Notice
of
Privacy Practices
This Notice describes how health
information about you may be used and disclosed and how you can get access to
this information. Please read it
carefully.
Effective April 14, 2003
River Edge Behavioral
Health Center understands that your health information is personal. We are
committed to protecting health information about you. River Edge creates a
record of the care and services you receive.
We need this record to provide you with quality care and to comply with
certain legal requirements. This Notice of Privacy Practices applies to all of
the records of your care generated and/or maintained by River Edge, including
the following people and organizations.
§
Any health care professional who is authorized to enter
information in your health record;
§
Any member of a volunteer group that we allow to help
you while you are receiving services; and
§
All providers that River Edge contracts with to provide
services to our clients.
This Notice
will tell you about the ways in which we may use and disclose health
information about you. We also describe
your rights and certain obligations we have regarding the use and disclosure of
health information.
River Edge is required by law to ensure that:
§
health
information that identifies you is kept private
§
you
are given notice of our legal duties and privacy practices with respect to health information about you
§
the
term of the notice that is currently in effect is followed.
The following
information describes different ways we use and disclose health information. If
you are receiving services for the evaluation or treatment of substance abuse
conditions, specific rules apply to the use and disclosure of information
related to those services. Please refer to the section entitled Substance Abuse
Health Information for those rules.
For Treatment.
We may use health information about you to provide and coordinate your health
care and related services. For example, we may need to use information about
you among our clinicians at a clinical team meeting to coordinate your care and
treatment. This may include River Edge psychiatrists, nurses, therapists, case
managers and other behavioral health professionals who are involved in your
care and treatment planning. We may disclose information to another health care
provider if you are being transferred to this provider in accordance with your
treatment/discharge plan.
Privileged Communications: Unless
otherwise permitted by federal or state law, an authorization must be obtained
for any use or disclosure of records of a consumer’s communications with a
psychiatrist, psychologist, licensed clinical social worker, clinical nurse
specialist-mental health, licensed marriage and family counselor, or licensed
professional counselor or of communications between them concerning a
consumer’s communications with them.
This includes any communication recorded (in any medium) by a mental
health professional documenting or analyzing the contents of conversation
during a private counseling session or a group, joint, or family counseling
session. It does not include medication
prescription and monitoring, counseling session start and stop times, the
modalities and frequencies of treatment furnished, results of clinical tests,
and any summary of the following items: diagnosis, functional status, the
treatment plan, symptoms, prognosis, and progress to date.
For Payment. We may use and disclose
health information about you so that the treatment and services you receive may
be billed and payment may be collected from appropriate payors. Examples include: we may need to share your
health information in order to determine if your insurance plan will approve
additional visits with your physician or counselor; or share your health
information with a Utilization Review Organization contracting with the State
of Georgia to ensure the appropriateness of your care and to justify the
charges for your care.
For Health Care Operations. We may use and disclose health information
about you for the business activities of River Edge. These uses and disclosures are necessary for administrative
functioning and to ensure our members receive quality care. For example, we may
use health information about you to review our treatment and services and to
evaluate the performance of our staff in caring for you. We may disclose health information about you
a governmental agency to evaluate the quality of services we provide or to
obtain licenses we need to offer services.
Individuals Involved in
Your Care. We may release health information about you
to a family member actively involved in your care and treatment as allowed by
state law and in accordance with our policies and procedures. This
information is limited and will not be disclosed without first asking your
permission. An example would be in an
emergency medical situation where you are unable to make decisions about your
health care.
Research. Under certain limited circumstances, we may
use and disclose health information about you for research purposes. For
example, a research project may involve the care and recovery of all members
who receive one medication for the same condition. We will ask for your specific
permission if the researcher will have access to your name, address or other
information that reveals who you are.
Appointment
Reminders. We may use and disclose health information
to contact you as a reminder that you have an appointment for treatment or
services .
