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New
Horizons Community Mental Health Center, Inc. has
adopted the following policies and procedures for protection of the privacy of
the people we serve.
Our Obligation to You
The Staff at New Horizons
Community Mental Health Center, Inc. respect your privacy. This is part of our
code of ethics. We are required by law to maintain the privacy of “protected
health information” about you, to notify you of our legal duties and your legal
rights, and to follow the privacy policies described in this notice. “Protected
health information” means any information that we create or receive that
identifies you and relates to your health or payment for services to you.
Use and Disclosure of
Information about You
Use and disclosure for
treatment, payment and health care operations.
We will use your protected
health information and disclose it to others as necessary to provide treatment
to you. Here are some examples:
Various
members of our staff may see your clinical record in the course of our care for
you. This includes clinical assistants, nurses, physicians, case managers and
other therapists.
It may
be necessary to send blood samples to a laboratory for analysis to help us
evaluate your medical condition.
We may
provide information to your health plan or another treatment provider in order
to arrange for a referral or clinical consultation.
We will
contact you to remind you of appointments.
We may
contact you to tell you about treatment services that we offer that might be of
benefit to you.
We will use or disclose your
protected health information as needed to arrange for payment for
service to you. For example, information about your diagnosis and the service
we render is included in the bills that we submit to your health insurance
plan. Your health plan may require health information in order to confirm that
the service rendered is covered by your benefit program and medically
necessary. A health care provider that delivers service to you, such as a
clinical laboratory, may need information about you in order to arrange for
payment for its services.
It
may also be necessary to use or disclose protected health information for our health
care operations or those of another organization that has a relationship
with you. For example, our quality assurance staff reviews records to be sure
that we deliver appropriate treatment of high quality. Your health plan may
wish to review your records to be sure that we meet national standards for
quality of care.
Our Policy:
It is our policy to obtain a
general written permission to use and disclose your protected health
information for treatment, payment or health care operations purposes. You will
be asked to sign a Consent form to permit all such uses and disclosures of your
information. - and -
It is our policy to obtain
specific written permission for every disclosure of protected health
information to third parties other than for payment purposes. You will be asked
to sign an Authorization form for disclosure to each person or organization
that receives the information.
Emergencies. If there
is an emergency, we will disclose your protected health information as needed
to enable people to care for you.
Disclosure to your family
and friends. If you are an adult, you have the right to control disclosure
of information about you to any other person, including family members or
friends. If you ask us to keep your information confidential, we will respect
your wishes. But if you don't object, we will share information with family
members or friends involved in your care as needed to enable them to help you.
Disclosure to health
oversight agencies. We are legally obligated to disclose protected health
information to certain government agencies, including the state of Florida
Department of Children and Families.
Disclosures to child
protection agencies. We will disclose protected health information as
needed to comply with state law requiring reports of suspected incidents of
child abuse or neglect.
Other disclosures without
written permission. There are other circumstances in which we may be
required by law to disclose protected health information without your
permission. They include disclosures made:
Pursuant
to court order;
To
public health authorities;
To law
enforcement officials in some circumstances;
To
correctional institutions regarding inmates;
To federal
officials for lawful military or intelligence activities;
To
coroners, medical examiners and funeral directors;
To
researchers involved in approved research projects; and
As
otherwise required by law.
Other disclosures.
We will follow the provisions of 42 CFR Part 2 governing disclosure of
protected health information. Except for the circumstances described above, we
will not disclose protected health information to a third party without your
written permission. If a request for disclosure of your client record is
received, you will be contacted and asked whether you wish to authorize
disclosure. If you refuse to authorize disclosure, or it is not possible for us
to contact you, we will not disclose your information without a court order.
Each request for disclosure will have a specific name and address to which the
information will be sent. We will never ask you to sign a non-specific release
of information form.
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Your
Legal Rights
Right to request
confidential communications. You may request that communications to you,
such as appointment reminders, bills, or explanations of health benefits be
made in a confidential manner. We will accommodate any such request, as long as
you provide a means for us to process payment transactions.
Right to request
restrictions on use and disclosure of your information. You have the right
to request restrictions on our use of your protected health information for
particular purposes, or our disclosure of that information to certain third
parties. We are not obligated to agree to a requested restriction, but we will
consider your request.
Right to revoke a Consent
or Authorization. You may revoke a written Consent or Authorization for us
to use or disclose your protected health information. The revocation will not
affect any previous use or disclosure of your information.
Right to review and copy
record. You have the right to see records used to make decisions about you.
We will allow you to review your record unless a clinical professional
determines that such review would create a substantial risk of physical harm to
you or someone else. If another person provided information about you to our
clinical staff in confidence, that information may be removed from the record
before it is shared with you. We will also delete any protected health
information about other people.
At your request, with
advance notice, we will make a copy of your record for you. We will charge a
reasonable fee for this service.
Right to
"amend" record. If you believe your record contains an error, you
may ask us to amend it. If there is a mistake, a note will be entered in the
record to correct the error. If not, you will be told and allowed the
opportunity to add a short statement to the record explaining why you believe
the record is inaccurate. This information will be included as part of the
total record and shared with others if it might affect decisions they make
about you.
Right to an accounting.
You have the right to an accounting of some disclosures of your protected
health information to third parties. This does not include disclosures that you
authorize, or disclosures that occur in the context of treatment, payment or
health care operations. If requested by law enforcement authorities who are
conducting a criminal investigation, we will suspend accounting of disclosures
made to them.
How
to Exercise Your Rights
Questions about our policies
and procedures, requests to exercise individual rights, and complaints should
be directed to our Contact Person.
Our Contact Person is
the Privacy Officer. The Contact Person can be reached at (305)635-0366.
Personal representatives.
A “personal representative” of a patient may act on their behalf in exercising
their privacy rights. This includes the parent or legal guardian of a minor. In
some cases, adolescents who are “mature minors” may make their own decisions
about receiving treatment and disclosure of protected health information about
them. If an adult is incapable of acting on his or her own behalf, the personal
representative would ordinarily be his or her spouse or another member of the
immediate family. An individual can also grant another person the right to act
as his or her personal representative in an advance directive or living will.
Disclosure of protected
health information to personal representatives may be limited in cases of domestic
or child abuse.
Complaints
If you have any complaints
or concerns about our privacy policies or practices, please submit a Complaint
to our Privacy Officer. Complaints should be submitted in writing on our
Privacy Complaint Form. Copies are available at all locations in the reception
area. Send the complaint to:
Privacy
Officer
1469 NW 36th Street
Miami, FL. 33142
You can also submit a
complaint to the United States Department of Health and Human Services. Send
your complaint to:
Office for Civil Rights
U.S.
Department of Health and Human Services
Room 509F, HHH Building
200 Independence Avenue, S.W.
Washington D.C. 20201
OCR Hotlines-Voice:1-800-368-1019
We will never retaliate
against you for filing a complaint.
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