Privacy
Policy Notice
This notice describes
how health and service information about you may be used and disclosed and how
you can get access to this information. Please review it carefully. You should
read this Notice before signing the Authorization of Disclosure for Release of
Information Consent Form for treatment, payment and health care operations of
OPTIONS.
I. Our Duty to
Safeguard Your Protected Health Information (PHI)
Individually
identifiable information about your past, present, or future health or
condition, the provision of health care to you, or payment for the 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 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 so, we will post a new Notice in the Main Office. You may request a
copy of the new notice from the front desk or our Privacy Information
Officer.
II. How We May Use and
Disclose Your Protected Health Information
We use and disclose
PHI for a variety of reasons. For most uses/disclosures, we must obtain your
consent. For others, we must have your written authorization. However, the law
provides that we are permitted to make some uses/disclosures without your
consent or authorization. The following offers more description and examples of
our potential uses/disclosures of your PHI.
Uses and Disclosures
Relating to Treatment Payment, or Health Care Operations
Generally, we must
have your consent to use/disclose your PHI:
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For services:
We may disclose your PHI to staff members, volunteers, and other service
delivery personnel who are involved in providing your services. For example,
your PHI will be shared among members of your service management team, or with
your treatment providers including therapists, teachers and other professionals,
etc. |
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To obtain payment:
We may use/disclose your PHI in order to bill and collect payment for your
services. For example, we may release portions of your PHI to Medicaid, a
private insurance plan, or a state office to get paid for services that we
delivered to you. |
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For service
operations: We may
use/disclose your PHI in the course of operating our agency. For example, we may
use your PHI in evaluating the quality of services provided, or disclose your
PHI to our accountant or attorney for audit purposes. Since we are an integrated
system, we may disclose your PHI to designated staff in our central office for
similar purposes. Release of your PHI to the county, state, and/or the Medicaid
agency might also be necessary to determine your eligibility for publicly funded
services. |
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Appointment
reminders: Unless you provide
us with alternative instructions, we may send appointment reminders and other
similar materials to your home. |
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Exceptions:
Although your consent is usually required for the use/disclosure of your PHI for
the activities described above, the law allows us to use/disclose your PHI
without your consent in certain situations. For example, we may disclose your
PHI if needed for emergency treatment if it is not reasonably possible to obtain
your consent prior to the disclosure and we think that you would give consent if
able. Also, if we are required by law to provide your treatment, we may
use/disclose your PHI for treatment, payment and operations without obtaining
your prior consent. |
Uses and Disclosures
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 below. Like consents, authorizations can
be revoked at any time to stop future uses/disclosures except to the extent that
we have already undertaken an action in reliance upon your authorization.
Uses and Disclosures
Not Requiring Consent or Authorization
The law provides that
we may use/disclose your PHI without consent or authorization in the following
circumstances:
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When required by law:
We may disclose PHI when a law requires that we report information about
suspected abuse, neglect or domestic violence, or relating to suspected criminal
activity, or in response to a court order. We must also disclose PHI to
authorities who monitor compliance with these privacy requirements. |
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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. |
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For health oversight
activities: We may disclose
PHI to an accrediting organization or another agency responsible for monitoring
the health care system for such purposes as reporting or investigation of
unusual incidents. |
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Relating to decedents:
We may disclose PHI relating to an individual's death to coroners, medical
examiners or funeral directors, and to organ procurement organizations relating
to organ, eye, or tissue donations or transplants. |
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For research purposes:
In certain circumstances, and under supervision of a privacy board, we may
disclose PHI to other agencies in order to assist medical/psychiatric research. |
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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. |
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For specific
government functions: We may
disclose PHI of military personnel and veterans in certain situations, to
correctional facilities in certain situations, to government programs relating
to eligibility and enrollment, and for national security reasons, such as
protection of the President. |
Uses and Disclosures
Requiring That You Have an Opportunity to Object
In the following
situations, we may disclose your PHI if we inform you about the disclosure in
advance and you do not object. However, if there is an emergency situation and
you cannot be given your opportunity to object, disclosure may be made if it is
consistent with any prior expressed wishes and disclosure is determined to be in
your best interests. You must be informed and given an opportunity to object to
further disclosure as soon as you are able to do so.
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Client Directories:
Your name, location, general condition, and religious affiliation may be put
into our client directory for use by clergy and callers or visitors who ask for
you by name.
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To families, friends
or others involved in your care:
We may share with these people information directly related to your family's,
friend's or other person's involvement in your care, or payment for your care.
We may also share PHI with these people to notify them about your location,
general condition, or death.
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Volunteer committees
and individuals involved in helping OPTIONS: Secure resources needed for your
service and the achievements of one or more of your stated desired outcomes.
Examples included the Supported Work Committee, Behavior Committee, volunteers
with social/recreational activities, attorneys, therapists, photographers/videographers,
landlords, etc.
III. Your Rights
Regarding Your Protected Health Information
You have the following
rights relating to your protected health information:
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To request
restrictions on uses/disclosures:
You have the right to ask that we limit how we use or disclose your PHI. We will
consider your request, but are not legally bound to agree to the restriction. To
the extent that we do agree to any restrictions on our use/disclosure of your
PHI, we will put the agreement in writing and abide by it except in emergency
situations. We cannot agree to limit uses/disclosures that are required by law. |
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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 for us to do so. |
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To inspect and copy
your PHI: Unless your access
is restricted for clear and documented treatment reasons, you have a right to
see your protected health information if you put your request in writing. 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,
but may be waived, 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. |
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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 correct or add to the record. We will respond
within 60 days of receiving your request. We may deny the request if we
determine that the PHI is: (i) correct and complete; (ii) not created by us
and/or not part of our records, or; (iii) not permitted to be disclosed. Any
denial will state the reasons for denial and explain your rights to have the
request and denial, along with any statement in response that you provide,
appended to your PHI. If we approve the request for amendment, we will change
the PHI and so inform you, and tell others that need to know about the change in
the PHI. |
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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
which you gave consent (i.e. for treatment, payment, operations, to you, your
family, or the facility directory). The list also will not include any
disclosures made for national security purposes, to law enforcement officials or
correctional facilities, or before April, 2003. We will respond to your written
request for such a list within 60 days of receiving it. Your request can relate
to disclosures going as far back as six years. There will be no charge for up to
one such list each year. There may be a charge for more frequent requests. |
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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. If you request an electronic copy via email, you must sign a consent
form to allow us to communicate with you in that manner. |
IV. How to Complain
about our Privacy Practices
If you think we may
have violated your privacy rights, or you disagree with a decision we made about
access to your PHI, you may file a complaint with the person listed in Section V below. You also may file a written complaint with the Secretary of the U.S.
Department of Health and Human Services at 200 Independence Avenue, S.W.;
Washington, DC 20201, or reach the Secretary by phone at (202) 690-7000. We will
take no retaliatory action against you if you make such complaints.
V. Contact Person
for Information, or to Submit a Complaint
If you have questions
about this Notice or any complaints about our privacy practices, please contact:
Human Resources and Privacy Information Officer
OPTIONS
19362
West Shelton Road
Hammond,
LA, 70401
Telephone:
985-345-6269 • Fax: 985-345-0297
Info@Options4u.org
VI. Effective Date
This
Notice was effective on April
14, 2003.
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