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Notice
Effective Date: <04/05/05>
BEHAVIORAL
HEALTH RESPONSE, DEPARTMENT OF MENTAL HEALTH ADMINISTRATIVE
AGENTS, AND DEPARTMENT OF MENTAL HEALTH FACILITIES COLLABORATE
TO PROVIDE ACCESS CRISIS INTERVENTION (ACI) SERVICES FOR
EASTERN MISSOURI
Notice
of Privacy Practices
This
notice is to explain the rules around the privacy of your own
medical/health records and our legal duties on how to protect
the privacy of your medical/health records that we create or
receive. Generally, we are required by law to ensure
that medical/health information that identifies you is kept
private. We are required by law to follow the terms of
the notice that are the most current.
This
notice will explain (i) how we may use and disclose your
medical/health information; (ii) our obligations related to
the use and disclosure of your medical/health information; and
(iii) your rights related to any medical/health information
that we have about you.
Sites Covered
This
privacy statement applies to the bhrworldwide.org website.
It does not apply to any linked sites owned, operated or
otherwise maintained by any third party. To learn about
the privacy policy of a linked site, please refer to the
privacy statement for that site.
Visiting Our Website
We
use “cookie” technology to obtain usage information from
our online visitors. You may disable your cookie
information by adjusting your browser preferences on your
personal computer at any time. Keep in mind that cookies
do not identify a specific user and are not used to collect
any personal information.
In order to provide you with the best possible service and
relevant information to you, we use cookies to:
- Track
resources and data accessed on the site per visitor
- Record
general site statistics and activity
- Assist
users experiencing problems with bhrworldwide.org.
There are times where you may choose to give us personal
information about you. For example, you may ask that a
medical/health professional call you, or you may request
additional information. We need certain information from
you so we can respond to your request. Many of our
customers register for online access to their account
information. We need information from you to register
you, and authenticate you, for this access.
Kinds of Information We Collect
We
collect and use Personal Information that you voluntarily give
us, and Site Visitorship Data, on this website, as follows:
We
collect Personal Information that you give us, for example, to
·
request
a call from a BHR representative or medical professional
·
register
for a service on this website
·
instruct
us to perform a transaction, if you are a registered customer
·
complete
a survey
This information commonly
includes your name, address, email address, telephone number,
and if applicable, your account number. Our website has
security safeguards that are designed to protect the security
of any personal information that you decide to give us via the
Internet.
We use Personal Information
collected on this website in several ways:
·
to
respond to your request for a call, referral, or additional
information
·
to
process transactions you request
·
to
tell you about products or services we offer to authenticate
registered customers
Site
Visitorship Data is data about the way a website is used that
is not associated with an individual’s identity. We
collect this information to analyze how our site is used and
to improve it.
The kind of information we collect includes:
·
the
pages visited on our site
·
the
features used
·
how
long a visitor stays
·
the
domain name of the site from which visitors connect to our
site
We
use Site Visitorship Data to develop, manage, and improve the
website. Sometimes we add Site Visitorship to Personal
Information from registered customers. We may use that
information to:
·
manage
the website
·
help
resolve problems
·
analyze
use of the site
·
tell
you about products or services that we offer
THIS
NOTICE (THE “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. This notice applies to the medical/health
records that are generated by the ACI System. The terms
"medical" and "medical/health" in this
Notice mean information about your physical or mental
condition which make you eligible for our services, or which
arise while we are serving you. For example, this may
include psychological tests, psychiatric assessments or
medical or social assessments.
We
may obtain, but we are not required to, your consent for the
use or disclosure of your protected health information for
treatment, payment or health care operations. We are
required to obtain your authorization for the use or
disclosure of your information for other specific purposes or
reasons. We have listed some of the types of uses or
disclosures below. Not every possible use or disclosure
is covered, but all of the ways that we are allowed to use and
disclose information will fall into one of the categories.
