WESLEY FAMILY SERVICES – NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MENTAL, BEHAVIORAL, MEDICAL, AND OTHER HEALTH CARE INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a set of federal laws designed to safeguard your health information. These Privacy laws serve several purposes. For example, they establish how your health information can be used by us—your health care provider. They also identify instances when your permission is required to disclose your health information to other persons. Additionally, they identify your rights, and our rights, when it comes to the handling of your health information. PER HIPAA, WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION.
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Your health record contains personal information about you and your health. State and federal law protects the confidentiality of this information. Protected Health Information (“PHI”) is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We will protect the privacy of the health information that we maintain that identifies you, whether it deals with the provision or payment of your health care. We are legally required to follow the privacy practices that are described in this Notice, which is currently in effect.
We reserve the right to change the terms of this Notice and our privacy practices at any time. Any changes will apply to any of your health information that we already have. Before we make an important change to our policies, we will promptly change this Notice and post a new Notice at your location of service. You may also request, at any time, a copy of our Notice of Privacy Practices that is in effect at any given time, from our Quality office at [412-342-2300]. You may view and obtain an electronic copy of this Notice on our web site at [http://www.wfspa.org].
At Wesley Family Services (WFS), we are committed to protecting the privacy of our patient’s mental and physical health information, as the federal and state laws require. This Notice explains how we will satisfy this commitment and your rights about what is in your WFS health record. When we use the terms “information,” we are referring to patient health, treatment, or payment information that identifies you, as a WFS patient. All staff and locations that make up WFS must follow this Notice. If you have any questions as a WFS patient, please ask a WFS staff member for more information.
Your PHI is confidential. We are required to maintain the confidentiality of your PHI by the following federal and Pennsylvania laws:
- The Health Insurance Portability and Accountability Act of 1996. The Department of Health and Human Services issued the following regulations: “Standards for Privacy of Individually Identifiable Health Information.” We call these regulations the “HIPAA Privacy Regulations.” We may not use or disclose your PHI except as required or permitted by the HIPAA Privacy Regulations. The HIPAA Privacy Regulations require us to comply with Pennsylvania laws that are more stringent and provide greater protection for your PHI.
- Pennsylvania Mental Health Confidentiality Laws. For individuals who receive treatment and services in our mental health programs, Pennsylvania laws may provide additional protection for your PHI. We will comply with any Pennsylvania laws that are more stringent than the HIPAA Privacy Regulations and provide greater protection for your PHI.
- Confidentiality of Drug and Alcohol Treatment Records. For individuals who receive treatment and services in our drug or alcohol substance abuse rehabilitation programs, federal and Pennsylvania laws may provide additional privacy protection for your PHI. We will comply with any federal and Pennsylvania laws that are more stringent than the HIPAA Privacy Regulations and provide greater protection for your PHI.
- Confidentiality of HIV-Related Information. Pennsylvania laws may provide additional privacy protection for PHI related to HIV. We will comply with any Pennsylvania laws that are more stringent than the HIPAA Privacy Regulations and provide greater protection for your PHI.
We must provide you with this Notice about our privacy practices. It explains how, when and why we may use and disclose your health information. With some exceptions, we will avoid using or disclosing any more of your health information than is necessary to accomplish the purpose of the use or disclosure. If this health information concerns mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and/or HIV status, we may be very limited in what we provide and may be required to first obtain from you specific authorization. Additionally, we will comply with Pennsylvania laws governing who may make decisions related to health information in the case of a minor patient or client.
Following are answers to some common questions concerning our privacy practices:
QUESTION: HOW WILL WESLEY FAMILY SERVICES USE AND DISCLOSE MY PROTECTED HEALTH INFORMATION?
Answer: We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your specific authorization. Below, we describe the different categories of our uses and disclosures and give you some examples of each.
A. Uses and Disclosures Relating to Treatment, Payment or Healthcare Operations. With the possible exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status ( for which we may need your specific authorization), we may, by federal law, use and disclose your health information for the following reasons:
- For Treatment. We may disclose your general treatment information to other providers who are involved in your care. For example, we may disclose your treatment history to a hospital if you need medical attention while at our facility or to a residential program we are referring you to. Reasons for such a disclosure maybe to get them the historical treatment information they need to coordinate your care, appropriately treat your condition, or schedule needed testing.
- To Obtain Payment for Treatment. We may use and disclose necessary health information in order to bill and collect payment for the treatment that we have provided to you. For example, we may provide certain portions of your health information to your health insurance company, Medicare or Medicaid, or to the County or a county-funded service coordination unit in order to get paid for your treatment.
