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 READ IT CAREFULLY.
We are required by law to:
1. Keep health information that identifies you private.
2. Give you this notice of our legal duties and privacy practices with respect to your health information.
3. Follow the terms of this notice that are currently in effect.
Protected health information (PHI), as defined by law, includes almost any information we have collected or received about you. It includes information that may identify you, such as name, social security number, date of birth, etc.
You have the right to the confidentiality of your PHI and the right to approve or refuse the release of specific information except when the release is required by law. If these practices described in this notice meet your expectations, there is nothing you need to do. If you prefer that we not share information, we may honor your written request in certain instances described below. If you have any questions about this notice, please contact our Privacy Officer at the address below.
Who Will Follow This Notice
This notice describes practices regarding the use of your health information and that of:
1. All employees, staff and other personnel who may need access to your information.
2. All sites and locations that may share health information.
How We May Use and Disclose Health Information about You
The following categories describe different ways that we may use and disclose your health information. Disclosures require your prior written consent.
For Treatment We may use and disclose your PHI to those involved in your care. For example, the staff at BCArc may discuss information about your services needs. We may disclose information to the Department of Mental Retardation, the Massachusetts Rehabilitation Commission, local housing authority or other agencies that offer you opportunities.
For Payment We may use and disclose your PHI in order to bill and collect payment for services we provide to you. For example we may disclose health information to our billing department and your health plan to get paid for your services. We may also provide health information to our business associates that may process health care claims. We may also use and disclose health information about you to obtain prior approval to determine whether your insurance or another payor will cover the services we provide.
For Health Care Operations We may use and disclose your health information for health care operations. This is necessary to make sure that all individuals in our programs receive quality services. We may use and disclose health information during evaluations of our performance while providing services to you. We may also provide health information to our accountants, attorneys, consultants and others to make sure we’re complying with the laws that affect us.
There are some exceptions to the consent requirement for these three categories. If for example, you were unable to communicate with us and we think you would consent if you were able to do so, or in an emergency situation, as long as we try to get your consent after the emergency
With your consent we may disclose PHI for special purposes, such as:
For Fundraising Activities We may use health information about you to raise funds for our organization. The money raised through these activities is used to expand and support the services and programs we provide to the community. If you do not wish to be contacted as part of our fundraising efforts, please contact the person listed below.
The following categories include certain uses and disclosures that do not require your consent:
For the Law We will disclose health information about you when required by Federal, State, or local law, judicial or administrative proceedings, or law enforcement. For example, we will disclose your health information when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect or domestic violence.
For Health Oversight Activities We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include for example, audits, investigations, inspections and accreditation. These activities are necessary for the government to monitor government programs and compliance with civil rights.
To Avoid Harm We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
For Specific Government Functions We may disclose health information of military personnel and veterans as required by military command authorities. We may also disclose health information for national security.
For Workers’ Compensation Purposes We may release health information about you for Workers’ Compensation or similar programs. These programs provide benefits for work related injuries or illness.
For Public Health Risks We may disclose health information about you for public health activities, such as to prevent or control disease, injury or disability or to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
For Health-Related Benefits and Services We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you.
In any other situation not described above, we will ask you for your written permission. If you choose to sign an authorization, you may later revoke your permission in writing to stop any future use and disclosures.
Your Rights Regarding Your Health Information
You have the following rights regarding health information we maintain about you:
Right to See and Copy In most cases, you have the right to look at or get copies of your health information that we have, but you must make the request in writing. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with the request. In certain situations, we may deny your request. If we do, we will tell you, in writing, the reasons for our denial and explain your right to have the denial reviewed.
Right to Amend If you feel that health information we have about you is incorrect or incomplete, you have the right to ask us to correct the information or add the missing information. You must provide your request and the reason for the request in writing. We may deny your request if you ask us to amend information that 1) is correct and complete, 2) was not created by us, 3) is not part of our records, or 4) is not allowed to be disclosed. Our written denial will explain the reasons for the denial and your right to file a written statement of disagreement with the denial. You have the right to request that your request and our denial be attached to all future disclosures of your health information.
Right to an Accounting of Disclosures You have the right to see a list of the disclosures we have made of health information about you. This list will not include uses or disclosures that you have already consented to, nor disclosures made to law enforcement personnel or for national security.
Right to Request Restrictions You have the right to ask that we limit how we use and disclose your health information. We will consider your request but are not legally required to accept it.
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 may request that we only contact you at work or by mail. Your request must be made in writing to our Privacy Officer and should specify how or where you wish to be contacted. We will accommodate all reasonable requests.
Right to a Paper Copy of This Notice You have the right to a paper copy of this notice at any time. If you have agreed to receive this notice electronically, you are still entitled to a paper copy. To obtain a paper copy of this notice, please request one in writing from our Privacy Officer at the address below.
If you believe that your privacy rights have been violated, you may file a complaint with Berkshire County Arc or with the Secretary of the Department of Health and Human Services. To file a complaint with Berkshire County Arc, contact our Privacy Officer at the address and phone number below. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
Privacy Officer (Quality Facilitator)
Berkshire County Arc
395 South Street
Pittsfield, MA 01202
Phone: (413) 499-4241
Changes to This Notice
This Notice of Privacy Practices is effective 4/14/03. We reserve the right to change the terms of our Notice of Privacy Practices. We also reserve the right to make the revised or changed Notice of Privacy Practices effective for all health information we already have about you as well as any health information we receive in the future. We will post a copy of the current Notice of Privacy Practices at our main office and at each site where we provide care. You may also obtain a copy of the current Notice of Privacy Practices by calling us at (413) 499-4241 and requesting a copy be sent to you in the mail or by asking for one any time you are at our offices.