out. If a client wishes to have an advance directive, they may communicate with their Mental Health Professional to initiate this process.

Confidentiality

ACCESS is dedicated to maintaining privacy of client health information as protected by law, including the Health Information Portability and Accountability Act (HIPAA). In efforts to do so, ACCESS strictly prohibits clients and/or parents/guardians from audio or video recording of any mental health therapy or testing session without all parties expressed written consent.

In conducting business, ACCESS creates client records regarding the treatment and services provided. By federal and state law, ACCESS must follow the terms of the notice of privacy practices that are in effect. The ACCESS policy on client confidentiality includes the following:

  • All information in client records is classified as confidential.
  • No information from the client record is to be released, except as permitted by regulation or unless proper authorization to do so is received from the client (who is their own legal guardian) or legal guardian.
  • All requests for release of information must be made in writing.
  • There may be a charge for copies of records sent to other agencies.
  • Clients and/or parents/guardians have a right to review the contents of client records. ACCESS reserves the right to schedule a time for such a request.
  • All records are stored in a secure area and protected from the use of or review by unauthorized individuals. An ACCESS employee cannot release information that did not originate within our organization. (Some information from outside sources may be released to our Medicaid’s designated Quality Assurance organizations or other payor sources when required for prior authorization, payment for services, or in the event of an audit).

Proper authorization to release information from a client’s records shall be received as a written document containing all of the following information:

  • Client name and date of the request;
  • A description of the information to be released and why the recipient requires it; and
  • A signature from the client (who is their own legal guardian) or the legal guardian each time information is requested.

Clinician Supervision/Interns

ACCESS mental health professionals are subject to supervision as required by regulatory and accrediting agencies. This supervision will include a review of client private health information and discussion of client specific case information.

Additionally, ACCESS may utilize interns as a part of the treatment process. Documentation completed by unlicensed graduate interns will be reviewed by the clinical supervisor assigned to that intern. As part of the intern’s graduate training program, anonymous case information may be discussed in class at the intern’s university.

Professional Conduct

ACCESS employees are held to a strict Ethical Code of Conduct which governs their practices in providing services, billing, and general behavior. This Ethical Code of Conduct is available for review upon request. All potential employees are screened through the interview process and by obtaining professional references from previous employers. Upon hire, employees receive background checks through numerous agencies including state and federal criminal databases, the Arkansas Child and Adult Maltreatment Registries, national sex offender database, and the Office of the Medicaid Inspector General. Additionally, any employee who drives on behalf of ACCESS has his/her driving record reviewed periodically through the Department of Motor Vehicles.

Drug-Free Policy

ACCESS is committed to providing a drug-free environment which is safe for client growth and learning. While ACCESS recognizes the need for compassionate treatment of those addicted and seeking help, the policy of not using drugs/alcohol at any time while on campus must be upheld.

Weapons

Because of a commitment to a safe environment for clients and staff, ACCESS prohibits weapons on campus. Serious consequences for violation of this policy will be strictly enforced. If services are being provided in a client’s home or other community-based setting, ACCESS requires that weapons be secured in a locked gun cabinet or safe. Services may be discontinued if this policy is not followed.

General Safety

First aid kits are available at the front desk, near the entrance of the ACCESS Evaluation and Resource Center, and near the therapist offices. First aid kits will be present in the vehicle any time employees transport clients. Fire exits and fire extinguishers are located throughout the building. “Evacuation routes” are posted in each treatment area and in the front office at each campus. As always, in the event of an emergency, dial 911.

Mandated Reporting

All ACCESS employees are considered mandated reporters of any suspected child or adult mistreatment. Staff members who have reasonable cause to suspect a client is being abused or neglected shall immediately report this to the appropriate Maltreatment Hotline. This number is posted at each campus.

Transition and Discharge Planning

The concept of completion of services should be considered at admission or shortly thereafter. Transition planning provides information regarding the services that ACCESS can provide to address areas of concern. This planning also facilitates ongoing discussion of the anticipated steps of treatment and ways to ensure a smooth transition from services when indicated. Transition from services can occur for a number of reasons, including a planned discharge or a move to a different program or service.

