NOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES
THIS NOTICE EFFECTIVE: 4/14/03
CENTER OF PSYCHOLOGICAL EFFECTIVENESS, INC.
7390 NW 5th Street, Suite 5, PLANTATION, FL, 33317
(954) 583-8831 1-(800) 714-COPE Fax (954) 583-9575
THIS NOTICE DESCRIBES HOW PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
PURPOSE OF THIS NOTICE
The Center of Psychological Effectiveness, Inc., is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information (PHI), and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. This Notice describes your legal rights, advises you of our privacy practices, and lets you know how the Center of Psychological Effectiveness, Inc., is permitted to use and disclose PHI about you.
This Notice is covered under HIPAA (Health Insurance Portablility & Accountablility Act). Any state law that is more stringent than the HIPAA rules and regulations has priority.
We are required to follow the privacy practices described in this Notice, thought we reserve the right to change our privacy practices and the terms of this Notice at any time. If we do so, we will post a new Notice in each direct-service office waiting area as well as our website at www.solutionsnottalk.com. You may request a copy of the new notice from Priscilla V. Marotta, Ph.D., Privacy Officer by calling (954) 583-8831.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED MENTAL HEALTH INFORMATION
We use and disclose PHI for a variety of reasons. For our most uses/disclosures, we must obtain your consent. However, the law provides that we are permitted to make some uses/disclosures without your consent. The following offers more description and examples of our potential uses/disclosures of your PHI.
Uses And Disclosures Requiring Your Consent:
For treatment: We may disclose your PHI to other mental health care practitioners who are involved in providing your mental health care. For example, a referral to a mental health practitioner for assessment and/or long-term treatment would require a signed consent form from you for us to release and/or receive PHI about you to appropriately coordinate your care.
For mental health care operations: We may use/disclose your PHI in the course of operating our Employee Assistance Program. For example, we may use your PHI in evaluating the quality of services provided, creating reports that do not individually identify you, or disclose your PHI to our accountant or attorney for audit purposes. Since we are an integrated system, we may disclose your PHI to designated staff in our administrative office.
Exceptions: Although your consent is usually required for the use/disclosure of your PHI for the activities described above, the law allows us to use/disclose your PHI without your consent in certain situations. For example, we may disclose your PHI if needed for emergency treatment if it is not reasonably possible to obtain your consent prior to the disclosure and we think that you would give consent if able. Also, if we are required by law to provide your treatment, we may use/disclose your PHI for treatment and operations without obtaining your prior consent.
Uses And Disclosures Requiring Authorization: For uses and disclosures beyond treatment and operations purposes we are required to have your written authorization (signed permission), unless the use or disclosure falls within one of the exceptions described below. Like consents, authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken an action in reliance upon your authorization.
Uses And Disclosures Not Requiring Consent Or Authorization: The law provides that we may use/disclose your PHI without consent or authorization in the following circumstances:
When required by law: We may disclose PHI when a law requires that we report information about:
• suspected abuse
• neglect or domestic violence
• suspected criminal activity
• in response to a court order
We must also disclose PHI to authorities who monitor compliance with these privacy requirements.
• For health oversight activities: We may disclose PHI for audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) or managed care companies to oversee the health care system.
• To avert threat to health or safety: In order to avoid a serious threat to health or safety, we may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm. For example, a plan to commit suicide or a homicidal act.
• For specific government functions: We may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to governmental programs relating to eligibility and enrollment, and for national security reasons, such as protection of the President.
• Uses And Disclosures Requiring You to have an Opportunity To Object: In the following situations, we may disclose your PHI if we inform you about the disclosure in advance and you do not object. However, if there is an emergency situation and you cannot be given your opportunity to object, disclosure may be made if it is consistent with any prior expressed wishes and disclosure is determined to be in your best interest. You must be informed and given an opportunity to object to further disclosure as soon as you are able to do so.
• To families, friends or others involved in your care: We may share with these people information directly related to your family’s, friend’s or other person’s involvement in your care. We may also share PHI with these people to notify them about your location or general condition. For example, parents of a minor have certain rights to PHI. Also, we may have to locate family members to inform them of the location of a client who was hospitalized after being diagnosed as severely depressed.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION.
You have the following rights relating to your protected mental health information:
• To request restrictions on uses/disclosures: You have the right to ask that we limit how we use or disclose your PHI. We will consider your request, but are not legally bound to agree to the restriction. To the extent that we do agree to any restrictions on our use/disclosure of your PHI, we will put the agreement in writing and abide by it except in emergency situations. We cannot agree to limit uses/disclosures that are required by law.
• To choose how we contact you: You have the right to ask that we send you information at an alternative address or by an alternative means. We must agree to your request as long as it is reasonably easy for us to do so. There may be a charge for your request.
• To inspect and copy your PHI: Unless your access is restricted for clear and documented treatment reasons, you have a right to see your protected health information if you put your request in writing. We will respond to your request within 30 days. If we deny your access, we will give you written reasons for the denial and explain any right to have the denial reviewed. If you want copies of your PHI, a charge for copying may be imposed, but may be waived, depending on your circumstances. You have a right to choose what portions of your information you want copied and to have prior information on the cost of copying.
• To request amendment of your PHI: If you believe that there is a mistake or missing information in our record of your PHI, you may request, in writing, that we correct or add to the record. We will respond within 60 days of receiving your request. We may deny the request if we determine that the PHI is: (i) amended and complete; (ii) not created by us and/or not part of our records; or (iii) not permitted to be disclosed. Any denial will state the reasons for denial and explain your rights to have the request and denial, along with any statement in response that you provide, appended to your PHI. If we approve the request for amendment, we will amend the PHI and so inform you, and tell others that need to know about the amendment in the PHI.
• To receive this notice: You have a right to receive a paper copy of this Notice by submitting a written request to the Privacy Officer at the Center of Psychological Effectiveness.
HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint. You may file a written complaint with the Office for Civil Rights (OCR), U.S. Department of Health and Human Services, Atlanta Federal Center, Suite 3B70, 61 Forsyth Street SW, Atlanta, GA, 30303-8909.
CONTACT PERSON FOR INFORMATION OR TO SUBMIT A COMPLAINT
If you have questions about this Notice or any complaints about our privacy practices, please contact: Priscilla V. Marotta, Ph.D., Privacy Officer ● Center of Psychological Effectiveness, Inc. ● 7390 NW 5th Street, Suite 5, Plantation, FL, 33317 ● (954) 583-8831 ● www.solutionsnottalk.com.
FREE Telephone consultations are available by calling 1-800-714-COPE / 954-583-8831 or CLICK HERE and make a difference in your life! COPE is located at 7390 NW 5th Street, Suite 5, in Plantation, Florida. We are located within the Greater Fort Lauderdale Area.