Privacy Practices

NOTICE OF PRIVACY PRACTICES
Effective Date: 09/18/2013
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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.

OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at WellStone Behavioral Health. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the WellStone Behavioral Health. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to: make sure that medical information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; notify affected individuals following a breach of certain unsecured medical information; and follow the terms of the notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment and Treatment Alternatives. We may use and disclose medical information about you to provide you with medical treatment or services. Individuals and programs within WellStone Behavioral Health may share health information about you to coordinate the services you may need. We may use and disclose your medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

For Payment. We may use and disclose medical information about you so that the treatment and services you receive through WellStone Behavioral Health may be billed to and payment may be collected from you, an insurance company or a third party. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Routine Health Care Operations. We may use and disclose medical information about you for WellStone Behavioral Health’s routine operations. These uses and disclosures are necessary to run WellStone Behavioral Health and make sure that all of our clients receive quality care. We may also combine the medical information we have with medical information from other entities to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.

Individuals Involved in Your Care or Payment for Your Care. We may release medical information about you to a friend or family member who is involved in your medical care, provided that such information is directly relevant to such person’s involvement with your medical care. We may also give information to someone who helps pay for your care, provided that such information is directly relevant to payment for your medical care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. However, you may object to such uses and disclosures and, as described below, you have the right to request a restriction or limitation on the medical information used or disclosed by us.

Appointment Reminders and Health-Related Benefits and Services. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment at WellStone Behavioral Health. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

Research. Under certain circumstances, we may use and disclose medical information about you to researchers. While most clinical research studies require specific patient consent, there are some instances where patient authorization is not required.

Fundraising Activities. We may use medical information about you to contact you in an effort to raise money for WellStone Behavioral Health. We only would release contact information such as your name, address and phone number and the dates you received treatment or services at WellStone Behavioral Health. If you do not want WellStone Behavioral Health to contact you for fundraising efforts, you must notify the Privacy Officer in writing.

Business Associates. There are some services provided at WellStone Behavioral Health through contracts with business associates. Examples include consultants, accountants, lawyers and third-party billing companies. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked
them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.

Public Health Activities. We may disclose medical information about you to public health or legal authorities charged with preventing or controlling disease, injury, or disability. For example, we are required to report the existence of a communicable disease, such as tuberculosis, to the Alabama Department of Public Health to protect the health and well-being of the general public. We may disclose medical information about you to individuals exposed to a communicable disease or otherwise at risk for spreading the disease. We may disclose medical information to an employer if the employer requires the healthcare services to determine whether you suffered a work-related injury.

Victims of Abuse, Neglect or Domestic Violence. We are required to report child, elder, and domestic abuse or neglect to the State of Alabama.

Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. We may disclose medical information for judicial or administrative proceedings, as required by law.

Law Enforcement. We may release medical information for law enforcement purposes as required by law, in response to a valid subpoena, for identification and location of fugitives, witnesses or missing persons, for suspected victims of crime, for deaths that may have resulted from criminal conduct and for suspected crimes on the premises.

Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. We may also release medical information to funeral directors as necessary to carry out their duties.

Organ and Tissue Donation. If you are an organ donor, we may use or release medical information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organ, eye or tissue to facilitate organ or tissue donation and transplantation.

To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs.

Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.

Use and Disclosure of Psychotherapy Notes, Use of Medical Information for Marketing, and Sale of Medical Information. In general, with few exceptions, unless you provide written authorization, we will not use or disclose your psychotherapy notes (except where permitted or required by law), we will not use or disclose your medical information for marketing purposes, and we will not sell your medical information.

Other Uses and Disclosures. Any other uses and disclosures will be made only with your written authorization.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
Although all records concerning your treatment obtained at WellStone Behavioral Health are the property of WellStone Behavioral Health, you have the following rights regarding medical information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.

To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing on the required form to the Health Information Department. If you request a copy of the information, we will charge a fee for the costs of copying, mailing or other supplies associated with your request. If the information you request is maintained electronically, and you request an electronic copy, we will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format. If the information cannot be readily produced in that form and format, we will work with you to come an agreement on form and format.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the entity.
To request an amendment, your request must be made in writing on the required form and submitted to the Privacy Officer. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: was not created by us, unless the person or entity that created the information is no longer available to make the amendment; is not part of the medical information kept by or for the entity; is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of certain disclosures we made of medical information about you.

To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12 month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.

Except as described below, we are not required to agree to your request. However, if we do agree, we will comply with your request, unless the information is needed to provide you emergency treatment or disclosure is required by law. We will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the information pertains solely to a health care item or service for which the health care provider involved has been paid out-of-pocket in full. We are not responsible for notifying subsequent health care providers of your request for restrictions on disclosures to health plans for those items and services, so you will need to notify other providers if you want them to abide by the same restriction.

To request restrictions, you must make your request in writing to the Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing to the Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to Revoke Authorization. You have the right to revoke your authorization to use or disclose your medical information except to the extent that action has already been taken in reliance on your authorization.

Right to Be Notified of a Breach. You have the right to be notified in the event that we discover a breach of your unsecured protected health information, as defined under federal law.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice, contact the Privacy Officer.

Confidentiality of Alcohol and Drug Abuse Records. The confidentiality of alcohol and drug abuse records maintained by this organization is protected by federal law and regulations. Generally, the program may not communicate to anyone outside the program that a specific individual attends the program, or disclose any information identifying a specific individual as an alcohol or drug abuser unless one of the following conditions is met: the individual consents to it in writing; the disclosure is allowed by a court order; the disclosure is made to medical personnel in a medical emergency or to qualified personnel for program evaluation. Violation of the federal law and regulations by a program is a crime. Suspected violation may be reported to the appropriate authorities in accordance with federal regulations.

Potential Impact of State Law. In some situations, state privacy laws may provide additional protections for your medical information that we use and disclose. For example, Alabama law may provide greater protections to medical information related to certain mental health records that we must comply with.

CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in MHC facilities.

FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions and would like additional information, you may contact the Privacy Officer at 256-533-1970. If you believe that your privacy rights have been violated, you may submit a written request to the WellStone Behavioral Health Privacy/Security Officer. You may also file a complaint with the Secretary of United States Department of Health and Human Services. You will not be penalized for filing a complaint.