The Human Resources Center
of Edgar and Clark
Counties
The Human Resources Center
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PRIVACY POLICY HUMAN
RESOURCES CENTER OF EDGAR AND CLARK COUNTIES THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE
REVIEW THIS NOTICE CAREFULLY. Your health record contains personal information about you and your health. State and federal law protects the confidentiality of this information. Protected Health Information (“PHI”) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. The confidentiality of mental health and alcohol and drug abuse patient records is specifically protected by Federal law and regulations. The confidentiality of mental health patient records is specifically protected by state law. The Human Resources Center of Edgar and Clark Counties (HRC) is required to comply with these additional restrictions. This includes a prohibition, with very few exceptions, on informing anyone outside the program that you attend the program, or disclosing any information that identifies you as an alcohol or drug abuser or mental health patient. The violation of these laws or regulations by this program is a crime. If you suspect a violation you may file a report to the appropriate authorities in accordance with applicable law. How We May
Use and Disclose Health Information About You §
For
Treatment. We may use medical and
clinical information about you to provide you with treatment or services. §
For
Payment. We may use and disclose medical information about you
so that we can receive payment for the treatment services provided to you.
If you are receiving substance abuse treatment services, this will only
be done with your authorization. §
For
Health Care Operations. We
may use and disclose your PHI for certain purposes in connection with the
operation of our program. §
Without
Authorization. Applicable law also permits us to disclose
information about you without your authorization in a limited number of other
situations, such as with a court order. These
situations are explained on the following pages. §
With
Authorization. We must obtain written authorization from you for other
uses and disclosures of your PHI. Your Rights
Regarding Your PHI.
You have the
following rights regarding PHI we maintain about you: §
Right
of Access to Inspect and Copy. You
have the right, which may be restricted in certain circumstances, to inspect and
copy PHI that may be used to make decisions about your care.
We may charge a reasonable, cost-based fee for copies.
§
Right
to Amend. If you feel that the PHI we have about you is
incorrect or incomplete, you may ask us to amend the information although we are
not required to agree to the amendment. §
Right
to an Accounting of Disclosures. You
have the right to request an accounting of the disclosures that we make of your
PHI. §
Right
to Request Restrictions. You
have the right to request a restriction or limitation on the use or of your PHI
for treatment, payment, or health care operations.
We are not required to agree to your request.
§
Right
to Request Confidential Communication. You
have the right to request that we communicate with you about medical matters in
a certain way or at a certain location. §
Right
to a Copy of this Notice. You
have the right to a copy of this notice. §
Complaints.
You have the right to file a complaint in writing to
us or to the Secretary of Health and Human Services if you believe we have
violated your privacy rights. We
will not retaliate against you for filing a complaint. If you have any
questions about this Notice of Privacy Practices, please contact our Privacy
Officer: Starr Nelson, Director of Operations P.O. Box 118, Paris IL, 61944;
217-465-4118, ext. 249; starr.nelson@hrcec.org This Notice of Privacy Practices describes how we may use and disclose your protected health information (“PHI”) in accordance with all applicable law. It also describes your rights regarding how you may gain access to and control your PHI. We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will make available a revised Notice of Privacy Practices by posting a copy on our website at www.hrcec.org , sending a copy to you in the mail upon request, or providing one to you at your next appointment. How We May Use and Disclose Health Information About You Listed below are examples of the uses and
disclosures that HRC may make of your PHI.
These examples are not meant to be exhaustive, but describe the types of
uses and disclosures that may be made. Uses
and Disclosures of PHI for Treatment, Payment and Health Care Operations Treatment.
Your PHI may be used and disclosed by
your physician, counselor, program staff and others outside of our program who
are involved in your care for the purpose of providing, coordinating, or
managing your health care treatment and any related services. This includes
coordination or management of your health care with a third party, consultation
with other health care providers or referral to another provider for health care
treatment. For example, your protected health information may be provided to the
state agency that referred you to our program to ensure that you are
participating in treatment. In addition, we may disclose your protected health
information from time-to-time to another physician or health care provider
(e.g., a specialist or laboratory) who, at the request of the program, becomes
involved in your care. Except for
emergency services, we will not send your PHI to an outside health care provider
who is caring for you unless you give us written authorization to do so.
Payment.
Examples
of payment-related activities are: making a determination of eligibility or
coverage for insurance benefits, processing claims with your insurance company,
reviewing services provided to you to determine medical necessity, or
undertaking utilization review activities.
If you are in a substance abuse treatment program, we will not use your
PHI to obtain payment for your health care services without your written
authorization. If you are in a mental health program, we may use your PHI to
obtain payment for your health care services without your written authorization.
Healthcare
Operations. We
may use or disclose, as needed, your PHI in order to support the business
activities of our program including, but not limited to, quality assessment
activities, employee review activities, training of students, licensing, and
conducting or arranging for other business activities.