Whenever possible, the Mental Health Professional and the client and/or parent/guardian will jointly plan for discharge of services. Discharge occurs when the client and/or family:

  • Completes the identified goals and objectives or is otherwise ready to discontinue services;
  • Needs a different level of service or intensity of care;
  • Needs a different type of service;
  • No longer wants to receive services at ACCESS;
  • No longer meets eligibility criteria;
  • Refuses to meet program standards or requirements;
  • Has needs that exceed ACCESS’ resources; or
  • Has court involvement and the court approves closure for mandated services.

Transition planning shall be developed with the input and participation of:

  • The client, when age-appropriate;
  • The parent/guardian and/or other legally authorized representative, when applicable;
  • ACCESS Mental Health Professionals;
  • The referral source, when appropriate and permitted; and/or
  • Other community services or supports, when appropriate and permitted.

For all clients leaving services, a written discharge summary is completed which summarizes treatment progress. This summary will help ensure continuity of care and will provide a baseline which may be helpful for future service providers. ACCESS will provide assistance in locating other treatment options as needed. Clients and/or parents/guardians will receive a discharge survey which requests feedback on service satisfaction, as well as providing an opportunity to report any regression or need for reassessment.

Expectations for Legally Required Appointments, Sanctions, or Court Notifications

Occasionally, clients are required to attend services through a court or other department. In those cases, Mental Health Professionals have the responsibility to notify the referral source of a client’s progress and participation in treatment. This may require that a consent form be completed prior to the notification

Restriction of Services

ACCESS will not restrict, reduce, or suspend services for any client or family in need except under the following conditions:

  • The client presents with a health condition that requires suspension of services until proper medical care has been established.
  • The client’s guardianship is challenged. In these cases, treatment may be suspended until legal documentation is received establishing guardianship.
  • The client or family member is under the influence of drugs and/or alcohol or is exhibiting threatening behavior. Services may resume when the client or family member presents in an acceptable manner and agrees in writing to maintain proper behavior and self-control.
  • The client or family fails to follow through with payment according to the signed financial agreement. Services may resume when the account is made current.
  • The client does not meet the requirements for enrollment.
  • The client does not meet age requirements.
  • ACCESS does not have a required written prior authorization to treat the client from the designated payor source.
  • The client does not have a required prescription and/or referral from the Primary Care Physician.
  • The client and/or parent/guardians have not provided ACCESS with all documents and/or signatures required for enrollment or continued enrollment.
  • The client, parents/guardians, or other involved family members are unable or unwilling to comply with ACCESS’ established policies and procedures, including requirements for family involvement in the client’s treatment process or follow-up on recommended services.
  • It is determined that services are not medically necessary.

Grievance and Appeal Procedures

It is ACCESS’ desire and policy to give equal and sincere attention to any and all questions, concerns, conflicts, complaints, or other issues brought to our attention regarding our clients or their services. While we will make every effort to resolve all concerns quickly and fairly, in the event that an issue cannot be resolved, clients and their guardians have the right to use the following procedures in order to file a grievance or to appeal if a decision regarding their grievance is not acceptable.

Client Rights and Responsibilities

  • To follow these procedures in order to resolve issues in an efficient and timely manner.
  • To be willing to communicate openly in order to resolve the issue.
  • To have all information necessary to follow these procedures provided to them.
  • To have these procedures explained in a manner that is understandable to the client or their legal guardian. This may
    include, but is not limited to, a thorough and clear explanation of each step and its requirements, or the use of an interpreter or other assistive methods as needed in order to ensure a complete understanding of this important process.
  • To seek an outside advocate or legal advice at any time during this process.

