Clinic Patient Services ADAPT Program Comm. (402) 294-7411 DSN 271-7411 Hours of Operation: 0730-1630, M-F After duty hours, crisis intervention services (402) 294-7332 Substance Abuse Admin National Institute on Alcohol Abuse and Alcoholism ADAPT Guide The primary objective of the ADAPT Program is to promote readiness along with health and wellness through the prevention and treatment of substance abuse to the individual, family, and organization; to provide comprehensive education and treatment to individuals who experience problems attributed to substance abuse; to return identified substance abusers to unrestricted duty status or to assist them in their transition to civilian life, as appropriate. Individuals (active duty, retired, DoD employees) may be referred by the following: 1. Self-identification 2. Commander/supervisor 3. Traffic-related arrest (DUI) 4. Arrest/investigation 5. Illict drug use 6. Medical Clinical Records Phone: Comm. (402)294-7415, DSN 272-7415 Hours of Operation: 0600-1630, Mon-Fri Services Available Third Party Liability Transcriptions Release of Information Office Comm. (402) 294-7415, DSN 271-7415 Fax (402) 294-7314 The Release of Information Office, located in Clinical Records, processes incoming and outgoing requests regarding medical information. Services include transferring of records between military health care facilities, and providing copies when records cannot be released. To ensure confidentiality, we will confirm that all requests contain sufficient legal authorization. To request a copy of your medical records, complete the appropriate form and fax to (402) 294-7314. Request copy of records for Separation/Retirement (Active Duty) Request copy of records (Retirees/Dependents) Request civlian records be sent to Military Hospital Customer Service Program Comm. (402) 294-9477 DSN 271-9477 Ehrling Bergquist Clinic is committed to providing patients with the fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values. The Customer Service Program is designed to help each and every patient with hospital policies, procedures, compliments, complaints, and suggestions. The Commander has designated a Customer Services Coordinator for the group. A Customer Service Representative has also been designated for each clinic. Photographs posted in the respective clinic will designate these individuals. Please feel free to ask them for assistance when you have a question or concern. Another avenue for addressing concerns is to contact your Unit Medical Liaison (UML). A UML has been assigned to represent every squadron on Offutt AFB. Contact your First Sergeant or the Customer Service Coordinator for more information. Family Advocacy The Family Advocacy Program supports Air force readiness by enhancing the health, welfare, and morale of the Air Force family. There are three main components of the program: the Exceptional Family Member Program (EFMP), the Outreach and Prevention Program, and the Family Maltreatment Program. Exceptional Family Member Program (EFMP) This is an Air Force mandated program for all active duty Air Force personnel with a special needs family member. Emphasis is on general medical services, medically related services, and special education services. The program screens all Air Force families with an overseas assignment to ensure all necessary services are available at the gaining base. Continuity of care is provided through referrals to local base and community agencies. Outreach and Prevention Program This program strengthens and enriches military families through primary prevention - providing services before problems occur and secondary prevention - providing services to "at risk" families. Hotlines -- Medical Emergencies 911 -- Poison Control 1-800-955-9119 -- Emergency Shelters Lydia House (shelter for women and children) 345-9342 Siena House (shelter for women and children) 341-1821 Stephen House (shelter for families, single men/women) 731-0238 Vincent House (shelter for families, single women) 342-3759 Salvation Army (shelter for families, single women) 554-5900 YES House (short-term shelter for teens) 345-5187 The Shelter (abused women, family violence) 558-5700 Child/Adult Abuse/Neglect 1-800-652-1999 -- Children's Crisis Center 553-6000 -- Crisis Line 449-4650 -- Education Pregnancy Support (EPS) 554-1000 -- Parent Assistance 937-9909 -- Runaway Crisis Hotline 322-3799 -- Alcoholics Anonymous 556-1880 -- ALANON (for families) 553-5033 -- ALATEEN 553-5033 -- Gamblers Anonymous 978-7557 -- Narcotics Anonymous 978-3105 -- First Call for Help 444-6666 -- Baby Information 572-2229 -- Meals on Wheels 293-3041 Douglas County General Assistance 444-6215 (Help with rent, utilities, food, personal need items, transportation, furniture, etc.) Bellevue Human Resources Office 293-3138 (Senior citizens or disabled transportation, information and referral, emergency food, baby sitting directory for Bellevue, limited financial assistance, Handyman Program for senior citizens, clothing and pantry referrals) Medical Evaluation Boards Comm. (402) 294-2989 DSN 271-2989 Hours of Operation: 0730-1630, M-F The Medical Evaluation Board (MEB) process helps the Air Force maintain a fit and vital force. Identification of a medical condition that keeps the active duty member from worldwide duty is thoroughly evaluated by a panel of physicians, who then recommend disposition. Overseas Clearance Comm. (402) 294-7886 DSN 271-7886 The Overseas Clearance Program screens active duty dependents for possible overseas assignment with their sponsor. A medical records review is conducted by a PCM. Additionally, and Exceptional Family Member Program (EFMP) screening is performed. The Overseas Clearance Office schedule necessary appointments. Final review is accomplished by the Chief of Medical Staff. Patient Rights 1. ACCESS: You have the right to reasonable access to care. 2. RESPECTFUL TREATMENT: You have the right to considerate and respectful care at all times under all circumstances. 3. EXPLANATION OF CARE: You have the right to be well informed about your illness, treatment, and prognosis in terms you can understand. When it is not medically advisable to give such information to you, the information will be made available to an appropriate person on your behalf. 