Privacy Notice
(Confidentiality)
THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
General Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 ("HIPAA "), 42 U.S.C. § 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2. Under these laws, Fairfield Behavioral Health Services may not say to a person outside Fairfield Behavioral Health Services that you attend the program, nor may Fairfield Behavioral Health Services disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law.
Fairfield Behavioral Health Services must obtain your written consent before it can disclose information about you for payment purposes. For example, Fairfield Behavioral Health Services must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before Fairfield Behavioral Health Services can share information for treatment purposes or for health care operations. However, federal law permits Fairfield Behavioral Health Services to disclose information without your written permission:
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Pursuant to an agreement with a business associate;
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For research, audit or evaluations;
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To report a crime committed on Fairfield Behavioral Health Services' premises or against Fairfield Behavioral Health Services personnel;
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To medical personnel in a medical emergency;
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To appropriate authorities to report suspected child abuse or neglect
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To appropriate authorities to anonymously or by court order report suspected abuse or neglect of an elderly person or a vulnerable adult, and/or
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As allowed by a court order
For example, Fairfield Behavioral Health Services can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, as long as there is a business associate agreement in place.
Before Fairfield Behavioral Health Services can use or disclose any information about your health in a manner that is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.
Your Rights
Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. Fairfield Behavioral Health Services is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency. You have the right to request that we communicate with you by alternative means or at an alternative location. Fairfield Behavioral Health Services will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA, you also have the right to inspect and copy your own health information maintained by Fairfield Behavioral Health Services, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances. Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in Fairfield Behavioral Health Services' records, and to request and receive an accounting of disclosures of your health related information made by Fairfield Behavioral Health Services during the six years prior to your request. You also have the right to receive a paper copy of this notice.
Fairfield Behavioral Health Services is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Fairfield Behavioral Health Services is required by law to abide by the terms of this notice. Fairfield Behavioral Health Services reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains. You will receive a copy of this notice at intake. When changes are made to this document, current clients will receive a copy of the revised Privacy Notice.
Complaints and Reporting Violations
If you believe that your privacy rights under HIPAA have been violated, you may complain to Fairfield Behavioral Health Services, the Secretary of the United States Department of Health and 1Division of Health Licensing (803-545-4370). If placing your complaint with Fairfield Behavioral Health Services, it must be in writing and sent to the Compliance Officer, Fairfield Behavioral Health Services,
Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.
Contact
For further information, contact the Compliance Officer at Fairfield Behavioral Health Services, 803-635-2335.
Effective Date
This notice became effective April 9, 2003.
