Client Rights and Privacy Practices

The Ashtabula County Mental Health & Recovery Services Board (MHRS Board) requires each service provider agency to appoint a Clients’ Rights Officer and alternate to be available to discuss concerns from consumers, family members, or advocates regarding adherence to the following list of consumer’s rights. In addition, the MHRS Board appoints a Clients’ Rights Officer for the system and has an established protocol for responding to concerns. If you would like further information, contact the MHRS Board Clients’ Rights Officer at 440-992-3121.

Each person who receives services from a provider certified by the Ohio Department of Mental Health and Addiction Services has the following rights:

(1) The right to be treated with consideration and respect for personal dignity, autonomy, and privacy;

(2) The right to reasonable protection from physical, sexual, or emotional abuse, neglect, and inhumane treatment;

(3) The right to receive services in the least restrictive, feasible environment;

(4) The right to participate in any appropriate and available service that is consistent with an individual service plan (ISP), regardless of the refusal of any other service, unless that service is a necessity for clear treatment reasons and requires the person’s participation;

(5) The right to give informed consent to or to refuse any service, treatment, or therapy, including medication absent an emergency;

(6) The right to participate in the development, review, and revision of one’s own individualized treatment plan and receive a copy of it;

(7) The right to freedom from unnecessary or excessive medication, and to be free from restraint or seclusion unless there is an immediate risk of physical harm to self or others;

(8) The right to be informed and the right to refuse any unusual or hazardous treatment procedures;

(9) The right to be advised and the right to refuse observation by others and by techniques such as one-way vision mirrors, tape recorders, video recorders, television, movies, photographs, or other audio and visual technology. This right does not prohibit an agency from using closed-circuit monitoring to observe seclusion rooms or common areas, which does not include bathrooms or sleeping areas;

(10) The right to confidentiality of communications and personal identifying information within the limitations and requirements for disclosure of client information under state and federal laws and regulations;

(11) The right to have access to one’s own client record unless access to certain information is restricted for clear treatment reasons. If access is restricted, the treatment plan shall include the reason for the restriction, a goal to remove the restriction, and the treatment being offered to remove the restriction;

(12) The right to be informed a reasonable amount of time in advance of the reason for terminating participation in a service, and to be provided a referral, unless the service is unavailable or not necessary;

(13) The right to be informed of the reason for denial of a service;

(14) The right not to be discriminated against for receiving services on the basis of race, ethnicity, age, color, religion, gender, national origin, sexual orientation, physical or mental handicap, developmental disability, genetic information, human immunodeficiency virus status, or in any manner prohibited by local, state or federal laws;

(15) The right to know the cost of services;

(16) The right to be verbally informed of all client rights, and to receive a written copy upon request;

(17) The right to exercise one’s own rights without reprisal, except that no right extends so far as to supersede health and safety considerations;

(18) The right to file a grievance;

(19) The right to have oral and written instructions concerning the procedure for filing a grievance, and to assistance in filing a grievance if requested;

(20) The right to be informed of one’s own condition; and,

(21) The right to consult with an independent treatment specialist or legal counsel at one’s own expense.


In Ohio’s behavioral health system, concerns or complaints are addressed through the grievance process. Grievance is an important right for people receiving mental health and substance use services. This process supports recovery and assures people are heard. It also empowers individuals receiving services to become self-advocates and provide input to make the system better for everyone.

A grievance can be filed by the individual receiving the services, by an agency on behalf of the individual, or by any other person involved. Concerns or complaints may be addressed either informally or formally.

The Mental Health and Recovery Board encourages a first attempt to resolve all complaints and grievances be made at the lowest and most direct possible level, in the environment where the situation occurred.

Informally Resolving Grievances

People receiving public mental health and/or substance use services have the right to informally discuss their concerns and complaints. Explaining the situation to a staff member or a client rights officer often resolves the issue.

Formally Resolving Grievances

People receiving public mental health and/or substance use services also have the right to have their concerns and complaints heard formally through the written grievance process. In addition, they have the right to oral and written instructions for filing a grievance. Every mental health and substance use provider must have a person whose job it is to help file grievances. According to Ohio law, service providers must post the grievance procedure in a place where it is easily seen and make copies available to clients when requested.

Appealing a Decision

The decision about a grievance is called a resolution. If someone is not satisfied with the decision or answer, he or she can appeal. An appeal is a request for a review of the answer.

To appeal an agency’s answer to your grievance, contact the Ashtabula County’s Mental Health and Recovery Services Board at 440-992-3121 and ask to speak to the Client Right’s Officer.  Discuss the grievance you have and if you want to file an appeal to the agency’s answer to your grievance. If you are not satisfied with their response, you can appeal their decision to the Ohio Department of Mental Health & Addiction Services (OhioMHAS) using the instructions below.

To appeal a hospital or mental health board’s answer to your grievance, contact OhioMHAS’s Community Supports and Clients Rights Office (CAP) or call  877-275-6364 (family and consumers only), 614-466-7228 (all others), TTY (888) 636-4889.

Health Insurance Portability and Accountability Act (HIPAA)

The following information is available for you to understand how your medical information may be used and disclosed and how you can access your medical information as required by the Health Insurance Portability and Accountability Act.



Effective: September 23, 2013


If you have any questions about this Notice, please contact:

Kaitie Hart, Privacy Officer
Ashtabula County Mental Health & Recovery Services Board
4817 State Road, Suite 203
Ashtabula, Ohio   44004


At the Ashtabula County Mental Health & Recovery Services Board, we understand that health information about you and your health is personal.  We are committed to protecting your health information and safeguarding that information against unauthorized use or disclosure.

When you receive services paid for in full or part by the Ashtabula County Mental Health & Recovery Services Board, we receive health information about you.  The information we receive may include, for example, eligibility, claims, and payment information.  We create a record of your enrollment in Ohio’s public mental health and addiction services system and maintain that record and records related to the services you receive in the public system and payment for those services.  We may also receive information from your treatment provider related to your diagnosis, treatment, progress in recovery, and any major unexpected emergencies or crises you may experience to help MHRS Board plan for and improve the quality of services paid for with MHRS Board funds.

We are required by law to 1) maintain the privacy of your health information; 2) give you notice of our legal duties and privacy practices with respect to your health information; 3) abide by the terms of the Notice that is currently in effect; and 4) notify you if there is a breach of your unsecured health information.  This Notice will tell you about the ways in which we may use and disclose your health information.  It also describes your rights and certain obligations we have regarding the use and disclosure of your health information.


We may use or share your health information for such activities as conducting our internal board business known as health care operations, paying for services provided to you, communicating with your healthcare providers about your treatment, and for other purposes permitted or required by law, as described in more detail below.

Payment– We may use or disclose your health information for payment activities such as confirming your eligibility, paying for services, managing your claims, conducting utilization reviews, and processing health care data.

Health Care Operations –We may use your health information for our internal health care operations such as to train staff, manage costs, conduct quality review activities, perform required business duties and make plans to better serve you and other community residents who may need mental health or substance abuse services.  We may also disclose your health information to health care providers and other health plans for certain health care operations of those entities such as care coordination, quality assessment, and improvement activities, and health care fraud and abuse detection or compliance, provided that the entity has had a relationship with you and the information pertains to that relationship.

Treatment – We do not provide treatment, but we may share your health information with your health care providers to assist in coordinating your care.

