NOTICE OF PRIVACY PRACTICES
Of the
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If you are a citizen of Butler County and have enrolled in
our health benefit plan to receive substance abuse services at a network
provider of the Board, this pamphlet describes how medical information about
you may be used and disclosed and how you can get access to this information.
Please review it carefully.
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003 Revised: May 20, 2010
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION.
If you have any questions about this
Notice, please contact our privacy officer:
OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
At the
WHY WE COLLECT PERSONAL HEALTH INFORMATION?
We collect personal information to:
·
Determine eligibility for health care coverage;
·
Manage and provide benefits and pay claims;
·
Conduct our service evaluation programs;
·
Provide other information for planning and improving mental health
and substance abuse services in the community.
.
We may also be required to collect and keep certain information so
that we meet legal and regulatory requirements.
We keep this information after a client's health care coverage ends.
PERSONAL INFORMATION WE COLLECT
We ask people seeking benefits to provide certain information when
they complete an enrollment form. This information may include, for example:
·
Name, address, phone number;
·
Date of birth;
·
Marital status;
·
Social Security number;
·
Family income.
We may also receive personal information about you from others,
such as:
·
Health care providers (doctors, clinics, hospitals);
·
Other behavioral health boards that provide coverage to our
clients;
·
Business partners (companies with whom we have arrangements to
assist us in providing products and services);
·
Other government agencies (criminal justice system, child welfare,
juvenile justice, etc.).
The information we collect from others may include, for example,
eligibility, claims and payment information.
We create and maintain a record of your enrollment in the public mental
health and or drug addiction and substance abuse system of the State of
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
When you receive services paid for in part or in full by the Butler
County Alcohol and Drug Addiction Services Board we may use your personal information
for such activities as conducting our normal business known as health care
operations. If the services we paid for
were substance abuse services, we may also use your personal information for
processing the billings for such services.
If you have a guardian or a power of attorney we will provide the
information to your guardian or attorney in fact.
Examples of how we use your information include:
Treatment ‑ we may use your information to coordinate or
manage your health care and related services by or among providers, or we may
use it to facilitate referrals from one provider to another provider.
Payment for Substance Abuse Services ‑ we keep records that
include payment information and documentation of the services provided to
you. Your information may be used to
obtain payment for your services from Medicaid, insurance or other sources. For example, we may disclose personal
information about the services provided to you to confirm your eligibility for
Medicaid and to obtain payment from Medicaid.
Health Care Operations ‑ we use personal information to train
staff, manage costs, conduct required business duties, and make plans to better
serve you and other community residents who may need mental health or substance
abuse services.
Other Services We Provide - we may also
use your personal information to:
·
Review and evaluate the quality, effectiveness, and efficiency of
the services you have received;
·
Conduct program and fiscal audits of programs who have provided you
with services;
·
Investigate major unusual incidents, report these kind of incidents
and take steps to protect your health and safety;
·
Prepare reports required by the Ohio Department of Alcohol and Drug
Addiction Services and other government authorities;
·
Contact you to provide you health information and educational
materials or for assistance in passing levies, unless you notify the Butler
County Alcohol and Drug Addiction Services Board that you do not wish to be
contacted for these purposes.
Sharing Your Personal Information
There are limited circumstances/situations when we are permitted or
required to disclose personal information without your signed authorization.
These situations are:
·
To reduce or prevent a serious threat to public health and safety;
·
To protect victims of abuse, neglect, or domestic violence;
·
For health oversight activities like investigations, audits,
program reviews or inspections;
·
For local, state, or federal agencies to monitor your services;
·
For lawsuits or judicial and administrative proceedings;
·
For public health purposes such as reporting communicable diseases,
work‑related illnesses, or other diseases and injuries permitted by law;
reporting births and deaths, and reporting reactions to drugs and problems with
medical devices;
·
When required by law;
·
When requested by law enforcement as required by law or court
order, except as limited by laws regarding disclosure of alcohol and other drug
treatment;
·
To coroners, medical examiners, and funeral directors;
·
For organ and tissue donation;
·
For workers' compensation or other similar programs if you are
injured at work and are covered by workers' compensation or other similar
programs;
·
For specialized government functions such as intelligence and
national security.
All other uses and disclosures, not described in this notice,
require your signed authorization. You
may revoke your authorization at any time with a written statement.
