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 condition, the provision of 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, only the minimum necessary PHI to accomplish the intended purpose will be released. The following privacy practices described in this notice represents 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 other staff. It is also posted on CCHB’s website at: http://www.cchbinc.com
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 of disclosure without your authorization. The law provides that CCHB is permitted to make some use/disclosures without your consent or authorization. The following describes and provides examples of our potential use/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 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, Ohio Department of the Mental Health and Addiction Services, the Ohio Department of Job and Family Services, the local Community Mental Health and Recovery Services Board through SHARES 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 SHARES 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. USE AND DISCLOSURES OF PHI REQUIRING AUTHORIZATION:
For use and disclosures beyond treatment, payment, and operation 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 use/disclosures except to the extent that CCHB’s staff has already taken an action in reliance upon your authorization.
IV. USE AND DISCLOSURES REQUIRING YOU TO HAVE AN OPPORTUNITY TO OBJECT:
To families, friends or others involved in your care. CCHB may share with those involved, information to assist in your care delivery 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 Use/Disclosures: You have the right to ask CCHB to 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 use/disclosures that are required by law.
To Choose How CCHB Contacts You: You have the right ask CCHB to send information to an alternative address or by other means. CCHB will agree to your request as long as it is reasonable or possible for CCHB to do so.
To Inspect and Request a Copy of Your PHI:
You may have access to your records, by 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 within 30 days. You have the right to choose what portions of your information you want copied and will receive prior information on the cost of copying.
After the personal request to receive records has been fulfilled, CCHB is no longer liable according to HIPAA Guideline, to protect your personal information that you have received to date.
To Request Amendment of Your PHI:
If you believe that there is a mistake or missing information in your CCHB record, you may request, in writing that CCHB correct or amend 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. The accounting will not apply to disclosures for national security purposes, to law enforcement officials or correctional facilities, or disclosures made before April 14, 2003. CCHB will respond to your written request for such a list within 60 days of receiving it. Your request can relate to disclosures going as far back as six years. There will be no charge for up to one such list each year. There will be a charge for more than one request per twelve month period.
VI. USES AND DISCLOSURES OF PHI FROM ALCOHOL AND OTHER DRUG RECORDS NOT REQUIRING CONSENT OR AUTHORIZATION
The law grants CCHB the right use/disclose your PHI from alcohol and other drug records without consent or authorization in the following circumstances;
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:
Arneardra Jackson, Privacy Officer Mary Byrd, Client Rights Officer
Central Community Health Board Central Community Health Board
532 Maxwell Avenue 532 Maxwell Avenue
Cincinnati, OH (513)45219 Cincinnati, OH 45219
Office: (513) 559-2937 Office: (513) 559-2902
Fax: (513) 559-2080 Fax: (513) 559-2013
You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Ave. SW, Washington, D.C. 20201 or call 877-896-6675. No staff at CCHB will take retaliatory action against you if you make such compliant.