Health-Related
Information and Resources. We may
use and disclose health information to tell you about other resources that may
be of interest to you. If you do not
want us to provide you with this information, please notify the privacy officer
in writing at 175 Emery Highway, Macon, Georgia 31217.
SUBSTANCE ABUSE HEALTH INFORMATION. The confidentiality of alcohol and drug
abuse client records related to the diagnosis, treatment, referral for
treatment or prevention, is protected by federal law and regulations (42 U.S.C.
290dd-3 and 42 U.S.C. 290ee-3) and regulation (42 C.F.R. part 2). Generally, a substance abuse program may not
disclose to anyone outside the program that a member attends the program or
disclose any information identifying a member as an alcohol or drug abuser,
unless:
·
The
member consents in writing, or
·
The
disclosure is allowed by a court order after showing just cause, or
·
The
disclosure is made to health personnel in a health emergency or to a qualified
personnel for research audit or program evaluation, or
·
The member
commits or threatens to commit a crime either at the program or against any
person who works for the program.
Violations of federal
laws and regulations by a program are a crime.
Suspected violations may be reported to the United States Attorney in
the district where the violation occurs, or to River Edge’s Privacy
Officer. Federal laws and regulations
do not protect any information about suspected child abuse and neglect from
being reported under state law to appropriate state or local authorities.
HIV INFORMATION All health information regarding HIV is kept
strictly confidential and released only in conformance with the requirements of
state and federal law. Disclosure of
any health information referencing a member’s HIV status may only be made with
the specific written authorization of the client. A general authorization for the release of health or other
information is not sufficient for this purpose.
SPECIAL
CIRCUMSTANCES Federal and state laws allows or requires River
Edge Behavioral Health Center to disclose health information other than
substance abuse or HIV information about you without your written authorization
in certain special situations, if they occur:
Public Health Risks (Health and Safety for you
and/or others). We may disclose health
information about you for public health activities, when necessary to prevent a
serious threat to your health and safety or the health and safety of the public
or another person. These activities generally include the following:
·
to
prevent or control disease, injury or disability
·
to
report births or deaths
·
to report
child abuse or neglect
·
to
report reactions to medications
·
to
notify people of recalls of medications they may be using
·
to
notify a person who may have been exposed to a disease or may be at risk for
contracting a disease or condition
·
to
avert a serious threat to the health or safety of a person or the public.
·
to
notify the appropriate government authority if we believe a member has been the
victim of abuse, neglect or domestic violence.
Health
Oversight Activities. We may disclose health information about you
to a health oversight agency for activities authorized by law. These oversight
activities may include audits, investigations, inspections, and licensure.
These activities are necessary for the government to monitor the behavioral
health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes.
We may disclose health information about your to a court or administrative
agency when a judge or administrative agency orders us to do so. We also may disclose health information
about you in legal proceedings without your permission or without a judge’s or
administrative agency’s order when we receive a subpoena for your health
information, however information deemed privileged according to state or
federal law will not be disclosed without your authorization.
Law Enforcement. We
may release health information about you if asked to do so by a law enforcement
official:
§
In
response to a valid court order, subpoena, summons, or similar lawful process.
§
About
criminal conduct occurring on River Edge premises; we will release the circumstances of an incident, if you have
been a patient, your name, address, and last known whereabouts.
Coroners/ Medical Examiners : We
may release information to a coroner or medical examiner according to state and
federal law.
National
Security, Intelligence Activities, Protective Services for the President and
Others.: We may release health
information about you to authorized federal officials for intelligence, counter
intelligence, other national security activities, to provide protection to the
President and other authorized persons or foreign heads of state as authorized
by law.
Workers’Compensation
: We may disclose your protected health information
as authorized by and to the extent necessary to comply with laws relating to
workers’ compensation and other similar programs, established by law that
provide benefits for work-related injuries or illness without regard to fault.
Inmates: We may disclose your information to a
correctional institution or law enforcement official having lawful custody of
you, if we are providing services to you while you are in custody, if such represents
to us that such information is necessary to provide health care to you, to
protect your health and safety of others, to enforce the law in the facility,
and to manage the facility.
