THIS NOTICE DESCRIBES HOW MEDICAL [INCLUDING MENTAL HEALTH] INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. During the process of providing services to you, Community Reach Center Systems will obtain, record, and use mental health and medical information about you that is protected health information. Community Reach Center will not use or disclose more information for payment purposes than is necessary. This is known as using only the minimum necessary amount to accomplish the purpose of use or disclosure. We are accountable to the Secretary of Health and Human Services to safeguard (keep secure) and protect (keep private) our patients’ information. Ordinarily that information is confidential and will not be used or disclosed, except as described below.
I. USES AND DISCLOSURES OF PROTECTED INFORMATION
A. General Uses and Disclosures Not Requiring the Client’s Consent. The Center will use and disclose protected health information in following ways.
1. Treatment. Treatment refers to the provision, coordination, or management of health care [including mental health care] and related services by one or more health care providers. For example, Community Reach Center Systems staff involved with your care may use your information to plan your course of treatment and consult with other staff to ensure the most appropriate methods are being used to assist you.
2. Payment. Payment refers to the activities undertaken by a health care provider [including a mental health provider] to obtain or provide reimbursement for the provision of health care. For example, Community Reach Center Systems will use your information to develop accounts receivable information, bill you, and with your consent, provide information to your insurance company for services provided. The information provided to insurers and other third party payors may include information that identifies you, as well as your diagnosis, type of service, date of service, provider name/identifier, and other information about your condition and treatment. If you are covered by Medicaid, information will be provided to the State of Colorado's Medicaid program, including but not limited to your treatment, condition, diagnosis, and services received. ] You have a right to request a restriction on certain disclosures to your health plan if the disclosure is purely for carrying out payment or health care operations and the requested restriction is for services paid out-of-pocket.
3. Health Care Operations. Health Care Operations refers to activities undertaken by the Center that are regular functions of management and administrative activities. For example, Community Reach Center Systems may use your health information in monitoring of service quality, staff training and evaluation, medical reviews, legal services, auditing functions, compliance programs, business planning, and accreditation, certification, licensing and credentialing activities.
4. Contacting the Client. Community Reach Center Systems may contact you to remind you of appointments and to tell you about treatments or other services that might be of benefit to you.
5. Required by Law. Community Reach Center Systems will disclose protected health information when required by law. This includes, but is not limited to: (a) reporting child abuse or neglect; (b) when court ordered to release information; (c) when there is a legal duty to warn or take action regarding imminent danger to others; (d) when the client is a danger to self or others or gravely disabled; (e) when required to report certain communicable diseases and certain injuries; (f) when a Coroner is investigating the client’s death; and (g) to government regulatory and oversight agencies that oversee the Center and staff activities;
6. Notification in the Case of a Breach. Community Reach Center Systems is required by law to notify our patients in case of a breach of their unsecured protected health information when it has been or is reasonably believed to have been accessed, acquired or disclosed as a result of a breach.
7. Crimes on the Premises or Observed by Center Personnel. Crimes that are observed by Community Reach Center Systems staff, that are directed toward staff, or occur on the Center’s premises will be reported to law enforcement.
8. Business Associates. Some of the functions of Community Reach Center Systems are provided by contracts with business associates. For example, some administrative, clinical, quality assurance, billing, legal, auditing, and practice management services may be provided by contracting with outside entities to perform those services. In those situations, protected health information will be provided to those contractors as is needed to perform their contracted tasks. Business associates are required to enter into an agreement maintaining the privacy of the protected health information released to them.
9. Research. Community Reach Center Systems may use or disclose protected health information for research purposes if the relevant limitations of the Federal HIPAA Privacy Regulation are followed. 45 CFR § 164.512(i).
10. Involuntary Clients. Information regarding clients who are being treated involuntarily, pursuant to law, will be shared with other treatment providers, legal entities, third party payers and others, as necessary to provide the care and management coordination needed.
11. Family Members. Except for certain minors, incompetent clients, or involuntary clients, protected health information cannot be provided to family members without the client’s consent. In situations where family members are present during a discussion with the client, and it can be reasonably inferred from the circumstances that the client does not object, information may be disclosed in the course of that discussion. However, if the client objects, protected health information will not be disclosed.
12. Fund Raising. Community Reach Center Systems, or its fund raising Foundation, may contact clients as a part of its fund raising activities. You have a right to opt out of being contacted for any fund raising activities, if you wish.
13. Emergencies. In life threatening emergencies Community Reach Center Systems staff will disclose information necessary to avoid serious harm or death.
14. Public Health Activities. We may use or disclose your PHI for public health activities that are permitted or required by law. For example, we may disclose your PHI in certain circumstances to control or prevent a communicable disease, injury or disability and for public health oversight activities or interventions. We also may disclose protected health information, if directed by a public health authority, to a foreign government agency that is collaborating with the public health authority.
15. Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law. For example, these oversight activities may include audits; investigations; inspections; licensure or disciplinary actions; or civil, administrative, or criminal proceedings or actions. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and government agencies that ensure compliance with civil rights laws.
16. Lawsuits and Other Legal Proceedings. We may disclose your PHI in the course of any judicial or administrative proceeding or in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized). If certain conditions are met, we may also disclose your protected health information in response to a subpoena, a discovery request, or other lawful process.
17. Client Authorization or Release of Information. Community Reach Center Systems may not use or disclose protected health information in any other way without a signed authorization or release of information. When you sign an authorization, or a release of information, it may later be revoked, provided that the revocation is in writing. The revocation will apply, except to the extent Community Reach Center Systems has already taken action in reliance thereon. II.
II. YOUR RIGHTS AS A CLIENT
A. Access to Protected Health Information. You have the right to inspect and obtain a copy of the protected health information Community Reach Center Systems has regarding you, in the designated record set. Information must be provided in electronic form, if requested. There are some limitations to this right, which will be provided to you at the time of your request, if any such limitation applies. To make a request, ask Community Reach Center Systems staff for the appropriate request form.
B. Amendment of Your Record. You have the right to request that Community Reach Center Systems amend your protected health information. Community Reach Center Systems is not required to amend the record if it is determined that the record is accurate and complete. There are other exceptions, which will be provided to you at the time of your request, if relevant, along with the appeal process available to you. To make a request, ask Community Reach Center Systems staff for the appropriate request form.
C. Accounting of Disclosures. You have the right to receive an accounting of certain disclosures Community Reach Center Systems has made regarding your protected health information. However, that accounting does not include disclosures that were made for the purpose of treatment, payment, or health care operations. In addition, the accounting does not include disclosures made to you, disclosures made pursuant to a signed Authorization, or disclosures made prior to April 14, 2003. There are other exceptions that will be provided to you, should you request an accounting. To make a request, ask Community Reach Center Systems staff for the appropriate request form.
D. Additional Restrictions. You have the right to request additional restrictions on the use or disclosure of your health information. Community Reach Center Systems does not have to agree to that request, and there are certain limits to any restriction, which will be provided to you at the time of your request. To make a request, ask Community Reach Center Systems staff for the appropriate request form.
E. Alternative Means of Receiving Confidential Communications. You have the right to request that you receive communications of protected health information from Community Reach Center Systems by alternative means or at alternative locations. For example, if you do not want Community Reach Center Systems to mail bills or other materials to your home, you can request that this information be sent to another address. There are limitations to the granting of such requests, which will be provided to you at the time of the request process. To make a request, ask Community Reach Center Systems staff for the appropriate request form.
F. Copy of this Notice. You have a right to obtain another copy of this Notice upon request.
III. ADDITIONAL INFORMATION
A. Privacy Laws. Community Reach Center Systems is required by State and Federal law to maintain the privacy of protected health information. In addition, Community Reach Center Systems is required by law to provide clients with notice of its legal duties and privacy practices with respect to protected health information. That is the purpose of this Notice.
B. Terms of the Notice and Changes to the Notice. Community Reach Center Systems is required to abide by the terms of this Notice, or any amended Notice that may follow. Community Reach Center Systems reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all protected health information that it maintains. When the Notice is revised, the revised Notice will be posted in the Community Reach Center Systems’s service delivery sites and will be available upon request.
C. Complaints Regarding Privacy Rights. If you believe Community Reach Center Systems has violated your privacy rights, you have the right to complain to Community Reach Center Systems management. To file your complaint, call Community Reach Center Systems consumer representative, Leslie Parker at 303-853-3594. You also have the right to complain to the United States Secretary of Health and Human Services by sending your complaint to the Office of Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 515F, HHH Bldg., Washington, D.C. 20201. It is the policy of Community Reach Center Systems that there will be no retaliation for your filing of such complaints.
D. Additional Information. If you desire additional information about your privacy rights at Community Reach Center Systems, please call the Community Reach Center Systems HIPAA Privacy Officer, Clay Cunningham at 303-853-3690.
E. Effective Date. This Notice is effective August 26, 2013.
F. Confidentiality of Alcohol and Drug Abuse Patient Records. The confidentiality of alcohol and drug abuse patient records maintained by Community Reach Center Systems is protected by Federal law and regulations. Generally, the Center may not say to a person outside the Center that a patient receives services from the Center, or disclose any information identifying a patient as an alcohol or drug abuser Unless: (1) The patient consents in writing: (2) The disclosure is allowed by a court order; or (3) The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Violation of the Federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations. Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities. (See 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR Part 2 for Federal regulations.)
If you would like to request your medical record or a portion of it, please complete the following form (English and Spanish versions available) and submit it to our Medical Records Department (Fax # 303-287-2477).
If you would like to allow Community Reach Center to release and exchange information with an outside agency, entity, or person then please complete the following form (English and Spanish versions available) and submit it to a provider on your treatment team.