In
addition to ACI departments, employees, staff and other
personnel, the following people will also follow the practices
described in this Notice of Privacy Practices:
- Any
health care professional who is authorized to enter
information in your medical/health record;
- Any
member of a volunteer group that we allow to help you
while you are in the ACI system; and
- All
providers within the collaborating group
The
entities that collaborate to provide ACI services are:
- state-operated
Missouri Department of Mental Health facilities in the
Eastern Region;
- administrative
agents and associate providers located in the Eastern
Region for the Division of Comprehensive Psychiatric
Services; and
- Behavioral
Health Response
In
addition, individuals and providers who are in the
collaborating group may share medical information with each
other about ACI consumers they serve in common for the purpose
of treatment, payment or health care operations as those terms
are described later in this Notice of Privacy Practices.
These other individuals and providers who are in the
collaborating group are included throughout this document
whenever we use the term "ACI." The following
categories describe different ways that we use and disclose
medical/health information. For each category of uses or
disclosures we will explain what we mean and try to give some
examples. 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.
We
can use or disclose medical information about you regarding
your treatment, payment for services, or for ACI operations,
and we will make a good faith effort to have you acknowledge
your copy of the Notice of Privacy Practices.
HIPAA Notice of Privacy Practices for Protected Health
Information
If
you need further information on the HIPAA Privacy Rule, please
see the following:
- HIPAA
Privacy Rule and Public Health Guidance from CDC and the
U.S. Department of Health and Human Services
- Standards
for Privacy of Individually Identifiable Health
Information
“We” refers to Behavioral Health Response, Inc. in its
capacity as a provider of <SERVICES OR PRODUCTS>.
“You” or “yours” refers to any individual who has
completed the registration process and has submitted personal
health information and other personal information on
bhrworldwide.org.
Federal law - as embodied in the privacy regulations
promulgated pursuant to the Health Insurance Portability and
Accountability Act -- requires Behavioral Health Response,
Inc. to maintain the privacy of protected health information
about you. We are not allowed to use or disclose it
unless we receive written consent or authorization signed by
you or as otherwise permitted by law. Federal law
requires us to provide you with a Notice of our legal duties
and privacy practices with respect to protected health
information relating to you. This Notice is to inform
you of uses and disclosures of protected health information
that we may make. It also informs you of your rights and
our duties with regard to protected health information.
We
are required to abide by the terms contained in this Notice.
We do reserve the right to change the terms of this Notice and
make the new Notice provisions apply to all the protected
health information we maintain. This includes protected
health information created or received prior any revision to
this Notice. We must promptly revise this Notice
whenever there is a material change to our uses or
disclosures, your rights, our duties and other related
circumstances. We will mail you any such revised Notice,
unless you have agreed to receive Notices electronically.
To receive such Notices electronically, you should make such a
request to the contact listed at the end of this Notice.
Use and Disclosure of Protected Health Information
Federal
law permits us to use and disclose protected health
information for purposes of treatment, payment and health care
operations as those terms are defined under federal law.
We do not provide treatment, but we may use and disclose
protected health information for payment purposes, such as in
connection with the payment of an insurance claim. We
may also use and disclose protected health information for the
health care operations we provide in connection with
transacting such insurance activities as underwriting and
other activities relating to the creation, renewal or
replacement of a contract of insurance. We will also
comply with any state or federal law that is more restrictive
as to our uses and disclosures of protected health
information.
There
are circumstances where federal law permits or requires us to
use or disclose protected health information about you without
your written authorization.
Permitted Disclosures
While
we may not necessarily make all of the uses and disclosures
described below, federal law permits use or disclosure of
protected health information without your written consent or
authorization under the following circumstances:
- We
may disclose protected health information to you.
- To
third party non-BHR business associates that perform
services for us or on our behalf, such as vendors.
- Where
disclosure is required by law.
- To
a public health authority authorized by law to collect or
receive such protected health information for the purposes
of preventing or controlling disease, injury or disability
or reviewing reports of child abuse and for the conduct of
other authorized public health activities and
responsibilities.
- To
a governmental authority when we reasonably believe that
you may be a victim of abuse, neglect or domestic violence
where the governmental authority is authorized to receive
such reports.
- To
a health oversight agency for such activities.
- For
judicial and administrative proceedings.
- To
a law enforcement official for a law enforcement purpose.
- To
a medical examiner for the purpose of identifying a
deceased person, determining the cause of death, or other
duties authorized by law.
- To
organ donor organizations in order to aid in such
donations.
- For
certain research purposes authorized by and subject to
federal law.
