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The Karuk Trial Health Program Patint Information Booklet is
now available. Copies may be picked up at the clinics or at
the Happy Camp Administration office. You can also download
a copy of the booklet here.
The Karuk Tribal Health Program provides services to Native Americans and other peoples living within its service area.
These services are provided through equal access, treatment, and consideration for the patient’s personal values and beliefs.
All patients shall be served regardless of their age, sex, race, color, creed or national origin.
The patient has a right to receive the following services (in accordance with available resources):
| • Evaluation |
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diagnosis of the patient's general health condition. |
| • Treatment |
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procedures to prevent, control or cure illness. |
| • Referral |
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for additional required services unavailable at Karuk clinics, or when a conflict with our mission or philosophy arises. |
Our patients have the right to be informed of and participate in care decisions regarding their treatment plan or medical condition.
If it’s not in their best interest, the patient has the right to choose another person to act in their behalf. These persons may be family, friends or a guardian. When the patient is a minor, family or guardians are legally responsible except in accordance with appropriate laws.
The patient has the right to refuse treatment and to refuse treatment in experimental research, (not presently conducted at KTHP), or to allow trainees to participate in their care as a learning experience. In addition, the patient has the right to be informed of the risk involved in discontinuing treatment against medical advice.
The patient has the right to confidential and private assessment and reassessment and treatment of their condition(s). Our patient’s report of pain will be respected and acted upon appropriately and quickly. Your right to effective pain management includes referral to alternative treatments, and the development of an individualized pain management plan (see also Patient Responsibilities).
Our patients have the right to be treated with consideration, respect, dignity, and recognition of individuality and privacy, regardless of condition or reputation. In addition, the patient has the right to confidential treatment of his/her medical record and to refuse release of those records to other agencies or providers.
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Right to Informed Consent
The patient has the right to informed consent. Informed consent means that:
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You are able to understand the nature, extent and likely consequence of planned medical treatments. |
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You are able to make sensible decisions about the risks and benefits of alternate procedures, and |
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You are able to demonstrate that you understand by using any method of communication. |
The patient or their representative has the right to know the name of the doctor or dentist, or other providers responsible for their care. If the patient is elderly, or has trouble understanding, hearing, communicating, or speaks a different language, they may have a representative act in their behalf or have the information translated or explained.
Right to Advanced Directives
The patient has the right to name someone to make decisions about their medical treatment when they are unable to make those decisions for themselves.
This is called an "Advanced Directive", and is a document that states your choice about medical treatment. Advance Directives are signed in advance (before you become unable to communicate) to let your doctor or other health care providers know your requests concerning your medical care. They enable you to make legally valid decisions about your future medical care and treatment.
If you are concerned about your future health care, our staff can help you prepare a Durable Power of Attorney for Health Care (advanced directive). Please contact a clinic receptionist or tell your physician you want to create an advanced directive. They will refer you to a staff member who can help you. For more information, Contact the Tribe’s local Community Health Representative (CHR), or Elders Worker.
Reporting of Abuse or Neglect
The patient has the right to know that our staff are mandated reporters and that all cases of suspected or known abuse and neglect, whether it be child or elder, will be reported as mandated by law.
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The patient has the right to make a complaint about health services.
When a complaint is made:
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The staff of the Karuk Tribal clinics will first attempt to resolve the complaint. If this initial effort is not successful, a patient may submit a formal written complaint. |
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A patient, parent(s), or guardian(s) has the right to request review of their complaint by completing a Patient Complaint Form. |
3. |
The complaint will be submitted to Lessie Aubrey, Director of Quality Management and Compliance for review, investigation, and response. |
The procedures for making a complaint are:
| 1. |
Complaints must be in writing and submitted to:
Lessie Aubrey
Director of Quality Management and Compliance
Karuk Tribal Health Program
P.O. Box 1016
Happy Camp, CA 96039
 E-Mail
Lessie Aubrey
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| 2. |
You may use the Patient Complaint Form available at
each clinic as your written complaint. Also called 'Quality
Incidence Form'. See 'JCAHO Quality Monitoring' (below)
for down-loadable forms. |
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Investigation of the complaint will begin within three working days after receipt. |
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Within five working days, the patient will receive notification by letter or telephone that their complaint is under investigation. |
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The Director of Quality Management and Compliance will have 15 working days to resolve the complaint or to make a recommendation to the Karuk Tribal Health Board. |
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The patient may submit their complaint to the Karuk Tribal Health Board only after receiving an unsatisfactory response from the Director of Quality Management and Compliance.
