NOTICE OF PRIVACY PRACTICES

Although your health record is the physical property of the Helen Farabee Regional MHMR Centers (HFRMHMRC), the information belongs to you. You have the right to:

§         Request a restriction on certain uses and disclosures of your information as provided by 45 CFT 164.522. HFRMHMRC may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency.

§         Obtain a paper copy of the notice of privacy practices upon request,

§         Inspect and obtain a copy of your health record as provided for in 45 CFR 164.524.

§         Request changes to your health record as provided in  45 CFR 164.528,

§         Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528, will not include disclosures made before April 14, 2003,

§         Request communications of your health information by alternative means or at alternative locations,

§         Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

This organization is required to:

§         The law requires us to protect the privacy of your health information.

§         We are required to give you this notice of our legal duties and privacy practices with respect to information we collect and maintain about you

§         Abide by the terms of this notice

§         Notify you if we are unable to agree to a requested restriction

§         Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will provide you with a copy of the revised notice.

We will ask for your written permission (authorization or consent) to use or disclose your health information.

We will not disclose information about you related to HIV/AIDS without your specific written permission, unless the law allows us to disclose the information.

Treatment

We may use health information about you to provide you with medical treatment or services. This includes providing care to you, consulting with another health care provider about you and

Referring you to another health care provider. For example, we can use your health information to prescribe medication for you. Unless you ask us not to, we may also contact you to remind you of an appointment or to offer treatment alternatives or other health-related information that may interest you.

Payment

We can use or disclose your health information to obtain payment for providing health care to you or to provide benefits to you under health plan such as the Medicaid program. For example, we can use your health information to bill your insurance company for health care provided to you.

Notice to applicants and recipients of financial assistance or payments under federal benefit programs; any information provided by you  may be subject to verification through matching programs.

Health Care Operations

We can also use your health information for health care operations; for activities to improve health care, evaluating programs, and developing procedures; reviewing the competence, qualifications, performance of health care professionals and others; conducting accreditation, certification, licensing, or credentialing activities; providing medical review, legal services, or audit functions; and engaging in business planning and management or general administration.

§         When required by law

§         National security and Intelligence activities              

§         To report suspected child abuse or neglect             

§         To address a serious threat to health or safety                     

§         For research

§         For public health and health oversight activities

§         Medical examiners/Coroners/Funeral Directors

§         Correctional Institution

§         Marketing/Fundraising

§         For government benefit programs

§         In judicial and administrative proceedings.

§         Commitment proceedings

§         Court-ordered examinations

§         Proceedings regarding abuse or neglect

§         License revocation proceedings

§         To the Secretary of Health and Human Services.

The confidentiality of alcohol and drug abuse client records maintained by this Center is protected by federal law and regulations. Generally, the program may not say to a person outside the Center that a client attends the program, or disclose any information identifying a client as an alcohol, drug or substance user, except as allowed by law.

HFRMHMRC may only disclose information about your treatment for alcohol or drug abuse without your permission in the following circumstances:

§         Pursuant to a special court order that complies with 42 Code of Federal Regulations Part 2 subpart E;

§         To medical personnel in a medical emergency;

§         To qualified personnel for research, audit, or program evaluation;

§         To report suspected child abuse or neglect;

Federal and State laws prohibit redisclosure of information about alcohol or drug abuse treatment without your permission.

If you believe your privacy rights have been violated and would like to file a complaint or would like further information regarding your rights or regarding uses and disclosures you may contact:

            U.S. Department of Health and Human Services
            200 Independence Avenue, S.W.
            Washington, D.C.  20201
            (800) 368-1019 

            Privacy Officer
            516 Denver
            Wichita Falls, Tx. 76301
            (940) 720-3516

You must file your complaint within 180 days of when you knew or should have known about the event that you think violated your privacy rights.

There will be no retaliation for filing a complaint.

Effective Date March 17, 2003. Version I