Privacy Statement
IT IS OUR LEGAL RESPONSIBILITY TO PROTECT YOUR CHART AND THE INFORMATION YOU SHARE WITH US.
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that provides new privacy protection and patients’ rights with regard to the use and disclosure of your Protected Health Information (PHI). PHI is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
Children’s Harbor (CH) will not use or disclose your health information without your consent or authorization, except as described in this notice. CH is required to abide by the terms of this Notice of Privacy Practices. CH reserves the right to change the terms of this Notice at any time. The new notice will be effective for all protected health information that is maintained at this time. We will provide a copy of any updates to you.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION WITHOUT YOUR CONSENT
Treatment:
Children’s Harbor may use and/or disclose your protected health
information to provide, coordinate, or manage your mental health
care and any related services. For example, this could include communication
of your protected health information to other physicians who are
treating you, or to a physician to whom you have been referred to
ensure that the physician has the necessary information to treat
you. We may also disclose information to referral sources as mandated
by law. For example, treatment information regarding clients referred
by the Broward Sheriff’s Office, the Department of Children
and Families, Children Services Council or ChildNet is entered into
a computer data bank on a continuous basis so the referral source
has access.
In addition, CH may disclose your protected health information from time-to-time to a health care provider (e.g., a specialist or laboratory), who at the request of your CH service provider, becomes involved in your care by providing assistance with your mental health care diagnosis or treatment to your physician.
Payment:
Your protected health information may be used, as needed, to obtain
payment for mental health care provided by CH. This may include
certain activities that your health insurance (for example, Medicaid)
may undertake before it approves or pays for the services we have
recommended for you. Examples are: Determination of eligibility
or coverage, reviewing services provided to you for medical necessity,
and undertaking utilization review activities. CH may also share
portions of your medical information with the following:
billing departments, collection departments or agencies, insurance
companies, health
plans, hospital departments and consumer reporting agencies (e.g.,
credit bureaus). For example, obtaining approval for a hospital stay
may require that your relevant protected health information be disclosed
to the health plan to obtain approval for the hospital admission.
In addition, client data may be shared with funding sources as back-up for billing as well as during monitorings or audits from these funding sources, to ensure contract compliance, utilization, and appropriate clinical care.
Social Service Operations:
CH may use or disclose, as needed, your protected health information
in order to support its operational activities. These activities
include, but are not limited to: quality assessment, employee review,
training of student interns, licensing, resolving grievances within
our organization, marketing, fundraising, and conducting or arranging
for other business activities.
For example, CH may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment, such as calling you or sending you a postcard.
CH may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other mental health-related benefits and services that may be of interest to you. CH may also use and disclose your protected health information for other marketing activities. For example, your name and address may be used to send you a newsletter about our organization and the services we offer.
CH may use or disclose your demographic information and the dates that you received treatment from us, as necessary, in order to contact you for fundraising activities supported by Children’s Harbor.
As required by law: Required by federal, state, local law, or other judicial or administrative proceedings.
Public health: Public health activities and purposes to a public health authority that is permitted by law to collect or receive information. The disclosure will be made for the purpose of controlling disease, injury or disability. It may also be disclosed, if directed by the public health authority, to a foreign agency that is collaborating with the public health authority.
Communicable diseases: If authorized by law to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Health oversight: For activities authorized by law, such as audits, investigations, and inspections. Entities seeking this information include: government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Abuse or neglect: If disclosure relates to victims of abuse, neglect or domestic violence.
Food and Drug Administration: To report adverse events, product defects or problems, biologic products deviations, track products; to enable products recalls; to make repairs or replacements, or to conduct post market surveillance, as required.
Legal proceedings: In response to a court order or administrative tribunal.
Law enforcement: In order to comply with laws requiring the reporting of certain types of wounds or other physical injuries.
Coroners, funeral directors, organ donation: For identification purposes, determining cause of death, or for the coroner or medical examiner to perform other duties authorized by law. It may also be used and disclosed for cadaveric organ, eye or tissue donation purposes.
Research: 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 protected health information.
To avoid harm: We will inform the parent/guardian, and/or law enforcement (depending on the nature of information), and/or interested parties in the case of suicidal or homicidal thoughts, plans, or attempts.
Criminal activity: To prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Workers’ Compensation: To comply with state workers’ compensation laws and other similar legally established programs.
Specialized government functions: If related to military and veterans’ activities, national security and intelligence activities, protective services for the President, and medical suitability or determinations of the Department of State.
Correctional institutions: If it relates to correctional institutions
and in other law enforcement custodial situations where they have
lawful custody of you or your child.
