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THE UNITED METHODIST CHILDREN’S HOME
HIPAA 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.
The United Methodist Children’s Home understands that medical information
about you is personal. We are committed to maintaining the privacy of your
protected health information, which includes both your medical and mental
health information, and information concerning the care and treatment you
receive at UMCH. This notice tells you how the United Methodist Children’s
Home may use and disclose your protected health information.
The Children’s Home creates a record of the services you receive at UMCH.
This notice outlines how the information included in your record may be
disclosed to third parties to coordinate the services you need, conduct
day-to-day business activities, and for other purposes either permitted or
required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
We are required to abide by the terms of this Privacy Notice. The notice
may be amended or updated from time to time. Should that happen, the new
notice will be effective for all protected health information at that time.
Upon your request, the Children’s Home will provide you with any revised
Privacy Notice practices by accessing our web site at
www.umchildrenshome.org
or calling the agency’s Privacy Officer at (404) 327-5820.
How We May Use Or Disclose Your Protected Health
Information
Your protected
health information may be used and shared by appropriate UMCH administrative,
supervisory or treatment team members that are involved in your care for the
purpose of providing services to you. The following are examples of the types
of ways that sharing your information may occur. The examples are not meant
to include all possibilities.
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Treatment
– In order to provide for your care, UMCH will sometimes need to disclose
pertinent medical or psychological information about you to other
professionals directly involved in your care, whether they are on our staff
or not, so they may understand your medical and/or mental health condition
and provide treatment or advice. For example, a psychologist from the
community treating you for a condition such as depression may need to know
what medications have been prescribed for you by other health care
providers who consult with UMCH.
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Payment – Your protected health information may be used by
UMCH, if needed, to either obtain reimbursement or avoid being billed for
services that are provided to you. For example, UMCH may disclose
information to health care providers in order to ensure that Georgia
Medicaid, and not the Children’s Home, is billed for the health services
you receive.
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Health Care
Operations
– We may use or disclose your information in order to support the business
activities of the Children’s Home as required by law as well as continuing
the quality of the care provided to you. For example, members of our
Quality Assurance Committee may use information in your record to assess
the care you receive at UMCH in an effort to improve the employee training
program.
Other Uses Or Disclosures For Which Authorization Is
Not Required
In addition to using
or disclosing protected health information for treatment, payment-related
issues and ongoing health care operations, the United Methodist Children’s
Home may use and/or share your information, without a written authorization
from you, in the following instances:
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Personal
Representative – The Children’s Home may disclose information about you
to a person who, by law, has the authority to represent you in making
health care decisions.
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Public
Health Activities – Such activities may include information collected
by a public health authority, as authorized by law, to prevent or control
disease, injury or disability. An example might be a report of child abuse
or neglect made to a representative of local Child Protective Services if
the Children’s Home believes that you have been victimized.
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Avoid a Serious Threat to Another’s Health or Safety – The
Children’s Home may use and disclose protected health information if it
believes that sharing the information is necessary to prevent or lessen a
serious and likely threat to the health or safety of an individual or the
public at large. In an instance such as this, the disclosure will be made
to a person who is considered to be reasonably able to prevent or lessen
the threat.
- Health
Oversight Activities – The Children’s Home may disclose protected
health information to government authorities, as required by law, for
oversight activities such as audits, inspections, and other proceedings
necessary for monitoring the health care system, government programs, and
compliance with civil rights laws.
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As
Required By Law and Law Enforcement – The Children’s Home will disclose
information about you when required to do so by federal, state or local
law. For example, the Children’s Home will comply with requests to
disclose information in a judicial or administrative proceeding, to
identify or locate a suspect, fugitive or material witness in a criminal
investigation, to report a missing person or a crime, and to assist a
coroner, medical examiner or funeral director who may require medical
information about you as permitted by law and as necessary to carry out
their duties.
