NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL AND SENSITIVE PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY
To Download a PDF version (Adobe Acrobat) of YDI's Privacy Practices CLICK HERE
Youth Development, Inc.’s Responsibilities
We are required by applicable federal and state law to maintain the privacy of your protected health and sensitive personal information. “Protected Health and Sensitive Personal Information” (PHSPI) is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition and related health care services. We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your PHSPI. We must follow the privacy practices that are described in this notice while it is in effect. This notice takes effect April 14, 2003, and will remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms of this notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all PHSPI that we maintain, including PHSPI we created or received before we made the changes.
Upon your request, we will provide you with any revised Notice of Privacy Practices or by accessing our website at www.ydinm.org , calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health and Sensitive Personal Information.
Your PHSPI may be used by our staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you. Your PHSPI may also be used and disclosed to receive payments to support the operation of this organization.
The following are examples of the types of uses and disclosure of your PHSPI that this organization is permitted to make: These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our Organization.
Treatment: We may use your PHSPI to provide, coordinate or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your PHSPI. We will disclose PHSPI to other mental health professionals who may be treating you. For example: Your PHSPI may be provided to a physician who may be treating you for an injury while in Youth Development, Inc.’s custody.
Payment: Your PHSPI will be used, as needed, to obtain payment for your health care services. We may disclose your PHSPI to another health care provider or entity subject to Privacy Rules for reimbursement purposes. Payment activities may include: making a determination of eligibility; reviewing to determine medically necessary services provided to you and undertaking utilization review activities. For example, Managed Care Organizations will require information to determine eligibility, medical necessity and utilization when determining the need for ongoing treatment and/or payment for services requested or rendered.
Health Care Operations: We may use and disclose, as needed, your PHSPI in connection with Youth Development, Inc.’s operations. These activities include, but are not limited to, quality assessment activities, employee review activities, training of staff, licensing certification and utilization review, and any other applicable state and local regulations. (For example: State Licensing department will review client files for immunization record.)
We may in Youth Development, Inc.’s operations disclose PHSPI to a third party “business associate ” that perform various activities (e.g., billing, assessments) for Youth Development, Inc., with whom we have written agreements containing terms to protect the privacy of your PHSPI.
We may disclose your PHSPI to another entity that is subject to the Federal Privacy Rules and that has a relationship with you for Youth Development, Inc.’s operations relating to quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, case management and care coordination, or detecting or preventing health care fraud and abuse.
Uses and Disclosures of Protected Health Information Based upon your Written Authorization: Other uses and disclosures of you PHSPI will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization, at any time, in writing, except to the extent that Youth Development, Inc. has taken an action in reliance on the use or disclosure indicated in the authorization. Your withdrawal will not affect any use or disclosures permitted by your authorization while in effect.
We will only disclose any psychotherapy notes if you provide us with a specific written authorization or when disclosure is permitted by law.
Mental Health and Developmental Disabilities Disclosure Information: We may not disclose your mental health or developmental disabilities information records from residential or outpatient treatment except to you and anyone else authorized by law unless we have written authorization to disclose such information.
Other Permitted and Required Uses and Disclosures That May Be Made With Your Authorization or Opportunity to Object: We may use and disclose your PHSPI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHSPI. If you are not present or able to agree or object to the use or disclosure of the PHSPI, then your YDI representative may, using professional judgment, determine whether the disclosure is in your best interest. In this case only the PHSPI that is relevant to your health care will be disclosed.
Personal Representatives: We will disclose your PHSPI to your personal representative when the personal representative has been properly designated by you and the existence of your personal representative is documented to us through a written authorization.
Disaster Relief: We may use or disclose your PHSPI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Health-Related Services: We may use your PHSPI to contact you with information about health-related benefits and services or about treatment alternatives that may be of interest to you. We may disclose your PHSPI to a business associate to assist us in these activities.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object: We may use or disclose, without your authorization, your PHSPI in the following situations seemed to be in the public interest or benefit. These situations include:
- As required by law;
- For public health activities, including disease and vital statistic reporting, child abuse reporting, certain Food and Drug Administration (FDA) oversight purposes with respect to an FDS-regulated product or activity, and to employers regarding work-related illness or injury required under the Occupational Safety and Health Act (OSHA) or other similar laws;
- To report adult abuse, neglect, or domestic violence;
- To health oversight agencies
- In response to court and administrative orders and other lawful processes;
- To law enforcement officials pursuant to subpoenas and other lawful processes, concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies, and for purposes of identifying or locating a suspect or other person;
- To avert a serious threat to health or safety;
- To the military and to federal officials for lawful intelligence, counterintelligence, and national security activities;
- To research when research has been approved by an institutional review board and has established protocols to ensure the privacy of your health information.
