Allen
This notice describes how medical information about individuals we serve may be used and disclosed and how you can get access to this information. Please review it carefully.
Understanding Your Health Record/Information
The Allen County Board
of Mental Retardation and Developmental Disabilities collects and maintains a
record of information about individuals we serve, some of which is “protected
health information” under federal law.
Typically, “protected health information” may contain information about
the individual’s diagnoses, testing and treatment, and a plan for future care
or treatment, but also may include demographic information that may identify
the individual and that relates to past, present or future physical or mental
health or condition. Protected health
information is essential to the care we provide for individuals we serve. It serves as a:
·
Basis for
planning care and treatment,
·
Means of
communication among the many health professionals,
·
Legal document
describing the care provided,
·
Means to verify
that services billed were actually provided,
·
Tool in
educating professionals,
·
Tool with which
we can assess and continually work to improve the care we provide and the
outcomes we achieve.
Individual
health records contains personal
health information, the confidentiality of which is protected under both state
and federal law. Understanding that we
expect to use and disclose this health information helps you to:
·
Ensure its
accuracy,
·
Better
understand who, what, when, where, and why your health care providers and
others may access your health information, and
·
Make more
informed decisions when authorizing disclosure to others.
Your Health Information Rights
Although individual
health records are the physical property of the healthcare practitioner or
facility that compiled it, the information belongs to you. Under the Federal Privacy Rules, 45 CFR Part
164, you have the right to:
·
Receive notice
of the uses and disclosures we expect to make of your health information,
including a paper copy of the notice if requested, even if you have agreed to
receive the notice electronically,
·
Request
additional restrictions on uses and disclosures of your health information
(though we are not required to agree to any such request), or request that we
send you confidential communications by alternative means or at alternative
locations,
·
Inspect and
obtain a copy of your health record,
·
Request that your
health record be amended,
·
Obtain an
accounting of disclosures of your health information made after
Under federal law,
however, you may not inspect or copy the following records; psychotherapy
notes; information compiled in reasonable anticipation of, or use in, a civil,
criminal, or administrative action or proceeding, and protected health
information that is subject to law that prohibits access to protected health information. In some circumstances, you may have a right
to have this decision reviewed.
Please direct requests, in writing, to: Privacy
Officer or Department Head, Allen County Board of MR/DD,
Our Responsibilities
We are required by the
Federal Privacy Rules to:
·
Maintain the
privacy of protected health information,
·
Provide you
with notice as to our legal duties and privacy practices with respect to health
information we collect and maintain about individuals,
·
Abide by the
terms of this notice, subject to the following reservation of rights.
We reserve the right to
change our health information practices and the terms of this notice, and to
make the new provisions effective for all protected health information we
maintain, including health information created or received prior to the
effective date of any such revised notice.
Should our health information practices change, we will post and/or
provide a revised notice. We will not
use or disclose your health information without your consent or authorization,
except as described in this notice.
Uses and Disclosures for Treatment, Payment and Health Operations, Based on Your Consent
·
We will use
health information for treatment.
·
We will use
health information for payment.
·
We will use
health information for regular health operations.
· We will provide some information to our Business associates.
Required Disclosures
The Federal Privacy
Rules require us to disclose your personal health information in two
instances: to you at your request, and
to the Secretary of Health and Human Services when requested as part of an
investigation or compliance review.
Disclosures Permitted Without Consent for National
Priority Purposes
In addition, law permits
uses and disclosure of individual health information without your consent or
authorization for certain “national priority” purposes, including:
·
When
required by state or federal law,
·
To state and
federal public health authorities, including state medical officers, the Food
and Drug Administration (FDA), and other agencies charged with preventing or
controlling disease,
·
To government
authorities, including protective service agencies, authorized to receive
reports of abuse, neglect, or domestic violence,
·
To government
health oversight agencies, such as the state and federal Departments of Health
and Human Services, Medicare/Medicaid Peer Review Organizations (PRO’s) and
other licensing authorities,
·
When required
or court ordered in a judicial or administrative proceeding,
·
To law
enforcement officials for certain law enforcement purposes, including the
reporting of certain types of wounds or injuries, or pursuant to a warrant,
subpoena, or other legal process, or for the purpose of identifying or locating
a subject, fugitive, material witness, missing person, or victim, provided that
the conditions in the rule are met,
·
To coroners,
medical examiners, or funeral directors for purposes of identifying a deceased
person or carrying out their duties as required by law,
·
When required
to avert a serious threat to health or safety,
·
When requested
for certain specialized government functions authorized by law, including
military and similar situations, and
·
As authorized
by law in connection with workers compensation programs.
Uses and Disclosures Specifically Authorized By You
We expect to make other
uses and disclosures of your protected health information only on the basis of
specific written authorization forms signed by you. You have the right to revoke any such
authorization at any time, except to the extent we have already relied on it in
making an authorized use or disclosure.
For More Information or to Report a Problem
If you have questions
you may contact any program administrator or the Board Privacy Officer, at
If you believe your
privacy rights have been violated, you can file a complaint with the Complaints
Office or the Privacy Officer at the above address, or with the Secretary of
Health and Human Services,
Effective Date: