Greater
Lakes Mental Healthcare Notice of Privacy
Practices
9330 59th Ave
S.W. Lakewood, WA 98499 |
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.
If you have any questions about this Privacy Notice, please
contact our Privacy Officer at 253-620-5148. |
Greater Lakes is committed
to protecting your health information and privacy. In this Notice of Privacy
Practices we describe:
- our obligations to protect
your health information;
- how your protected health
information may be used or disclosed to others for treatment, payment or health
care operations;
- other purposes that are
permitted or required by law;
- your rights regarding
health information we maintain about you, and;
- a brief description of how
you may exercise these rights.
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"Protected health
information," means health information (including identifying information about
you) we have collected from you or received from your health care providers,
health plans, your employer or a health care clearinghouse. It may include
information about your past, present or future physical or mental health
condition, the provision of your health care, and payment for your health care
services.
We are obligated to comply with the terms of our current
Notice of Privacy Practices.
This notice applies to Greater Lakes Mental
Healthcare Foundation doing business as Greater Lakes Mental Healthcare and
Greater Lakes Therapy Services.
| What laws protect my health information?
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The Federal Health
Insurance Portability and Accountability Act of 1996 (HIPAA) sets the minimum
standards. Washington State laws for mental health care are, in most instances,
stricter than the federal rules (based on WAC 388-865-0435, 388-865-0436,
388-865-0440, 388-862-360; RCW 70.02, 71.05, 71.34, 18.19, 70.24, 71.12, 13.50,
and 26.44).
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| Who will see my health information? |
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We will use and
disclose your health information as described in each category listed below.
When we disclose the information it will only be the minimum necessary to serve
your healthcare needs. For each category, we will explain what we mean in an
example.
For Treatment. We will use and disclose your health
information to provide, coordinate and manage your health care and any related
services. For example, we may need to disclose information to a case manager
who is responsible for coordinating your care.
For Payment. We
may use or disclose your health information so that the treatment and services
you receive are approved, billed to, and payment is collected from your health
plan or other third party payer. For example, your health plan may ask for your
health information to determine if the plan will approve additional visits to
your therapist.
For Health Care Operations. We may use and
disclose health information about you for our health care operations. These
uses and disclosures are necessary to run our organization and make sure that
our consumers receive quality care. These activities may include:
- evaluation of the
performance of our staff;
- assessment of the
quality of care and outcomes in your case and similar cases;
- efforts to improve
our facilities and services; and
- efforts to
improvement of the quality and effectiveness of the healthcare we
provide.
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| When will Greater Lakes ask permission to share my information?
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We will ask you to
sign a CONSENT TO RECEIVE SERVICES, and a CONSUMER AUTHORIZATION FOR RELEASE OF
CONFIDENTIAL INFORMATION form.
You may revoke an authorization at any
time. If you revoke your authorization we will not make any further uses or
disclosures of your health information under that authorization, unless we have
already taken an action relying upon your previously authorization.
We
will request your permission to disclose your health information to another
health care provider (e.g., your primary care physician or a laboratory)
working outside of Greater Lakes Mental Healthcare for purposes of your
treatment.
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| When will Greater Lakes disclose my health information without my
permission? |
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Persons
Involved in Your Care. We may provide health information about you to
someone who helps pay for your care. We may use or disclose your health
information to notify or assist in notifying a family member, personal
representative or any other person that is responsible for your care of your
location, general condition or death.
In limited circumstances, we may
disclose health information about you to a friend or family member who is
involved in your care. However, if you are physically present and capable of
making health care decisions, your health information may only be disclosed
with your agreement to persons you designate.
In an emergency, we may
disclose your health information to a spouse, family member, or friend so that
person may assist in your care. In this case we will determine whether the
disclosure is in your best interest and, if so, only disclose information that
is directly relevant to participation in your care.
If you are unable
to make health care decisions, we will disclose your health information to: a
person designated to participate in your care by a valid advance directive;
your guardian or other person appointed by a court; or if applicable, a state
agency responsible for consenting to your care.
Business
Associates. We may disclose your health information to others such as
auditors, attorneys and organizations that help with our business activities.
If we share your information, they must agree to protect your
privacy.
Emergencies. We may use and disclose your health
information in an emergency treatment situation. For example, we may provide
your health information to a paramedic who is transporting you in an ambulance.
If a clinician is required by law to treat you and your treating clinician has
been unable to obtain your authorization, the treating clinician may
nevertheless use or disclose your health information to treat you.
As
Required By Law. We will disclose health information about you when
required to do so by federal, state or local law.
To Avert a Serious
Threat to Health or Safety. We may use and disclose health information
about you to prevent a serious and imminent threat to your health or safety; to
the health or safety of the public; or to another person. Under these
circumstances, we will only disclose health information to someone who is able
to help prevent or lessen the threat.
Public Health Activities.
We may disclose health information about you without your consent for public
health activities including, for example, disclosures to:
- report to public
health authorities for the purpose of preventing or controlling disease, injury
or disability;
- report vital events
such as birth or death;
- conduct public
health surveillance or investigations;
- report child abuse
or neglect;
- report certain
events to the Food and Drug Administration (FDA) including information about
defective products or problems with medications;
- notify a person who
may have been exposed or is at risk of contracting or spreading a communicable
disease or condition;
- notify the
appropriate government agency if we believe you have been a victim of abuse,
neglect or domestic violence, or if we are required or authorized by law to
report such abuse, neglect or domestic violence.