Call the Tribal Administration Office at 530-493-5305 and ask to be placed on the agenda for a Tribal Health Board meeting. |
The patient has the right to know of the charges for their care.
Fee schedules will be provided upon the patient’s request.
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An Important Message to Karuk Tribal Health Program
Patients
Our patients are a very essential part of the of the KTHP
Organization and we want to inform you that if you have any
concerns about your care or safety, you may contact Lessie
Aubrey, Director of Quality Management, or Arch Super, Tribal
Chairman at 530-493-1600 in order to express your concerns.
It is our pleasure to serve you; therefore we will try to
quickly resolve your issue(s). However, if we at KTHP are
unable to resolve your concerns at the organization’s
level, you may contact the Joint Commission on Accreditation
of Healthcare Organizations.
You may send your complaint by mail, fax or e-mail. Please
include a one or two page summary, and include your name,
street address, city, and the state of the KTHP (California).
JCAHO will inform you about actions taken or may need to contact
you for further information.
E-Mail to: complaint@JCAHO.org
(You can download and attach the Quality Incident
Report Form* to your email)
Fax to:* Office of Quality Monitoring (630) 792-5636
Mail to:*
Office of Quality Monitoring
Joint Commission on Accreditation of Healthcare
Organizations
One Renaissance Blvd.
Oakbrook Ter race, IL 60181
*Please use the Quality Incident Report Form
(Click
here to download editable MS Word Quality Incident Report
form)
(Click here to download
printable Quality Incident Report PDF form)
If you have any questions about how to file your complaint,
you may contact the Joint Commission at this toll free U.S.
telephone number, 8:30 – 5:00 pm, Central time, weekdays:
(800) 994-6610
Quality Incident Report Forms are also located in the clinic
lobbys.
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1. Appointments:
Patients are responsible for keeping their appointments at the scheduled time, and for notifying the clinic 24 hours in advance, if unable to keep an appointment.
The patient is responsible for checking in with the receptionist before being seated in the lobby, and providing truthful and accurate information regarding their medical history, current problem, complaint, medication, advanced directive, billing, and personal information or identification.
If the patient does not understand his/her medical or dental condition or treatment plan, it is the patient’s responsibility to ask questions until satisfaction is achieved.
2. Pain Management:
It is the patient’s responsibility to help the provider assess your pain, and to tell your provider when your pain is not relieved.
It is the patient’s responsibility to participate in alternative therapies as pain relief options, and to follow your individualized Pain Management Plan, which may include a Pain Management Contract for Opioid treatment.
It is the patient’s responsibility to discuss with your provider any worries you have regarding your pain, complications, or treatments. If you do not understand your condition, treatment or plan, it is your responsibility to ask questions.
It is the patient’s responsibility to comply with your provider’s instructions. It is the patient’s responsibility to understand non-compliance will not be permitted in regards to treatment with controlled substances.
3. Dental Complications:
It is the patient’s responsibility to notify the appropriate dental clinic whenever dental problems exist, and to follow scheduled emergency hours listed in the patient handbook.
It is the patient’s responsibility to wait to be seen between scheduled visits when instructed that it’s necessary.
It is the patient’s responsibility to follow instructions, whenever medical conditions require evaluation or treatment prior to receiving dental services.
4. Care Instructions:
The patient is responsible for following instructions while being treated at the clinic or at home, and to take medications as directed by his/her provider.
Dental patients are responsible for keeping their teeth clean by brushing and flossing daily or as instructed.
5. Patient Conduct:
It is the patient’s responsibility to wait in the clinic waiting area until called. While waiting, it’s the patient’s responsibility to be courteous, kind, and considerate to other patients waiting to be seen.
It is the patient’s responsibility to control their children and keep them quiet, and while parent or surrogate is being treated to seek care for the children prior to his/her visit. It is a parent’s responsibility to understand that staff is unable to watch children during clinic hours.
It is the patient’s responsibility to conduct themselves in an orderly manner, and to understand that voiced or physical hostility will not be tolerated under any circumstances.
It is the patient’s responsibility to be respectful and considerate to all staff members.
It is the patient’s responsibility to understand that disruptive behavior will be cause for refusal of services.
Services may be continued at a later time, if proper behavior has been established.
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