- To
avert a serious threat to health or safety.
- To
government officials regarding military personnel and
certain domestic and foreign government officials for
certain functions authorized by federal law.
- To
comply with workers' compensation and other similar
programs.
- To
make certain marketing communications and for certain
fundraising purposes.
Additionally, where appropriate, we may disclose protected
health information to a group health plan or plan sponsor in
accordance with federal law.
Required Disclosures
We
are required to disclose protected health information about
you when required by the Secretary of the Department of Health
and Human Services to investigate or determine our compliance
with federal health privacy regulations.
We
are also required, with certain exceptions, to provide you
with access to inspect and obtain a copy of health information
about you that we maintain in our record system. See “Right
to Inspect and Copy”below.
Need for Authorization
We
will not make any uses or disclosures other than those
mentioned above without your written authorization in
accordance with federal law. You may revoke such
authorization, provided it is in writing. Your
revocation will not, however, be effective 1) if we took
action relying on the written authorization before it was
revoked, or 2) if we obtained the authorization as a condition
of issuing you insurance coverage, and other law provides us
with the right to contest a claim under the policy or the
policy itself. To revoke such an authorization, please
write the contact listed at the end of this Notice. If
you wish additional information regarding authorizations, you
should address your inquiry or complaint to the contact listed
at the end of this Notice.
Treatment
We may
use medical information about you to provide you with
treatment or services. We may disclose medical
information about you to qualified mental health professionals
(each , a “QMHP”); qualified mental retardation
professionals (each, a “QMRP”); or to qualified
counselors; or, technicians, medical students or residents, or
other ACI personnel, volunteers or interns who are involved in
providing services for you or interpreters needed in order to
make your treatment accessible to you. For example, your
treatment team members will internally discuss your
medical/health information in order to develop and carry out a
plan for your services. Different agencies within the
OHCA also may share medical/health information about you in
order to coordinate the different things you need, such as
prescriptions, medical tests, special dietary needs, respite
care, personal assistance, day programs, etc.
Payment
We may
use and disclose medical/health information about you so that
the treatment and services you receive may be billed to and
payment may be collected from you, an insurance company or a
third party. For example, we may need to provide your
insurance plan information about psychiatric treatment or
habilitation services you received so your insurance plan, or
any applicable Medicaid or Medicare funds, will pay us for the
services. We may also tell your insurance plan or other
payor about a service you are going to receive in order to
obtain prior approval or to determine whether the service is
covered. In addition, in order to correctly determine
your ability to pay for services, we may disclose your
information to the Social Security Administration, the
Division of Employment Security, or the Department of Social
Services.
Health Care Operations
We may
use and disclose medical/health information about you for ACI
operations. These uses and disclosures are necessary to
run the system and make sure that all of our consumers receive
quality care. For example, we may use medical/health
information for quality improvement to review our treatment
and services and to evaluate the performance of our staff in
caring for you. We may also combine medical information
about many consumers to decide what additional services the
system should offer, what services are not needed, and whether
certain new treatments are effective. We may also
disclose information to doctors, nurses, technicians, medical
students and residents, and other personnel as listed above
for review and learning purposes. We may also combine
the medical/health information we have with medical/health
information from other facilities to compare how we are doing
and see where we can make improvements in the care and
services we offer. It may also be necessary to obtain or
exchange your information with the Department of Elementary
and Secondary Education, the Department of Social Services,
Vocational Rehabilitation, the Office of State Courts
Administrator, or other Missouri state agencies or interagency
initiatives, such as the Juvenile Information Governance
Commission, or System of Care initiative. Or, 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 the identity of
specific consumers. This may be in the form of providing
information to our regional advisory councils or state
advisory councils or planning councils.
Uses
and Disclosures of Medical/Health Information That Do Not
Require Your Consent or Authorization
We
can use or disclose health information about you without your
consent or authorization when:
- there
is an emergency or when we are required by law to treat
you,
- when
we are required by law to use or disclose certain
information, or
- when
there are substantial communication barriers to obtaining
consent from you.
We
can also use or disclose health or medical information about
you without your consent or authorization for:
·
to
contact you as a reminder that you have an appointment for
treatment or services.