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Health Oversight
Activities. We may disclose your health information to a health oversight
agency for activities authorized by law. These include government agencies that
oversee the health care system such as Medicare or Medicaid, or other
government programs regulating health care and civil rights laws.
Disclosures in Legal Proceedings. We may disclose health information
about you to a court or administrative agency when a judge or administrative
agency orders us to do so. We also may disclose health information about you in
legal proceedings without your permission or without a judge or administrative
agency's order when we receive a court order for your health information. An
attorney seeking health information must give at least 14 days advance notice
to you and to us, giving an opportunity to seek a protective
order.
Law Enforcement Activities. We may disclose health
information to a law enforcement official for law enforcement purposes
when:
- a court order,
subpoena, warrant, summons or similar process requires us to do so;
or
- the information is
needed to identify or locate a suspect, fugitive, material witness or missing
person; or
- we report a death
that we believe may be the result of criminal conduct; or
- we report criminal
conduct occurring on the premises of our facility; or
- we determine that
the law enforcement purpose is to respond to a threat of an imminently
dangerous activity by you against yourself or another person; or the disclosure
is otherwise required by law.
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Crime
Victims. We may also disclose health information about a client who is a
victim of a crime, without a court order or without being required to do so by
law. However, we will do so only if the disclosure has been requested by a law
enforcement official and the victim agrees to the disclosure or, in the case of
the victim's incapacity, the following occurs:
- the law enforcement
official represents to us that (i) the victim is not the subject of the
investigation and (ii) an immediate law enforcement activity to prevent serious
danger to the victim or others depends upon the disclosure; and
- we determine that
the disclosure is in the victim's best interest.
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Medical
Examiners. We may provide health information about our consumers to a
medical examiner.
Military and Veterans. If you a member of the
armed forces, we may disclose your health information as required by military
command authorities.
National Security and Protective Services for
the President and Others. We may disclose medical information about you to
authorized federal officials for national security activities authorized by
law.
Inmates. If you are an inmate of a correctional institution
or under the custody of a law enforcement official, we may disclose health
information about you to the correctional institution or law enforcement
official.
Workers' Compensation. We may disclose health
information about you to comply with the state's Workers' Compensation Law.
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| May
I put limits on sharing my information? |
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You may request a
restriction on the health information we use or disclose. You must request the
restriction in writing on the CONSUMER AUTHORIZATION FOR RELEASE OF
CONFIDENTIAL INFORMATION.
We are not required to agree to a restriction
that you may request. If we do agree, we will honor your request unless the
restricted health information is needed to provide you with emergency
treatment.
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| May
I see and have a copy of my information? |
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You have the right
to receive a copy of your health information used to make decisions about your
care. Usually, this would include clinical and billing records. We will provide
you with a copy of the information at our premises. If you wish to receive the
information in another format or location, you will need to make the request in
writing.
You should give your request to our Privacy Officer or a case
manager on a CONSUMER AUTHORIZATION FOR RELEASE OF CONFIDENTIAL INFORMATION
form.
We may deny your request to inspect or copy your health
information in certain limited circumstances. The denial will be reviewed by a
licensed health care professional not directly involved in the original
decision. We will honor the final decision made by the reviewing licensed
health care professional.
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| Do
you keep a record of who you give my information to? |
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You have the right
to request an accounting of disclosures we have made of your health
information. An accounting is a list of disclosures. But this list will not
include certain disclosures of your health information, by way of example,
those we have made for purposes of treatment, payment, and health care
operations.
To request an record of disclosures, you must submit your
request in writing to the Privacy Officer. The request should state the time
period for which you wish to receive an accounting. This time period should not
be longer than six years and not include dates before April 14, 2003.
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| May
I change my records? |
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You have the right
to request an amendment any health information used to make decisions about
your care - usually, this would include clinical and billing records.
You must submit a written document to our Privacy Officer and tell us why you
believe the information is incorrect or inaccurate.
We will deny your
request if you ask us to amend health information that: was not created by us;
is not part of the health information we maintain to make decisions about your
care; is not part of the health information that you would be permitted to
inspect or copy; or is accurate and complete.
You may then provide a
written statement disagreeing with the denial. The requested amendment and our
denial will be attached to all future disclosures of the health information
subject of your request for amendment.
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| May
I have a copy of this notice? |
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We will post a
copy of the current Notice at each site where we provide care, and make copies
available. You may also obtain a copy at our website http://www.glmhc.org or by
calling our Privacy Officer at 253-620-5148 and requesting one be mailed to
you.
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| Can
you change your Privacy Practices? |
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We may change the
terms of our Notice of Privacy Practices to be effective for all health
information we already have about you, and any health information we receive in
the future.
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| What if I believe my privacy rights have been violated?
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Our Privacy
Officer, at Greater Lakes Mental Healthcare, will assist you with writing your
complaint, if you request such assistance.
You can file a complaint with
us, in writing, at the address on the front page of this notice. You may also
file a complaint with the Secretary of the U.S. Department of Health and Human
Services.
We will not retaliate against you for filing a
complaint. |
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a
United Way Member
agency. |
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Copyright
© 1998-2004. All rights reserved
Please send
comments, suggestions, or corrections to:
webmaster@glmhc.org
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