Privacy Statement
NOTICE OF PRIVACY PRACTICES:
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Effective Date: April 14, 2003
Our Duty to Safeguard Your Protected Health Information Individually identifiable information about your past, present or future health or condition, the provision of health care to you, or payment for health care is considered "Protected Health Information (PHI)." We are required to extend certain protections to your PHI, and to give you this Notice about our privacy practices that explains how, when, and why we may use or disclose your PHI. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the intended purpose of the use or disclosure.
We are required to follow the privacy practices described in this Notice, though we reserve the right to change our privacy practices and the terms of this Notice at any time. If we do change this Notice, a revised notice will be available to you at NEIGHBORING, and will also be sent to you in the mail at the address you provide.
How We May Use and Disclose Your Protected Health Information
With your consent, we have a limited right to use and/or disclose your PHI for the purposes of treatment, payment, and for our healthcare operations. For use beyond that, we must have your written permission unless the law permits or requires us to make the use or disclosure without your authorization. If we disclose your PHI to an outside entity in order to perform a function on our behalf, we must have in place an agreement from the outside entity that it will extend the same degree of privacy protection to your information that we do. However, the law provides that we are permitted to make some disclosures without your consent or authorization. Generally, we may use or disclose your PHI as follows:
For treatment:
We may disclose your PHI to doctors, nurses, counselors and other personnel who are involved in providing your health or mental health care. For example, your PHI will be shared among members of your treatment team at NEIGHBORING. Your PHI may also be shared with outside entities performing ancillary services, such as lab work, or with the central pharmacy program to assist in obtaining medication for you.
To obtain payment:
We may use/disclose your PHI in order to bill and collect payment for treatment and services provided to you. For example, we may release portions of your PHI to the Medicaid program, to a private insurance company, or through the state’s MACSIS (Multi- Agency Community Information System) system, in order to be paid for services that we provided to you.
For health care operations:
We may use or disclose your PHI in the course of operating our agency. For example, we may review your PHI in the course of evaluating the quality of services provided at NEIGHBORING, or share your PHI with our accountant or attorney for auditing purposes. Release of your PHI to the state MACSIS system may also be necessary for determining your eligibility for publicly funded services.
Uses and Disclosures of PHI Requiring Authorization
For uses and disclosures beyond treatment, payment and operations purposes, we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described in the following section. You may revoke your authorization at any time to stop future use or disclosure, except to the extent that we have already disclosed information before you revoked your permission.
Uses and Disclosures of PHI from Mental Health Records Not Requiring Consent or Authorization
The law provides that we may use/disclose your PHI from mental health records without your consent in the following circumstances:
When required by law:
We may disclose PHI when a law requires that we report information about suspected abuse or neglect, or domestic violence, or relating to suspected criminal activity, or in response to a court order. We must also disclose PHI to authorities that monitor our compliance with these privacy requirements.
For public health activities:
We may disclose PHI when we are required to collect information about disease or injury, or to report vital statistics to the public health authority.
For health oversight activities:
We may disclose PHI to the protection and advocacy agency, or to another agency responsible for monitoring the healthcare system for such purposes as reporting or investigation of unusual incidents, and monitoring of the Medicaid program.
Relating to decedents:
We may disclose PHI related to a death, to coroners, medical examiners or funeral directors, as necessary to carry out their duties, and to organ procurement organizations relating to organ, eye, or tissue donations or transplants.
For research purposes:
In certain circumstances, and under supervision of a privacy board, we may disclose PHI to research staff and their designees in order to assist or participate in medical or psychiatric research.
To avert threat to health or safety:
In order to avoid a serious threat to health or safety, we may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm.
For specific government functions:
We may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government benefit programs relating to eligibility and enrollment, and for national security reasons, such as protection of the President.
Uses and Disclosures of PHI from Alcohol and Other Drug Records Not Requiring Consent or Authorization
The law provides that we may use/disclose your PHI from alcohol and other drug records without consent or authorization in the following circumstances:
When required by law:
We may disclose PHI when a law requires that we report information about suspected child abuse or neglect, or when a crime has been committed on the program premises or against program personnel, or in response to a court order.
Relating to decedents:
We may disclose PHI relating to an individual’s death if state or federal law requires the information for collection of vital statistics or inquiry into cause of death.
For research, audit or evaluation purposes:
In certain circumstances, we may disclose PHI for research, audit or evaluation purposes.
To avert threat to health or safety:
In order to avoid a serious threat to health or safety, we may disclose PHI to law enforcement when a threat is made to commit a crime on the program premises or against program personnel.
Your Rights Regarding Your Protected Health Information
You have the following rights relating to your Protected Health Information:
To request restrictions on uses/disclosures:
You have the right to ask that we limit how we use or disclose your PHI. We do not have to agree to your request. However, to the extent that we do agree, we will put the restriction in writing and abide by it except in emergency situations. We cannot agree to limit uses/disclosures that are required by law.
To choose how we contact you:
You have the right to ask that we send you information at an alternative address or by an alternative means. We must agree to your request as long as it is reasonably easy or feasible for us to do so.
To inspect and request a copy of your PHI:
Unless your access to your records is restricted for clear and documented treatment reasons, you have a right to see your PHI upon your written request. We will respond to your request within 30 days. If we deny your access, we will give you written reasons for the denial and explain any right to have the denial reviewed. If you want copies of your PHI a charge for copying may be imposed, depending on your circumstances. You have a right to choose what portions of your information you want copied, and to have prior information on the cost of copying.
To request amendment of your PHI:
If you believe that there is a mistake or missing information in our record of your PHI, you may request in writing that we amend the record. We will respond within 60 days of receiving your request. We may deny the request if we determine that the PHI is: (a) correct and complete; (b) not created by us and/or not part of our records; (c) not permitted to be disclosed. Any denial will state the reasons for denial and explain your rights to have your request and the denial appended to your PHI, along with any statement you may provide in response to the denial. If we approve the request for amendment, we will amend the PHI and so inform you, and tell others that need to know about the amendment in the PHI.
To find out what disclosures have been made:
You have a right to get a list of when, to whom, for what purpose, and what content of your PHI has been released, other than instances of disclosure for treatment, payment, or healthcare operations, or disclosures made to you, your family, or with your written authorization. The list also will not include any disclosures made for national security purposes, to law enforcement or corrections facilities, or disclosures made before April, 2003. We will respond to your written request for such a list within 60 days of receiving it. There will be no charge for providing you up to one such list each year. There may be a charge for more frequent requests.
You Have the Right to Receive this Notice
You have a right to receive a paper copy of this Notice and/or an electronic copy by email upon request.
How to File a Complaint About Our Privacy Practices
If you think we may have violated your privacy rights, or you disagree with a decision we make about access to your PHI, you may file a complaint with the person(s) listed below. You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Ave SW, Washington D.C. 20201, or by calling 1-877-696-6775. We will take no retaliatory action against you if you make such complaints.
Contact Person(s) for Information or to Submit a Complaint
If you have questions about this Notice or any complaints about our privacy practices, please contact:
Ms. Laurie Rider, Client Rights Officer, OR
Mr. Kenneth Gill, Privacy Officer
NEIGHBORING
5930 Heisley Rd.
Mentor, OH 44060
Phone: (440) 354-9924
Fax: (440) 354-5808