As Required By Law.
We will disclose health information about you when required to do so by
federal, state, or local law.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT
YOU
Right to
Inspect and Copy. You have the right to inspect and copy health
information that may be used to make decisions about your care. Usually, this includes progress notes,
evaluations/assessments, treatment plans, and billing information. To inspect
and copy your health information, contact the Privacy Officer. If you request a
copy of the information, you may receive one copy at no cost each year. For any
additional copies during the same year, you may be charged a fee for the costs
of copying, mailing, or other supplies associated with your request. Your
request to inspect and copy your information may be denied in certain very
limited circumstances. In those circumstances, the agency retains the right to
withhold information that may be detrimental to your care. If you are denied
access to any part of your health information, you may request that the denial
be reviewed. Information regarding how to initiate that review process will be
provided in writing at the time of any denial of your access to the
information.
Right to Amend. If you feel that health information we have about
you is incorrect or incomplete, you may ask us to amend the information. You
have the right to request an amendment for as long as your health information is kept by River
Edge. To request an amendment, your
request must be made in writing and submitted to the Privacy Officer. You must
provide a reason that supports your request. We may deny your request if you
ask us to amend information that:
§
Was
not created by us, unless the person or entity that created the information is
not longer available to make the amendment;
§
Is
not part of the health information kept by or for River Edge
§
Is
not part of the information which you would be permitted to inspect or copy; or
§
Is
accurate and complete.
Right to
an Accounting of Disclosures. You have the right to
request an accounting of disclosures. This is a list of the disclosures we made
of health information about you to others. The accounting does not include
information disclosed based on your written permission or as a part of
treatment, payment or health care operations.
To request this accounting, you must submit your request in writing to
the Privacy Officer. Your request must state a period of time for the
accounting that may not be longer than six years and may not include dates
before April 14, 2003.
Right to Request Restrictions.
You have the right to request a restriction or limitation on the health
information we use or disclose about you.
We are not required to agree to your request. If we do agree, we will
comply with your request unless the information is needed to provide you
emergency treatment. To request restrictions,
you must make your request in writing to the Privacy Officer. In your request, you must tell us what information you want to limit, and to whom
you want the limit to apply.
Right to
Request Confidential Communications. You have the right to
request that we communicate with you about health matters in a certain way or
at a certain location if you believe that you will be otherwise endangered. For
example, you can ask that we only contact you at a certain telephone number or
address. To request confidential
communications, you must make your request in writing to the Privacy Officer.
We will accommodate all reasonable requests. Your request must specify how or
where you wish to be contacted.
Right to
Paper Copy of this Notice. You have the right to a
paper copy of this privacy notice. You may ask us to give you a copy of this
privacy notice at any time by requesting a copy from the Privacy Officer or
from any front desk staff at your treatment site.
Changes
To This Notice: River Edge Behavioral Health
Center reserves the right to change this notice. We reserve the right to make
the revised or changed notice effective for health information River Edge
already has about you as well as any information we will receive in the future. River Edge will make you aware of any
revisions by posting a revised notice with the effective date in each
site/division lobby.
COMPLAINTS If you believe your privacy rights have been
violated, you may contact or file a complaint in writing to the Privacy Officer
at 175 Emery Highway, Macon, Georgia
31217. For further questions, you may contact the Privacy Officer at (478)
751-4519. If we cannot resolve your concern, you also have the right to
file a written complaint with the United States Secretary of the Department of
Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201.
The quality of your care will not be jeopardized nor will you be penalized for
filing a complaint.
Other uses and
disclosures of health information not covered by this notice or the laws that
apply to River Edge Behavioral Health Center will be made only with your
written permission. If you provide us
permission to use or disclose health information about you, you may revoke that
permission, in writing, at any time. You understand that River Edge is unable
to take back any disclosures already made with your permission, and that we are
required to retain our records of the care and services we provided to you.