Privacy Policy
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.
Supportive Concepts for Families, Inc. (SCFFI) 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. If you have questions about any part of this notice or if you want more information about the privacy practices at SCFFI please contact:
Effective Date of This Notice: April 14, 2003
- How SCFFI may Use or Disclose Your Health Information
- Treatment - SCFFI may disclose private health information for treatment purposes. An example of this would be when a Registered Nurse shares your medication administration requirements with a Community Specialist to ensure appropriate administration of medications.
- Payment - SCFFI may disclose private health information to obtain payment for services provided by us. An example of this would be to share time card documentation with the County MH/MR program to support invoices submitted for payment.
- Regular Health Care Operations - SCFFI may disclose private health information for regular internal operations. An example of this would be processing of time card, and related documentation by the Fiscal Department for payroll purposes. This may also include use of private health information for training or quality enhancement activities. In the event of an emergency, SCFFI may disclose portions of your private health information. Such disclosure will be limited to the minimum necessary to relieve the emergency situation.
- Information provided to you - SCFFI may disclose private health information to you. An example of this would be any access to your files.
- Internal Directory - SCFFI may list your name, your general medical condition and your religious affiliation in our internal directory. This information may be provided to members of the clergy. This information, except your religious affiliation, may be provided to other people who ask for you by name. If you do not want us to list this information in our internal directory and provide it to clergy and others, you must tell us that you object.
- Notification and communication with family - SCFFI may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
- Required by law - SCFFI may use and disclose your health information when required to do so by law.
- Public health - As required by law, SCFFI may disclose your health information to public health authorities for purposes related to: preventing or controlling disease; injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure. SCFFI may disclose your private health information to the extent it is necessary to report the above circumstances.
- Health oversight activities - SCFFI may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
- Judicial and administrative proceedings - SCFFI may disclose your health information in the course of any administrative or judicial proceeding where you are involved.
- Law enforcement - SCFFI may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
- Deceased person information - SCFFI may disclose your health information to coroners, medical examiners and funeral directors.
- Research - SCFFI may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board, SCFFI Risk Management Committee or you.
- Public safety - SCFFI may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
- Specialized government functions - SCFFI may disclose your health information for military and national security purposes.
- Worker's compensation - SCFFI may disclose your health information as necessary to comply with worker's compensation laws.
- Marketing - SCFFI may contact you to provide appointment reminders or to give you information about other treatments or health-related benefits and services that may be of interest to you. However, SCFFI will not use or disclose your health information to other organizations for marketing purposes.
- Change of Ownership - In the event that SCFFI is sold or merged with another organization, your health information/record will become the property of the new owner.
- When SCFFI May Not Use or Disclose Your Health Information
- Your Health Information Rights
- You have the right to request restrictions on certain uses and disclosures of your health information. SCFFI is not required to agree to the restriction that you requested but will advise you if SCFFI cannot comply.
- You have the right to receive your health information through a reasonable alternative means or at an alternative location. All requests for alternative communication must be in writing using the "Confidential Channel Communication Request" form. This form may be obtained by contacting the Human Resource Department referenced at the top of this form. The completed form must be returned to the Human Resource Department. The Human Resource Department will provide a written response within thirty (30) days. In the event that the alternative channel results in an additional cost beyond what would have otherwise been incurred, the incremental cost will be charged to you.
- You have the right to inspect and copy your health information.
- You have a right to request that SCFFI amend your health information that you may believe to be incorrect or incomplete. This request must be made in writing using the "Request for Amendment of or Addition to Protected Health Information" form. This form may be obtained by contacting the Human Resource Department referenced at the top of this form. The completed form must be returned to the Human Resource Department. The Human Resource Department will provide a written response within thirty (30) days. If SCFFI rejects your request to change or amend your information, you have the right to respond to this rejection. Your response must be in writing using the "Response to Rejection of Amendment Request" form. This form may be obtained by contacting the Human Resource Department referenced at the top of this form. The completed form must be returned to the Human Resource Department. SCFFI is not required to change your health information. However, future disclosures of the contested information will include your request, and associated responses.
- You have a right to receive an accounting of disclosures of your health information made by SCFFI, except that SCFFI does not have to account for the disclosures described in parts 1 (treatment), 2 (payment), 3 (health care operations), 4 (information provided to you), 5 (directory listings) and 15 (certain government functions) of section I of this Notice of Privacy Practices.
- You have a right to a paper copy of this Notice of Privacy Practices.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact the Human Resource Department referenced at the top of this form. - You have the right to exercise your rights under the Health Insurance Portability and Accountability Act without concern for any form of retaliation, such as termination of services.
- SCFFI will notify you in writing in the event that your personal health information is disclosed, or potentially disclosed in a manner inconsistent with our policy or your consent.
- Changes to this Notice of Privacy Practices
- Complaints
SCFFI collects health information from you and stores it in a file and on a computer. This is your medical record. The medical record is the property of SCFFI, but the information in the medical record belongs to you. SCFFI protects the privacy of your health information. The law permits SCFFI to use or disclose your health information for the following purposes:
Except as described in this Notice of Privacy Practices, SCFFI will not use or disclose your health information without your written authorization. If you do authorize SCFFI to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
SCFFI reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, SCFFI is required by law to comply with this Notice.
SCFFI will communicate all such changes in writing at the address on file for the consumer, or by the method requested as an alternative communication channel.
Complaints about this Notice of Privacy Practices or how SCFFI handles your health information should be directed to the Human Resource Department referenced at the top of this form.
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
You may also address your complaint to one of the regional Offices for Civil Rights. A list of these offices can be found online at http://www.hhs.gov/ocr/regmail.html.