PERMITTED AND REQUIRED USES AND DISCLOSURES TO WHICH YOU MAY OBJECT:
You have the opportunity to agree or object to the use or disclosure
of all or part of your
PHI. If you are not present or able to agree or object to the use
or disclosure of the PHI, then your CH service provider may, using
professional judgment, determine whether the disclosure is in your
best interest. In this case, only the PHI that is relevant to your
mental health care will be disclosed.
Unless you object in writing, to a member of your family, a relative,
a close friend or other identified person, your PHI that directly
relates to that person’s involvement in your mental health
care, also to notify or assist in notifying a designated person responsible
for your care, of your location, general condition or death.
To assist in disaster relief efforts, such as the American Red Cross
In the event of an emergency
To contact you to provide appointments reminders
To manage or coordinate your mental health care by contracting you
with information about treatment, services, products or health care
providers.
To contact you for fundraising activities
ANY OTHER USE OR DISCLOSURE OF YOUR PROTECTED HEALTH INFORMATION
REQUIRES YOUR WRITTEN AUTHORIZATION
Under any circumstances other than those listed above, your written
authorization is needed before your PHI is used or disclosed. If
you sign a written authorization allowing the disclosure of your
PHI in a specific situation, you can later revoke your authorization
in writing. If you revoke your authorization in writing, your PHI
will not be disclosed after receiving your revocation, except for
disclosures, which were made before your revocation was received.
YOUR RIGHTS:
You have the right to request restrictions of the uses and disclosures
of your protected health information.
You have the right to request a restriction on the use and disclosure
of your PHI. CH is not required by federal regulation to agree to
your request. Even if CH agrees with your request, your restrictions
may not be followed in certain situations, as described in the section
of this Notice entitled “Uses and Disclosures of Protected
Health Information Permitted Without Your Consent.” To make
a restriction, you must make your request in writing.
You have the right to request to receive confidential communications
from CH by alternative means, or at an alternative location.
CH will accommodate reasonable requests made by you in writing. CH
may condition this accommodation by asking you for the information
as to how payment will be handled, or specification of an alternative
address, or other method of contact.
You have the right to inspect and copy your protected health information.
You have a right to review and request a copy of your PHI for as
long as the medical record is maintained by CH. Your request must
be made in writing. We will respond to you within 30 days of receiving
your written request. You may be charged related fees. Instead
of providing you with a full copy of the PHI, you may be given
a summary or explanation of this information, if you agree in advance
to the form and cost of the summary or explanation. There are certain
circumstances in which CH is not required to comply with your request.
Depending on the circumstances, you may have the right to have
this decision reviewed.
You have the right to correct or update your Protected Health Information.
If you believe there is a mistake in your PHI, or that a piece of
important information is missing, you have the right to request
that we correct the existing information or add the missing information.
Your request must be in writing and must explain your reasons for
the amendment. We will respond within 30 days of receiving your
written request. We many deny the request if the PHI is a) correct
and complete, b) not created by us, c) not allowed to be disclosed,
or d) not part of our records. Our denial will state the reasons
for the denial and explain your right to request that your request
and our denial be attached to all future disclosures of your PHI.
If we approve the request, we will make the change to your PHI,
tell you that we have done it, and tell others that need to know
about the change to your PHI.
If your request for amendment is denied, you have the right to file a statement of disagreement with CH, and CH may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive a list of disclosures made by CH of
your Protected Health Information.
You have the right to receive a written list of certain disclosures
of your PHI. The right to receive this information is subject to
certain exceptions, restrictions and limitations. Your request must
be made in writing. The list will not include disclosures that you
have already consented to, disclosures made for national security
purposes, to corrections or law enforcement personnel. We will respond
within 30 days of receiving your written request. The list will include
disclosures made with the last year (prior to date of request), the
date of the disclosure, to whom PHI was disclosed, a description
of the information disclosed, and the reason for the disclosure.
We will provide you the list at no charge.
QUESTIONS OR COMPLAINTS:
If you think your privacy rights have been violated by Children’s
Harbor, or you want to complain to us about our privacy practices
or file a complaint, you may contact our Privacy Officer:
Sue Glasscock
19425 S.W. 58th Manor
Pembroke Pines, FL 33332
(954) 252-3072 ext. 204
The complaint will be investigated by the Privacy Officer, who will gather all relevant information and complete a written report within 30 days from the receipt of the complaint. A copy of the report shall be given to you.
You may also send a written complaint to the United States Department
of Health and Human Services (HSS), Attn: Office of Civil Rights,
Sam Nunn Atlanta Federal center. Suite 3B70;
61 Forsyth Street SW; Atlanta, GA 32303-8909. If you file a complaint,
we will not take retaliatory action against you.
Effective date of this notice: June 10, 2008.