Recovery Website
Notice Of Privacy
Practices
(Effective April 14,
2003)
This notice describes how your medical information may be used and disclosed and how you can access this information. Please review it carefully. If you click on the Table Of Contents below, you will be taken to that part of the document.
If you have any questions about this notice, please contact, Bob Bretland, Privacy Officer, at 513-946-8619 or bobb@hamilton.mh.state.oh.us
Table Of Contents
The
Board's Pledge Regarding Your Health Information
Why
The Board Collects Personal Health Information
Personal
Information Collected
How
Your Health Information May Be Used And
Disclosed
Examples
Of How The Board Uses Your Information
Other
Ways The Board May Use Your Health
Information
Sharing
Your Personal Information
Other
Uses Of Your Information
Safeguarding
Your Health Information
Individual
Client Rights
Changes To This
Notice
Complaints
Board
Contact Information
The Board's Pledge Regarding Your
Health Information
The Hamilton County Mental
Health and Recovery Services Board (Board) trustees and staff know that information about you
and your health is personal. The Board is committed to protecting health
information about you and safeguarding that information against
unauthorized use or disclosure. The Board is required by law to: 1) assure
health information that identifies you is kept private; 2) give you notice
of the Board’s legal duties and privacy practices with respect to health
information about you; and, 3) follow the terms of the notice. This notice
tells you about the ways in which the Board may use and disclose your
health information. The notice also describes your rights and certain
obligations the Board has regarding the use and disclosure of your health
information. The notice applies to all records related to your services,
payments for services, and other information about you that the Board
collects.
Why The Board Collects
Personal Health Information
The Board collects personal information
to:
 |
Determine eligibility for health care coverage that pays some or all of the cost of services you receive |
|
|
Provide benefits and pay claims |
|
|
Conduct service evaluation |
|
|
Manage Board business |
|
|
Provide other information for planning and improving mental health services in the community |
|
|
Protect the safety of members |
The Board may also be required to collect and keep certain information to meet legal and regulatory requirements. This information is kept after a client’s health care coverage ends.
Personal Information
Collected
People seeking benefits are asked to
provide certain information when completing a form for enrollment in Board
benefit plans. This information may include, for example:
|
|
Name, Address, Phone Number |
|
|
Date of Birth |
|
|
Marital Status |
|
|
Social Security Number |
|
|
Family Income |
The Board may also receive personal information about you from others, such as:
|
|
Health care providers (doctors, clinics, hospitals) |
|
|
Other county behavioral health boards that provide coverage to Board clients |
|
|
Business partners (companies with whom the Board has arrangements to assist in providing products and services) |
|
|
Other government agencies (courts, child welfare, juvenile justice, law enforcement, etc.) |
The information collected from others may include, for example, eligibility, claims and payment information. The Board creates and maintains a record of your enrollment in the Multi-Agency Community Services Information System (MACSIS). MACSIS is the public behavioral health claims processing system of the State of Ohio.
MACSIS also contains records of payment for treatment you receive in the public system. From time to time, the Board also receives information from your treatment provider about your diagnosis, treatment, treatment outcomes, progress in recovery and major, unexpected emergencies or crises you may experience. This information helps the Board plan for and improve the quality of services provided to residents of Hamilton County and ensure the safety of members.
How Your Health
Information May Be Used And Disclosed
When you receive services paid for in
part or in full by the Board, your personal information may be used for
conducting normal Board business known as health care operations. If the
services the Board paid for were mental health services, your personal
information may also be used for payment and billing.
If you have a guardian or a power of attorney the Board will provide the information to your guardian or attorney in fact.
Examples of how The
Board uses your information
Payment for Mental Health Services
– The Board keeps records that include payment information and
documentation of the services provided to you. Your information may be
used to obtain payment for your services from Medicaid, insurance or other
sources. For example, the Board may disclose personal information about
the services provided to you to confirm your Medicaid eligibility and to
obtain payment from Medicaid.
Health Care Operations – The Board uses information about you to evaluate service outcomes, train staff, manage costs, conduct required business duties and make plans to better serve you and other community residents who need mental health services. The Board exchanges operational information with organizations that provide mental health services to you.
