THE EFFECTIVE DATE OF THIS NOTICE IS APRIL 21, 2017.
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.
Haymarket Center, its facilities and all associates are committed to providing you with comprehensive behavioral health solutions. An important part of that commitment is protecting your health information according to applicable law. This notice (“Notice of Privacy Practices”) describes your rights and our duties under Federal Law. Protected health information (“PHI”) is information about you, including demographic information, which may identify you and relates to your past, present or future physical or mental health or condition; the provision of healthcare services; or the past, present or future payment for the provision of healthcare services to you.
Confidentiality is a fundamental aspect of the physician-patient relationship, and it is especially important for patients with addiction. Unfortunately, because of the legal and social ramifications associated with addiction, patients are often reluctant to tell their doctor that they may have an addiction or consent to the disclosure of information about their addiction treatment for fear of prosecution. This is an unfortunate aspect of the stigma that surrounds this disease, and it exacerbates the addiction treatment gap that exists in this country.
To address this issue, the federal government has implemented 42 CFR Part 2, regulations that protect the confidentiality of addiction treatment records of any person who has sought treatment for or been diagnosed with addiction at a federally assisted program. 42 CFR Part 2 aims to encourage people to seek treatment without fear of legal or social consequences. Improper sharing of a patient's addiction treatment information can lead to: negative perceptions and discrimination; criminal legal consequences, such as probation or jail time; and civil legal consequences, such as loss of child custody, employment or housing.
Haymarket Center appreciates the heightened need for confidentiality protections of a patient's addiction treatment records as well as the need for complete and accurate medical information to be shared among a patient's treating clinicians.
Your rights regarding your PHI.
You have the following rights regarding PHI we maintain about you:
Right of access to inspect and copy. You have the right, which may be restricted in certain circumstances, to inspect and copy PHI that may be used to make decisions about your care. We may charge a reasonable, cost-based fee for copies.
Right to amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information although we are not required to agree to the amendment.
Right to Revocation. It is your right to revoke any authorizations, at any time by sending written notification to the Privacy Officer at the addresses listed below.
Right to an accounting of disclosures. You have the right to request an accounting of the disclosures that we make of your PHI.
Right to request restrictions. You have the right to request restrictions or limitation on the use of your PHI for treatment, payment or health care operations. We are not required to agree to your request.
Right to request confidential information. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
Right to a copy of this notice. You have the right to a copy of this notice.
Complaints. You have the right to file a complaint in writing to us or to the Secretary of Health and Human Services if you believe we
have violated your privacy rights. We will not retaliate against you for filing a complaint.
Confidentiality of Alcohol and Drug Abuse Patient Record
The confidentiality of alcohol and drug abuse patients record is protected by additional Federal law and regulations. Haymarket Center is required to comply with these additional restrictions. This includes a prohibition, with very few exceptions, on informing anyone outside the program that you attend the program or disclosing any information that identifies you as an alcohol or drug abuser.
Some of the exceptions to this general rule include:
If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer:
932 W. Washington, Chicago, IL 60607
(312) 226-7984, ext. 366
This Notice of Privacy Practices describes how we may use and disclose your protected health information (“PHI”) in accordance with all applicable law. It also describes your rights regarding how you may gain access to and control you PHI. We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will make available a revised Notice of Privacy Practices by posting a copy on our website (www.hcenter.org), sending a copy to you in the mail, or providing one to you at your next appointment.
Listed below are examples of the uses and disclosures that Haymarket Center may make of your protected health information (“PHI”). These examples are not meant to be a complete list. Rather, they describe types of uses and disclosures that may be made.
Your PHI may be used and disclosed by your physician, counselor, program staff and others outside of our program that are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and any related services. This includes coordination or management of your health care with a third party, consultation with other health care providers or referral to another provider for health care treatment. For example, your protected health care information may be provided to the state agency that referred you to our program to ensure that you are participating in treatment. In addition, we may disclose your protected health information from time to time to another physician or health care provider (such as a specialist or a laboratory) who, at the request of the program, becomes involved in your care.
With your authorization, we may use and disclose protected health information about you so that we can receive payment for the treatment services provided to you. Your information may be used for making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, to obtain payment for your services from Medicaid, insurance, or other sources or undertaking utilization review activities.
