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.
The terms of this Notice of Privacy Practices apply to Hattie Larlham Center for Children with Disabilities, Hattie Larlham Care Group, Hattie Larlham Community Services, Hattie Larlham Community Services/Vocational, Hattie Larlham Foundation and the professional medical staff while providing services at the facilities of the foregoing entities, operating as a clinically integrated health care arrangement and an organized system of health care participating in joint activities (collectively "Hattie Larlham"). Each of the Hattie entities is acting as a health care provider under the privacy regulations promulgated under the Health Insurance Portability and Accountability Act of 1996, as amended from time to time ("HIPAA"), except that Hattie Larlham Care Group is acting as a health care clearing house. The personnel of the Hattie Larlham entities work and practice at the facilities identified at the end of this Notice and will share protected health information of persons served by Hattie Larlham as necessary to carry out treatment, payment, and health care operations as permitted by law.
Hattie Larlham is required by law to maintain the privacy of the protected health information of the people we serve, to notify you if there is a breach of your protected health information, and to provide you with notice of its legal obligations and privacy practices. Hattie Larlham is required to abide by the terms of this Notice so long as it is in place. This Privacy Notice, which may be amended from time to time, will remain in effect for as long as we maintain your protected health information. We review our privacy practices at least annually and any time there is a change in the applicable law. Hattie Larlham reserves the right to change the terms of this Notice as necessary and to make the new terms effective for all protected health information we maintain. We will post a copy of the current Notice at our facilities and on our website. You may get a paper and/or electronic copy of the current Notice at any time at one of the Hattie Larlham facilities or by mailing a written request to:
Authorization. Except for uses and disclosures described other places in this Notice, Hattie Larlham will not use or disclose your protected health information unless you have signed a written authorization giving Hattie Larlham permission. You have the right to revoke an authorization in writing unless Hattie Larlham has already taken action based on the authorization. To revoke an authorization, you must deliver or mail the written revocation to:
Uses and Disclosures Required or Permitted by Law. The law permits and in some cases requires Hattie Larlham to use and/or disclose your protected health information without your authorization. Hattie Larlham may use or disclose your protected health information for:
When applicable, Hattie Larlham will comply with State and Federal laws that are more stringent than the privacy regulations promulgated pursuant to HIPAA regarding Hattie Larlham's use or disclosure of your protected health information.
Uses and Disclosures for Treatment, Payment or Health Care Operations. Hattie Larlham will use and disclose your protected health information, as needed for treatment, payment and health care operations purposes and the Hattie Larlham entities will share protected health information with each other to carry out treatment, payment or health care operations activities of the organized health care arrangement. Examples of such uses and disclosures include: nurses, doctors and other professionals involved in your care using information in your medical record to put in place a treatment plan and to carry out that plan; and in some situations disclosing to other health care facilities or providers who will be treating you; sending information about you and your treatment to insurance companies, governmental agencies and programs and other entities or individuals who will pay for your care; and using your protected health information in meetings and as part of other actions Hattie Larlham takes to make sure Hattie Larlham entities are licensed, accredited, the doctors and other professionals involved in its facilities have proper credentials and in many other activities designed to make sure of, and improve upon, the quality of care Hattie Larlham provides.
Business Associates. As part of the services Hattie Larlham provides, it sometimes seeks the help of outside persons or businesses. These outside entities help in a number of ways with our treatment payment and health care operations activities like giving us legal help, accrediting our facilities or auditing our records, just to list some examples. In order to get their help, Hattie Larlham must often give them your protected health information. Before we give out any protected health information to these outside parties, we require them to agree to protect the privacy of your information.
Facility Directories. Hattie Larlham does maintain a directory at some of its facilities. You have the right at the time you register at the main campus facility to exclude all or part of your information from a directory and restrict what part of the information is given and to whom. Unless you ask to be excluded or for a restriction at registration, your name is included in the directory and it and your general condition, only, are disclosed to anyone asking for you by name.