Other Uses and Disclosures – We may use or disclose your health information, in accordance with specific requirements, for the following purposes:  To alert proper authorities if we reasonably believe that you may be a victim of abuse, neglect, domestic violence or other crimes; to reduce or prevent threats to public health and safety; for health oversight activities such as evaluations, investigations, audits, and inspections; to governmental agencies that monitor your services; for lawsuits and similar proceedings; for public health purposes such as to prevent the spread of a communicable disease; for certain approved research purposes; for law enforcement reasons if required by law or in regards to a crime or suspect; to correctional institutions in regards to inmates; to coroners, medical examiners and funeral directors (for decedents); as required by law; for specialized government functions such as military and veterans activities, national security and intelligence purposes, and protection of the President; for Workers’ Compensation purposes; for the management and coordination of public benefits programs; to respond to requests from the U.S. Department of Health and Human Services; for us to receive assistance from business associates that have signed an agreement requiring them to maintain the confidentiality of your health information; and for the purpose of raising funds to benefit MHRS Board.

If you have a guardian or a power of attorney, we are also permitted to provide information to your guardian or attorney in fact.

Fundraising Activities – We may also use your health information to contact you to raise money as part of fundraising efforts, such as for assistance in passing levies. You have the right to opt-out of receiving such communications by notifying us, at the address below, that you do not wish to be contacted for such purposes.


We are prohibited from selling your health information, such as to a company that wants your information in order to contact you about their services, without your written permission.

We are prohibited from using or disclosing your health information for marketing purposes, such as to promote our services, without your written permission.

All other uses and disclosures of your health information not described in this Notice will be made only with your written permission.  If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose your health information for the reasons covered by your written permission.  We are unable to take back any disclosures we have already made with your permission.


If we use or disclose your health information for underwriting purposes, we are prohibited from using and disclosing any genetic information in your health information for such purposes.


If any state or federal privacy law requires us to provide you with more privacy protections than those described in this Notice, then we must also follow that law in addition to HIPAA.  For example, drug and alcohol treatment records generally receive greater protections under federal law.


You have the following rights regarding your health information:

  • Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for purposes of treatment, payment, and health care operations and to inform individuals involved in your care about that care or payment for that care.    We will consider all requests for restrictions carefully but are not required to agree to any requested restrictions.*
  • Right to Request Confidential Communications.   You have the right to request that we communicate with you about health matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.
  • Right to Inspect and Copy.  You have the right to request access to certain health information we have about you.  Under certain circumstances we may deny access to that information such as if the information is the subject of a lawsuit or legal claim or if the release of the information may present a danger to you or someone else.  We may charge a reasonable fee to copy information for you.*
  • Right to Amend.  You have the right to request corrections or additions to certain health information we have about you.  You must provide us with your reasons for requesting the change.
  • Right to an Accounting of Disclosures.  You have the right to request an accounting of the disclosures we make of your health information, except for those related to treatment, payment, our health care operations, and certain other purposes, such as if the information is the subject of a lawsuit or legal claim or if release of the information may present a danger to you or someone else.  Your request must state the period of time desired for the accounting, which must be within the six years prior to your request. The first accounting is free, but a fee will apply if more than one request is made in a 12-month period.*
  • Right to a Paper Copy of Notice.  You have the right to receive a paper copy of this Notice.  This Notice is also available on our website:, but you may contact us to obtain a paper copy.

To exercise any of your rights described in this paragraph, please contact the MHRS Board Privacy Officer at the address or phone number listed below:

Kaitie Hart, Privacy Officer
Ashtabula County Mental Health & Recovery Services Board
4817 State Road, Suite 203
Ashtabula, Ohio   44004

* To exercise rights marked with a star (*), your request must be made in writing.  Please contact us if you need assistance with your request.


We reserve the right to change this Notice at any time.  We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future.  We will post a copy of the current Notice at the MHRS Board Office and on our website at:  Each Notice will contain an effective date on the first page in the top center.  In addition, each time there is a change to our Notice, we will mail information about the revised Notice and how you can obtain a copy to the last known address we have for you in our plan enrollment file.


If you believe your privacy rights have been violated, you may file a complaint with MHRS Board or with the Secretary of the Department of Health and Human Services.  To file a complaint with the MHRS Board, contact the Privacy Officer at the address above.  We will investigate all complaints and will not retaliate against you for filing a complaint.

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