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NOTICE OF PRIVACY PRACTICES
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
and Drug Abuse Prevention, Treatment, and Rehabilitation Act
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.
When you receive treatment or benefits (such as Medicaid) from
Community Healthcore, we will obtain and/or create health information
about you. Health information includes any information that relates
to (1) your past, present, or future physical or mental health
or condition; (2) the health care provided to you; and (3) the
past, present, or future payment for your health care.
The following notice tells you about our duty to protect your
health information, your privacy rights, and how we may use or
disclose your health information.
Community Healthcore’s Duties:
- The law requires us to protect the privacy of your health
information. This means that we will not use or let other people
see your health information without your permission except in
the ways we tell you in this notice. We will safeguard your
health information and keep it private. This protection applies
to all health information we have about you, no matter when
or where you received or sought services. We will not tell anyone
if you sought, are receiving, or have ever received services
from us, unless the law allows us to disclose that information.
- We will ask you for your written permission (authorization)
to use or disclose your health information. There are times
when we are allowed to use or disclose your health information
without your permission, as explained in this notice. If you
give us your permission to use or disclose your health information,
you may take it back (revoke it) at any time. If you revoke
your permission, we will not be liable for using or disclosing
your health information before we knew you revoked your permission.
To revoke your permission, send a written statement, signed
by you, to Sabine Valley Center, providing the date and purpose
of the permission and saying that you want to revoke it.
- We are required to give you this notice of our legal duties
and privacy practices, and we must do what this notice says.
We will ask you to sign an acknowledgement that you have received
this notice. We can change the contents of this notice and,
if we do, we will have copies of the new notice at our facilities
and on our website, www.communityhealthcore.com The new notice
will apply to all health information we have, no matter when
we got or created the information.
- Our employees must protect the privacy of your health information
as part of their jobs. We do not let our employees see your
health information unless they need it as part of their jobs.
We will punish employees who do not protect the privacy of your
health information.
- We will not disclose information about you related to testing
for Human Immunodeficiency Virus or Acquired Immune Deficiency
Syndrome without your specific written permission, unless the
law allows us to disclose the information.
- If you are being treated for alcohol or drug abuse, your records
are protected by federal law and regulations found in the Code
of Federal Regulations at Title 42, Part 2. Violation of these
laws that protect alcohol or drug abuse treatment records is
a crime, and suspected violations may be reported to appropriate
authorities in accordance with federal regulations. Federal
law will not protect any information about a crime committed
by you either at Community Healthcore or against any person
who works for Community Healthcore or about any threat to commit
such a crime. Federal laws and regulations do not protect any
information about suspected child abuse or neglect from being
reported under state law to appropriate state or local authorities.
Your Privacy Rights at Community Healthcore
- You can look at or get a copy of the health information that
we have about you. There are some reasons why we will not let
you see or get a copy of your health information, and if we
deny your request we will tell you why. You can appeal our decision
in some situations. You can choose to get a summary of your
health information instead of a copy. If you want a summary
or a copy of your health information, you may have to pay a
reasonable fee for it.
- You can ask us to correct information in your records if you
think the information is wrong. We will not destroy or change
our records, but we will add the correct information to your
records and make a note in your records that you have provided
the information
- You can get a list of the disclosures of your health information
that we made to other people in the last six years. The list
will not include disclosures for treatment, payment, health
care operations, national security, law enforcement, or disclosures
where you gave your permission. The list will not include disclosures
made before April 14, 2003. There will be no charge for one
list per year.
- You can ask us to limit some of the ways we use or share your
health information. We will consider your request, but the law
does not require us to agree to it. If we do agree, we will
put the agreement in writing and follow it, except in case of
emergency. We cannot agree to limit the uses or sharing of information
that are required by law.
- You can ask us to contact you at a different place or in some
other way. We will agree to your request as long as it is reasonable.
- You can get a copy of this notice any time you ask for it.
Treatment, Payment, and Health Care
Operations
We may use or disclose your health information to provide care
to you, to obtain payment for that care, or for our own health
care operations.
Health information about you may be exchanged between the Texas
Department of Mental Health and Mental Retardation, local mental
health or mental retardation authorities, community MHMR centers,
and contractors of mental health and mental retardation services,
for purposes of treatment, payment, or health care operations,
without your permission.
Treatment: We can use or disclose your health information to
provide, coordinate, or manage health care or related services.
This includes providing care to you, consulting with another health
care provider about you, and referring you to another health care
provider. 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.
Pavment: We can use or disclose your health information to obtain
payment for providing health care to you or to provide benefits
to you under a health plan such as the Medicaid program.
