staff at The Fellowship House welcomes you to The Fellowship
House Prevention and Treatment Center Rehabilitation program! The
Fellowship House Treatment Programs are structured to provide you with basic tools to begin your
recovery from alcohol, and or drug addiction. You will have an opportunity to
learn about your illness, explore your thoughts and feelings, and
set personal goals.
Persons admitted to the agency are provided with the treatment
opportunity to enhance one's mental, physical, social, and spiritual
well being. Your needs are evaluated and the following services may
be provided: Individual counseling; family counseling (when
indicated); didactic sessions; recreational and leisure activities;
adequate rest and proper nutrition; medical consultation and
referral, when appropriate; aftercare planning; and referral for
We believe that family, employers, and significant others
involved in your life play a major role in the recovery process.
Therefore, their involvement in the overall treatment and aftercare
plan is encouraged.
We believe that Alcoholics Anonymous (A.A.), and
Narcotics Anonymous (N.A.) are voluntary self-help organizations
that are helpful to persons
striving to maintain recovery. You will be introduced to the
treatment process of A.A., G.A., and N.A.
When you are scheduled for a clinical assessment interview, the
assessment will take 3-4 hours, so make sure your transportation
person can stay the 3-4 hours. This assessment is to determine the
severity of the problem and the intensity of treatment needed.
You need to:
1–Bring all prescribed
medication you are taking when you come for your appointment.
For inpatient/residential only: You must bring a 30 day supply with
you and a written statement from your physician specifically stating
the medication dosage and when the medication is to be taken.
2–Bring all DUI Evaluations that
you have had done other than at The Fellowship House.
3–Bring documentation regarding
the T.B. (Tuberculin) test if you have it. If you have had a
positive T.B. skin test in the past, bring documentation regarding
what was done.
4–Bring income verification. You
must bring, at least, one of the following: a recent paycheck stub;
1040; W-2; unemployment verification; or Medicaid card. Bring
insurance card if you have any kind of health insurance. The
verification is required to determine if you are eligible to receive
funding assistance. This is a requirement of the State of Illinois.
If you are unable to obtain documentation to verify your income or
if your reported income does not qualify you for funding assistance,
you must pay cash for assessment and treatment prior to the
5–Bring state issued photo
identification (i.e., driver’s license, FOID card, or Secretary of
State I.D.) This is required by the State.
your personal hygiene/toiletries. The following items are
allowed but NOT in Aerosel form (i.e., deodorant, soap,
toothbrush, toothpaste, fabric softener, powdered beach, razor,
aftershave, baby powder, shampoo, tampons, make-up, etc.).
7–Bring phone cards if you want
to use the patient phone. However, telephone usage is discouraged and
available for limited time. NO CELL PHONES!
8–Bring some cash if you want to
use the vending machines. You can purchase soda and snack items
from the vending machines to eat in designated areas. You and your
family/friends cannot bring your own food/drinks. The agency does
not have room to store these items and snacks are not provided.
9–Inform your FAMILY/FRIENDS who
are supportive and encouraging your recovery that you can receive
mail at 800 North Main Street, Anna, IL 62906. You can purchase stamps to
send letters as well.
10–Inform your supportive and
encouraging family/friends that their visitation is dependent upon
their participation in the family programs, your length of time in
treatment, and type of program you are admitted into. More
information will be provided by your Case Manager.
11–Understand that the following
may result in your immediate DISCHARGE: Physical or verbal abuse of
staff or other patients; bringing alcohol, other drugs, weapons of
any kind, leaving the grounds without permission, smoking inside the
facility, or breaking a contract.
12–Understand that you cannot
bring in radios, televisions, tape players, tapes, DVD’s, cell
phones, computers, magazines, newspapers, and any other personal
items like that. The agency does not cash personal checks for
patients while in treatment. Money orders only will be cashed by
13–Understand that your
participation in treatment is confidential and information about you
will be provided only when you give us permission to do so in
writing. You must keep other patients’ identity confidential as
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE
REVIEW IT CAREFULLY.
Effective Date: April 14, 2003
We respect patient confidentiality and only release medical
information about you in accordance with the Illinois and federal law.
This notice describes our policies related to the use of the records
of your care generated by this agency.
If you have any questions about this policy or
your rights, contact your case manager or the Quality
Improvement/Utilization Review/Program Evaluation Manager (Privacy
Officer) at (618)833-4456.
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
In order to effectively provide you care, there are times when we
will need to share your medical information with others beyond our
agency. This includes:
We may use or disclose medical information about you
to provide, coordinate, or manage your care or any related services,
including sharing information with others outside our agency that we
are consulting with or referring you to.
Information will be used to obtain payment for the
treatment and services provided. This will include contacting your
health insurance company for prior approval of planned treatment or
for billing purposes.
We may use information about you to
coordinate our business activities. This may include setting up your
appointments, reviewing your care, training staff.
Information Disclosed Without Your Consent.
Under Illinois and
federal law, information about you may be disclosed without your
consent in the following circumstances:
Sufficient information may be shared to address
the immediate emergency you are facing.
Follow Up Appointments/Care.
We may be contacting you to remind
you of future appointments or information about treatment alternatives
or other health-related benefits and services that may be of interest
As Required by Law.
This would include situations where we have
a subpoena, court order, or are mandated to provide public health
information, such as communicable diseases or suspected abuse and
neglect such as child abuse, elder abuse, or institutional abuse.
Coroners, Funeral Directors, and Organ Donation.
disclose medical information to a coroner or medical examiner and
funeral directors for the purposes of carrying out their duties. When
organs are donated sufficient information is provided to the program
as necessary to facilitate the organ or tissue donation.
We may disclose information to a
health oversight agency for activities authorized by law, such as
audits, investigations inspections and licensure. There also might be
a need to share information with the Food and Drug Administration
related to adverse events or product defects. We are also required to
share information if requested with the Department of Health and Human
Services to determine our compliance with federal laws related to
Criminal Activity or Danger to Others.
If a crime is committed
on our premises or against our personnel we may share information with
law enforcement when we believe an immediate danger may occur to
Changes in Policy.
The Fellowship House reserves the right to
change its privacy practices based on the needs of The Fellowship
House and changes in state and federal law.
If you have further questions feel free to call.