CENTER FOR HUMAN SERVICES NOTICE OF PRIVACY PRACTICES
Effective: 04/14/03
Revised:
 

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Protected Health Information includes individually identifiable information, which relates to your past, present or future health treatment or payment for health care services. This notice also describes your rights with respect to the Protected Health Information and how you can exercise those rights.

We are required to provide this Notice to you by the Health Insurance Portability and Accountability Act (HIPAA).

We are required by law to:

* maintain the privacy of your Protected Health Information;
* provide you this notice of our legal duties and privacy practices with respect to your Protected Health Information; and
* follow the terms of this notice.

We protect your Protected Health Information from inappropriate use or disclosure. Our workforce members are required to comply with our requirements that protect the confidentiality of Protected Health Information. They may look at your Protected Health Information only when there is an appropriate reason to do so, such as to administer our services.

We will not disclose your Protected Health Information to any other agency for their use in marketing their services to you. However, as described below, we will use and disclose Protected Health Information about you for business purposes related to your services.

Use and Disclosure of Your Medical Information

The Center for Human Services uses your medical information to provide you with medical treatment and services, to receive payment for those services, and in daily health care operations.

Uses and Disclosures That Do Not Require Your Authorization

In certain situations, your authorization is not required for the use or disclosure of your medical information. Those situations are described below:

* When it is required by law and the use or disclosure is limited to the relevant requirements of such law;
* When it involves use and disclosure for public health activities, such as mandated disease reporting, the reporting of vital events, births, deaths, etc.;
* When reporting information about victims of abuse, neglect or domestic violence as required by law;
* When disclosing information for the purpose of health oversight activities, such as audits, investigations, licensure or disciplinary actions or legal proceedings or actions [check with legal counsel to determine whether the request is permitted by law;]
* When disclosing information for judicial and administrative proceedings in accordance with state and/or federal law; for instance, in response to a court order, such as a subpoena or discovery request;
* When disclosing information for law enforcement purposes, for instance, to locate or identify a suspect, fugitive, witness or missing person, or regarding a victim of a crime who can not give consent or authorization because of incapacity;
* When disclosing information about deceased persons to medical examiners, coroners and funeral directors;
* When disclosing or using information for organ and tissue donation purposes;
* When disclosing information related to a research project when a waiver of authorization has been approved by the Institutional Review Board or Research Review Committee,
* When the Privacy Officer believes in good faith that the disclosure is necessary to avert a serious health or safety threat to the individual or to the public’s safety;
* When disclosure is necessary for specialized government functions, such as military service, for the protection of the president or for national security and intelligence activities;
* In the case of a prison inmate, information can be released to the correctional facility in which he or she resides for the following purposes: (1) for the institution to provide the inmate with health care; (2) to protect the health and safety of the inmate or the health and safety of others; or (3) for the safety and security of the correctional facility; and
* When disclosure is necessary to comply with worker’s compensation laws or purposes.

All other uses or disclosures of your medical information will be made only with your written authorization. You may revoke your written authorization at any time.

Your Rights Regarding Protected Health Information We Maintain About You
The federal law that protects the privacy of your health information gives you several rights. Should you have questions about a specific right, please write:

Center for Human Services
Attention: Privacy Officer
1500 Ewing Drive
Sedalia, MO 65301

The following are your various rights as an individual under HIPAA concerning your Protected Health Information:

* Right to Inspect and Copy your Protected Health Information: In most cases, you have the right to inspect and obtain a copy of the Protected Health Information that we maintain about you. To inspect and copy Protected Health Information, you must submit your request in writing. To receive a copy of your Protected Health Information, you may be charged a fee for the costs of copying, mailing and other supplies associated with your request. However, certain types of Protected Health Information will not be made available for inspection and copying. This includes psychotherapy notes; and also includes Protected Health Information collected by us in connection with, or in reasonable anticipation of any claim or legal proceeding. In very limited circumstances we may deny your request to inspect and obtain a copy of your Protected Health Information. If we do, you may request that the denial be reviewed. An individual chosen by us who was not involved in the original decision to deny your request will conduct the review. We will comply with the outcome of that review.

* Right to Amend Your Protected Health Information: If you believe that your Protected Health Information is incorrect or that an important part of it is missing, you have the right to ask us to amend your Protected Health Information while it is kept by or for us. You must provide your request and your reason for the request in writing. We may deny your request if it is not in writing or does not include a reason that supports the request. In addition, we may deny your request if you ask us to amend Protected Health Information that:

1. was not created by us, unless the person or entity that created the Protected Health Information is no longer  available to make the amendment;
2. is not part of the Protected Health Information kept by or for us; or
3. is not part of the Protected Health Information which you would be permitted to inspect and copy.

* Right to List of Disclosures. You have the right to request a list of the disclosures we have made of Protected Health Information about you. This list will not include disclosures made for treatment, payment, health care operations, for purposes of national security, made to law enforcement or to corrections personnel or mad pursuant to your authorization or made directly to you. To request this list, you must submit your request in writing. Your request must state the time period from which you want to receive a list
of disclosures. The time period may be no longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12 month period will be free. We may charge you for responding to any additional requests. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

* Right to Request Restrictions. You have the right to request a restriction or limitation on Protected Health Information we use or disclose about you for treatment, payment or health care operations, or that we disclose to someone who may be involved in your care or payment for your care, like a family member or friend. While we will consider your request, we are not required to agree to it. If we do agree to it, we will comply with your request. To request a restriction, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply (for example, disclosures to your spouse or parent). We will not agree to restrictions on Protected Health Information uses or disclosures that are legally required, or which are necessary to administer our business.

* Right to Request Confidential Communications. You have the right to request that we communicate with you about Protected Health Information in a certain way or at a certain location if you tell us that communication in another manner might endanger you. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing and specify how or where you wish to be contacted. We will accommodate all reasonable requests.

* Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health or Human Services. To file a complaint with us, please contact us by using the following address: The Center for Human Services, HIPAA Complaint Division, 1500 Ewing Drive, Sedalia, MO 65301. All complaints must be submitted in writing. You will not be penalized for filing a complaint. If you have any questions as to how to file a complaint, please contact us at 660.826.4400.

ADDITIONAL INFORMATION

Changes to this Notice. We reserve the right to change the terms of this notice at any time. We reserve the right to make the revised or changed notice effective for Protected Health Information we already have about you as well as any Protected Health Information we receive in the future. The effective date of this notice is April 14, 2003. If we change the terms of this notice, you will receive a copy of any revised notice from the Center for Human Services by mail or by e-mail, but only if e-mail delivery is offered by the Center for Human Services and you agree to such delivery.

Further Information: You may have additional rights under other applicable rules. For additional information regarding our HIPAA privacy policies or our general privacy policies, please contact us at 660.826.4400 or write to us at:

Center for Human Services
Privacy Policies
1500 Ewing Drive
Sedalia, MO 65301
 

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Center for Human Services · 1500 Ewing Drive, Sedalia, Missouri 65301 · (660) 826-4400