This Notice describes how we may use and disclose your mental and medical health information to carry out treatment, payment, or healthcare operations and for other purposes as permitted or required by law.
It also describes your rights and certain obligations we have regarding the use and disclosure of mental and medical health information.
We and other healthcare providers offering you care at our facilities are committed to our patients. Our primary responsibility is to safeguard the confidentiality of your mental and medical health information and records. We are required by law to (1) maintain the privacy of PHI, (2) provide individuals with notice of our legal duties and privacy practices with respect to PHI, (3) notify affected individuals following a breach of unsecured PHI, and (4) abide by the terms of the notice currently in effect. We must give you this Notice of our privacy practices, and we hereby inform you that we must follow the terms of this Notice that are currently in effect. We will notify you if a breach of your PHI occurs and we will not disclose your information (other than as described below) without your written permission.
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 health information we already have about you as well as any information we may receive in the future. We will post a copy of the current notice on Jackson House Recovery Center’s website.
COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with the respective facility’s Privacy Officer. Complaints must be submitted in writing and directed to any of the following:
You also have the right to file a complaint with the Department of Health & Human Services. There will be no retaliation for filing a complaint.
How We May Use and Disclose Mental and Medical Health Information About You
The following categories describe different ways that we and other healthcare providers offering you care at our facilities may use your health information and disclose your health information. We have provided descriptions of different categories of uses and disclosures. We have not listed every use or disclosure within each category, but all permitted uses and disclosures will fall within one of the following categories. In addition, there are some uses and disclosures such as certain Drug & Alcohol information, HIV information and Mental Health information that are entitled to special restrictions and will require your specific written authorization.
The following uses and disclosures of your health information are permitted by law without your verbal or written consent:
TREATMENT: We may use and disclose mental and medical health information about you to provide, coordinate or manage your healthcare and any related services. We may use and disclose health information about you to another healthcare provider such as doctors, nurses, technicians, interns, transport companies, pharmacy, laboratory, pastoral/clergy needs, community agencies, skilled nursing facilities, home health agencies, crisis houses, group homes, independent living facilities or other allied health personnel at a non-participating OHCA and at a participating OHCA facility for the purposes of providing coordination of your treatment plan needs, discharge planning, continuity of care, and assistance to your physician during treatment with us. For example, we may give your physician access to your medical information to assist your physician in treating you and directing your care.
PAYMENT: We may use and disclose health information about you so that the treatment and services you receive at our participating OHCA facilities may be billed to and have payment collected from you, an insurance company, or a third party, including a collection agency, if needed. This may include the disclosure of your health information to obtain prior authorization for treatment, procedures and/or admission from your insurance plan, or for making a determination of eligibility or coverage for insurance benefits and undertaking utilization review and case management activities. For example, we may give your health plan information about a surgery you received so your health plan will pay us or reimburse you for that surgery.
HEALTHCARE OPERATIONS: Uses and disclosure of your mental and medical health information are necessary to operate our healthcare facilities and to make sure all of our patients receive quality care. As a part of healthcare operations, your health information may be subject to review. For example, we may use and disclose mental or medical health information about you for healthcare operations including quality assurance, risk management, performance improvement, case management, infection control and care coordination activities; granting medical staff credentials; legal services and regulatory compliance; licensing and accreditation; contractual obligations; employee review and educational activities; post-discharge telephone calls to follow-up on your health status and/or continuity of care; administrative activities including, and Jackson House Recovery Center financial, business planning and development; customer service activities including investigation of claims, complaints or lawsuits; and certain marketing activities such as health education opportunities for care and services. We may also call you, by name, (i.e., in the Waiting room area, etc.) when your healthcare provider is ready to see you and/or you will be asked to complete our sign-in sheets for program attendance. We also visibly display and post each patient’s first name and last initial on the respective unit’s census board every day for treatment purposes.
DISCLOSURE AT YOUR REQUEST: We may use and disclose health information about you when requested by you. This disclosure at your request may require a written authorization.
FAMILY MEMBERS OR OTHERS YOU DESIGNATE: Upon request of a family member and with your consent, we may give the family member notification of your diagnosis, prognosis, medications prescribed and their side effects and progress. If a request for information is made by your spouse, parent, child, or sibling and you are unable to authorize the release of this information, we are required to give the requesting person notification of your presence in the hospital, except to the extent prohibited by federal law. Upon your admission, we must make reasonable attempts to notify your next of kin or any other person designated by you, of your admission, unless you request that this information not be provided. We must make reasonable attempts to notify your next of kin or other person designated by you, of your release, transfer, serious illness, injury or death only upon request of the family member.
BUSINESS ASSOCIATES: There are some services provided in our organization through contracts with third-party “business associates”. Examples of business associates include accreditation agencies, management consultants, quality assurance reviewers, billing, transcription services, copy services, laboratory services, technicians, collection services, etc. We may use and disclose your mental and medical health information to our business associates so that they can perform the job that we have asked them to do. To protect your health information, we require our business associates to sign contracts or written agreements that state they will appropriately safeguard your information.
APPOINTMENT REMINDERS AND CONTINUITY OF CARE: We may use and disclose mental and medical health information about you to contact you as a reminder and/or for follow-up purposes for treatment, services, referrals, prescriptions, aftercare and/or continuity of care.
HEALTH RELATED BENEFITS OR SERVICES: Sometimes we may want to contact you regarding service reminders, health related products or services that may be of interest to you, such as health care providers or settings of care or to tell you about other health related products or services offered at a participating OHCA facility. You have the right not to accept such information.
TREATMENT ALTERNATIVES: We may tell you about or recommend possible treatment options or alternatives that may be of interest to you such as E.C.T., pain management, aftercare groups, etc.
DISASTER RELIEF EFFORTS: We may use and disclose mental and medical health information about you to an authorized public or private entity assisting in disaster relief efforts (such as the Red Cross) so that your family or personal representative can be notified about your general condition, location, status or death.
SPECIAL CATEGORIES OF INFORMATION: In some circumstances, your health information may be subject to restrictions that may limit or preclude some uses or disclosures described in this notice. For example, there are special restrictions on the use or disclosure of certain types of medical information (e.g., HIV test results, mental health records, and alcohol and substance abuse treatment records). Government health benefit programs may also limit the disclosure of beneficiary information for purposes unrelated to the program and the care provided to the beneficiary.
The following uses and disclosures of your health information are permitted by law without your verbal or written consent:
ABUSE OR NEGLECT: We may use and disclose health information about you to a Public Health authority that is authorized by law to receive reports of abuse or neglect. We may use and disclose your health information if we believe that you have been a victim of abuse or neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
AVERTING A SERIOUS THREAT TO HEALTH OR SAFETY: We may use and disclose health information about you when necessary to prevent or lessen a serious and imminent threat to your health or safety or the health and safety of another person or the public. Any disclosure would be made only to someone able to help prevent the threat.
ORGAN AND TISSUE DONATION: If you are an organ donor, we may use and disclose health information about you to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.
RESEARCH THAT DOES NOT INVOLVE YOUR TREATMENT: When a research study does not involve your treatment, we may use and disclose health information about you to researchers when an Institutional Review Board, (IRB), has reviewed the research proposal, established appropriate protocols to ensure the privacy of your health information, and has approved the research
MILITARY ACTIVITY AND VETERANS: If you are or were a member of the armed forces, we may use and disclose health information about you to military command authorities, as required by law.
NATIONAL SECURITY/INTELLIGENCE ACTIVITIES/PROTECTION OF ELECTIVE CONSTITUTIONAL OFFICERS: We may use and disclose mental health information about you to authorized federal officials for conducting national security activities, intelligence and counterintelligence, including for the provision of protective services for federal and state elective constitutional officers and their families including the President of the United States. We may disclose your mental health information to the Senate or Assembly Rules Committee for the purpose of legislative investigation.
WORKER’S COMPENSATION: We may use and disclose health information about you to comply with Worker’s Compensation or other similar programs if you have a work-related injury. These programs provide benefits for work-related injuries.
HEALTH OVERSIGHT ACTIVITIES: We may use and disclose health information about you to a health oversight agency for activities authorized by law, such as a government agency, and/or accrediting and licensing agencies, for audits, investigations, and inspections. These activities are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights laws.
PUBLIC HEALTH RISKS & ACTIVITIES: We may use and disclose mental health information about you for public health risks and activity purposes to a public authority. These purposes generally include the following:
LAWSUITS AND DISPUTES: In connection with a lawsuit, legal proceedings or disputes, we may use and disclose health information about you in response to a court or administrative order, or in response to a subpoena, discovery request, summons or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written notice to you) or to obtain an order protecting the information requested. We may disclose mental health information to courts, attorneys and court employees in the course of conservatorship, and certain other judicial or administrative proceedings.
LAW ENFORCEMENT: We may use and disclose mental health information about you if asked to do so by law enforcement officials for the following reasons:
INMATES: If you are an inmate of a correctional institution or under custody of law enforcement officials, we may use and disclose mental health information about you to the correctional institution or the law enforcement official as authorized. This is necessary for the correctional institution to provide you with healthcare, to protect your health and safety, or health and safety of others, or the safety and security of the correctional institution.
DEPARTMENT OF JUSTICE: We may disclose limited information to the California Department of Justice for movement and identification purposes about certain criminal patients, or regarding persons who may not purchase, possess or control a firearm or deadly weapon.
ADVOCACY GROUPS: We may release mental health information to the statewide protection and advocacy organization if it has a patient or patient representative’s authorization, or for the purposes of certain investigations. We may release health information to the County Patients’ Rights Office if it has a patient or patient representative’s authorization, or for investigations resulting from reports required by law to be submitted to the Director of Mental Health.
CORONERS, MEDICAL EXAMINERS AND FUNERAL HOME DIRECTORS: We may use and disclose health information about you to a coroner or medical examiner for identification purposes of the deceased, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also use and disclose health information to a funeral home director, as necessary, in order to permit them to carry out their duties.
INCIDENTAL USES AND DISCLOSURES: Incidental uses and disclosures of your health information are those that cannot be reasonably prevented, are limited in nature and that occur as a by-product of a permitted use or disclosure. Such incidental uses and disclosures are permitted as long as we use reasonable safeguards and use or disclose only the minimum amount of your health information necessary.
Situations that Do Require Your Authorization with Your Verbal Agreement
CLIENT DIRECTORY: Jackson House Recovery Center has a “Patient Roster/Directory” of information about current patients that may include certain limited data about you, such as your name, room number or unit/program location while you are in treatment at our facility. Upon admission, you will be given a unique Patient Identification Number (PIN), which changes with each consecutive admission, and instructions on the use and disclosure of your PIN to individuals whom you choose to disclose your presence at our facility to. All incoming calls and/or visitors to our facility will be requested to supply your PIN to us prior to receiving any acknowledgement of your presence or any contact with you at our facility. If your PIN is not given or not known by the requester, we will inform them that we cannot confirm or deny your presence at our facility. You have the right to refuse to have all or part of your information disclosed for such purposes.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: We may use and disclose health information about you to a family member who is involved in your healthcare, or to any other personal representative whom you designate, with your written authorization, unless you tell us, in advance, not to provide this information.
EMERGENCIES: We may use or disclose health information about you in an emergency treatment situation. If this happens, your physician shall try to obtain your consent as soon as reasonably practicable after the delivery of treatment. If your physician or another health care provider is required by law to treat you and they have attempted to obtain your consent but is unable to obtain your consent, he/she may still use or disclose your health information in an effort to provide you with immediate quality treatment and care.
Situations Requiring Your Specific Written Authorization
If there are other reasons that we need to use and disclose your health information not covered by this Notice or the laws that apply to us, we will obtain your written authorization. If you authorize us to use or disclose mental or medical health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care we provided to you. Some typical disclosures that require your authorization are as follows:
MARKETING: We will obtain your authorization for any marketing related activities except for direct face-to-face communications or giving gifts to you that are of nominal value.
FUNDRAISING: We will obtain your authorization for fundraising activities except if we use your information for our own fundraising purposes and if we only use demographic information and dates of service.
RESEARCH INVOLVING YOUR TREATMENT: When a research study involves your treatment, we may disclose your health information to researchers only after you have signed a specific written authorization. In addition, for any such research study, an Institutional Review Board, (IRB) will already have reviewed the research proposal, established appropriate protocols to ensure the privacy of your health information, and approved the research. You do not have to sign the authorization, but if you do refuse to sign the authorization, you cannot be part of the research study and may be denied research-related treatment.
DISCLOSURES REQUESTED BY A PARTICIPATING OHCA FACILITY: We may ask you to sign an authorization allowing us to use or to disclose your demographic health information to others for specific purposes such as notifying you of future educational or social events that you might enjoy.
DRUG AND ALCOHOL ABUSE TREATMENT DISCLOSURES: We will disclose drug and alcohol treatment information about you only in accordance with the Federal Privacy Act and applicable laws. In general, the Privacy Act requires your written authorization or the written authorization of your legal representative for any such disclosures.
DISCLOSURE OF MENTAL HEALTH OR SPECIAL CATEGORIES OF TREATMENT INFORMATION: In most cases, state or federal law requires your written authorization or the written authorization of your legal representative for any disclosures of mental health treatment, HIV, AIDS test results.
SALE OF PROTECTED HEALTH INFORMATION: We will obtain your authorization for any disclosure of your protected health information which is a sale of protected health information as defined under federal law.
YOUR RIGHTS REGARDING INFORMATION ABOUT YOU
You have the following rights regarding information we maintain about you and a brief description of how you may exercise these rights. You may contact the Health Information Service representative in writing at any of the following:
YOU HAVE THE RIGHT TO:
If we believe it is in your best interest to permit access, use and disclosure of your health information, then your information will not be restricted. If we agree to your restriction request, we will comply with your request unless the information is needed to provide you with emergency treatment. Your written request must state 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.