NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL RELATED INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY.
(Effective April 14, 2003)
General Information
Information regarding your health care, including payment for health care,
is protected by two federal laws: the Health Insurance Portability and
Accountability Act of 1996 (“HIPAA”), 42 U.S.C. § 1320d et seq., 45 C.F.R.
Parts 160 and 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42
C.F.R. Part 2. Under these laws, Substance Abuse Services Center (SASC)
may not say to a person outside SASC that you attend the program, nor may
SASC disclose any information identifying you as an alcohol or drug
abuser, or disclose any other protected information except as permitted by
federal law.
SASC must obtain your written consent before it can disclose information
about you for payment purposes. For example, SASC must obtain your written
consent before it can disclose information to your health insurer in order
to be paid for services. Generally, you must also sign a written consent
before SASC can share information for treatment purposes or for health
care operations. However, federal law permits SASC to disclose information
without your written permission:
1. Pursuant to an agreement with a qualified service organization/business
associate;
2. For research, audit or evaluations;
3. To report a crime committed on SASC’s premises or against SASC
personnel;
4. To medical personnel in a medical emergency;
5. To appropriate authorities to report suspected child and dependent
adult abuse or neglect;
6. As allowed by a court order.
For example, SASC can disclose information without your consent to our
medical director or collection agency for non-payment of fees as long as
there is a qualified service organization/business associate agreement in
place.
Before SASC can use or disclose any information about your health in a
manner which is not described above, it must first obtain your specific
written consent allowing it to make the disclosure. Any such written
consent may be revoked by you in writing.
Your Rights
Under HIPAA you have the right to request restrictions on certain uses and
disclosures of your health information. SASC is not required to agree to
any restrictions you request, but if it does agree then it is bound by
that agreement and may not use or disclose any information which you have
restricted except as necessary in a medical emergency.
You have the right to request that we communicate with you by alternative
means or at an alternative location. SASC will accommodate such requests
that are reasonable and will not request an explanation from you. Under
HIPAA you also have the right to inspect and copy your own health
information maintained by SASC, except to the extent that the information
contains psychotherapy notes or information compiled for use in a civil,
criminal or administrative proceeding or in other limited circumstances.
Under HIPAA you also have the right, with some exceptions, to amend health
care information maintained in SASC’s records, and to request and receive
an accounting of disclosures of your health related information made by
SASC during the six years prior to your request. You also have the right
to receive a paper copy of this notice.
To request the right to inspect and copy your own health information,
amend health care information and/or an accounting of disclosures of our
health related information please contact the privacy officer at
563-927-5112 or 1-888-771-6771.
Substance Abuse Services Center’s Duties
SASC is required by law to maintain the privacy of your health information
and to provide you with notice of its legal duties and privacy practices
with respect to your health information. SASC is required by law to abide
by the terms of this notice. SASC reserves the right to revise or amend
this notice. SASC reserves the right to make the revised or changed notice
effective for treatment information we already have about you as well as
any information we receive in the future. We will post a copy of the
current notice in prominent places with in the agency. The notice will
contain on the first page the effective date. The new notice will be
provided to all clients at their counseling session and will be posted at
our web site, http://www.sasc-dbq.org. A list of the programs and offices
that are covered by this Notice is listed below.
Complaints and Reporting Violations
You may complain to SASC if you believe that your privacy rights have been
violated under HIPAA by calling the Privacy Officer at 563-927-5112 or
1-888-771-6771 or with the Secretary of the Department of Health and Human
Services.
You will not be retaliated against for filing such a complaint.
Violation of the Confidentiality Law by a program is a crime. Suspected
violations of the Confidentiality Law may be reported to the United States
Attorney in the district where the violation occurs.
Contact
For further information, contact the Privacy Officer at 563-927-5112 or
1-888-771-6771.
