SCOPE OF SERVICES: SWFGC is a designated Relative Success Center providing resources and supports to kinship guardians living in the State of New Mexico through the Fostering Family Program, which is funded through the State of New Mexico and the Children, Youth, and Families Department.
LEGAL RIGHTS: All clients have the legal right to:
- Refuse services.
- Seek alternative mental health services elsewhere.
- Address needs/complaints via appropriate channels listed in the Complaints/Grievances section of this document.
- Ask your therapist about their training and their therapeutic approach.
- Choose an authorized representative to assist in their treatment decisions.
CONFIDENTIALITY: Discussions between client and professionals at Southwest Family Guidance Center are confidential. No client information will be released unless the client or guardian provides written consent. Possible exceptions to releasing confidential information include but are not limited to the following situations:
- Imminent danger or threat to self or others.
- Abuse or neglect of a child or vulnerable adult.
- Legal matters in which information is subpoenaed by a court of law.
- Information requested by an insurance carrier responsible for providing mental health coverage
and payment for those services.
EMERGENCY MEDICAL CARE: In the event of an emergency I give SWFGC consent to seek emergency medical care on my behalf including, but not limited to: administering first aid, CPR, medication and contacting/informing emergency personal including 911 operators, ambulance, physician and/or law enforcement.
EMERGENCIES: In the event of an emergency where there is imminent risk of danger, please call 911 immediately. If you are having a critical, clinical emergency, please contact the NM State Crisis Line 1-855-662-7474.
GRIEVANCES/COMPLAINTS: You have the right to be treated ethically, professionally and with respect by all SWFGC staff members. If you have any questions or concerns, please call Dr. Craig Pierce, Chief Clinical Officer, at (505) 830-1871. If you feel that SWFGC has not addressed the situation to your satisfaction, you may contact CYFD’s Behavioral Health Division at 1-505-827-4538.
ENDING SERVICES: SWFGC believes that ending services is an important aspect of the Fostering Family Program. If a client decides to end services, it is asked that the Community Support Worker be informed in order to ensure closure between the CSW and client.
DISCONTINUATION OF SERVICES: The following circumstances, including noncompliance with SWFGC Policies, may result in the discontinuation of services:
- Inappropriate behaviors: These include, but are not limited to: harming, threatening, or harassing SWFGC staff or fellow clients; vandalism, theft, or destruction of SWFGC or other client property; accessing or attempting to access confidential information to which you are not entitled.
- Inactive Status: If there are more than 3 unresponsive attempts to reach the client, the client will be placed on Inactive Status in the Fostering Family Program.
RESUMING SERVICES: A client can resume services at any time if needed and if they continue to meet Fostering Family Program eligibility requirements.
QUALIFICATIONS: To qualify for the Fostering Family Program, an individual must be living in New Mexico and must be a relative, godparent, member of the child's tribe or clan, or an adult with a significant bond (fictive kin) who is raising the child because the biological parents are unable or unwilling to do so. The individual does not have to have legal guardianship to receive services.
CONSENT FOR TREATMENT: I voluntarily agree to receive Mental Health/Support Services and authorize SWFGC and its associated staff to collaborate internally and to provide services that are considered necessary and advisable.
I understand and agree that I will participate in the planning and treatment of these services and that I may stop such services at any time. By signing below, I acknowledge that I have read, understood, and agree to the Service Policies stated above.