| |
Your Privacy is Important
Tikor Community & Human Services, Inc. (TCHS) understands the importance of your privacy. We must maintain the privacy of your personal health information and give you this notice that describes our legal duties and privacy practices concerning your personal health information. We are required to abide by the terms of this notice. We will handle this information only as allowed by federal/state law and TCHS policy, adhering to the most stringent law that protects your health information.
In the event that you have the belief that your rights have been violated, you are advised to contact the following in writing or verbally:
- Your primary supervisor
- TCHS Privacy Officer
- State Advocate
- Secretary of Health and Human Services of the Federal Government
Addresses and phone numbers to use are listed at the end of this notice. It is your right to complain. You will not suffer any change in services or retaliation for filing a complaint.
You should note that our records contain your assessment, service plan, progress notes, diagnoses, treatment, and plan for future care or treatment.
Your Federally defined Rights under 45 C.F.R. Parts 160 and 164 (HIPAA Privacy Standards), and under The Commonwealth of Virginia's Administrative Code, Title 12, Sections 35-115-80 and 35-115-90 (Human Rights).
You have several rights with regard to your health information. Specifically, you have the right to:
-
Inspect and copy your health information: You have legal right to inspect or request for copies of your records. This process will be kept confidential. This right is not absolute. This request must be made in writing to your supervisor or the TCHS Privacy Officer. In circumstances where you could be harmed, TCHS can deny access. In the event of denial, you will receive notice of the decision and reason in writing. A copy of this request and written reply becomes a part of your record.
-
Request to correct your health information: If you believe your health information is incorrect, you may ask us to clarify this by adding information to your records. Your request must be in writing to your supervisor or the TCHS Privacy Officer, and must explain why the information should be clarified. If we believe your health information is correct, or if we did not create the information you believe to be incorrect, we have the right to deny your request and the denial will be in writing. You may respond with a written statement as to why you would disagree with the decision, which will be added to the records. If we agree to clarify the records as requested, the additional information will accompany any released copies of the original information.
-
Request restrictions on certain uses and disclosures: You have the right to request additional restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment or our payment or health care operation activities. This request will be given serious consideration by the TCHS staff and you will be informed promptly whether we will be able to honor the requested restriction and still offer effective services, receive payment and maintain health care operations. TCHS is not required to agree to any restrictions you request, but if we do agree, we are bound by that agreement except under certain emergency circumstances.
Use and Disclosure of your information
By signing the TCHS Consent Form, you are allowing TCHS to collect, use and disclose necessary information about you within TCHS and with Business Associates to provide treatment/service, receive payment for treatment/service and conduct TCHS' day-to-day health care operations. Examples are as follows:
-
For provision of effective treatment/service, your supervisor has the right to consult with outside service providers thereby sharing this information.
-
For payment purposes, your information will be sent to companies or groups responsible for your payment coverage. Your monthly bills will be noted on the financial forms and sent to responsible parties identified by you.
-
In the day-to-day health care operations, trained staff may handle your client record in order to have the record assembled, available for review by your primary supervisor/Support Coordinator/other TCHS personnel or for filing of documentation. Certain data elements are entered into our computer system that processes most billing, and for state statistical reporting to the Department of Behavioral Health Developmental Services. As a part of our continuous quality improvement efforts to provide the most effective services, your record may be reviewed by professional staff to assure accuracy, completeness and organization. Records may also be reviewed during licensing reviews by the Department of Behavioral Health Developmental Services and accreditation surveys by the Commission on Accreditation of Rehabilitation Facilities (CARF).
Individuals involved in your care or payment for that care
TCHS may disclose information about you to any body involved in your care and may also release similar information to any one who helps to pay for your care unless you object.
Enhancing your Healthcare
Some TCHS programs provide the following support to enhance your overall health care and may contact you to provide:
-
Appointment reminders by call or letter
-
Information about treatment alternatives
-
Information about health-related benefits and services that may be of interest to you.
Specific circumstances for Disclosure
TCHS is also allowed by Federal and State law in certain circumstances to disclose specific health information about you. These specific circumstances are:
-
As required by law (ex: reports required for public health purposes, such as reporting certain contagious diseases).
-
Judicial and Administrative proceedings (ex: Order from a court or administrative tribunal, or legal counsel to the agency, or Inspector General).
-
Law Enforcement purposes (ex: reporting of gun shot wounds; limited information requested about suspects, fugitives, material witnesses, missing persons, criminal conduct on premises).
-
To avert a serious threat to Health and Safety of another person (ex: in response to a specific threat made by the person served to harm another).
-
Children or incapacitated adults who are victims of abuse, neglect or exploitation.
-
Specialized Government functions.
-
Military Services (ex: in response to appropriate military command to assure the proper execution of the military mission).
-
National Security and Intelligence activities (ex: in relation to protective services to the President of the United States).
-
State Department (ex: medical suitability for the purpose of security clearance).
-
Workers Compensation to facilitate processing and payment.
-
Coroners and Medical Examiners for identification of a deceased person or to determine cause of death.
-
To the Federal Department of Health and Human Services in connection with an investigation of us for compliance with federal regulations.
Other Uses and Disclosures of your information by Authorization only
TCHS is required to get your authorization to use or disclose your protected health information for any reason other than for treatment/services, payment, or health care operations, and those specific circumstances outlined previously. TCHS uses Authorization to Use/Disclose Forms that specifically states what information will be given to whom, for what purpose and it must be signed by you or your Legal Representative. You could revoke the signed authorization in writing at any time unless the authorization has already been acted upon.
Changes to Privacy Practices
TCHS reserves the right to change the privacy practices described in this notice, in accordance with Federal and State law. TCHS is also allowed to make these changes effective for all protected health information TCHS maintains.
TCHS will post a Revised Notice of Privacy Practices at all its service sites, made available upon request by mailing or discussion with a TCHS representative, or electronically on the TCHS's Website or a combination of the three.
For additional information relating to your privacy rights or the information in this notice or State and Federal laws pertaining to privacy or how to file a complaint, please contact the following:
|
|
