March 4, 2011
Staff and volunteers at the YWCA of Greater Flint Domestic Violence and Sexual Assault Services (DVSAS) will keep confidential all information communicated to them by survivors of domestic violence and sexual assault utilizing YWCA services. This means that:
- We will not disclose to any other person or entity whether we have had contact with you or provided services to you, or whether or not you are residing in our shelter.
- We will not disclose to any other person or entity information or materials that you have disclosed or given to us or that we have disclosed or given to you.
- We will oppose any subpoena or other legal effort to obtain this information from us, when you have not authorized the release of this information.
There are some exceptions to this. The information that you give us may not be kept confidential if:
- We learn or have reason to suspect that a minor child is being abused or neglected. In such a case, we will contact Child Protective Services;
- We witness through sight or hearing an actual or imminent physical assault or other unlawful and dangerous act upon you by another person. In such case, we may contact law enforcement for assistance;
- We learn or have reason to believe that you intend to harm yourself. In such case, we may notify law enforcement and/or emergency medical personnel to seek assistance for you;
- We learn or have reason to believe that you intend to harm another person and have the means and ability to do so. In such case we may contact law enforcement and/or may warn the person who you intend to harm.
If you give us written or verbal permission to release information to others, we will do so in accordance with the terms of that permission. You have the right to revoke that permission at any time.
In order to further protect the confidentiality of survivors of domestic violence, we ask that you not share the names, identities, or any other information about anyone you believe to be receiving services from YWCA of Greater Flint.
|Client’s Rights and Grievance (Complaint) Procedure|
We welcome your thoughts, suggestions, and concerns regarding our services. Please share them either with the person you are working with or with their supervisor. You can find out who someone’s supervisor is by calling our Crisis Line (810) 238-7233.
You have the right to a fair hearing if services to you are denied, reduced, or ended, or if we fail to act upon your request for service within a reasonable period of time. You have the right to start a formal grievance process. This is how:
Filing a Recipient’s Rights Grievance:
- Address your issue directly with the staff member involved. If you feel that this is not safe or that the resolution is unlikely, proceed to step #2.
- Contact the staff person’s direct supervisor to discuss your issue.
- If the matter cannot be resolved by the supervisor, submit your written grievance within 6 days to the Program Director. You may ask for assistance in writing your statement. Please include the following information so that your concerns can be addressed as quickly as possible:
- Statement explaining your grievance.
- What right(s) you feel have been violated.
- What you think will resolve your grievance.
Within five business days of receiving your grievance, the Program Director will contact you and the staff involved. If necessary, a meeting may be set up between the Program Director, you, and staff.
A letter with solutions and/or outcomes will be sent to you within five business days of all discussions and meetings.
- If your grievance has not been resolved by step #3, you may submit another written statement within five business days to the Program Director which will be forwarded to the CEO within two business days.
Within five business days, the CEO will send you and the Quality Assurance Committee a letter informing you of actions taken to resolve the grievance. The QA Committee will use information from the grievance procedure to consider changes in agency practices. The timelines are for your guidance; every effort will be made to resolve your grievance in a timely manner.
I, ______________________________________, understand the YWCA Flint DVSAS Policy of:
- Confidentiality as explained to me by a staff member. I have received a copy of this policy.
- I understand that DVSAS will report to Child Protective Services any known or suspected child abuse or neglect. I also understand that DVSAS will contact law enforcement if we have reason to believe that you will harm yourself and/or another person.
- Further, I agree not to disclose any identifying information about anyone that I encounter during my interaction with YWCA Flint or YWCA DVSAS. This includes saying whether or not someone is staying at or receiving services from YWCA DVSAS.
- This is to acknowledge that the client rights and grievance procedure has been explained to me on this date, and I fully understand what has to be done to file a grievance if it becomes necessary.
I have received a copy of the YWCA of Greater Flint DVSAS Confidentiality Notice and Client’s Grievance Procedure.