Policies and Procedures
Initial Intake
A preliminary telehealth visit will be conducted to build a therapeutic client-provider relationship while evaluating symptoms, and history of presenting illness (HPI) for proper diagnosis and treatment. This includes prior medications, diagnosis, review of medical history, etc. We will discuss the prognosis and the client’s understanding of their mental health. At Nuture Mental Health (NMH) Services, we empower our patients and promote autonomy by displaying compassion, and empathy, nonjudgmental communication/interactions, involving you in the treatment planning of your health management through knowledge and skills, allowing you to ask questions and express your concerns, provide you with clear information regarding your condition and treatment options to make the best decision there is in regard to your well-being. At Nuture, we believe every patient is unique; hence, deserves special attention in receiving our services. During the first visit, an initial assessment also known as ” Psych Evals,” will be conducted to determine the client’s mental state and psychiatric care needs. This will take between 60 – 90 minutes. Follow-up visits will take about 30 to 60 minutes. In the event of a long-term plan, a routine schedule with your provider will be established for safe and efficient management of your condition. We will work with you to schedule future appointments at your convenience to monitor, determine, and deliberate on the effectiveness of your treatment plan i.e., medication tolerability, stabilization, psychoeducation, side effects, etc. An electronic payment method will be required on file to process copays and deductibles during the intake assessment.
Care Delivery Schedule and Times
At Nuture Mental Health Services we are open to Telehealth, and will soon expand into in-person sessions to serve our clients at their convenience where ever they are. However, during Telehealth services, your provider will not be able to conduct physical assessments such as vital signs ( Blood pressure, Height, weight, Heart rate, etc). Such assessments are basic indicators of health, it is crucial to be able to have these done regularly and report any concerns to your provider. Please be aware of these set times, as your provider may not be available to answer questions. For after working hours, holidays, and weekends, please call the crisis clinic at 1.866.4CRISIS (1.866.437.4747), As Nuture Mental Health Services does not have on-call coverage for emergent situations.
Health Monitoring and Collaboration of Care:
Your provider will request your consent to obtain collateral information, and release of information (ROI) for us to discuss issues relevant to your health and treatment with your primary care provider, psychotherapist, family or counselor, and all other relevant healthcare providers. We also request that you provide us copies of any relevant lab work results and investigative studies (electrocardiograms, CT scans, MRIs, sleep studies, etc.) ordered by other healthcare providers during our therapeutic relationship. This collaboration in care will allow your provider to provide care most safely and efficiently.
Emergency Situations:
An Emergency is a sudden unforeseen situation that poses an immediate risk to health, life, property, or environment and requires immediate action. These include medication adverse effects such as swelling of the tongue, severe rigidity, involuntary jerky movements, etc. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and we may only be able to offer palliative care for the aftermath. if you or someone you know is experiencing such please call 911 or go to the nearest emergency room immediately.
If you need consultation outside of an appointment ( medication side effects, increase in symptoms, etc.). please direct your questions to us via the email or phone number listed.
Email: info@nmhservices.org
Phone: (360) 649-4309
FMLA, disability, and other paperwork requests:
The Family and Medical Leave Act (FMLA) is administered by the Wage and Hour Division (WHD). The FMLA provides a means for employees to balance their work and family responsibilities by taking unpaid, job-protected leave for certain reasons. The Act is intended to promote the stability and economic security of families as well as the nation’s interest in preserving the integrity of families. When calamity befalls, or circumstance in which you find yourself impaired, or inability to function fully, you may be eligible to use FMLA or disability to provide support until functioning is returned. At Nuture Mental Health Services, we can provide support in securing the help you need to get back on your feet. However, the provider does not complete this paperwork for new clients, with whom the provider does not have an established therapeutic relationship. For individuals requesting this type of assistance, we require that you meet your provider at Nuture to discuss the specifics of your impairments. Please be advised completion of these documents may take up to 5 business days.
Cancellation Policy:
At Nuture we take pride in what we do. Meeting our client needs is our priority. Appointment times are reserved for individual purposes only. We do not double-book clients. We respect and value your time, in return, we ask that to be mutual. We request that you provide our office with a minimum of 24-hour notice if you are unable to make it to your appointment. Please call our office at 360-547-9947 for all scheduling needs. If there a is pattern of frequently canceled appointments ( giving 24-hour notice or not), we will bill you for canceling multiple appointments, and your provider may be unable to continue to provide services and reserve the right to cancel future appointments. We understand life happens, (illness, Parenting, Emergencies, etc) but rest assured we will do our best to work with you in every way we can.
Telehealth / Telemedicine
“Is the delivery of health care through technology such as mobile phones or computers. It can help reduce barriers to care for people who live far away from specialists or who have transportation issues”. This has been increasingly popular within the last years and is expected to grow in the future, as providers/clinicians are utilizing the use of remote clinical services. Examples include videoconferencing for consultations with specialists or transmission of patient or medical information between health care providers. Telehealth sessions at Nuture, we will be connecting using a system that is encrypted to the federal standard and HIPAA compatible. It is the responsibility of the providers to choose a secure location to interact with technology-assisted media and to be aware that family, friends, employers, co-workers, strangers, and hackers could either overhear our communications or have access to the technology that we are interacting with. Additionally, your provider agrees not to record any Telehealth session. During a Telehealth session, you and the provider could encounter a technological failure. The most reliable backup plan is to contact one another via telephone. Your provider will ensure that there is a phone available and that the phone number has been provided to you the client.