For Healthcare Operations
We may use or disclose, as needed your PHI in order to support the business activities of our program including, but not limited to, quality assessment activities, employee review activities, training of students, licensing, and conducting or arranging for other business activities. For example, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and possibly provide other identifiable information. We may also call you by name in the waiting room when it is time for you to be seen. We may share your PHI with third parties that perform various business activities (for example, billing, typing or collections) for Haymarket Center, provided we have a written Contract with the business that prohibits it from re—disclosing your PHI and requires it to safeguard the privacy of your PHI.
Applicable law permits Haymarket Center to disclose information about you without your authorization in a limited number of other situations, such as with a court order. These situations are explained below.
Haymarket Center must obtain written authorization from you for other uses and disclosures of your PHI.
Haymarket Center may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third party payers like insurance companies) and peer review organizations performing utilization and quality control. If we disclose PHI to a health oversight agency, we will have an agreement in place that requires the agency to safeguard the privacy of your information.
Haymarket Center may share health information about you with public health authorities for public health activities such as: preventing or controlling disease, injury or disability; keeping vital records; avoiding a serious threat to health or safety of a person or the public; and reporting suspected abuse, neglect, or domestic violence to governmental or social services agencies. Haymarket Center also may share your health information with a governmental agency authorized to oversee government health care programs. We may disclose PHI regarding the fact that you have contracted a certain communicable disease to a public health authority authorized by law to collect or receive such information.
We may use or disclose your PHI to the extent that the use or disclosure is required by law, made in compliance with the law, and limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures. Under the law, we must make disclosures of your PHI to you upon your request. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule. We must also share the evaluation results of a DUI offender with the Illinois circuit court of venue or its court officials as specified by local court rules and/or the Office of the Secretary of State.
We may disclose PHI to researcher if:
(a) an Institution Review Board reviews and approves the research and a waiver to the authorization requirement;
(b) the researchers establish protocols to ensure the privacy of your PHI;
(c) the researchers agree to maintain the security of your PHI in accordance with applicable laws and regulations; and
(d) the researchers agree not to re-disclose your protected health information except back to Haymarket Center.
Haymarket Center may communicate with you regarding fundraising efforts in support of agency operations. In each such communication you are provided the option to opt-out of future correspondence.
We may use your protected health information to contact you for evaluation and follow-up studies conducted by Haymarket Center staff in order to determine effectiveness of Haymarket Center services. Haymarket Center may also disclose PHI to external program evaluators (including HHS for HIPAA rules, compliance and enforcement purposes), with an agreement in place, if substance abuse records are requested to be sent to or taken with the evaluator.
Haymarket Center may disclose your PHI in a medical emergency situation to medical personnel in accordance with applicable laws and regulations.
Haymarket Center may disclose your PHI to a state or local agency that is authorized by law to receive reports of child abuse or neglect. However, the information we disclose is limited to only that information which is necessary to make the initial mandated report.
With authorization, Haymarket Center may disclose PHI to coordinate the continuity of care with third parties. Examples would include treatment planning, outpatient services and government health reporting.
Haymarket Center may provide your PHI in order to comply with rules and regulations mandating staff to report to law enforcement or government agencies. Examples may include reporting to DHS, and duty to warn situations.
We may disclose PHI regarding deceased patients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics, or permitting inquiry into the cause of death.
Haymarket Center may disclose your PHI to law enforcement officials if you have committed a crime on program premises or against program personnel or have threatened to do so.
We may disclose your PHI if the court issues an appropriate order and follows required procedures.
If you are an active military member or veteran, we may disclose your PHI as required by military command authorities. We may disclose your PHI to authorized federal officials for national security and intelligence reasons and to the Department of State for medical suitability determinations.
Violation of the Federal laws and regulations is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations.
We will investigate all complaints and will not retaliate against you for filing a complaint. If you believe we have violated your privacy rights, you
may file a complaint in writing to us by notifying our Privacy Officer at:
932 W. Washington, Chicago, IL 60607, (312) 226-7984 ext. 366, or by email at GFuller@hcenter.org.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter or calling:
233 N. Michigan Ave., Suite 240, Chicago, Illinois, 60601; (P) (312) 886- 2359/(F) (312) 886-1807
200 Independence Avenue, S.W. Washington, D.C. 20201, calling (877)-696-6775
We will not retaliate against you for filing a complaint.