- To correctional institutions regarding inmates; and as authorized by and to the extent necessary to comply with state worker’s compensation laws.
Use and Disclosure of certain Types of Medical Information: For certain types of PHSPI we may be required to protect your privacy in ways more strict than we have discussed in this notice. We must abide by the following rules for use or disclosure of certain types of your PHSPI.
HIV Test Information: We may not disclose the result of any HIV test or that you have been the subject of an HIV test unless required by law; or the disclosure is to you or other persons under limited circumstances; or you have given us written permission to disclose this information.
STD or Viral Hepatitis Test Information: We may not disclose the result of any Sexually Transmitted Disease (STD) or Viral Hepatitis test or that you have been the subject of one of these tests unless required by law; or the disclosure is to you or other persons under limited circumstances; or you have given us written permission to disclose this information.
Genetic Information: If any genetic test information is included in our records we receive, we may not disclose your genetic information unless the disclosure is made as required by law; or you provide us with written permission to disclose such information.
Mental Health and Developmental Disabilities Information: We may not disclose your mental health or developmental disabilities information, or records from residential treatment except to you and anyone else authorized by law or you provide us with written permission to disclose such information.
Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.50 et. Seq.
2. Individual Rights
You have the right to inspect and copy your protected health and sensitive personal information: You have the right, with limited exceptions, to look at or get copies of your PHSPI contained in a designated record set. A “designated record set” contains records we maintain such as enrollment, billing information, and case management records. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. You must make a request in writing to obtain access to your PHSPI and may obtain a request form from us. If we deny your request, we will provide you a written explanation, the reason for the denial and instructions for appealing the decision. We will also tell you if the reason for the denial can be reviewed and how to ask for such a review or if the denial cannot be reviewed. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in a civil, criminal, or administrative action or proceeding, and PHSPI that is subject to law that prohibits access to PHSPI. In some circumstances, you may have a right to have this decision reviewed. Please contact our HIPAA Compliance Officer, at the address provided at the end of this publication, if you have any questions about access to your PHSPI record.
You have the right to request a restriction of your protected health and sensitive personal information: You have the right to request that we place additional restrictions on our use or disclosure of your PHSPI. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency). Any agreement we may make to a request for additional restrictions must be in writing signed by a person authorized to make such an agreement on our behalf. We will not be bound unless our agreement is in writing.
You have the right to request and receive confidential communication from us by alternative means or at an alternative location: You have the right to request that we communicate with you about your PHSPI by alternative means or at alternative locations. You must make your request in writing. This right only applies if the information could endanger you if it is not communicated by the alternative means or to the alternative location you want. You do not have to explain the basis for your request, but you must state that the information could endanger you if it is not communicated by the alternative means or location is not changed. We must accommodate your request if it is reasonable, and specifies the alternative means or location.
You have the right to have your mental health professional amend your protected health and personal information: You have the right, with limited exceptions, to request that we amend your PHSPI. Your request must be in writing, and it must explain why the information should be amended and originator of the PHSPI is available to act on the proposed amendment. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement to be attached to the information you wanted amended. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information: You have the right to receive a list of instances since April 14, 2003, in which we or our business associates disclosed your PHSPI for purposes other than treatment, payment, health care operations, or as authorized by you, and for certain other activities. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations. If you request this accounting more than once in a 12 month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. We will provide you with more information on our fee structure at your request.
You have the right to receive a paper copy of this notice from us: You may request a copy of our notice at anytime by contacting the YDI Compliance Officer, at the address listed below or by using our web site, www.ydinm.org. If you receive this notice on our website or by electronic mail (e-mail), you are also entitled to request a copy of this notice.
We reserve the right to change our practices and to make the new provisions effective for all individually identifiable health and sensitive personal information that we maintain. The new notice will be in effect for all protected health and sensitive personal information that we maintain at the time. Upon your request, we will provide you with any revised Notice of Privacy Practices by calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
3. Questions and Complaints
You may complain to us or to the Secretary of Health and Human Services, Office of Civil Rights if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact (listed below) of your complaint. Youth Development, Inc. will not retaliate against you for filing a complaint.
For further information about our privacy practices, questions or concerns, please contact us using the information below.
|Larry Fortess, VP/CAO
Youth Development, Inc.
6301 Central N.W.
Albuquerque, NM 87105
You also may submit a written complaint to the U.S. Department of Health and Human Services, Office of Civil Rights at the address listed below:
|U.S. