CSB Medical Records, Client Rights, Services & Fees, Dispute Resolution and CSB Board Meetings
Client Portal- Access Your CSB Medical Records
Clients of CSB services-- including mental health, substance use treatment and intellectual/developmental disabilities-- can view their CSB treatment records and bills, enjoy messaging, and much more right from a cell phone or computer. See the printable flyer.
Follow the steps below to set up your secure user account.
STEP 1- Request access through your CSB Case Manager, Intake or Reception staff. Adults and/or legal guardians must register to view information for those under 18 years of age. After requesting access to the client portal, you will receive an email within two business days with a registration key code and link.
STEP 2- Enter all information requested and follow all instructions as you register.
STEP 3- Once all steps have been followed you will have access to your client information.
Clients may call a case manager or email DCHSClientPortal@alexandriava.gov. (Please note--social service records are not available in this portal.)
For third-party chart requests, please email email@example.com.
Requesting Behavioral Health Medical Records
To request copies of CSB/behavioral health medical records, call 703.746.3555 and speak to any of the staff. You can also walk into our office at the Del Pepper Community Resource Center (4850 Mark Center Drive), go to the second floor reception and ask for H.I.M./Medical Records. To send a release of information form, please email MHMedicalRecords@alexandriava.gov .
The following handouts are provided to all clients of Alexandria Community Services Board behavioral health programs at intake and are reviewed annually.
The No Surprises Act
Disclosure of Rights and Requirements for the No Surprises Act
A new Federal law. “The No Surprises Act”, requires that health care providers give written cost estimates for services. The written estimate is referred to as a “Good Faith Estimate”. The law is intended to protect people from surprise medical bills. This is called No Surprise Billing.
- If you schedule an appointment or service at least three business days in advance, you must receive a Good Faith Estimate, at least one business day after scheduling the appointment.
- If you scheduled an appointment or service at least 10 business days in advance, you must receive a Good Faith Estimate within three business days after scheduling. (Emergency services is not required to give estimates prior to service.)
The notice can be provided to you via email or standard mail. If you have an insurance that Alexandria Services Board (ACSB) participates in, your insurance will be billed, and if the service is covered by your insurance, you will not be required to pay any additional amounts outside of Copay, Deductible and Co-insurance.
The estimates that you receive are based on the full cost of the service which is the maximum you would owe for the service. Your actual cost may be lower than this amount based on your income and family household size. The amount you will have to pay is based on a sliding scale and is called the monthly liability. (See attachments: liability fee scale and fees for services.)
At intake and annually your liability will be determined. At intake, services will be recommended to you in addition to discussing “Freedom of Choice”. This means that your provider will explain the recommended services and alternatives, both within and outside of ACSB. Throughout your treatment episode with ACSB you may receive one or more services simultaneously or you may move from one service to another. Each time new services are recommended and accepted by you, you will be given a cost estimate and a choice of alternative services.
Payment disputes between uninsured (or self-pay) consumers and providers
After you get the care, if you’re billed an amount that’s more than $400 over the estimate you received, you can use a new patient-provider dispute resolution process to determine a payment amount. This process uses a third-party arbitrator to review your good faith estimate, final bill, and information submitted by your provider or facility.
You can use this dispute process if you meet these 5 conditions: You’re uninsured or self-pay (meaning you have insurance but don’t plan to have your health insurance pay for the care)
- You got medical items or services on or after January 1, 2022
- You have a good faith estimate from your provider or the facility who provided your care
- You got a bill within the last 120 calendar days
- The difference between the good faith estimate and your bill is at least $400
Attached is the full disclosure related to No Surprise Billing and a link to the Center for Medicaid Services. If you have further questions, please contact our reimbursement department between the hours of 8am to 4pm at 703.747.3444.
All clients of Alexandria Community Services Board (CSB) programs have the right to file a complaint about a program and to seek a satisfactory resolution. Please see the department policy for details. The following actions will be taken when a client has a complaint or is not in agreement with a program decision.
1. Clients may express complaints in a variety of manners: gestures to indicate displeasure if they are unable to verbally communicate, verbally, in writing or by completing the dispute resolution form available in all lobbies and public areas of the CSB including in the Residential Program group homes.
