NOTICE OF PRIVACY PRACTICES
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.
When you receive treatment from STAR Council on Substance Abuse, we will obtain and/or create health information protected health information, (PHI) about you. Health information includes any information that relates to your physical or mental health condition, the health care provided to you, the payment for your health care, and individually identifiable information, such as your name, address, telephone number or social security number. This notice tells you about our duty to protect your health information, your privacy rights, and how we may use or disclose your health information. It is effective beginning April 14, 2003.
STAR Council on Substance Abuse's Duties:
The law requires us to protect the privacy of your health information. This means that we will not use or let other people see your health information without your permission except in the ways we tell you in this notice. We will safeguard your health information and keep it private. This protection applies to all health information we have about you, no matter when or where you received or sought services. We will not give permission to any person to interview, photograph, film, or record you without your written agreement. We will not tell anyone if you sought, are receiving, or have ever received services from STAR Council on Substance Abuse, unless the law allows us to disclose that information.
We will ask you for your written permission (authorization) to use or disclose your health information. There are times when we are allowed to use or disclose your health information without your permission, as explained in this notice. If you give us your permission to use or disclose your health information, you may take it back (revoke it) at any time. If you revoke your permission, we will not be liable for using or disclosing your health information before we knew you revoked your permission. To revoke your permission, send a written statement, signed by you, to the STAR Council on Substance Abuse office where you gave your permission, providing the date and purpose of the permission and saying that you want to revoke it.
We are required to give you this notice of our legal duties and privacy practices, and we must do what this notice says. We can change the contents of this notice and, if we do, we will have copies of the new notice at any of our STAR Council offices. The new notice will apply to all health information we have, no matter when we received or created the information.
Our employees must protect the privacy of your health information as part of their jobs. We do not let our employees see your health information unless they need it as part of their jobs. We will discipline employees who do not protect the privacy of your health information.
We will report any information about a crime committed by you either at STAR Council on Substance Abuse or against any person who works for STAR Council on Substance Abuse or about any threat to commit such a crime unless law prevents it.
We will report any information about suspected child abuse or neglect to appropriate state or local authorities unless law prevents it.
We will not disclose information about you related to HIV/AIDS or alcohol or substance abuse without your specific written permission, unless the law allows us to disclose the information.
Your Privacy Rights at STAR Council on Substance Abuse
You can look at or get a copy of the health information that we have about you. You can choose to get a summary of your health information instead of a copy. If you want a summary or a copy of your health information, you may have to pay a reasonable fee for it. There are some reasons why we will not let you see or get a copy of your health information, and if we deny your request we will tell you why. You can appeal our decision in some situations.
You can ask us to change information in your records if you think the information is wrong. We will not destroy or change our records, but we can put the new information in your records and make a note in your records that you have provided the information. Sometimes we may not add this information, but will make a note of your request in your records.
You can get a list of when we have given health information about you to other people in the last six years. The list will not include disclosures for treatment, payment, health care operations, national security, law enforcement, or disclosures where you gave your permission. The list will not include disclosures made before April 14, 2003. There will be no charge for one list per year.
You can ask us to limit some of the ways we use or share your health information. We will consider your request, but the law does not require us to agree to it. If we do agree, we will put the agreement in writing and follow it, except in case of emergency. We cannot agree to limit the uses or sharing of information that are required by law.
We may contact you to send reminder notices of future appointments for your treatment. You can ask us to contact you at a different place or in some other way. We will agree to your request as long as it is reasonable.
You can get a copy of this notice any time you ask for it.
Treatment, Payment, and Health Care Operations
We may use or disclose your health information to provide care to you, to obtain payment for that care, or for our own health care operations; for example:
Treatment: We can use or disclose your health information to provide, coordinate, or manage health care or related services. This includes providing care to you, consulting with another health care provider about you, and referring you to another health care provider. For example, we can use your health information to prescribe medication for you. Unless you ask us not to, we may also contact you to remind you of an appointment or to offer treatment alternatives or other health-related information that may interest you.
Payment: We can use or disclose your health information to obtain payment for providing health care to you or to provide benefits to you under a health plan such as the Medicaid program. For example, we can use your health information to bill your insurance company for health care provided to you.
Health Care Operations: We can also use or disclose your health information for treatment services/research/health care operations:
Activities to improve treatment services, evaluating programs, and developing procedures;
Case management and care coordination;
Reviewing the competence, qualifications, performance of treatment professionals and others;
Conducting training programs and resolving internal grievances;
Conducting accreditation, certification, licensing, or credentialing activities;
Providing medical review, legal services, or auditing functions;
Engaging in business planning and management or general administration.
STAR Council on Substance Abuse is permitted to use or disclose your protected health information without your permission for the following purposes.
To report suspected child abuse or neglect. We may disclose your health information to a government authority if necessary to report abuse or neglect of a child.
To a court of law: We may disclose your protected health information in response to a court order that meets the requirements of federal regulation, 42 CFR Part 2 concerning Confidentiality of Alcohol and Drug Abuse Patient Records.
To address a serious threat to health or safety. We may use or disclose your health information to medical or law enforcement personnel if you or others are in danger and the information is necessary to prevent physical harm.
STAR Council On Substance Abuse will not disclose that part of your health information to any person outside of STAR Council On Substance Abuse without your written permission except as allowed by law.