Our Rights and Responsibilities

  • To follow these procedures in order to resolve issues in an efficient and timely manner.
  • To be willing to communicate openly in order to resolve the issue.
  • To provide to our clients any forms or information necessary to complete this process.
  • To explain this process in a manner that is understandable to the client and their legal guardian. This may include, but is not limited to, a thorough and clear explanation of each step and its requirements or the use of an interpreter or other assistive methods as needed in order to ensure a complete understanding of this important process.
  • To welcome any advocates or other representatives that the client may use during this process.

Filing a grievance will not result in any action taken against a client, their guardian, family members, or representatives, nor will it cause treatment to be reduced, withheld, or terminated.

We encourage families to first meet with the involved staff to attempt to resolve any concerns or complaints that arise. If staff have been unable to resolve an issue or problem involving any part of the client’s care to their satisfaction, they have the right to file a formal grievance. The Grievance Form may be obtained from the back of this booklet, from the information binder in the lobby on either ACCESS campus, or by request of any employee in our organization.

The company organizational chart is located in the binder in the lobby on either ACCESS campus. This chart may be consulted for an outline of the staff members and their respective supervisors.

How to file a written grievance:

  • The initial grievance should be submitted in writing to the appropriate Program Director, using the Grievance Form. If a client or their legal guardian is unable or unwilling to complete this form, a staff member or the Program Director, will complete the form on their behalf. Clients are encouraged to keep a copy of their written grievance for their records. The Program Director will investigate the grievance as quickly as possible, and you will be provided with a written response within ten working days of the Director’s receipt of your grievance. If the Program Director is part of the concern, you have the right to submit the written grievance directly to ACCESS’ Client Grievance Officer.
  • At any point during the grievance process, you may choose to involve the Client Grievance Officer to discuss the grievance and provide a neutral platform for seeking a resolution.
  • If you are not satisfied with the response and/or decision, you have the right to appeal to the Client Grievance Officer. This should be done in writing by using a new Grievance Form so that any additional or new information may be included. Refer to the organizational hart for the name of ACCESS’ Client Grievance Officer. Forms may be turned into to the front desk or may be mailed directly to the Client Grievance Officer at 10618 Breckenridge Drive, Little Rock, AR 72211.
  • Once received, the Client Grievance Officer will respond to your appeal in writing within ten working days, and a resolution will be determined. The Client Grievance Officer will include others in this process, including, but not limited to, the Executive Director. You will receive written confirmation of the resolution with 10 additional working days.
  • If you are not satisfied with the resolution, you may request a review of the appeal determination by ACCESS’ Board of Directors. The Board of Directors will review and respond in writing within 60 calendar days.
  • If the client and legal guardian is not satisfied with the decision made by the Board of Directors, or at any time during this process, they may consult an attorney for legal advice or one of the following agencies for information regarding further appeals and advocacy services:
    • Arkansas Department of Human Services: 501-682-8292
    • Division of Provider Services and Quality Assurance: 501-682-8551
    • Court Appointed Special Advocates: 1-866-284-8111
    • Arkansas Legal Services: 501-376-3423 or 1-800-952-9293 (Toll-free hotline)
  • During this process, we will use the following methods to resolve the issue:
    • Assistance in finding advocacy services if requested;
    • Fact gathering by members of the administration or designated staff members in order to ensure the accuracy of all information;
    • Meetings scheduled with appropriate staff members, including the Program Director, Client Grievance Officer, Executive Director, ACCESS Board members, family members, outside advocates, and/or legal representation in order to gather information and discuss solutions;
    • Policy review, in order to ensure that proper procedures have been and are followed and/or that our current policies are adequate; and/or
    • Other methods as deemed appropriate to ensure timely and thorough resolutions.
  • Not every problem can be resolved to everyone’s total satisfaction, but only through understanding and discussion of mutual problems can we develop confidence in each other. This confidence is important and is the foundation of a trusting relationship.

Clients and their legal guardians may request copies of the mental health agency regulations and/or the outpatient mental health services regulations in writing at any time. We will provide these copies within 15 days of receipt of the written request.

AERC Grievance Form For Students, Clients, Parents/Guardians, and Visitors