Health Care Operations:
We can also use your health information for health care operations:
- activities to improve health care, evaluating programs, and
developing procedures;
- case management and care coordination;
- reviewing the competence, qualifications, performance of health
care professionals and others;
- conducting training programs and resolving internal grievances;
- conducting accreditation, certification, licensing, or credentialing
activities;
- providing medical review, legal services, or auditing functions;
and
- engaging in business planning and management or general administration.
Unless you are receiving treatment for alcohol or drug abuse,
Community Healthcore is permitted to use or disclose your health
information without your permission for the following purposes.
- When required by law. We may use or disclose your health information
as required by state or federal law.
- To report suspected child abuse or neglect. We may disclose
your health information to a government authority if necessary
to report abuse or neglect of a child.
- To address a serious threat to health or safety. We may use
or disclose your health information to medical or law enforcement
personnel if you or others are in danger and the information
is necessary to prevent physical harm.
- For research. We may use or disclose your health information
if a research board says it can be used for a research project,
or if information identifying you is removed from the health
information. Information that identifies you will be kept confidential.
- To a government authority if we think that you are a victim
of abuse. We may disclose your health information to a person
legally authorized to investigate a report that you have been
abused or have been denied your rights.
- For public health and health oversight activities. We will
disclose your health information when we are required to collect
information about disease or injury, for public health investigations,
or to report vital statistics.
- To comply with legal requirements. We may disclose your health
information to an employee or agent of a doctor or other professional
who is treating you, to comply with statutory, licensing, or
accreditation requirements, as long as your information is protected
and is not disclosed for any other reason.
- For purposes relating to death. If you die, we may disclose
health information about you to your personal representative
and to coroners or medical examiners to identify you or determine
the cause of death.
- To a correctional institution. If you are in the custody of
a correctional institution, we may disclose your health information
to the institution in order to provide health care to you.
- If you are in the criminal justice system, we may disclose
your health information to other state agencies involved in
your treatment, rehabilitation, or supervision.
- For government benefit programs. We may use or disclose your
health information as needed to operate a government benefit
program, such as Medicaid.
- To your legally authorized representative (LAR). We may share
your health information with a person appointed by a court to
represent your interests.
- If you are receiving services for mental retardation, we may
give health information about your current physical and mental
condition to your parent, guardian, relative, or friend, unless
you object.
- In judicial and administrative proceedings. We may disclose
your health information in any criminal or civil proceeding
if a court or administrative judge has issued an order or subpoena
that requires us to disclose it. Some types of court or administrative
proceedings where we may disclose your healthinformation are:
- Commitment proceedings for involuntary commitment for
court-ordered treatment or services.
- Court-ordered examinations for a mental or emotional condition
or disorder.
- Proceedings regarding abuse or neglect of a resident of
an institution.
- License revocation proceedings against a doctor or other
professional.
- For national security. We will disclose your health information
if necessary for national security and intelligence activities,
and to protect the president of the United States.
- To the Secretary of Health and Human Services. We must disclose
your health information to the United States Department of Health
and Human Services when requested in order to enforce the privacy
laws.
If you are also being treated for alcohol or drug abuse, Community
Healthcore will not tell any unauthorized person outside of that
you have been admitted to or that you are being treated for alcohol
or drug abuse, without your written permission. We will not disclose
any information identifying you as an alcohol, drug, or substance
user, except as allowed by law.
Community Healthcore 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;
- To Advocacy, Inc. and/or the Texas Department of Protective
and Regulatory Services, as allowed by law, to investigate a
report that you have been abused or have been denied your rights.
Federal and State laws prohibit re-disclosure of information
about alcohol or drug abuse treatment without your permission.
Federal rules restrict any use of information about alcohol or
drug abuse treatment to criminally investigate or prosecute any
alcohol or drug abuse patient.
COMPLAINT PROCESS:
If you believe that Community Healthcore has violated your privacy
rights, you have the right to file a complaint. You may complain
by contacting:
Marlene Karger
105 Woodbine Place - Office 176
Longview, TX 75601
903-237-2323 or 830-367-5961
You may also file a complaint with:
TDMHMR Consumer Services and
Protection/Ombudsman Office
P.O. Box 12668
Austin, Texas 78711
(512) 206-5670 or
(800) 252-8154 (toll free)
TDMHMR Consumer Services and
U.S. Department of Health and Human Services
1301 Young Street, Suite 1169
Dallas, TX 75202
(214) 767-4056
(214) 767-8940 (TDD)
(800) 368-1019 (toll free OCR Hotline)
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.
You may also contact:
For complaints against alcohol or drug abuse treatment programs,
contact the United States Attorney's Office for the judicial district
in which the violation occurred. To locate this office, consult
the blue pages In your telephone book.
Community Healthcore will not retaliate
against you if you file a complaint.
For further information contact:
Marlene Karger:
Community Healthcore
105 Woodbine Place - Office 176
Longview, TX 75601
903-237-2323 or 830-367-5961
Effective Date:
April 14, 2003.
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