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LA
FAMILIA, INC.
Notice of Information Practices |
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| 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. |
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› Understanding
Your Mental Health Record Information
› Your Rights under
the Federal Privacy Standard
› Our Responsibilities
Under the Federal Privacy Standard
› How to Get More
Information or to Report a Problem
› Examples of Disclosures
for Treatment, Payment, and Health Operations |
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Understanding
Your Mental Health Record Information
Each time you visit a hospital, a physician, a therapist, or another health
care provider, a record is made of your visit. Typically, this record contains
your health history, current symptoms, examination and test results, diagnoses,
treatment, and plan for future care or treatment. This information, often
referred to as your medical record, is used for the following reasons:
• To plan your care and treatment.
• To communicate among the many health
professionals who contribute to your care.
• As a legal document describing the
care that you received.
• A means by which you or your insurance
company can verify that you actually received the services
billed.
• As a tool in medical education.
• As a source of information for public
health officials.
• As a tool to assess the appropriateness
and quality of care that you receive.
• As a tool to improve the quality of
your health care and your overall well being.
Understanding what is in your health records and how your health information
is used helps you to--
• Be sure it is correct and complete.
• Understand who, what, where, why,
and how others may access (view or use your) health information.
• Make informed decisions about who
will access your health information.
• Better understand your health information
rights detailed below.
Your Rights Under the Federal
Privacy Standard
Although your health records are the physical property of the health care
provider who provides you treatment, you have the following rights with
regard to the information in your medical record:
• You may request restriction on uses
and disclosures of your health information for treatment, payment,
and health care operations. “Health care operations” means
activities that are necessary to carry out the operations of
the provider, such as quality assurance and outcomes review.
Other uses and disclosures include, for example, those required
by law, such as mandatory communicable disease reporting to
public health officials. In those cases, you do not have a
right to request restriction. Please note that La Familia does
not have to agree to restrictions you might request. If we
do, we will abide by it unless you request otherwise or we
give you advance notice. You may also ask us to communicate
with you by alternate means, (e.g., having correspondence mailed
to a post office box rather than to your home) and if the method
of communication is reasonable, we must grant the alternate
communication request. You may request restriction or alternate
communications on the consent form for treatment, payment,
and health care operations.
• You may obtain a copy of this notice
of information practices. Although we have posted a copy in
prominent locations throughout the facility and on our website,
you have a right to a paper copy upon request.
• You may inspect and copy your health
information upon request. Again, this right is not absolute.
In certain situations, such as if access would cause harm,
we can deny access. You do not have a right of access to the
following:
» Psychotherapy notes. Such notes consist
of those notes that are recorded in any medium by a health care provider who
is a mental health professional documenting or analyzing a conversation during
a private, group, joint, or family counseling session and that are separated
from the rest of your medical record.
» Information compiled in reasonable
anticipation of or for use in civil, criminal, or administrative actions or proceedings.
» Protected health information (“PHI”)
to the extent that giving you access would be prohibited by law.
» Information that was obtained from
someone other than a health care provider under a promise of confidentiality
and the requested access would be reasonably likely to reveal the source of the
information. (E.g., a person who makes a claim of child abuse or neglect against
you, and who requests to remain anonymous.)
In other situations, we may deny you access, but if we do, we must provide
you a review of our decision denying access. These grounds for denial subject
to review include the following:
» A licensed healthcare professional,
such as your attending physician, has determined, in the exercise of professional
judgment, that the access is reasonably likely to endanger the life or physical
safety of yourself or another person.
» PHI makes reference to another person
(other than a health care provider) and a licensed health care provider has determined,
in the exercise of professional judgment, that the access is reasonably likely
to cause substantial harm to such other person.
» The request is made by your personal
representative and a licensed health care professional has determined, in the
exercise of professional judgment, that giving access to such personal representative
is reasonably likely to cause substantial harm to you or another person.
For these grounds subject to review, another licensed professional must
review the decision of the provider denying access within 60 days. If we
deny you access, we will explain why and what your rights are, including
how to seek review. If we grant access, we will tell you what, if anything,
you have to do to get access. We reserve the right to charge a reasonable,
cost-based fee for making copies.
• You may request amendment/correction
of your health information. We do not have to grant the request
if the following conditions exist:
» We did not create the record. If,
as in the case of a consultation report from another provider, we did not create
the record, we cannot know whether it is accurate or not. Thus, in such cases,
you must seek amendment/correction from the party creating the record. If the
party amends or corrects the record, we will put the corrected record into our
records.
» The records are not available to
you as discussed immediately above.
» The record is accurate and complete.
If we deny your request for amendment/correction, we will notify you why,
how you can attach a statement of disagreement to your records (which we
may rebut), and how you can complain. If we grant the request, we will
make the correction and distribute the correction to those who need it
and those whom you identify to us that you want to receive the corrected
information.
• You may obtain an accounting of non-routine
uses and disclosures, those other than for treatment, payment,
and health care operations. We do not need to provide an accounting
for the following disclosures:
» To you for disclosures of protected
health information to you.
» For the facility directory or to
persons involved in your care or for other notification purposes as provided
in § 164.510 of the federal privacy regulations (uses and disclosures requiring
an opportunity for the individual to agree or to object, including notification
to family members, personal representatives, or other persons responsible for
your care, of the your location, general condition, or death).
» For national security or intelligence
purposes under § 164.512(k)(2) of the federal privacy regulations (disclosures
not requiring consent, authorization, or an opportunity to object).
» To correctional institutions or law
enforcement officials under § 164.512(k)(5) of the federal privacy regulations
(disclosures not requiring consent, authorization, or an opportunity to object).
» That occurred before April 14, 2003.