Controlled Substances
Current legislation (Ryan Haight Online Pharmacy Consumer Protection Act of 2008) prohibits me from prescribing controlled substances to patients through Telehealth. Several of these are used commonly in psychiatric care for ADHD, certain types of anxiety disorders, insomnia and to treat side-effects to other therapeutic agents used in this area of healthcare. For this reason, I do not treat or carry out ADHD testing via Telehealth. If you are looking for standard and first-line treatment for ADHD I recommend in-person office visits only. Having said this, there are non-stimulant/non-controlled treatments for ADHD which I do provide, as appropriate, for individuals with ADHD and that can be done via Telehealth.
The following is a link to controlled substances that the provider at Nuture Mental Health Service does not prescribe via Telehealth: Controlled Substance Schedules (usdoj.gov)
Examples include hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®, Percocet®), and fentanyl (Sublimaze®, Duragesic®), morphine, opium, codeine, hydrocodone, amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), methylphenidate (Ritalin®), amobarbital, glutethimide, pentobarbital, (Tylenol with Codeine®), buprenorphine (Suboxone®), benzphetamine (Didrex®), phendimetrazine, ketamine, anabolic steroids such as Depo®-Testosterone, alprazolam (Xanax®), carisoprodol (Soma®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®), (Robitussin AC®, Phenergan with Codeine®), and ezogabine.
Financial Responsibility and Insurance Billing Practices
A payment will be effected immediately after services are rendered or once insurance is billed for any deductibles and coinsurances. During your first visit with your provider at Nuture. We will require a credit card on file if you have a copay, deductible or you are a self-pay client for on-time service, timely payment, and prevent uninterrupted services. Please provide your full insurance/card information for us to determine the eligibility of benefits and secure authorization from your insurance provider if necessary. However, if there is a change in your insurance please inform us immediately to ensure payment. At Nuture we reserve the right to bill our standard fees for case coordination clinical and legal write-ups, and phone consultations (school personnel, primary health provider) exceeding 15 minutes per week. We will serve you with high-quality professional services while your care is with us at. There is no charge for routine telephone calls to Nuture Mental Health administrative staff regarding scheduling, appointments, or billing.
Confidentiality:
The information discussed during therapy is confidential. By law, information concerning your treatment may be released only with the consent of the person treated (or the person’s guardian if applicable). In the event where there is suspected child abuse, neglect, exploitation (RCW 26.44), or imminent danger of harm to one’s self or others, the law requires the release of confidential information. In these instances, we are required to make a report to the appropriate authorities. In addition, the courts may subpoena treatment records in certain circumstances. Any type of release of confidential information will be discussed with you. We are compliant with the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and patient rights with regard to personal health care information (PHI). HIPAA requires that we provide you with a Notice of Privacy Practices. This Notice, which is attached to this agreement, explains HIPAA in detail and its application to your personal health care information.
Notice of Privacy Practices:
Your Information – Your Rights – Provider Responsibilities. Please review carefully.
Under Washington Administrative Code (WAC) 388-877-0600, you have the right to:
Receive services without regard to race, creed, national origin, religion, gender, sexual orientation, age to disability.
Practice the religion of choice as long as the practice does not infringe on the rights and treatment of others or the treatment service. Individual participants have the right to refuse participation in any religious practice.
Be reasonably accommodated in case of sensory or physical disability, limited ability to communicate, limited English proficiency, and cultural differences.
Be treated with respect, dignity, and privacy, except that staff, may conduct reasonable searches to detect and prevent possession or use of contraband on the premises.
Be free of any sexual harassment.
Be free of exploitation, including physical and financial exploitation.
Have all clinical and personal information treated by state and federal confidentiality regulations.
Review your clinical record in the presence of the administrator or designee and be allowed to request amendments or corrections.
Receive a copy of agency grievance system procedures upon request and file a grievance with the agency, or behavioral health organization (BHO), if applicable, if you believe your rights have been violated.
Lodge a complaint with the Washington State Department of Health when you feel the agency has violated a WAC requirement regulating the behavior of health agencies.
Washington State – Department of Health
Health Systems Quality Assurance (HSQA)-Complaint Intake P.O. box 47857
Olympia, WA 98504-7857 email: HSQAcomplaintintake@doh.wa.gov
Responsibilities as your Clinician: Your Provider’s Responsibilities:
At Nuture Mental Health Services, by law, we are required to maintain the privacy and security of your protected health information.
Your provider will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
Your provider must follow the duties and privacy practices described in this notice and give you a copy.
Your provider will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let our office know in writing if you change your mind. For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Responding to Lawsuits and Legal Actions:
If required/requested your provider can share health information about you in response to a court or administrative order, or in response to a subpoena.
If your information will be shared, your provider will provide a Release of Information to request specific information and with whom for you to sign consent.