Federal and State laws prohibit re-disclosure of information about alcohol or drug abuse treatment without your permission.
When you receive treatment from STAR Council on Substance Abuse, we will obtain and/or create health information protected health information, (PHI) about you. Health information includes any information that relates to your physical or mental health condition, the health care provided to you, the payment for your health care, and individually identifiable information, such as your name, address, telephone number or social security number. This notice tells you about our duty to protect your health information, your privacy rights, and how we may use or disclose your health information. It is effective beginning April 14, 2003.
STAR Council on Substance Abuse's Duties:
The law requires us to protect the privacy of your health information. This means that we will not use or let other people see your health information without your permission except in the ways we tell you in this notice. We will safeguard your health information and keep it private. This protection applies to all health information we have about you, no matter when or where you received or sought services. We will not give permission to any person to interview, photograph, film, or record you without your written agreement. We will not tell anyone if you sought, are receiving, or have ever received services from STAR Council on Substance Abuse, unless the law allows us to disclose that information. We will ask you for your written permission (authorization) to use or disclose your health information. There are times when we are allowed to use or disclose your health information without your permission, as explained in this notice. If you give us your permission to use or disclose your health information, you may take it back (revoke it) at any time. If you revoke your permission, we will not be liable for using or disclosing your health information before we knew you revoked your permission. To revoke your permission, send a written statement, signed by you, to the STAR Council on Substance Abuse office where you gave your permission, providing the date and purpose of the permission and saying that you want to revoke it. We are required to give you this notice of our legal duties and privacy practices, and we must do what this notice says. We can change the contents of this notice and, if we do, we will have copies of the new notice at any of our STAR Council offices. The new notice will apply to all health information we have, no matter when we received or created the information. Our employees must protect the privacy of your health information as part of their jobs. We do not let our employees see your health information unless they need it as part of their jobs. We will discipline employees who do not protect the privacy of your health information. We will report any information about a crime committed by you either at STAR Council on Substance Abuse or against any person who works for STAR Council on Substance Abuse or about any threat to commit such a crime unless law prevents it. We will report any information about suspected child abuse or neglect to appropriate state or local authorities unless law prevents it. We will not disclose information about you related to HIV/AIDS or alcohol or substance abuse without your specific written permission, unless the law allows us to disclose the information. Your Privacy Rights at STAR Council on Substance Abuse
You can look at or get a copy of the health information that we have about you. You can choose to get a summary of your health information instead of a copy. If you want a summary or a copy of your health information, you may have to pay a reasonable fee for it. There are some reasons why we will not let you see or get a copy of your health information, and if we deny your request we will tell you why. You can appeal our decision in some situations. You can ask us to change information in your records if you think the information is wrong. We will not destroy or change our records, but we can put the new information in your records and make a note in your records that you have provided the information. Sometimes we may not add this information, but will make a note of your request in your records. You can get a list of when we have given health information about you to other people in the last six years. The list will not include disclosures for treatment, payment, health care operations, national security, law enforcement, or disclosures where you gave your permission. The list will not include disclosures made before April 14, 2003. There will be no charge for one list per year. You can ask us to limit some of the ways we use or share your health information. We will consider your request, but the law does not require us to agree to it. If we do agree, we will put the agreement in writing and follow it, except in case of emergency. We cannot agree to limit the uses or sharing of information that are required by law. We may contact you to send reminder notices of future appointments for your treatment. You can ask us to contact you at a different place or in some other way. We will agree to your request as long as it is reasonable. You can get a copy of this notice any time you ask for it. Treatment, Payment, and Health Care Operations
We may use or disclose your health information to provide care to you, to obtain payment for that care, or for our own health care operations; for example:
Treatment: We can use or disclose your health information to provide, coordinate, or manage health care or related services. This includes providing care to you, consulting with another health care provider about you, and referring you to another health care provider. For example, we can use your health information to prescribe medication for you. Unless you ask us not to, we may also contact you to remind you of an appointment or to offer treatment alternatives or other health-related information that may interest you.
Payment: We can use or disclose your health information to obtain payment for providing health care to you or to provide benefits to you under a health plan such as the Medicaid program. For example, we can use your health information to bill your insurance company for health care provided to you.
Health Care Operations: We can also use or disclose your health information for treatment services/research/health care operations:
Activities to improve treatment services, evaluating programs, and developing procedures; Case management and care coordination; Reviewing the competence, qualifications, performance of treatment professionals and others; Conducting training programs and resolving internal grievances; Conducting accreditation, certification, licensing, or credentialing activities; Providing medical review, legal services, or auditing functions; Engaging in business planning and management or general administration. STAR Council on Substance Abuse is permitted to use or disclose your protected health information without your permission for the following purposes.
To report suspected child abuse or neglect. We may disclose your health information to a government authority if necessary to report abuse or neglect of a child. To a court of law: We may disclose your protected health information in response to a court order that meets the requirements of federal regulation, 42 CFR Part 2 concerning Confidentiality of Alcohol and Drug Abuse Patient Records. To address a serious threat to health or safety. We may use or disclose your health information to medical or law enforcement personnel if you or others are in danger and the information is necessary to prevent physical harm. STAR Council On Substance Abuse will not disclose that part of your health information to any person outside of STAR Council On Substance Abuse without your written permission except as allowed by law.Federal and State laws prohibit re-disclosure of information about alcohol or drug abuse treatment without your permission.
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