If you request an accounting, we must provide the accounting within 60
days. The accounting must include the following information:
» Date of each disclosure.
» Name and address of the organization
or person who received the protected health information.
» Brief description of the information
disclosed.
» Brief statement of the purpose of
the disclosure that reasonably informs you of the basis for the disclosure or,
in lieu of such statement, a copy of your written authorization or a copy of
the written request for disclosure.
The first accounting in any 12-month period is free. Thereafter, we reserve
the right to charge a reasonable, cost-based fee.
• You may revoke your consent or authorization
to use or disclose health information except to the extent
that we have taken action in reliance on the consent or authorization.
Our Responsibilities
Under the Federal Privacy Standard
In addition to providing you your rights, as detailed above, the federal
privacy standard requires us to take the following measures:
• Maintain the privacy of your health
information, including implementing reasonable and appropriate
physical, administrative, and technical safeguards to protect
the information.
• Provide you this notice as to our
legal duties and privacy practices with respect to individually
identifiable health information that we collect and maintain
about you.
• Abide by the terms of this notice.
• Train our personnel concerning privacy
and confidentiality. |
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| WE
RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO
MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY
IDENTIFIABLE HEALTH INFORMATION THAT WE MAINTAIN.
IF WE CHANGE OUR INFORMATION PRACTICES, WE WILL MAIL
A REVISED NOTICE TO THE ADDRESS THAT YOU HAVE GIVEN
US. |
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• Implement
a sanction policy to discipline those who breach privacy/
confidentiality or our policies with regard thereto.
• Mitigate (lessen the harm of)
any breach of privacy/confidentiality.
• We will not use or disclose your
health information without your consent or authorization,
except as described in this notice or otherwise required
by law.
How to Get More Information
or to Report a Problem
If you have questions and/or would like additional information, you may
contact the privacy officer or the director of health information management
or privacy officer at (505) 766-9361.
Examples of Disclosures for
Treatment, Payment, and Health Operations
• If you give us consent, we
will use your health information for treatment. For
example: A physician, a physician’s assistant, a
therapist or a counselor, or another member of your health
care team will record information in your record to diagnose
your condition and determine the best course of treatment
for you. The primary caregiver will give treatment orders
and document what he or she expects other members of the
health care team to do to treat you. Those other members
will then document the actions they took and their observations.
In that way, the primary caregiver will know how you are
responding to treatment. We will also provide your physician,
other health care professionals, or a subsequent health
care provider, copies of your records to assist them in
treating you once we are no longer treating you.
• If you give us consent, we
will use your health information for payment. For
example: We may send a bill to you or to a third-party
payer, such as a health insurer. The information on or
accompanying the bill may include information that identifies
you, your diagnosis, treatment received, and supplies used.
• If you give us consent, we
will use your health information for health operations. For
example: Members of the clinical staff, the risk or quality
improvement manager, or members of the quality assurance
team may use information in your health record to assess
the care and outcomes in your cases and the competence
of the caregivers. We will use this information in an effort
to continually improve the quality and effectiveness of
the care and services that we provide.
• Business associates: We
provide some services through contracts with business associates.
Examples include treatment foster parents, psychotropic medication management,
and the like. When we use these services, we may disclose your health
information to the business associates so that they can perform the function(s)
that we have contracted with them to do and bill you or your third-party
payer for services provided. To protect your health information, however,
we require the business associates to appropriately safeguard your information.
• Patient/Client Census Reports: Unless
you notify us that you object, we will use your name, location
in the facility or agency programs, and general condition,
for census report purposes. This information may not be
provided to other people who ask for you by name.
• Notification in the Case of
Emergencies: We may use or disclose information to
notify or assist in notifying a family member, a personal
representative, or another person responsible for your
care, your location, and general condition.
• Communication with family: Unless
you object, health professionals, using their best judgment,
may disclose to a family member, another relative, a close
personal friend, or any other person that you identify
health information relevant to that person’s involvement
in your care or payment related to your care.
• Research: We may disclose
information to researchers when their research has been
approved by an institutional review board that has reviewed
the research proposal and established protocols to ensure
the privacy of your health information.
• Funeral directors: We
may disclose health information to funeral directors consistent
with applicable law to enable them to carry out their duties.
• Marketing/continuity of care: We
may contact you to provide appointment reminders or information
about treatment alternatives or other health-related benefits
and services that may be of interest to you.
• Fundraising: We may contact
you as a part of a fundraising effort. You have the right
to request not to receive subsequent fundraising materials.
• Food and Drug Administration
(“FDA”): We may disclose to the FDA health
information relative to adverse effects/events with respect
to food, drugs, supplements, product or product defects,
or postmarketing surveillance information to enable product
recalls, repairs, or replacement.
• Workers compensation: We
may disclose health information to the extent authorized
by and to the extent necessary to comply with laws relating
to workers compensation or other similar programs established
by law.
• Public health: As required
by law, we may disclose your health information to public
health or legal authorities charged with preventing or
controlling disease, injury, or disability.
• Correctional institution: If
you are an inmate of a correctional institution, we may disclose
to the institution or agents thereof health information necessary
for your health and the health and safety of other individuals.
• Law enforcement: We may
disclose health information for law enforcement purposes
as required by law or in response to a valid subpoena.
• Health oversight agencies
and public health authorities: If a member of our
work force or a business associate believes in good faith
that we have engaged in unlawful conduct or otherwise violated
professional or clinical standards and are potentially
endangering one or more patients, workers, or the public,
they may disclose your health information to health oversight
agencies and/or public health authorities, such as the
department of health.
• The federal Department of
Health and Human Services (“DHHS”): Under
the privacy standards, we must disclose your health information
to DHHS as necessary to determine our compliance with those
standards.
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Effective
date: April 14, 2003 |
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