Effective Date: April 14, 2003 and modifications as of September 22, 2013
The information on the following pages describes how medical and confidential individual information about individuals may be used and disclosed and how one can get access to this information. Please review it carefully.
Contact our Agency's Privacy Contact with questions:
Beth KochManager Privacy and Health Information
Phone: (309) 671-8005
The Human Service Center respects each individual’s confidentiality and will only release confidential information about a client in accordance with federal and Illinois law. This notice describes our policies related to the use of the records of care and treatment that are generated by the Agency.
USE and DISCLOSURE of PROTECTED HEALTH INFORMATION:
In order to effectively provide care, there are times when we will need to share confidential information with others. This includes:
|Treatment||We may use or disclose treatment information to provide, coordinate, or manage care or any related services, including sharing information with others outside our Agency that we are consulting with or to whom we are referring an individual.|
|Payment||With written consent, information will be used to obtain payment for the treatment and services provided. This will include contacting health insurance companies for prior approval of planned treatment or for billing purposes. You have a right to restrict certain disclosures of your protected health information if you pay out of pocket in full for the services provided to you.|
|Healthcare Options||We may use client information to coordinate our business activities. This may include setting up appointments, reviewing your care, training our staff, and working with third party entities with whom we have a Business Associate Agreement.|
INFORMATION MAY BE DISCLOSED WITHOUT YOUR CONSENT:
Under federal and Illinois law, client information may be disclosed without consent in the following circumstances:
- We may disclose demographic information including but not limited to name, date of birth, and social security number and information about mental health services to the Illinois Department of Human Services, Division of Mental Health, for the purpose of obtaining funding for those services. This information is stored in the DHS/DMH database.
- Sufficient information may be shared to address the immediate emergency an individual is facing.
- We will contact individuals with reminders of future appointments or information about treatment alternatives or other health-related benefits and services that may be of interest to individuals. We will leave appointment information on answering machines or voicemail unless told not to.
- This would include situations where we have a subpoena, court order, or are mandated to provide public health information, such as communicable diseases or mandated to report suspected abuse and neglect such as child abuse, elder abuse, or institutional abuse.
- We are required to disclose information about the circumstances of a client's death to a coroner who is investigating it.
- We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. We are also required to share information, if requested with the U.S. Department of Health and Human Services to determine our compliance with federal laws related to health care and to Illinois state agencies that fund our services or for coordination of your care.
- If a crime is committed on our premises or against our personnel we may share information with law enforcement to apprehend the criminal. We also have the right to involve law enforcement when we believe an immediate danger may occur to someone.
- Information may be disclosed for scientific research if the program director agrees, but information that identifies an individual may not be re-disclosed.
- Human Service Center may disclose mental health information to another medical provider for the purpose of treatment planning, coordinating care, or for admission or discharge planning. This includes presence in mental health treatment, medication and allergy information, mental health diagnosis, and results of recent assessments, evaluations, and contacts. The purpose of this disclosure is to integrate primary and behavioral health care.
- Human Service Center provides information to the IL Dept of Human Services according to law and regulation for the purpose of determination by the Illinois State Police of whether an individual receiving mental health services is disqualified from receiving or retaining a Firearm Owner’s ID (FOID) card. This includes persons who are court ordered for mental health services, admission and discharge dates to Adams Street Living Center, and those deemed a clear and present danger to self or others.
YOU HAVE THE FOLLOWING RIGHTS UNDER FEDERAL AND ILLINOIS LAW:
- Copy of Record
- Clients are entitled to inspect the individual record our Agency has generated about them. We may charge a reasonable fee for copying and mailing records.
- Release of Records
- Clients may consent in writing to release their records or information to others for any purpose they choose. This could include one’s attorney, employer or others who one wishes to have knowledge of their care. Individuals may revoke this consent in writing at any time but only to the extent no action has been taken in reliance on prior authorization. Except as described in this Notice or as required by Illinois or Federal law, we cannot release your protected health information without your written consent.
- Restriction on Record
- Clients may ask us not to use or disclose part of the clinical information. This request must be in writing. The Agency is not required to agree to the request if we believe it is in the client’s best interest to permit use and disclosure of the information. The request should be given to the Privacy Contact.
- Contacting You
- Clients may request that we send information to another address or by alternative means. We will honor such request as long as it is reasonable and we are assured it is correct. We have a right to verify that the payment information provided is correct. We also will be glad to provide information by email if requested. If an individual wishes us to communicate by email, they are also entitled to a paper copy of this privacy notice.
- Amending Record
- If a client believes that something in their record is incorrect or incomplete, an amendment may be requested. To do this, contact the Privacy Contact or the Records Department and ask for the Request to Amend Health Information form. In certain cases, we may deny the request. If we deny the request for an amendment, individuals have the right to file a statement that they disagree with us. We will then add our response and the client’s statement to the record.
- Accounting for Disclosures
- Clients may request an accounting of any disclosures we have made related to their confidential information, except for information we used for treatment, payment, or healthcare operations purposes or that we shared with the client or client’s family, or information that we were given specific consent to release. This also excludes information that we were required to release. To receive information regarding disclosure made for a specific time period (no longer than six years and after April 14, 2003,) please submit a request in writing to our Privacy Contact. We will notify individuals of the cost involved in preparing this listing.
- Notification of Breach
- You have a right to be notified if there is a breach of your unsecured protected health information. This would include information that could lead to identify theft. You will be notified if there is a breach or a violation of the HIPAA Privacy Rule and there is an assessment that your protected information may be compromised.
- Questions and Complaints
- If an individual has any questions or wishes a copy of this policy or has any complaints, our Privacy Contact may be contacted in writing for further information. Clients may also complain to the Secretary of U.S. Department of Health and Human Services if they believe our Agency has violated their privacy rights. We will not retaliate against individuals for filing such a complaint. Clients may contact the public payer or its designee and be informed of the public payer’s process for reviewing grievances.
- Changes in Policy