Others Involved in Your Care. If you approve, Hattie Larlham may disclose your protected health information to people that you designate (typically family and friends), who are involved in your care or in payment of your care, to help them with your care or paying for your care. If you are not available, incapacitated, or have a health emergency, and Hattie Larlham determines that a limited disclosure may be in your best interest, Hattie Larlham may disclose protected health information with the people involved in your care or paying for your care without your approval. In some cases, Hattie Larlham may also disclose your protected health information to parties involved in disaster relief to help them find your family member or other persons involved in your care or paying for your care.
Fundraising and Marketing. Hattie Larlham may contact you to give something as part of its fundraising. You can ask to "opt-out" of getting this fundraising information by sending your name, address and a written statement that you do not want to get fundraising materials from Hattie Larlham to:
You may opt out of specific fund-raising activities or all fund-raising activities and if you opt out, you may request to opt back in at any time. Hattie Larlham may use your protected health information to contact you about health products and services necessary for your care, about new products and services it offers, and to give you general health and wellness information without obtaining your authorization. Most other uses and disclosures for marketing and disclosures that constitute a sale require your authorization.
Services/Communications. Hattie Larlham may contact you to provide appointment reminders, test results or other information regarding your care. You have the right to ask and Hattie Larlham will accommodate reasonable requests to receive communications about your protected health information from us in a different way or at a different place. For example, if you want reminders to not be sent to a particular address, you must make the request in writing to:
Research. Sometimes Hattie Larlham may use and disclose your protected health information for research purposes. If Hattie Larlham does not get your specific authorization, your privacy will be protected by the strict confidentiality requirements of an Institutional Review Board that oversees the research and/or by representations of the researchers that limit their use and disclosure of your information.
Right to Receive Notice. You have the right to receive a copy of this Notice on paper even if you have requested the Notice by e-mail or in some other electronic transmission.
Access to Protected Health Information. You have the right to copy and/or inspect the protected health information that Hattie Larlham has about you. You have to ask us in writing and sign the request. You can make this request in writing to:
For copies, Hattie Larlham will charge you a reasonable cost per page, and will also charge for postage if you request a mailed copy. For preparing a summary of the requested information, Hattie Larlham will charge its reasonable costs to prepare.
Amendments to Protected Health Information. You have the right to request that Hattie Larlham amend your protected health information. Hattie Larlham does not have to make your amendments but will carefully consider your request. All amendment requests must be in writing, signed and state the specifics for the amendment. You can submit this request to:
Accounting for Disclosures of Protected Health Information. You have the right to get an accounting of certain disclosures Hattie Larlham makes after April 14, 2003 of your protected health information. To get this accounting, you have to sign and complete a written request to:
It will not cost you anything for one accounting in a 12-month period, but for each accounting after one in a 12-month period, Hattie Larlham will charge you a reasonable cost per page, and will also charge for postage if you request a mailed copy.
Restrictions on Uses and Disclosures. You have the right to ask for restrictions on certain uses and disclosures Hattie Larlham makes of your protected health information for treatment, payment or health care operations. You can request restrictions on certain uses and disclosures by submitting this in writing to:
Hattie Larlham does not have to agree to any restriction, except in certain situations if you ask us not to give your health plan information related to services you paid us for out of pocket in full, but will review it and if considered appropriate will allow the restriction. Hattie Larlham reserves the right to stop any restriction at any time by giving you written notice. You can also stop a restriction by giving written notice to:
If you believe your privacy rights have been violated, you can file a written complaint with:
Hattie Larlham will review it and respond to you. You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, D.C., 20201 or call 877-696-6775, or by email to OCRComplaint @ hhs.gov. There will be no retaliation for filing a complaint.
If you have any questions about this notice, you can talk to:
or by phone at 330-840-6835.
This notice of privacy practices is effective November 23, 2015.