COOS COUNTY MENTAL HEALTH DEPARTMENT
CONSUMER RIGHTS AND RESPONSIBILITIES
As a consumer you have a right to:
--Service without regard to race, color, creed, age, gender, sexual preference, religion or disability.
--Be free from abuse or exploitation.
--Take part in treatment planning, to be informed of treatment options and risks, to choose from the options, review progress and be free from retaliation for exercising a right.
--Refuse treatment unless ordered by a court (and medically appropriate), and to know the consequences if court ordered services are refused.
--Have the information given to Mental Health staff kept confidential according to the laws on confidentiality, as described in the Coos County Mental Health Department Notice of Privacy Practices.
--Talk with a Mental Health crisis worker (if your primary therapist is unavailable) for emergencies during and after work hours by telephoning 756-8601.
--Talk with staff or file a written complaint if you are unhappy with the services or have other concerns. We would like the opportunity to resolve the matter with you. Please contact your therapist, or case manager, or ask at the Reception Desk for the Privacy Officer. If the matter is not resolved to your satisfaction, you have the right to file a written complaint and the procedure for filing a complaint is available upon request from the Privacy Office. A copy of these procedures will be made available to you at any time.
--Have your rights and responsibilities read and explained to you.
--Be given a copy of the fee policy and be informed in writing what your fee will be. (Included on the back of this page.)
--If at any time you believe that any of your rights have been violated, please contact the Privacy Office. You may call (541) 756-2020 ext. 528, or ask at the Reception Desk.
As a consumer you have the responsibility to:
--Keep appointments or cancel them as far in advance as possible.
--If you take medication, to take it only as prescribed.
--Inform our office of any changes in your, income, address, or telephone number (s). You may report changes to your therapist, case manager, or the Business Office.
--Not drop out of services without first discussing it with your therapist.
--Seek appropriate help if alcohol or other non-prescribed drugs make your symptoms worse or interfere with your treatment plan.
COOS COUNTY MENTAL HEALTH DEPARTMENT
POLICY REGARDING CONSUMER FEES
You are expected to pay for the services you receive according to your ability to pay. Mental Health services are supported by State and County funds. In order to maintain the services needed for Coos County residents, it is necessary to supplement these funds through fees. Fees are determined on a sliding scale based on your household’s gross monthly income and the number of dependents in your household. You are responsible for providing the Business Office proof of your income and notifying them of any changes in your financial situation. Your fee will be adjusted accordingly. No person otherwise eligible for services will be refused services because of an inability to pay.
Payments are due at the time of service unless prior arrangements are made.
No person otherwise eligible for services will be refused services because of an inability to pay.
If you have Medicaid or Oregon Health Plan coverage bring your medical card with you each time you come for service. If you have private insurance coverage or Medicare, your insurance company will be billed for the full cost of the services. You, however, are responsible only for your assigned fee.
Coos County Mental Health Department's Sliding Fee Schedule
This chart shows the discounted fee you will be expected to pay if you provide proof of income and your insurance or assistance benefits do not cover the full cost of services. Otherwise, you will be responsible for the full balance due.
|
# IN FAMILY |
[~~~~~~~~~ |
~~~~~~~~~~~~GROSS MONTHLY INCOME RANGE~~~~~~~~~~~ |
~~~~~~~] |
||||
|
1 |
|
$0-908 |
$909-1,134 |
$1,135-1,361 |
$1,362-1,588 |
$1,589-1,815 |
$1,816+ |
|
2 |
|
$0-1,226 |
$1,227-1,532 |
$1,533-1,839 |
$1,840-2,145 |
$2,146-2,452 |
$2,453+ |
|
3 |
|
$0-1,544 |
$1,545-1,930 |
$1,931-2,316 |
$2,317-2,702 |
$2,703-3,088 |
$3,089+ |
|
4 |
|
$0-1,863 |
$1,864-2,328 |
$2,329-2,794 |
$2,795-3,259 |
$3,260-3,725 |
$3,726+ |
|
5 |
|
$0-2,181 |
$2,182-2,726 |
$2,727-3,271 |
$3,272-3,816 |
$3,817-4,362 |
$4,363+ |
|
6 |
|
$0-2,499 |
$2,500-3,124 |
$3,125-3,749 |
$3,750-4,374 |
$4,375-4,998 |
$4,999+ |
|
7 |
|
$0-2,818 |
$2,819-3,522 |
$3,523-4,226 |
$4,227-4,931 |
$4,932-5,635 |
$5,636+ |
|
8 |
|
$0-3,136 |
$3,137-3,920 |
$3,921-4,704 |
$4,705-5,488 |
$5,489-6,272 |
$6,273+ |
|
9 |
|
$0-3,454 |
$3,455-4,318 |
$4,319-5,181 |
$5,182-6,045 |
$6,046-6,908 |
$6,909+ |
|
10+ |
|
$0-3,773 |
$3,774-4,716 |
$4,717-5,659 |
$5,660-6,602 |
$6,603-7,545 |
$7,546+ |
|
FEE: |
$0 |
$5 |
$8 |
$10 |
$13 |
$13+ |
|
The chart below lists the cost per hour for Coos County Mental Health Department to provide mental health services. These costs are billed to your insurance company, Medicare, Medicaid, Oregon Health Plan or other assistance benefit payer.
Psychiatrist: Assessment $790.00, Individual Treatments $616.00, Group Treatments $185.00
Nurse Practitioners: Assessment $517.00, Individual Treatments $403.00, Group Treatments $121.00
Registered Nurses: Individual Treatments $239.00, Group Treatments $72.00
QMHPs: Screening Services $341.00, Assessment $313.00, Crisis Services $304.00, Individual Treatments $244.00, Group Treatments $73.00
QMHAs: Individual Treatments $218.00, Group Treatments $66.00