OTHER USES OF PERSONAL HEALTH INFORMATION
Other uses and disclosures of your personal health information not
covered by this Notice or the laws that apply to us will be made only with your
written permission. If you provide us
permission to use or disclose health information about you, you may revoke that
permission, in writing, at any time. If
you revoke your permission, we will no longer use or disclose your health
information for the reasons covered by your written permission. You understand that we are unable to take
back any disclosures we have already made with your permission, and that we are
required to retain our records of the services that we provided to you.
SAFEGUARDING YOUR PERSONAL INFORMATION
We maintain physical, electronic and procedural safeguards that
comply with applicable federal and state laws and regulations to guard your
personal information against unauthorized use or disclosure. Any third party processor or consultant used
by the Board has signed an agreement with us requiring such entity to maintain
the confidentiality of your personal information. We also restrict access to your personal
information to those employees who need to know the information in order to
perform their job duties. The Board
maintains policies and procedures that prohibit employees and agents of the
Board from using, disclosing, transferring, providing access to or otherwise
divulging client health information to any person or entity other than to the
individual who is the subject of the
information.
FEDERAL LAWS PROTECTING THE DISCLOSURE OF ALCOHOL AND OTHER DRUG
INFORMATION
Federal laws referred to as “42 CFR” limit the disclosures that can
be made of alcohol and other drug personal health information without client
authorization. These records have
special protections under this federal law and, except for a few limited exceptions, disclosure cannot be made without individual
written consent. These exceptions
are: 1. When the information is to be used for
research, audit, or evaluation purposes in limited circumstances, 2. When state law requires the reporting of
information about suspected child abuse or neglect, or 3. In response to a court. order.
INDIVIDUAL CLIENT RIGHTS
You have the following rights regarding the health information we
maintain about you:
·
Right to Request Restrictions. You have the right
to request a restriction or limitation on the health information we use or
disclose about you for payment or health care operations. This includes the right to request a limit on
the health information we disclose about you to a family member or friend who
is involved in your care if you are receiving mental health services and have
previously agreed to limited disclosure to such a family member. We will consider all requests for
restrictions carefully but are not required to agree to any requested
restrictions.*
·
Right to Request Confidential Communications.
You have the right to request that we communicate with you about health
matters in a certain way or at a certain location. For example, you can ask that we only contact
you at work or by mail.
·
Right to Inspect and Copy. You have the right
to access the personal information we collect upon request. Under certain circumstances, we may not share
information that we collected, for example, if the information is the subject
of a lawsuit or legal claim or if release of mental health information may
present a danger to you or someone else. Fees may apply to copied information.*
·
Right to Amend. You have the right to
request corrections or additions to your personal information. You must give the reasons for wanting the
change.*
·
Right to An Accounting of Disclosures.
You have the right to request an accounting of disclosures made of your
personal information that were not related to our business operations or your
authorization. Under certain
circumstances, we may not share information that we collected, for example, if
the information is the subject of a lawsuit or legal claim or if release of the
information may present a danger to you or someone else. Your request must state the period of time
desired for the accounting, which must be within the six years prior to your
request. The first accounting is free but
a fee will apply if more than one request is made in a 12‑month period.*
·
Right to a Paper Copy of Notice. You have the right
to a paper copy of this Notice. You may
obtain a copy of the Notice by contacting the Board Office.
Requests marked with a star (*) must be made in writing. Contact the
Six
(513) 867-0777
CHANGES TO THIS NOTICE
We reserve the right to change this Notice at any time. We reserve the right to make the revised or
changed Notice effective for health 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 at
the Board Office. The Notice will
contain on the first page in the top center, the effective date. In addition, each time there is a change in
the Notice, you will receive a copy by mail at the last known address we have
in our plan enrollment file.
COMPLAINTS
If you have a complaint about our privacy policies and procedures
or you believe your privacy rights have been violated, you may file a complaint
with the Board or with the Secretary of the Department of Health and Human
Services. To file a complaint with the
Board, contact the Privacy Officer at the address above. We will investigate all complaints and will
not retaliate against you for filing a complaint. If you wish to file a complaint with the
Secretary you may send the complaint to:
HIPAA Complaint
NOTIFICATION OF BREACH IN CONFIDENTIALITY
The Board has an obligation under federal law to notify you of any
breach of your confidentiality rights and to mitigate the any negative impact
of that breach.