·
to
tell you about or recommend possible treatment options or
alternatives or health-related benefits or services that may
be of interest to you.
·
Should
a disaster occur, we may disclose medical information about
you to any agency assisting in a disaster relief effort so
that your family can be notified about your condition, status
and location.
·
Under
certain circumstances, we may use and disclose medical/health
information about you for research purposes when a waiver of
authorization has been approved by the Institutional Review
Board, or Privacy Committee. For example, a research
project may involve comparing the health and recovery of all
consumers who received one medication to those who received
another for the same condition. All research projects,
however, are subject to a special approval process under
Missouri law. This process evaluates a proposed research
project and its use of medical information, trying to balance
the research needs with consumers' need for privacy of their
medical/health information. Before we use or disclose
medical/health information for research, the project will have
been approved through this research approval process. We
may, however, disclose medical/health information about you to
people preparing to conduct a research project, for example,
to help them look for consumers with specific medical needs,
so long as the medical information they review does not leave
the facility. We may also use or disclose your health
information without your consent when disclosing information
related to a research project when a waiver of authorization
has been approved by the Professional Review Committee or a
university-sponsored Institutional Review Board.
·
We
will disclose medical/health information about you when
required to do so by federal, state or local law.
·
We
may use and disclose medical/health information about you when
necessary to prevent a serious threat to the health and safety
of you, the public, or any other person. However, any
such disclosure would only be to someone able to help prevent
the threat.
SPECIAL
SITUATIONS
Military
and Veterans
If you are a member of the armed forces, we may release
medical/health 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.
Workers'
Compensation
When disclosure is necessary to comply with Workers'
Compensation laws or purposes, we may release medical/health
information about you for workers' compensation or similar
programs. These programs provide benefits for
work-related injuries or illness.
Public
Health Risks
We may disclose medical/health information about you for
public health activities. These activities generally
include the following: to prevent or control disease, injury
or disability; to report births and deaths; to report child
abuse or neglect; to report reactions to medications or
problems with products; to notify people of recalls of
products they may be using; to notify a person who may have
been exposed to a disease or may be at risk for contracting or
spreading a disease or condition; to notify the appropriate
government authority if we believe a consumer has been the
victim of abuse, neglect or domestic violence. We will only
make this disclosure if you agree or when required or
authorized by law.
Health
Oversight Activities
We may disclose medical/health 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/health information about you in response to a court or
administrative order.
Law
Enforcement
We may release medical/health information if asked to do so by
a law enforcement official; however, if the material is
protected by 42 CFR Part 2 (a federal law protecting the
confidentiality of drug and alcohol abuse treatment records),
a court order is required. We may also release limited
medical/health information to law enforcement in the following
situations: (1) about a consumer who may be a victim of a
crime if, under certain limited circumstances, we are unable
to obtain the consumer's agreement; (2) about a death we
believe may be the result of criminal conduct; (3) about
criminal conduct at the facility; (4) about a consumer where a
consumer commits or threatens to commit a crime on the
premises or against program staff (in which case we may
release the consumer's name, address, and last known
whereabouts); (5) in emergency circumstances, to report a
crime, the location of the crime or victims, and the identity,
description and/or location of the person who committed the
crime; and (6) when the consumer is a forensic client and we
are required to share with law enforcement by Missouri
statute.
Coroners,
Medical Examiners and Funeral Directors
We may release medical/health information to a coroner or
medical examiner. This may be necessary, for example, to
identify a deceased person or determine the cause of death.
We may also release medical/health information about consumers
to funeral directors as necessary to carry out their duties.
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 conduct special investigations
or provide protection to the President and other authorized
persons or foreign heads of state.
Inmates
If you are an inmate of a correctional institution or under
the custody of a law enforcement official, we may release
medical/health information about you to the correctional
institution or law enforcement official if the release is
necessary (1) for the institution to provide you with health
care; (2) to protect your health and safety or the health and
safety of others; or (3) for the safety and security of the
correctional institution.
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 your medical/health
information with the exception of psychotherapy notes and
information compiled in anticipation of litigation. To
inspect and copy your medical/health information, you must
submit your request in writing to this facility's Privacy
Officer or designee. If you request a copy of the
information, we may charge a fee for the costs of copying,
mailing or other supplies associated with your request.
