We believe we can better assist you if you are aware of your rights and responsibilities concerning decisions that affect your treatment.

1. You have a right to services regardless of race, creed, sex, age, national origin, political belief, sexual preference or disability. Reasonable accommodation for disability will be made upon request.

2. You have the right to be treated with courtesy, respect and dignity.

3. You have the right to privacy. We hold all your personal information confidential within the Counseling Service. This information cannot be given to persons outside the agency not involved in your care without your permission. However, there are exceptions to this rule, required by Vermont Law. Some of these include threats to do bodily harm to yourself or others, or to destroy property; suspected abuse or neglect of children, elderly or disabled persons; and/or Court ordered subpoenas to disclose confidential information. Please refer to our Notice of Privacy Practices for further information.

4. You have the right to an explanation regarding any treatment procedures and to participate in the development of your treatment plan.

5. You have the right to treatment in the least restrictive appropriate environment.

6. You have the right to know your therapist’s qualifications and experience. You also have the right to have a list, provided by the Office of Professional Regulation, of specific practices that constitute acts of unprofessional conduct. Please see below:

Psychologists: 26 VSA 3016
Clinical Social Workers: 26 VSA 3210
Mental Health Counselors: 26 VSA 3271
Marriage and Family Therapists: 26 VSA 4042
Psychoanalysts: 26 VSA 4062
Rostered / Non-licensed Psychotherapists: 26 VSA 4093

7. You have the right to know of possible side effects of any medication or treatment suggested to you.

8. You have the right to terminate treatment at any time.

WE ENCOURAGE CLIENTS to know their rights, to ask questions, and to make suggestions about their treatment. In the event that you are not satisfied with some aspect of our services, we encourage you or your advocate to discuss this with your assigned staff or contact the Director of the program in which your services are being provided.

You have the right to file a complaint; CSAC will provide assistance to you/your representative to complete the complaint.

If you are not satisfied that the issues have been resolved, or are uncomfortable with the results, there is a grievance and appeal process available. You may file a grievance if dissatisfied with any aspect of your care at CSAC such as the quality of service or aspects of interpersonal relationships. We welcome all feedback about your experience with CSAC. Grievance forms are available at our reception desk or by calling 802-388-6751. You may also write a letter and mail to CSAC, 89 Main Street, Middlebury, VT 05753. You may also speak with CSAC staff. If you have an emergency situation please tell us so that we may respond as quickly as possible. We will take all submissions seriously.

You also have a right to appeal any decisions made about eligibility of services, placement on a waiting list, reduction in services, denial of services, or suspension of services.

If you have questions you may also call the VT Office of Health Care Ombudsman 800-917-7787.

1. You have a responsibility to give us complete information about your problems and pertinent circumstances.

2. You have a responsibility to play an active role in your treatment.

3. There are times when medication may be an appropriate treatment option. Medications are best used in conjunction with psychotherapy, as part of a medically supervised treatment plan. If medication is prescribed, you should be careful to follow the directions given. You have a responsibility to take medications prescribed, only as directed. Keep all medications out of the reach of children.

4. You have a responsibility to respect the confidentiality of other clients, and not to disclose to anyone outside the Counseling Service any information received in the course of participating in group, family or couple treatment.

5. You are responsible to provide CSAC with current and accurate insurance cards, or other verification of insurance, for photocopying or scanning.

6. You have a responsibility to pay your bill promptly.

7. We ask that all service participants observe our building safety requirements regarding refraining from bringing weapons on site.

No one will be denied emergency treatment by CSAC because of the inability to pay, based upon your provided financial information.  However, clients who fail to fulfill their financial obligation to CSAC and request additional non-emergent care will not be approved for additional services until financial arrangements have been made. 

It is the policy of the Board of Directors of CSAC to maintain a secure and prudent financial operation in order to facilitate and support the rendering of quality mental health and developmental health care services.  Although partially supported by federal, state and local sources, CSAC is a private, non-profit organization receiving a substantial portion of revenue from the collection of fees for services provided to the community.  Providing services costs money.  To remain financially viable, CSAC must collect reimbursement for services rendered. 

