Catholic Charities, Inc.
Notice of Privacy Practices
This notice describes how treatment information about you may be used and disclosed and how you can get access to this information.
PLEASE REVIEW IT CAREFULLY (Effective 04/14/2003)
The Catholic Charities, Inc (known as CCI), must by law keep your health information private and give you notice of its legal duties and privacy practices for your health information. If you have questions about any part of this notice or if you want more information about the privacy practices at CCI, please contact:
Catholic Charities, Inc
530 George Street
Jackson, MS 39202
I. How CCI May Use or Disclose your Health Information:
In certain situations, which will be described in Section II below, we must obtain your written authorization in order to use and/or disclose your protected health information (PHI). PHI is defined as any information we gather about you and is documented in your record.
1. Treatment: CCI provides various therapeutic treatment programs to all ages of consumers as well as advocacy services. During the course of your treatment, we may use and disclose PHI to physicians, nurses and other health care personnel who provide you with health care services or are involved in your care. In addition, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also disclose PHI to other providers involved in your treatment. Alcohol and Drug treatment programs will provide additional security to insure your privacy.
2. Payment: We may use and disclose PHI to obtain payment for services that we provide to you. For example, disclosures to claim and obtain payment from your health insurer, HMO or other company that arranges or pays the cost of some or all of your health care to verify that your payor will pay for health care. You should be aware if you are not the policy holder, certain information may be disclosed to the policy holder by the insurance carrier. Even when Catholic Charities releases this information, the utmost caution is used to insure that your information is not misdirected to anyone other than your health insurer, HMO or other company that arranges or pays the cost of you treatment.
3. Health care operations: We may use and disclose PHI for our health care operations, which include internal administration and planning and various activities, such as an internal peer review, that improve the quality and cost effectiveness of care that we deliver to you. For example, we may use PHI to evaluate the quality and competence of our workers. We may disclose PHI to our administrative staff to conduct medical reviews, needs assessment, and to check quality control of services available.
We may also provide PHI to your other health care providers when such PHI is required for them to treat you, receive payment for services they render to you, or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or health care fraud and abuse detection or compliance.
4. Information provided to you: CCI allows you to look at your medical records. You must make the request in writing which will be noted in your records. You have the right to a copy of your records but the physical record remains the property of Catholic Charities, Inc. If we do not have your PHI but we know who does, we will tell you how to get it. CCI will not be able to disclose third party information to anyone but the individual receiving services or their legal authorized personal representative.
5. Notification and communication with family: We may disclose PHI to a family member, your personal representative or any other person identified by you who is responsible for your care about where you are, your general condition or if you die. If you are able and can agree or object, CCI will give you a chance to object prior to making this notification. If you are unable or cannot agree or object, our health professionals will use their best judgment in telling your family and others.
Guardians of minors who are residents in a CCI facility will be notified as soon as possible of situations where the minor’s care or general condition changes dramatically. If there is an emergency situation or if the guardian can not be reached, Catholic Charities, Inc. staff will make decisions based on the best interest of the minor’s health.
6. Required by law: As required by law, we may use and disclose your PHI, such as a court order.
7. Public health: We may disclose your PHI to public heath authorities for purposes related to: preventing or controlling disease, report child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.
8. Health oversight activities: We may disclose your PHI to agencies during the course of audits, investigations, inspections, licensure and other proceedings.
9. Judicial and administrative proceedings: We may disclose your PHI in the course of any administrative or judicial proceeding.
10. Specialized government functions: We may disclose your PHI for the military, national security, correctional institutions and government benefits purposes.
11. Law enforcement: We may disclose your PHI to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
12. Deceased person information: We may disclose your PHI to coroners, medical examiners and funeral directors.
13. Research: We may disclose your PHI to researchers doing research that has been approved by Catholic Charities, Inc., provided that you give prior consent to participate in that research.
14. Public safety: We may disclose your PHI to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public. Catholic Charities, Inc. will provide enhanced security to extremely sensitive personal information such as HIV/AIDS, mental health, sexually transmitted diseases, and alcohol and drug, in accordance to the law, professional ethics, and licensure.
15. Worker’s compensation: We may disclose PHI as necessary to comply with worker’s compensation laws.
II. When CCI May Not Use or Disclose Your Health Information:
Except as described in this Notice of Privacy Practices, CCI will not use or disclose your health information without your written authorization. If you do authorize CCI to use or disclose your PHI for another purpose, your authorization remains valid six months from the time it is signed unless you may take back your authorization in writing at any time.
III. Your Health Information Rights
1. You have the right to ask for restrictions on certain uses and disclosures of your PHI. You may inform us of any restrictions on disclosures in writing which will be added to your record and forwarded to all entities which request this information or have requested your information. When there is an issue of safety to you or another person, CCI does not have to agree to the restriction that you request.
2. You have the right to get your PHI through a reasonable alternative means or at an alternative location. You must present a CCI form which tells your specific request. There may be a charge to get this information.
3. You have the right to see and obtain a copy of your PHI. Under limited circumstances, we may deny you access to a portion of your records. (You should take note that, if you are a parent or legal guardian of a minor, certain portion of the minor’s medical record will not be accessible to you including records relating to pregnancy, abortion, sexually transmitted disease, substance use and abuse, and contraception and/or family planning services.) You must submit a completed CCI Release of Information form. If you request copies, we may charge you as much as $10.00 fee plus $0.25 for each page.
4. You have the right to request that CCI change your PHI that is not correct or complete. CCI does not have to change your PHI if we feel that the information is correct or other special circumstances apply, but your written comments will be included in the records.
5. You have a right to get a list of disclosures of your PHI made by CCI, except for disclosures for: 1. treatment, 2. payments, 3. health care operations 4. Information provided to you, 5. Certain government functions of Section I of this Notice of Privacy Practices during any period of time prior to the date of your request provided such period does not exceed six years and does not apply to disclosures that occurred prior to April 14, 2003.
IV. Changes to this Notice of Privacy Practices
CCI reserves the right to change this Notice at any time in the future, and to make the new provisions effective for all information that it keeps, including information that was created or received prior to the date of such change. Until such change is made, CCI must comply with this notice. If we change this Notice, we will post the new notice in waiting areas and on our internet site at www.catholiccharitiesjackson.org and have copies available upon your request.
Complaints about this Notice of Privacy Practices or how CCI handles your PHI should be sent to:
Catholic Charities, Inc.
530 George Street
Jackson, MS 39202
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201