Notice of Privacy Practices

We are required by the Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule to provide a “Notice of Privacy Practices” to inform you about:

• How your medical information may be used and disclosed
• How you can get access to your health information

We are also required, by law, to state in writing that you received the notice:

• The law does not require you to sign the “Acknowledgement of receipt of notice of Notice of Privacy Practices”.
• Signing the acknowledgment does not mean that you have agreed to any special uses or disclosures (sharing) of your health records.
• Refusing to sign the acknowledgement does not prevent us from using or disclosing health information as HIPAA permits.
• If you refuse to sign the acknowledgement, we must keep a record of this fact.

Following is a summary our Notice of Privacy Practices:

Your Rights:

• Get an electronic or paper copy of your medical record.
• Ask us to correct your medical record.
• Request confidential communications.
• Ask us to limit what we use or share.
• Get a list of those with whom we have shared information.
• Get a copy of this Privacy Notice.
• Choose someone to act for you.
• File a complaint if you feel your rights are violated.

Your Choices

• For certain health information you can tell us your choices about what we share.
• In some cases, we never share your information unless you give us written permission.

Our Uses & Disclosures

• Treat you.
• Run our organization.
• Bill for your services.
• Help with public health and safety issues.
• Do research.
• Comply with the law.
• Respond to organ & tissue donation requests.
• Work with medical examiner or funeral director.
• Address workers’ compensation, law enforcement and other government requests.
• Respond to lawsuits and legal actions.

Our Responsibilities

• Maintain privacy and security of your PHI.
• Advise you of breaches that might compromise your PHI.
• Follow the duties & practices of this notice.
• Not use or disclose your information other than as prescribed

Where You Can Find Our “Notice of Privacy Practices”

Our Notice of Privacy Practices can be found:

• Located in this Client Handbook
• Posted in our Agency office; and/or,
• Displayed on patient online knowledgebase

You will receive a Notice of Privacy Practices:

• Usually at your initial assessment
• In an urgent situation, you will receive notice as soon as possible after the event.

Anyone may request to see our Notice of Privacy Practices.