You are encouraged to call or meet with the staff of the Billing Assistance Center (BAC) near the time of your CSAC admission date. CSAC billing department will be available to assist you with general or specific billing questions or problems. You may contact the Billing Assistance Center by calling 802-388-0302 ext 460 or by going to 109 Catamount Park in Middlebury to meet face to face.

Every client seen at CSAC will be responsible for co-pay and/or a portion of his/her charges for each date of service. The type of health insurance determines what the client will pay out-of-pocket for services. Nonpayment may result in discontinuation of services after being communicated in CSAC authored collection letters.

At the time of service, reception personnel will collect all current co-pay or self pay amounts plus any outstanding self-pay balances or bad debts from prior dates of service. These self-pay and past due balances will be noted on the clients “face” sheet that the client will be asked to review at each visit.

If a client has insurance coverage, the carrier will be billed for the charges. If the remaining balance creates a financial hardship, clients will be offered a hardship application to complete to determine what % on the sliding fee scale the client would be eligible for. Clients that do not have health insurance coverage will be evaluated at intake for immediate eligibility for the sliding scale and/or referred to the Billing Assistance Center to determine eligibility for Medicaid. Acceptable proof of income will be need to be submitted to the Billing Assistance Center within 60 days or fee will revert to 100%.

If you find yourself with an owed balance, please contact our Billing Assistance Center to discuss possible payment arrangements.

We have a limited amount of subsidy dollars to provide certain services to county residents who cannot afford to pay our full cost of service. You will need to keep these financial considerations in mind as you and your therapist plan your treatment. The sliding fee charged to the client is set using a standard percentage ranging from 30% to 100% of the standard charge. Gross household income and qualifying dependents will determine eligibility.

There are some circumstances where the sliding fee scale is not available and charges will be based on the full fee for services. These are:

1. When the client chooses not to use the mental health or developmental disability service options available through his/her health insurance, and/or

2. All deductible amounts. Co-pays: Individuals having co-pays will be charged 100% of the co-pay amount.

3. When the client does not inform CSAC of insurance or changes to insurance in a timely manner.

4. Services not covered by your insurance.

CSAC recognizes there may also be specific circumstances where a reduction of fees separate from the sliding fee scale may need to be considered. A form is available for hardship adjustments requests, and can be received from the Billing Assistance Center.

CSAC will permit the use of the sliding fee scale, in circumstances where services are mandated by an organization such as courts, schools, probation and parole, SRS, court diversion etc. Reports that are required by the referral source (such as to verify that referral requirements or conditions have been met) will not be released until full payment of any balance is made.

Monthly payments are required on all accounts. Clients with outstanding balances will receive monthly statements. When a balance becomes 30 days old (with no installment payment arrangement in place) billing staff will commence the CSAC collection process. If no payment is received for 90 days, and no payment arrangement has been agreed upon, a client will receive a letter describing the discontinuation of their services.

Initial appointments can be made by calling the Counseling Service’s main office in Middlebury at (802) 388-6751. Appointments traditionally involve face to face time of 50 minutes, with the remaining 10 minutes of the hour used by your provider to prepare for your session. If you are more than fifteen minutes late to your appointment, your therapist may be unable to see you and may need to reschedule your appointment.

THE NUMBER TO CALL FOR CANCELLATIONS IS 802-388-6751.

CSAC is invested in your well being, and believes it is important for you to be consistent in treatment so as progress can be made towards your identified treatment goals.

A missed appointment without adequate notice results in someone else having to wait longer for an appointment. Clients are expected to call 24 hours in advance if they cannot make a scheduled appointment. After the third late cancel / no show, the Agency may determine it necessary to cancel any standing future appointments with you. Your therapist may be directed to cancel individual treatment; however, you may be offered an alternative service such as group therapy. Emergency services will always remain available.

Remember, if you are seeing a psychiatrist at CSAC, you need to come to your appointments with a therapist. Ending therapy may result in termination of psychiatrist services.

The 24-hour Emergency Phone Number is (802) 388-7641.

The Counseling Service has a 24-hour per day emergency number for residents of Addison County who are experiencing a mental health crisis. When our offices are closed your call will be routed to an answering service. The receptionist will take your call and the Counseling Service Emergency worker will get in touch with you as quickly as possible

Reasonable accommodation will be made upon request to insure that all benefits services and activities of the Counseling Service of Addison County are fully accessible to all individuals.