- For Health Care Operations. We may, at times, need to use and disclose your health information to run our organization. For example, we may use your health information to evaluate the quality of the treatment that our staff has provided to you. We may also need to provide some of your health information to our accountants, attorneys and consultants in order to make sure that we are complying with the law.
B. Certain Other Uses and Disclosures are Permitted by Federal Law. With the possible exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status (for which we may need your specific authorization), we may use and disclose your health information without your authorization for the following reasons:
- When a Disclosure is Required by Law. For example, we may disclose your protected information if we are ordered by a court, or if a law requires that we report that sort of information to a government agency or law enforcement authorities, such as in the case of a dog bite, suspected child abuse or a gunshot wound.
- For Public Health Activities. Under the law, we need to report information about certain diseases, and about any deaths, to government agencies that collect that information. We are also permitted to provide some health information to the coroner or a funeral director, if necessary, after a client’s death.
- For Health Oversight Activities. For example, we will need to provide your health information if requested to do so by the County and/or the State when they oversee the program in which you receive care. We will also need to provide information to government agencies that have the right to inspect our offices and/or investigate healthcare practices.
- For Organ Donation. If one of our clients wished to make an eye, organ or tissue donation after their death, we may disclose certain necessary health information to assist the appropriate organ procurement organization.
- For Research Purposes. In certain limited circumstances for example, approved by an appropriate (Privacy Board or Institutional Review board under federal law), we may be permitted to use or provide protected health information for a research study.
- To Avoid Harm. If one of our service providers, counselors, physicians or nurses believes that it is necessary to protect you, or to protect another person or the public as a whole, we may provide protected health information to the police or others who may be able to prevent or lessen the possible harm.
- For Specific Government Functions: We may disclose the health information of military personnel or veterans here required by U.S. military authorizations. Similarly, we may also disclose a client’s health information for national security purposes, such as assisting in the investigation of suspected terrorists who may be a threat to our nation.
- For Workers’ Compensation. We may provide your health information as described under the workers’ compensation law if your condition was the result of a workplace injury for which you are seeking workers’ compensation.
- Appointment Reminders and Health-Related Benefits or Services. Unless you tell us that you would prefer not to receive them, we may use or disclose your information to provide you with appointment reminders or give you information about helpful alternative programs and treatments.
- Disclosure to Business Associates. We may share your information with business associates who perform services on our behalf. The business associate must agree in writing to protect the confidentiality of the information.
- Fundraising Activities. For example, if our organization chooses to raise funds to support one or more of our programs or facilities, or some other charitable cause or community health education program, we may use the information that we have about you to contact you. If you do not wish to be contacted as part of any fundraising activities, please contact your program director.
C. Certain Uses and Disclosures Require You to Have the Opportunity to Object.
- Disclosures to Family, Friends or Others Involved in Your Care. We may provide a limited amount of your health information to a family member, friend or other person known to be involved in your care or in the payment for your care, unless you tell us not to. For example, if a family member comes with you to your appointment and you allow them to come into the room with you, we may disclose otherwise protected health information to them during the appointment, unless you tell us not to.
- Disclosures to Notify a Family Member, Friend or Other Selected Person. When you first started in our program, we asked that you provide us with an emergency contact person in case something should happen to you while you are at our facilities. Unless you tell us otherwise, we will disclose certain limited health information about you (your general condition, location, etc.) to your emergency contact or another available family member, should you need to be admitted to the hospital, for example.
- Disaster Relief. We may use or disclose information to a public or private entity by law to assist with and coordinate disaster relief efforts.
D. Other Uses and Disclosures Require Your Prior Written Authorization. In situations other than those categories of uses and disclosures mentioned above, or those disclosures permitted under federal law, we will ask for your written authorization before using or disclosing any of your protected health information. If you choose to sign an authorization to disclose any of your health information, you can later revoke it to stop further uses and disclosures to the extent that we haven’t already taken action relying on the authorization, so long as it is revoked in writing.
QUESTION: WHAT RIGHTS DO I HAVE CONCERNING MY PROTECTED HEALTH INFORMATION (PHI)?
Answer: You have the following rights with respect to your protected health information:
A. The Right to Request Limits on Uses and Disclosures of Your Health Information. You have the right to ask us to limit how we use and disclose your health information. We will certainly consider your request, but you should know that we are not required to agree to it. If we do agree to your request, we will put the limits in writing and will abide by them, except in the case of an emergency. A Wesley Family Services patient or their representative has the right to request, and we are required to grant, that the PHI not be disclosed to a health plan (i.e. insurance company) for payment or treatment when the service that is to be excluded from the disclosure was paid for out-of-pocket in full by the patient or person on the consumers behalf.
