CENTRAL COMMUNITY HEALTH BOARD, INC
PRIVACY NOTICE
Effective:
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION MAY BE USED AND
DISCLOSED AND HOW YOU MAY GAIN ACCESS TO THIS INFORMATION.
PLEASE READ CAREFULLY.
I.
CCHB’s DUTY TO SAFEGUARD YOUR PROTECTED HEALTH
INFORMATION
Personal health information about your past
present, or future health or condition, the provision of
health care to you, or payment for health care is considered
“Protected Health Information” (PHI).
CCHB is required by law to maintain the privacy of your
personal health information and to give you this Notice about
CCHB’s privacy practices that explains how, when and why we may
use or disclose your PHI.
Except in special circumstances, we
must use or disclose only the minimum necessary PHI to
accomplish the intended purpose of the use or disclosure.
The
following privacy practices described in this Notice
represent CCHB’s current practices.
CCHB reserves the right to change these privacy practices
and the terms of this
Notice at any time.
You may request a copy of the new notice from CCHB’s Privacy
Officer, Client Rights Officer or any other staff.
II.
HOW CCHB USES AND DISCLOSES YOUR PERSONAL HEALTH
INFORMATION
CCHB
uses and discloses your Protected Health Information (PHI) for a
number of reasons.
We have a restricted right to use and/or disclose your PHI for
treatment, payment and for CCHB’s health care operations.
Beyond those uses, CCHB must have your written
authorization unless the law permits or requires CCHB to make
the use or disclosure without your authorization.
The law provides that CCHB is permitted to make some
uses/disclosures without your consent or authorization.
The following describes and provides examples of our
potential uses/disclosures of your PHI.
Treatment:
CCHB may disclose your PHI to doctors, nurses, social workers,
counselors and other health care providers who are involved in
providing your health care.
For example your PHI will be shared among members of your
treatment team, various pharmacies and community support
personnel. Your PHI
may be shared with pharmacies, and other community mental health
agencies involved in the provision or coordination of your care.
Payment:
CCHB may use/disclose your PHI in order to bill and
collect payment for services provided.
For example, we may release portions of your PHI to
Medicaid, Medicare, the Ohio Department of Mental Health, the
Ohio Department of Job and Family Services, the local Community
Mental Health Board through the MACSIS, and/or a private insurer
to get paid for services that CCHB delivers to you.
Health Care
Operations:
CCHB may use/disclose your PHI in the course of operating CCHB.
For example CCHB may also release your PHI to the MACISIS
and /or state agencies, Job and Family Services to determine
your eligibility for publicly funded services.
Appointment reminders:
Unless you provide us with alternative instructions, we
may send appointment reminders and other similar materials to
your home or place of residence.
III.
USES AND DISCLOSURES OF
PHI
REQUIRING AUTHORIZATION
For
uses and disclosures beyond treatment, payment and operations
purposes CCHB is required to have your written authorization
unless the use falls within one of the
following
exceptions.
Your authorization may be revoked at any time to stop future
uses/disclosures except to the extent that CCHB’s staff has
already taken an action in reliance upon your authorization.
Exceptions:
1)
When required by law.
For example child abuse reporting laws, abuse, domestic
violence, or relating to suspected criminal activity, or in
response to a court order.
We must also disclose PHI to authorities that monitor
compliance with these privacy requirements.
1)
Public
Health Activities:
2)
Health
oversight activities:
3)
Relating to decedents: CCHB may disclose PHI related to death to
coroners, medical examiners or funeral directors.
4)
Research:
Presently, CCHB does not participate in any research program.
5)
To stop
a threat to health or safety: CCHB may disclose PHI to law
enforcement or other persons to prevent or reduce the threat of
harm.
6)
For
specific government functions: CCHB may disclose PHI to military
personnel and veterans in certain situations, to correctional
facilities in certain situations, to government benefit programs
relating to eligibility and enrollment, and for national
security reasons.
IV.
USES AND DISCLOSURES REQUIRING YOU TO HAVE AN
To
families, friends or others involved in your care.
CCHB may share with these people information to assist in
your care, or to payment for your care such as group home
operators. CCHB may
also share PHI with these people to notify them about your
location, general condition, or death.
Generally this information would be limited to diagnosis
and prognosis, list of services and personnel available to
assist you and your family or group home operator.
V.
YOUR RIGHTS
TO
REQUEST RESTRICTIONS ON USES/ DISCLOSURES:
You have the right to ask that CCHB limit how it uses or
discloses your PHI.
CCHB will consider your request, but is not legally bound to
agree to your requested restriction.
CCHB cannot
limit
uses/disclosures that are required by law.
TO
CHOOSE HOW CCHB CONTACTS YOU:
You have the right to ask CCHB to send you information at an
alternative address or by another means.
CCHB will agree to your request as long as it is
reasonably easy or possible for CCHB to do so.
TO
INSPECT AND REQUEST A COPY OF YOUR PHI:
You may have access to your records, by your written request,
unless a licensed health care professional has determined that
the access requested is reasonably likely to endanger the life
or physical safety of you or another person.
CCHB will respond to your request in 30 days. You have a
right to choose what portions of your information you want
copied and to have prior information on the cost of copying.
TO
REQUEST AMENDMENT OF YOUR PHI:
If you
believe that there is a mistake or missing information in CCHB’s
record of you, you may request, in writing, that CCHB correct or
add to the record.
CCHB will respond within 60 days of receiving your request.
CCHB may deny the request if it determines that the PHI
is (1) correct and complete; (2) not created by us and/or not
part of our records, or; (3) not permitted to be disclosed.
TO FIND
OUT WHAT DISCLOSURES HAVE BEEN MADE:
You have a right to obtain a list of when, to whom, for what
purpose, and what content of your PHI has been released other
than instances of disclosure for treatment, payment and
operations; to you, your family, or the pursuant to your written
authorization. This
accounting will not apply to disclosures for national security
purposes, to law enforcement officials or correctional
facilities, or disclosures made before
VI.
USES AND DISCLOSURES OF PHI FROM ALCOHOL AND OTHER DRUG
RECORDS NOT REQUIRING CONSENT OR AUTHORIZATION
The law
grants CCHB the right to use/disclose your PHI from alcohol and
other drug records without consent or authorization in the
following circumstances:
1)
When
required by law:
2)
Relating to decedents
3)
For
research, audit or evaluation purposes
4)
To stop
a threat to health
or safety:
VII. HOW TO COMPLAIN ABOUT CCHB’s PRIVACY PRACTICES
If you
think CCHB may have violated your privacy rights, or you
disagree with a decision CCHB made about access to your PHI, you
may file a complaint with CCHB's Privacy Officer or Client
Rights Officer:
Ms.
Charlene Davis, CRO
Central Community Health Board
(513)
559-2015
(513)
559-2013
You may
also file a written complaint with the Secretary of the U.S.
Department of Health and Human Services at