Your rights
Respect and fair treatment
- To be treated with dignity and respect, in a safe setting free from abuse, neglect, exploitation and harassment.
- To receive care without discrimination, as our Nondiscrimination Notice describes.
- As a Medicaid client, to receive the same scope, quality and manner of care as every other client.
Your clinician
- To be told in writing, before your first session, your clinician's name and license, including whether your clinician holds a limited license (LLMSW) and so practices under the supervision of a licensed master's social worker. You may ask for the supervisor's name. A supervisor's review of your care stays confidential.
Your care
- To clear information, in words you understand, about your diagnosis, your treatment choices, their likely benefits and risks and what to expect, and to ask questions at any time.
- To give informed consent before treatment begins and to help create and review your treatment plan. A parent or guardian consents for a child or teen.
- To refuse or stop any treatment and to have the possible effects explained.
Your privacy and its limits
- To privacy, and to the privacy rights our Notice of Privacy Practices lists. Our clinicians are licensed by the State of Michigan, and Michigan law gives extra protection to what you tell them.
- To be told the limits of privacy before treatment begins. We share information without your permission only when a law requires it and Michigan law allows it. The main limits:
- Abuse or neglect. We must report suspected abuse or neglect of a child, or of an adult who cannot protect themselves, to the State of Michigan immediately. This includes a teen who started therapy on their own. If a report about an adult concerns you, we tell you, unless your clinician believes that would put you at risk of serious harm.
- A threat to hurt someone. If you tell your clinician of a threat of physical violence against a person who can be identified, and you appear to have the intent and ability to carry it out in the foreseeable future, Michigan law requires your clinician to act to protect that person, such as by arranging hospital care or by warning the person and telling the police.
- A serious risk that you will harm yourself. If the risk is serious and immediate, your clinician may contact emergency services, a crisis team or a person you have named, to help keep you safe. You name that person, and agree to this, at intake. For teens, see below.
- Courts and other laws. Without your written permission, we release information on a subpoena or other legal demand only when a judge orders it or another law requires it, such as a state child-protection caseworker's written request, and only what is required. Other uses, such as billing your health plan with the consent you give at intake, are in our Notice of Privacy Practices.
Children and teens
- A parent or legal guardian must consent before we treat anyone under 18. The exceptions are a legally emancipated minor, who consents as an adult, and a teen we agree to see on their own (below).
- Under 14. The clinician may keep some of what a child says private, using professional judgment, and explains to parents at intake what they will usually hear. Parents can still ask to see their child's records.
- 14 and older. At intake we ask each parent or guardian to sign an agreement that the teen's sessions are private. We then share what a teen tells us with a parent or guardian only through a release the teen signs that says exactly what will be shared. The exceptions are disclosures the law requires and a serious risk that the teen will harm themselves, when the clinician may tell the parent or guardian.
- What a paying parent receives. Without the teen's signed release, a parent or guardian who consented and pays receives only what is needed to arrange and pay for care: appointment times they help arrange, and estimates and bills listing services, dates and charges, with no diagnosis or clinical detail. Insurance statements come from the health plan and may show a diagnosis code.
- Seen without a parent. Michigan law lets a teen 14 or older receive limited outpatient care without a parent's consent, for up to 12 sessions or 4 months, whichever comes first, and the parent does not pay. We do not tell a parent without the teen's consent, unless the clinician finds a compelling need because of a substantial probability of harm, and then the clinician tells the teen first. Our Clinical Director decides each request case by case, and the clinician explains the limits first.
Your records
- To see and get a copy of your records, including billing records, and to ask us to correct them, as our Notice of Privacy Practices explains. Whatever our answer, you may add your own written statement to your record.
Fees and payment
- To know our fees, how payment works and how cancellations work before services begin, and to get a Good Faith Estimate if you have no insurance or choose not to use it.
- We do not charge for missed or late-cancelled appointments.
- As a Medicaid client, to have Medicaid's payment, including a Medicaid health plan's, accepted as payment in full.
- With Medicare: to ask in writing for an itemized statement of Medicare-paid services, which we send within 30 days; as a Qualified Medicare Beneficiary, not to be billed Medicare deductibles, coinsurance or copays; and with Original Medicare, to get an Advance Beneficiary Notice before a service Medicare is expected not to pay for.
- If you start the federal dispute process for a self-pay bill, we pause collection and late fees on that bill and take no action against you for disputing it.
Language help, disability aids and service animals
- To an interpreter, a sign language interpreter or another aid, free of charge, when you or a parent, guardian or companion needs one to communicate with us. You never have to bring or pay for your own interpreter. Our Free Language Help and Disability Aids notice explains how to ask.
- To bring a service animal to the office. An emotional-support animal is not a service animal.
Telehealth
- To consent before your first telehealth session, to the same standard of care as in person and to stop a session and ask for an in-person appointment. Telehealth is available only while you are physically in Michigan, and when it is right for your care.
A different clinician, ending services and concerns
- To ask for a different clinician, or a referral, at any time. We offer another clinician when one is available and suitable, or help you find a referral.
- To end services at any time. If we end services, to be told why, to get referrals and, in a crisis, to be connected with crisis or higher-level care first.
- To raise a concern, with us or an outside agency, without retaliation. You do not have to use our process first, and nothing we ask you to sign gives up your right to complain to an agency. If a concern leads to a change in your care, we explain why, and the reason will never be your complaint. Our How to Raise a Concern notice explains the steps.
Your responsibilities
We ask you to:
- give complete and accurate information, and tell us when your contact details, insurance or (for parents and guardians) custody, guardianship or protective orders change
- take an active part in your care, and tell us if something isn't working
- give as much notice as you can to cancel or reschedule, and tell us ahead, when you can, if you need an interpreter or another aid
- for telehealth, join from a private place in Michigan, tell your clinician where you are at the start of each session and tell us ahead if you will be away
- keep a service animal under your control, treat staff and other clients with respect and meet the payment arrangements you agreed to.
In a crisis or emergency, call or text 988, call 911 or go to the nearest emergency room. Text, email and voicemail are not crisis services.
How to reach us
Personal Courage, LLC, 2040 Raybrook St. SE, Suite 300, Grand Rapids, MI 49546
Phone: 616-287-3218 (relay users dial 711). Fax: 616-239-2820. Email: admin@findyourpersonalcourage.com
Regular text and email may not be secure, so please do not send health details that way.