We may deny your request to inspect and copy in certain
limited circumstances. If you are denied access to your
medical/health information because of a threat or harm issue,
you may request that the denial be reviewed. Another
licensed health care professional chosen by the facility will
review your request and the denial. 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 Request an Amendment
If you feel that medical/health 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 facility.
Requests for an amendment must be made in writing and
submitted to the Privacy Officer or designee. You must
provide a reason to support your request for an amendment.
We may deny your request if it is not in writing or if it does
not include a reason supporting 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
facility;
·
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", a list of the disclosures made by the
facility of your medical/health information. To request
an accounting of disclosures, you must submit your request in
writing to this facility's Privacy Officer or designee.
Your request must state a time period which may not go back
more than six years. Your request should indicate in
what form you want the list (for example, on paper or
electronically). The first list you request within a
twelve-month period will be free. For additional lists
in a twelve-month period, we may charge you for the cost of
providing the list. We will notify you what that cost
will be and give you an opportunity to withdraw or modify your
request before you are charged. This right does not
apply to: disclosures made to carry out treatment, payment, or
health care operations; disclosures made pursuant to an
authorization in compliance with federal law; disclosures made
for law enforcement purposes; disclosures authorized by law;
or disclosures that occurred before April 14, 2003. In
addition, there are some disclosures that we do not have to
track. For example, when you give us an authorization to
disclose some information, we do not have to track that
disclosure.
Right
to Request Restrictions
You have the right to request a restriction or limitation on
the medical/health information we use or disclose about you
for treatment, payment or health care operations. For
example, you could ask that we not use or disclose information
about your family history to a particular community provider.
We are not required to agree to your request. If we do
agree, we will comply with your request unless the information
is needed to provide you emergency treatment. To request
a restriction on the use or disclosure of your medical/health
information for treatment, payment or health care operations,
you must make your request in writing to the facility's
Privacy Officer or designee. 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
facility's Privacy Officer or designee. Your request
must specify how or where you wish to be contacted. We
will not ask you the reason for your request and will
accommodate all reasonable requests.
Right
to a Paper Copy of This Notice
You have the right to a paper copy of this notice even if you
have agreed to receive the notice electronically. You
may ask us to give you a copy of this notice at any time by
contacting the facility's Privacy Officer or designee.
You may also obtain a copy of this notice at our website,
www.bhrworldwide.org
If
you wish to exercise any of these rights, please contact:
Privacy Officer (address below)
If you
believe your privacy rights have been violated, you have the
right to complain to us by writing to the contact listed at
the end of this Notice or to the federal Secretary of the
Department of Health and Human Services, Hubert H. Humphrey
Building, 200 Independence Avenue, Washington, DC 20201, or
you may call them at 877.696.6775. In addition, you may
file a grievance with the Office of Civil Rights by calling
866-OCR-PRIV (866.627.7748), or 886.788.4989 TTY.
Federal law prohibits retaliation against you for filing such
a complaint. The contact listed at the end of this
Notice is also available to provide you information regarding
questions you have or other information concerning matters
contained in this Notice. All complaints must be
submitted in writing.
Uses
or disclosures not covered in this Notice of Privacy Practices
will not be made without your written authorization. If
you provide us written authorization to use or disclose
information, you can change your mind and revoke your
authorization at any time, as long as it is in writing.
If you revoke your authorization, we will no longer use or
disclose the information. However, we will not be able
to take back any disclosures that we have made pursuant to
your previous authorization.
We
reserve the right to change this notice. We may make the
revised notice effective for medical/health 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 the facility. The notice will contain on the first
page, in the top right-hand corner, the effective date.
In addition, each time you register at, are admitted, or apply
for services to the facility for treatment or services, we
will offer you a copy of the current notice in effect.
If you want to request any revised Notice of Privacy Practice,
you may access it at our website, www.bhrworldwide.org
If
you have any questions about the content of this Notice of
Privacy Practices, or if you need to contact someone at the
facility about any of the information contained in this Notice
of Privacy Practices, the contact person is the Privacy
Officer or designee:
Privacy
Officer, Behavioral Health Response
P.O.
Box 1125
Maryland Heights, MO 63043
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