For example, we may use a
sign-in sheet at the registration desk where you will be asked to sign your name
and indicate your physician or counselor. We may also call you by name in the
waiting room when it is time to be seen. We may share your PHI with third
parties that perform various business activities (e.g., billing or typing
services) for HRC, provided we have a written contract
with the business that prohibits it from re-disclosing your PHI and requires it
to safeguard the privacy of your PHI. We
may contact you to remind you of your appointments or to provide information to
you about treatment alternatives or other health-related benefits and services
that may be of interest to you. We
may also contact you concerning HRC’s fundraising activities.
Other
Uses and Disclosures That Do Not Require Your Authorization Required by Law. We may
use or disclose your PHI to the extent that the use or disclosure is required by
law, made in compliance with the law, and limited to the relevant requirements
of the law. You will be notified,
as required by law, of any such uses or disclosures. Under the law, we must make disclosures of your PHI to you upon your
request. In addition, we must make
disclosures to the Secretary of the Department of Health and Human Services for
the purpose of investigating or determining our compliance with the requirements
of the Privacy Rule. Health Oversight. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors) and peer review organizations performing utilization and quality control. Medical Emergencies. We
may use or disclose your PHI in a medical emergency situation to medical
personnel only. Our staff will try to provide you a copy of this notice as soon
as reasonably practicable after the resolution of the emergency. Child Abuse or Neglect. We may disclose your PHI to a state or local agency that is authorized by law to receive reports of child abuse or neglect. However, the information we disclose is limited to only that information which is necessary to make the initial mandated report. Deceased Patients. We may disclose PHI regarding deceased patients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics, or permitting inquiry into the cause of death. Research. If you are in
a substance abuse treatment program only, we may disclose PHI to researchers if
(a) an Institutional Review Board reviews and approves the research and a waiver
to the authorization requirement; (b) the researchers establish protocols to
ensure the privacy of your PHI; (c) the researchers agree to maintain the
security of your PHI in accordance with applicable laws and regulations; and (d)
the researchers agree not to re-disclose your protected health information
except back to HRC. Criminal Activity on Program Premises/Against Program Personnel. We may disclose your PHI to law enforcement officials if you have committed a crime on program premises or against program personnel. Court Order. We may disclose your PHI if the court issues an appropriate order and follows required procedures. Interagency Disclosures. Limited PHI may be disclosed for the purpose of coordinating services among government programs that provide mental health services where those programs have entered into an interagency agreement. Public Safety. If you are in a mental health treatment program only, we may disclose PHI to avert a serious threat to health or safety, such as physical or mental injury being inflicted on you or someone else. Uses
and Disclosures of PHI With Your Written Authorization Other uses and disclosures of your PHI will be made only with your written authorization. You may revoke this authorization at any time, unless the program or its staff has taken an action in reliance on the authorization of the use or disclosure you permitted. Your Rights Regarding Your Protected
Health Information Your rights with respect to your protected health information are explained below. Any requests with respect to these rights must be in writing. A brief description of how you may exercise these rights is included. You
have the right to inspect and copy your Protected Health Information You may
inspect and obtain a copy of PHI that is contained in a designated record set
for as long as we maintain the record. A
“designated record set” contains medical and billing records and any other
records that the program uses for making decisions about you.
Your request must be in writing, except if you are in a mental health
treatment program in which case we will accept a verbal request.
We may charge you a reasonable cost-based fee for the copies. We can deny
you access to your PHI in certain circumstances.
In some of those cases, you will
have a right to appeal the denial of access.
Please contact our Privacy Officer if you have questions about access to
your medical record. You may have the right to request amendment of your Protected Health
Information.
You may request, in writing, that we amend PHI that has been included in a designated record set. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with a copy of it. Please contact the HRC Privacy Officer if you have questions about amending your medical record. You have
the right to receive an accounting of some types of Protected Health Information
disclosures.
You may request an accounting of disclosures for a period of up to six years (excluding disclosures made to you, made for treatment purposes, made as a result of your authorization, and certain other disclosures). We may charge you a reasonable fee if you request more than one accounting in any 12-month period. Please contact our Privacy Officer if you have questions about accounting of disclosures. You
have a right to receive a paper copy of this notice. You have the right to obtain a copy of this notice from us. Any questions should be directed to our Privacy Officer. You have the right to request added
restrictions on disclosures and uses of your Protected Health Information. You have the right to ask us not to use or disclose any part of your PHI for treatment, payment or health care operations or to family members involved in your care. Your request for restrictions must be in writing and we are not required to agree to such restrictions. Please contact our Privacy Officer if you would like to request restrictions on the disclosure of your PHI. You have a right to request confidential communications. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable, written requests. We may also condition this accommodation by asking you for information regarding how payment will be handled or specification of an alternative address or other method of contact. We will not ask you why you are making the request. Please contact the Privacy Officer if you would like to make this request. Complaints
If you
believe we have violated your privacy rights, you may file a complaint in
writing to us by notifying our Privacy Officer, Starr Nelson at P.O.
Box 1118, Paris, Illinois, 61944;
217-465-4118, extension 249; or by e-mail at starr.nelson@hrcec.org. We will not retaliate against you for
filing a complaint. You may also file a complaint with the
U.S. Secretary of Health and Human Services as follows:
200 Independence Avenue, S.W. Washington, D.C. 20201 (202) 619-0257 The effective date of this Notice is April 14, 2003. |
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