B. The Right to Choose How We Send Health Information to You or How We Contact You. You have the right to ask that we contact you at an alternate address or telephone number (for example, sending information to your work address instead of your home address) or by alternate means – for example, by (e-mail/mail) instead of telephone. We must agree to your request so long as we can easily do so. Your request must be made in writing.
C. The Right to See or to Get a Copy of Your Protected Health Information. In most cases, you have the right to look at or get a copy of your health information that we have and use to make decisions about your care. This includes your right to request a copy of your electronic medical record in electronic form. Your request must be in writing. Request forms are available at the reception desk or ask your Wesley Family Services service provider. We will respond to you within 30 days after receiving your written request. If we do not have the health information that you are requesting, but we know who does, we will tell you how to get it. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial. In certain circumstances, you may have a right to appeal the decision. If you request a copy of any portion of your protected health information, we may charge you only as allowed under applicable state law. We may need to require that payment be made in full before we will provide the copy to you. If you agree in advance, we may be able to provide you with a summary or an explanation of your records instead. There may be a charge for the preparation of the summary or explanation.
D. The Right to Receive a List of Certain Disclosures of Your Health Information That We Have Made. You have the right to get a list of certain types of disclosures that we have made of your health information. You also have the right to receive an accounting of disclosure from our business associates. This list would not include uses of disclosures for treatment, payment or healthcare operations, and disclosures to you or with your written authorization, or disclosures to your family for notification purposes or due to their involvement in your care. This list also would not include any disclosures made for national security purposes, or disclosures to corrections or law enforcement authorities if you were in custody at the time. You may not request an accounting for more than a six- (6) year period. To make such a request, we require that you do so in writing. A request form is available upon asking at our reception desk or from your Wesley Family Services service provider. We will respond to you within 60 days of receiving your request. The list that you may receive will include the date of the disclosure, the person or organization that received the information (with their address, if available), a brief description of the information disclosed, and a brief reason for the disclosure. We will provide such a list to you at no charge; but, if you make more than one request in the same calendar year, you will be charged a reasonable fee for each additional request that year.
E. The Right to Ask to Correct or Update Your Health Information. If you believe that there is a mistake in your health information or that a piece of important information is missing, you have a right to ask that we make an appropriate change to your information, as long as the information is maintained by or for Wesley Family Services. This does not permit you to alter or change the original record created by your health care provider or their staff. You must make the request in writing, with the reason for your request, on a request form that is available at the reception desk or from your Wesley Family Services service provider. We will respond within 60 days of receiving your request. If we approve your request, we will make the change to your health information, tell you when we have done so, and will tell others that need to know about the change. We may deny your request if the protected health information: (1) is correct and complete; (2) was not created by us; (3) is not allowed to be disclosed to you; or (4) is not part of our records. Our written denial will state the reasons that your request was denied and explain your right to file a written statement of disagreement with the denial.
F. The Right to Information Regarding Disclosures. You have the right to ask for an accounting of disclosures of where Wesley Family Services disclosed your PHI in the six years prior to the date of your request, who we shared it with, and why. We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as the ones you asked us to make). We will provide one accounting per year for free but will charge a reasonable, cost-based fee if you ask for another within twelve months.
G. The Right to be Notified Following a Breach of Unsecured Protected Health Information. If there is a breach of your protected health information we will send you information about your rights and our obligations related to the breach of your unprotected information.
H. The Right to get a Paper Copy of This Notice. If you have received this Notice electronically, you have the right to a paper copy of this Notice.
QUESTION: HOW DO I COMPLAIN OR ASK QUESTIONS ABOUT WESLEY FAMILY SERVICES’ PRIVACY PRACTICES?
In the event that a breach of your PHI occurs by Wesley Family Services or one of it’s business associates, you will be provided with written notification as required by law.
If you believe your privacy has been violated by us, you may file a complaint directly with us. If you have any questions about anything discussed in this Notice, or about any of our privacy practices, or if you have any concerns please contact the Wesley Family Services Privacy Officer at 412-342-2300. You also have the right to file a written complaint with the Secretary of the U.S. Department of Health and Human Services. We may not take any retaliatory action against you if you lodge any type of complaint.
Wesley Family Services
221 Penn Avenue
Pittsburgh, PA 15221
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Ave. S.W.
Room 509F HHH Building
Washington, DC 20201
This Notice took effect on May 1, 2018 and was revised July 1, 2018.