Online Counseling Disclosure

The Village Family Service Center believes in a client's right to self-determination.  The Village delivers service in a manner which provides for maximum freedom of choice by persons served including setting personal goals, being fully informed about service options, and making all possible decisions with regard to services.

Client's Rights

We pledge that you, as our client, have the right:

·     to prompt, confidential financial services;

·      to treatment with respect and courtesy;

·      to receive services from a qualified professional financial representative;

·      to be informed of the cost of services before receiving services;

·      to be free from being the subject of discrimination on the basis of race, religion,   gender or other unlawful category while receiving services; 

·      to be actively involved in a comprehensive assessment of your financial situation including an appropriate action plan; 

·      to have access to your file according to The Village policy (available in QA manual - Confidentiality/Data Privacy Standards of Practice); 

·      to express dissatisfaction through a complaint resolution process;

·      to discontinue your relationship with us at any time; 

·      to ask questions and to have your questions and concerns addressed. 

·      to confidentiality as defined by policy and law.  The Village maintains a strict policy on the confidentiality of your records (in both written and computer file form).  All information you share, or which we become aware of through our work with you, will remain confidential. There are some circumstances in which this policy becomes void and we are required by law to release information:

a. If we become aware through our work that you may be a danger to yourself or others,

b. If we become aware of or suspect child abuse or neglect,

c. If we become aware of or suspect abuse or neglect of a vulnerable adult (MN statute 626.557, ND statute - Vulnerable Adult Protection Services - Chapter 50-25-2)

d. If we are court ordered to testify or to submit our records to the court.

The Village's Expectations

As The Village provides services, it is expected:

1. That clients will be present and on time for appointments, or will call in advance to cancel or reschedule;
2. That clients will participate in service planning;
3. That clients will not exhibit abusive, threatening or assaultive behaviors (a copy of The Village's Behavior Management Standards of Practice is available upon request);
4. That clients will not be under the influence of chemicals during services.

The Village reserves the right to deny services based on the above criteria.

Counseling Agreement

As a client:

·      I understand that most of The Village Financial Resource Center funding is voluntary contributions from creditors who participate in Debt Management Plans (DMP). Since creditors have a financial interest in getting paid, most are willing to make a contribution to help fund our agency. These contributions are usually calculated as a percentage of payments made through DMP up to fifteen percent (15%) of each payment received. However, accounts with creditors will always be credited with one hundred percent (100%) of the amount paid through The Village and we work with all creditors regardless of whether they contribute to our agency.

·      I understand that DMPs are voluntary programs that serve the dual role of helping clients repay their debts, and helping creditors collect money owed them.

·      I will receive complete details of the operations, requirements and responsibilities if I enroll in The Village's DMP. Debt Management Services are not suitable for all debtors. There are other ways, including bankruptcy, to deal with indebtedness.

·      I am aware that a financial representative may answer questions about bankruptcy, but not give legal advice. If I want legal advice, I will be referred for appropriate assistance. While an attorney can make a recommendation to file bankruptcy, it is a personal choice based on individual circumstances.

Quality Improvement

The mission of our Quality Assurance program is to continually strive to improve the quality of systems through which we affect people's lives.  To measure client progress and satisfaction, we may use non-identifying demographic information (e.g. age, marital status, statement of problem) that you provide.

Complaint Procedure

As we continually strive to provide high-quality services to customers, we rely on our customers to let us know if something concerns them about the services we offer or our organization. Our customers have the right to make a complaint at any time. The complaint will be handled according to the following guidelines:

1. When a complaint is received by a staff person or other Village representative, the information is recorded on a Village Customer Complaint Form.
2. The form is passed on to the supervisor of the program or department involved.
3. The supervisor reviews the complaint and determines any follow-up, action or resolution within two weeks of the original complaint. Copies are forwarded to staff as necessary to ensure appropriate follow-up, training, etc. The complaint is passed on to the Quality Assurance department.
4. The complainant is informed of the resolution or outcome either in person, by telephone, or by letter if he/she is not anonymous and has agreed to be contacted. Client may appeal the outcome through any of the individuals/entities listed at the end of this document.
5. All complaints are reviewed on a quarterly basis by Quality Assurance teams made up of staff and Board members. Based on trends or patterns of complaints, ideas are discussed and action plans may be created to change and/or improve service to our customers.
6. All complaints are maintained in the agency's Quality Assurance department.

If you think we need to improve in any area and wish to let us know, you may write to:

The Village Family Service Center
ATTN: President
P.O. Box 9859
Fargo, ND 58106-9859

OR call The Village office where services were received (check local directory for number),
OR speak with your service provider or other Village representative,
OR provide comments on a customer satisfaction survey.
Thank you for your suggestions for improvement!

Privacy Policy|
The Village Financial Resource Center is committed to assuring the privacy of individuals and/or families who contact us for assistance. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. The following are examples of how this data may be used:

All Clients

1. To assist us in our work with you, our staff may seek supervision/consultation with professional colleagues within the agency and, where appropriate and necessary, with other resources in the community.

2. For the purpose of evaluating our services, gathering valuable research information and designing future programs, we may use aggregated case file information. Except as required by accrediting, licensing or funding entities, your anonymity will be maintained through the use of your client number or by using aggregate data.

Counseling Only

3. If you only receive financial counseling, and your creditors ask for information, we will confirm the following:

a) Verification of appointment 
b) Disposition (i.e. clients will handle affairs on their own, pending action)
c) Date of counseling
d) Other _______________________

Debt Management

4. If you enroll in the Debt Management Program, we will disclose the following to your creditors:

a) Your address and home phone number if published
b) Total debt information
c) Income, net and gross
d) Living expenses
e) A list of your creditors
f) Personal information concerning your financial circumstances, but not lifestyle or personal habits
g) Place of employment will be verified only

In all other situations, your information may be released to appropriate individuals or agencies only upon your written request or when our staff have been served by a valid subpoena.

The following Privacy Practices detail the circumstances under which we will release your information to a third party:

1. We do not disclose any non-public personal information about our clients or former clients to anyone, except as permitted by law.
2. We may compile data and aggregate information that you give to us, but this information may not be disclosed in a manner that would personally identify you in any way.
3. We may disclose some or all of the information that we collect, as described below, to creditors, or third parties that you have authorized who need this information in order to assist you after a counseling session.
4. We may disclose all of the information that we collect, as described below, to creditors and related financial institutions that need this information in order to put you on a Debt Management Plan (DMP).
5. We restrict access to non-public personal information about you to those employees who need to know that information to provide services to you.We maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your non-public personal information.
6. We collect non-public personal information about you from the following sources:
   • Information we received from you on our application or other forms you provide
   • Information about your transactions with us, your creditors, or others; and
   • Information we receive from a credit reporting agency.
7. We may disclose the following kinds of non-public personal information about you:
   • Information we receive from you on applications or other forms such as your name, address, social security number, assets, and income;
   • Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties to transactions and credit card usage; and
   • Information we receive from credit reporting agencies, such as your credit history.

RELEASE: I hereby authorize The Village Financial Resource Center to release all non-public information it obtains about me, as set forth above, to (1) my creditors and (2) any third parties necessary to resolve the matter(s) discussed during my counseling session, and (3) as required by accrediting, licensing or funding entities.

I further RELEASE and authorize all of my creditors to provide non-public information about me to The Village.