4. INFORMED CONSENT: You have the right to receive information necessary for you to give informed consent prior to starting any procedure or treatment. Except in emergencies, such information should include, but not necessarily be limited to, the specific procedures or treatment, the medically significant risks involved, and the probable duration of incapacitation. When medically significant alternatives for care or treatment exist, you have the right to such information. 5. REFUSAL OF TREATMENT: You have the right to refuse a treatment, to the extent permitted by law or military instructions and to be informed of the medical consequences of your action. If you refuse a recommended treatment, you will receive other needed and available care. 6. PRIVACY AND SECURITY: You have the right to every consideration of your privacy concerning your own medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discretely. Those not directly involved in your care must have your permission to be present during an episode of care. You have the right to know if you are being treated by a physician extender, rather than a physician. You should also be advised whether nursing students, physician assistants in training, or residents are present and for what purpose. You have the right to receive care in a secure environment. 7. CONFIDENTIALITY: You have the right to expect that all communications and records pertaining to your care will be treated as confidential information 8. CONTINUITY OF CARE: You have the right to expect reasonable continuity of care. You have the right to know in advance what appointment times and physicians are available. Hospitalized patients have the right to expect the hospital to provide a means whereby they are informed by the physician of their continuing health care requirements following discharge. 9. RESEARCH & EXPERIMENTATION: You have the right to be advised if the hospital proposes to engage in or perform human experimentations affecting your care. If you choose to decline you will receive the most effective care the hospital otherwise provides. (No human experimentation or research projects are permitted without the express approval of the hospital commander.) 10. RULES & REGULATIONS: You have the right to know what hospital rules affect you, your treatment and your conduct as a patient. (The Nurse Manager on each unit should ensure that each patient is aware of applicable hospital rules and regulations that apply to their conduct). 11. CUSTOMER SERVICE REP: You have the right to know about hospital resources such as customer service representatives that can help you resolve problems and questions about your care or hospitalization. 12. ADVANCED DIRECTIVES: You have the right to initiate an advanced directive such as a living will or durable power of attorney for healthcare (documents which express your choices about your future care or name someone to decide, if you cannot speak for yourself). If you have an advance directive, you should provide a copy to the hospital, your family, and your doctor. 13. SPECIAL NEEDS: The dying patient has the right to have special needs met by the staff providing their care. The staff will ensure respectful, responsible care directed to fostering the patient's comfort and dignity, aggressively managing pain and responding to the patient's and family's psychosocial, spiritual and cultural values. 14. ETHICAL ISSUES: You have the right to participate in the resolution of ethical questions that arise in your care, including issues of resuscitative services, forgoing or withdrawal of life sustaining treatment, and participation in investigational studies or clinical trials. Patient Responsibilities PROVIDING INFORMATION: You are responsible for providing information about your health, including past illnesses, hospitalizations, and use of medicines. You're responsible for asking questions if you don't understand information or instructions. MEDICAL RECORDS: Any medical records documenting care provided or funded by a military treatment facility are the property of the US Government and need to be maintained in the hospital files. RESPECT AND CONSIDERATION: You, accompanying family members and your visitors are responsible for being considerate of the needs of other patients and staff. This includes the control of excessive noise and the number of visitors. COMPLIANCE WITH MEDICAL CARE: If you believe you can't follow your treatment plan, you're responsible for telling your doctor. This includes keeping appointments on time and notifying the hospital when appointments can't be kept. RESOURCE CONSERVATION: You are responsible for providing information for insurance and for working with the hospital to arrange payment when needed. HEALTH CARE MAINTENANCE: You are responsible for recognizing the effect of life style on your personal health and assisting the medical staff in maintaining/improving your health. RECOMMENDING IMPROVEMENTS: If you see an area where we could improve, we would like to know. Your recommendations, questions, or complaints should be directed to a patient representative or the Customer Service Coordinator at 294-9477. Third Party Collections Comm. (402) 294-9403 DSN 271-9403 or Comm. (402) 294-0335 DSN 271-0335 By law, all military healthcare facilities must bill private insurance companies--third party insurers--for the care of military family members, retirees and their family members. The Third Party Collection Program was established to seek reimbursement of care provided at EBC, and all other DoD health care facilities. You are required by law to divulge or verify any insurance during clinic visits and pre-admission interviews before you receive care. The insurance companies are billed a flat rate for outpatient services and at diagnosis related group rates for inpatient services. Prescription drugs are billed at current costs. The insurance company will pay the hospital directly and patients are not responsible for any uncollected charges. All funds collected through this program are retained by EBC and are used to enhance and expand medical services.