2. The complaint can be made to any member of the CSB staff. In all cases the client and/or their designee will be offered the contact information for CSB human rights advocate.
3. The client will receive a response within 24 business hours of submitting the complaint. The individual making the complaint can have a family member, friend, or anyone of their choosing present during the resolution process and/or make a complaint on their behalf. If the client has an authorized representative (AR) or guardian, the staff person will inform and involve that individual in the resolution of the complaint. The client is encouraged to discuss their concerns and work with staff to attempt to resolve the problem as quickly as possible. Staff will institute a resolution within ten business days. The complaint and resolution will be documented in writing and provided to the client.
4. If after the program supervisor’s attempt to resolve the complaint, the client, guardian or AR is not satisfied with the resolution, the client will be informed of the appeal process and given the Center Director’s contact information and asked to appeal to the Center Director. The Center Director or their designee will investigate further and provide a written response to the client within five business days.
5. If the client is still not satisfied with the resolution, they have five working days to file a complaint with the CSB Executive Director. The Executive Director or their designee will investigate further if appropriate and provide a written response to the client within five business days.
6. If the client is still not satisfied with the resolution, they have five working days to file a complaint with the Department of Community and Human Services Department Director. The Department Director or their designee will investigate further if appropriate and provide a written response to the complainant within five business days. The decision of the Department Director is final.
Release of Information Forms
These forms, available in four languages, are for general authorization to use and exchange information. Also available are forms specific to the release of information from the Alexandria Sexual Assault Center and Domestic Violence Program.
About the CSB Board
The Alexandria Community Services Board (CSB) is a group of 12 volunteers appointed by Alexandria City Council. The
CSB oversees the use of public funds to provide mental health, developmental disability and substance abuse services through the Department of Community and Human Services. The Department has a Center of Administration and three service centers: Center for Adult Services, Center for Children and Families and Center for Economic Support.
CSB meetings are opened to the public. Meetings are held at 6:30 p.m. on the first Thursday of the month. (If there is a conflict, the meeting will be held on the second Thursday.) The board is on recess in July and August, resuming in September. Please call 703.746.3400 in advance to sign up to speak at a board meeting. Accommodations will be made for persons with a disability.
It is our policy not to discriminate in the admission or access to, or treatment or employment in, its programs and activities on the basis of race, color, sex, sexual orientation, handicap, religion or national or ethnic origins. Programs and activities are accessible to people with physically handicapping conditions. If you require accommodations, have any questions or complaints, please call 703.746.3400 and we will try to assist you.
Serving as an Alexandria Community Services Board Member
The Community Services Board has the responsibility for policy and budget direction, project development, and program oversight for all City of Alexandria mental health, intellectual disability and substance abuse services. The Board is also responsible for the development and implementation of a human rights policy for local programs providing services to individuals with mental illness, developmental disability and substance use disorders.
Number of Members
Six citizen members, four consumers (current or former direct recipient of public or private mental health, developmental disability or substance abuse treatment rehabilitation services) or family members of consumer (immediate family member or the principal caregiver who is not paid), one consumer who is currently receiving services and the Sheriff or the Sheriff's designee (Sheriff's designation to be delivered to CSB Chair).
Term of Service
City Staff Contact
DEPT. OF COMMUNITY & HUMAN SERVICES
For further information about the CSB, visit alexandriava.gov/Boards and search by board name. To apply to serve on this board or commission contact the City Clerk's Office at 703.746.4550.
CSB Board Meeting Agendas and Minutes
See the Alexandria Community Services Board's public meeting agendas and the final approved minutes summarizing the discussions of the previous meeting.
The Community Services Board has the responsibility for policy and budget direction, project development, and program oversight for all mental health, intellectual disability and substance use services. The Board is also responsible for the development and implementation of a human rights policy for local programs providing services to individuals with mental illness, intellectual disability and substance use disorders. The Board meets on the first Thursday of each month at 6:30 p.m. at 4850 Mark Center Drive, except during recess in July and August.