- Specialized
Government Functions – The Children’s Home may disclose information of
individuals who are Armed Forces personnel for activities deemed necessary
by appropriate military command authorities or for the purpose of a
determination by the Department of Veterans Affairs of your eligibility for
benefits. In addition, the agency may also share your information with
authorized federal officials who are conducting national security and
intelligence activities, and for the provision of protective services to
the President or other authorized individuals.
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Inmates
– The Children’s Home may share your protected health information with a
correctional institution if you are an inmate of that facility and your
information is necessary to provide care and treatment to you or is
necessary for the health and safety of other inmates.
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Emergencies
– The Children’s Home may use or share your information in an emergency
treatment situation if treatment is required by law and the health care
provider has not been successful in obtaining your consent.
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Research
– The Children’s Home may disclose information about you for a research
project that has been approved by a review board. The review board must
review the research project and its rules to ensure the privacy of your
information.
- Business
Associates – A business associate is someone the Children’s Home
contracts with to provide you or the agency with a service. Whenever a
business associate arrangement involves the use or disclosure of your
health information, UMCH will have written assurance that the associate
will maintain the same standards of safeguarding your privacy that we
require of our own employees.
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De-Identified
Information – The Children’s Home may disclose information about you in
public relations presentations or publications, but only when the
information about you has been changed so that it does not identify you.
Your
Rights Regarding Your Protected Health Information
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Uses and disclosures, other than those described above, will
be made only with your written authorization. With some limitations you
have the right to cancel the authorization at any time. To
request cancellation, you must submit a written request to UMCH’s Privacy
Officer.
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You have the right to request that the Children’s Home
restrict uses or disclosures of your protected health information to
carry out treatment, payment and health care operations or
communications with family members or friends. To request restrictions,
you must submit a written request to UMCH’s Privacy Officer and be
specific about what information you want to limit and to whom you want the
limits to apply. The Children’s Home is not required to agree to your
request.
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You have the right to request that UMCH send communications
that contain your protected health information by alternative means or to
alternative locations. For example, you can request that the Children’s
Home contact you by e-mail or by fax. You must make your request in
writing to UMCH’s Privacy Officer. By law, the agency must accommodate
all reasonable requests if you state in writing that the disclosure of the
information through normal channels could endanger you.
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You
have the right to inspect and copy health information that UMCH maintains
about you. To do so, you must submit a written request to the
agency’s Privacy Officer. UMCH, by law, can charge you a fee for the costs
related to copying, labor and postage. In certain situations, UMCH may
deny your request, but you will have the right to have the denial reviewed.
- You have the
right to have UMCH amend your protected health information for as long as
the agency maintains such information. Your written request to UMCH’s
Privacy Officer must include the reason that supports your request. The
Children’s Home may deny your request for an amendment if it is determined
that the record was not originally created by UMCH, the information is not
available for inspection as specified by law, or is accurate and complete.
- You have the
right to receive an accounting of who your protected health information has
been shared with, what was shared and when it was shared in the six years
prior to the date such an accounting is requested. This right applies to
those purposes other than treatment, payment or business activities as
described in this Notice. This right does not include those times that
information was shared with you for notification purposes or those times
that disclosures were made prior to the HIPAA compliance date of April 14,
2003. The request should be in writing to UMCH’s Privacy Officer and
should indicate in what form you want the list. There will be no charge for
the first list you request within a twelve (12) month period, but UMCH may
charge you for the cost of providing additional lists.
- You have the
right to obtain a paper copy of this Notice at any time by requesting a
copy, in writing, from UMCH’s Privacy Officer.
How To File a Complaint If You Believe Your Privacy
Rights Have Been Violated
If you believe that your privacy rights with respect to your protected
health information have been violated, you may complain, either in writing or
by phone call, to:
The United
Methodist Children’s Home
Attention: Privacy Officer
500 South Columbia Drive
Decatur, Georgia 30030
(404) 327-5820
You
may also file a complaint with the Secretary of the Department of Health and
Human Services, Hubert H. Humphrey Building, 200 Independence Avenue, SW,
Washington, D.C. 20201. You will not be retaliated against for filing a
complaint.
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©
2008 The United Methodist Children's Home of the North Georgia
Conference.
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