Tiptons 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. Tipton’s Children’s Facility and Tipton Therapeutic Foster Care Homes (henceforth referred to as Tipton’s) provide many types of services, such as assessments, therapy, and residential services. Our staff must collect information about you to provide these services. We know that the information that we collect about you and your health is private. We are required to protect this information by Federal and State law. We call this information “protected health information” (PHI), whether oral, written, or electronic format. This Notice of Privacy Practices tells you how Tipton’s may use or disclose information about you. As required by law, only the minimum necessary information will be disclosed. Not all situations are described. Tipton’s is required to give you a notice of our legal duties and privacy practices for the information we collect and keep about you. We are required to follow the terms of the notice currently in effect. We reserve the right to revise the terms of this notice and to make the provisions of the new notice effective for all health care information that we maintain. If we make changes to this Notice, we will post the new Notice in central locations of any facilities that we operate. Copies of the new Notice will be available upon request through any of our facilities, or you may contact us at 828-286-2040. If you have questions about the information in this Notice or about our privacy practices, please contact our Privacy Officer at 828-286-2040. In Many Instances, Tipton’s May Use and Disclose Information Without Your Authorization For Treatment. Tipton’s may use or disclose information with health care providers who are involved in your health care. For example, information may be shared to create and carry out a plan for your treatment. For Payment . Tipton’s may use or disclose information to get payment or to pay for the health care services you receive. For example, Tipton’s may provide PHI to bill your health plan for health care services provided to you. For Health Care Operations. Tipton’s may use or disclose information in order to manage its programs and activities. For example, we may use PHI to monitor and ensure the quality of services we are providing you. Appointments. Tipton’s may contact you to remind you of appointments. We may also send you information about health services that may be of interest to you. Public Health Activities. Tipton’s will report suspected communicable diseases as required by law. For Health Oversight Activities. Tipton’s may use or disclose information when required to by state or federal agencies responsible for inspecting health care providers. As Required by Law and For Law Enforcement. Tipton’s will use and disclose information when required or permitted by federal or state law or by a court order. For Abuse Reports and Investigations. Tipton’s is required by law to report any suspected abuse, neglect, or exploitation. If you are receiving treatment for alcohol or drug abuse, you should know that Federal law and regulations governing confidential of substance abuse records do not protect any information about suspected child abuse and neglect from being reported under State law. For Government Programs. Tipton’s may use and disclose information for public benefits under government programs. For example, Tipton’s may disclose information for the determination of Supplemental Security Income (SSI) benefits. To Avoid Harm. Tipton’s may disclose PHI in order to avoid a serious threat to the health and safety of a person or the public. Emergency Disclosures. Tipton’s may disclose PHI in emergency situations such as medical/psychiatric emergencies or criminal behavior. If you are receiving treatment for alcohol or drug abuse, you should know that Federal law and regulations governing confidential of substance abuse records do not protect any information about a crime committed by a patient either on the premises of a program or against personnel who work for the program or about any threat to commit such a crime. Minors. If the consumer is a minor, we may disclose health care information about the minor to a parent, guardian or other person responsible for the minor except in limited circumstances. Persons Involved in Your Care. We may disclose health care information about you to a relative, close personal friend, or any other person you identify if that person is involved in your care and the information is relevant to your care except as mandated by state and federal regulations. We may use or disclose health information about you to a relative, another person involved in your care, or possibly a disaster relief organization (such as Red Cross), if we need to notify someone about your location or condition. You may ask us not to disclose health information about you to persons involved in your care. Other Uses and Disclosures Require Your Written Authorization For other situations, Tipton’s will ask for your written authorization before using or disclosing information. You may cancel this authorization at any time in writing. Tipton’s cannot take back any uses or disclosures already made with your authorization. Other Laws Protect PHI. Other laws protect the use and disclosure of information about you as well: Federal laws CFR Part 2; North Carolina G.S. 122-C; North Carolina Division of MH/DD/SA Services Confidentiality Rules APSM 45-1. If you are receiving treatment for alcohol or drug abuse, the confidentiality of alcohol and drug abuse patient records maintained by Tipton’s is protected by Federal law (CFR Part 2) and regulations. Violation of the Federal law and regulations is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations. Generally, the program may not say to a person outside the program that a patient attends the program, 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 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. Your Privacy Rights Right to Request Restrictions on Uses and Disclosures. You have the right to request that we limit the use and disclosure of health care information about you for treatment, payment, and health care operations. We are not required to agree to your request. If we do agree to your request, we must follow your restrictions (except when disclosure of information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, we may cancel a restriction as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation. Right to Request an Alternative Method of Contact. You have the right to be contacted at a different location than your home or by a method of your choice. For example, you may prefer to have all written information mailed to your work address rather than your home address. We will agree to any reasonable request for alternative methods of contact. If you would like to request an alternative method of contact, you must provide us with a request in writing. Right to See and Get Copies of Your Records . In most cases, you have the right to look at or to get copies of your records. You must make the request in writing. You may be charged a fee for the cost of copying your records. We may deny your request in certain circumstances. If we deny your request, we will explain our reasons for doing so in writing. We will also inform you in writing if you have the right to have the decision to deny your request reviewed by another person. Right to Request to Correct or Update Your Records. You may ask Tipton’s to change or add missing information to your records if you think there is a mistake. You must make the request in writing, and provide a reason for your request. We may deny your request in certain circumstances. If we deny your request, we will explain our reasons for doing so in writing. You also have the right to send us a statement explaining why you disagree with our decision to deny your request to change or add information, and we will include your statement when we disclose that information in the future. Right to Get a List of Disclosures. You have the right to ask Tipton’s for a list of disclosures made by our agency going back six years from the date of your request. You must make the request in writing. This list will not include times that information was disclosed for treatment, payment, or health care operations. The list will not include any information provided directly to you or your family, or that was disclosed with your authorization. Right to Receive a Copy of the Notice of Privacy and any Revisions Thereafter. You have a right to receive a copy of the notice of privacy practice and any revisions made thereafter. The terms of this notice may be changed in the future, and those changes will be posted in the waiting room of the agency. You may also request a copy of the new Notice by contacting our Privacy Officer at (828) 286-2040. YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies and procedures, you may file a complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint. To file a written complaint with Tipton’s, you may bring your complaint to one of our facilities, or you may mail it to the following address: Privacy Officer Tipton’s 517 E. Main Street Spindale, NC 28160 To file a complaint with the federal government, you may send your complaint to the following address: Office for Civil Rights US Department of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building Washington, DC 20201 *** Below is the link to the new state consumer handbook. Providers as are responsible for making available a printed copy of this manual to consumers and putting the handbook or a link to it on their websites. The information is pretty general. Communication Bulletin #94 regarding the DMH/DD/SAS Consumer Handbook has been posted on the DMH web. You can find it here: http://www.ncdhhs.gov/mhddsas/announce/index.htm
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