Other Ways the Board May
Use Your Health Information
The Board may use your personal
information to:
|
|
Review and evaluate the quality, effectiveness and efficiency of services you have received |
|
|
Conduct program and fiscal audits of providers from which you have received services |
|
|
Investigate major unusual incidents, report these kinds of incidents and take steps to protect your or others’ health and safety |
|
|
Prepare reports required by the Ohio Department of Mental Health, the Ohio Department of Job and Family Services and the Hamilton County Probate Court |
|
|
Notify you of issues related to provision of mental health services |
Sharing Your Personal
Information
There are limited situations when the
Board is permitted or required to disclose personal information without
your signed authorization. These situations are:
|
|
To protect you or victims of abuse, neglect or domestic violence |
|
|
To reduce or prevent a serious threat to public health and safety |
|
|
To conduct health oversight activities such as investigations, audits and inspections |
|
|
To report to state or federal agencies that oversee or monitor Board operations |
|
|
To respond to lawsuits and similar proceedings |
|
|
To report for public health purposes dangerous mental conditions, communicable diseases and other diseases and injuries as permitted or required by law |
|
|
To report to law enforcement as required by law or court order |
|
|
To report to coroners and medical examiners |
|
|
To contribute to specialized government functions such as intelligence and national security |
Other Uses Of Your
Information
Other uses and disclosures of your
personal health information not covered by this Notice or the laws that
apply to the Board will be made only with your written permission. If you
provide permission to use or disclose health information about you, you
may revoke that permission, in writing, at any time. If you revoke your
permission, the Board will no longer use or disclose your health
information for the reasons covered by your written permission. The Board
can not take back any disclosures made before you took back your
permission.
Safeguarding Your Health
Information
In order to protect your health
information against unauthorized use or disclosure, the Board maintains a
variety of physical, electronic and procedural safeguards that comply with
applicable federal and state laws and regulation. Any third party
processor or consultant used by the Board has signed an agreement
requiring it to maintain the confidentiality of your personal information.
The Board also restricts access to your personal information to those
employees who need to know the information in order to perform their job
duties. The Board maintains policies and procedures that prohibit
employees and agents of the Board from improperly using, disclosing,
transferring, providing access to or otherwise divulging your health
information.
Individual Client Rights
You have the following rights regarding
the health information the Board maintains about you:
|
|
Right to Request Restrictions. * You have the right to request a restriction or limitation on the health information the Board uses or discloses about you for payment or health care operations. The Board will carefully consider all requests for a restriction but is not required to agree to any requested restrictions. |
|
|
Right to Limits on Communications. *You also have the right to request a limit on the health information disclosed about you to a family member who is involved in your care if you are receiving mental health services and have previously agreed to limited disclosure to such a family member. The Board will comply with any such restrictions you request regarding disclosure to a family member. |
|
|
Right to Request Confidential Communications. You have the right to request that the Board communicate with you about health matters in a certain way or at a certain location. For example, you can ask that you are only contacted at work or by mail. |
|
|
Right to Inspect and Copy.* You have the right to request access to the personal information the Board collects about you. Under certain circumstances, the Board may not share collected information, for example, if the information is the subject of a lawsuit or legal claim, or if release of mental health information may present a danger to you or someone else. Reasonable fees may apply to copied information. |
|
|
Right to Amend.* You have the right to request corrections or additions to your personal information. You must give the reasons for wanting the change. |
|
|
Right to an Accounting of Disclosures.* You have the right to request an accounting of disclosures made of your personal information that were not related to Board business operations or your authorization. Under certain circumstances, the Board may not share collected information, for example, if the information is the subject of a lawsuit or legal claim, or if release of the information may present a danger to you or someone else. Your request must state the period of time desired for the accounting, which can be no longer than the six years prior to your request. The first accounting is free but a fee may apply if more than one request is made in a 12-month period. |
|
|
Right to a Paper Copy of Notice. You have the right to a paper copy of this notice at any time and can obtain a copy by contacting the Board office (see the end of this document). This notice is also available on the Board’s web site (www.hccmhb.org). |
Requests marked with a star (*) must be made in writing. Contact the Board Client Rights Officer with your request.
To exercise any of your rights described in this paragraph, please contact the Board Client Rights Officer at the address or phone number listed at the end of this document.
Changes To This Notice
The Board reserves the right to change
this notice at any time and to make the changed notice effective for
health information about you that is already on file as well as any
information received in the future. Copies of the current notice are
available at the Board Office. The effective date of the notice will
always be displayed at the top of the first page. In addition, each time
there is a change in the notice, the Board will mail a copy to you at the
address shown in the Board’s records.
Complaints
If you have a complaint about the Board’s
privacy policies and procedures or you believe your privacy rights have
been violated, you may file a complaint with the Secretary of the
Department of Health and Human Services.
Office for Civil Rights
U.S. Department of Health and Human Services
233 N. Michigan Avenue, Suite 240
Chicago, Ill. 60601.
Voice Phone (312) 886-2359
FAX (312) 886-1807
TDD (312) 353-5693.
You can also complain to the Board. The Board welcomes the opportunity to hear and respond to your concerns. To file a complaint with the Board, contact the Board Client Rights Officer at the address below. The Board will investigate all complaints promptly and will not retaliate against you in any way for filing a complaint.
Board
Contact Information
Hamilton County Community
Mental Health Board
2350 Auburn Avenue
Cincinnati, OH 45219
513-946-8600
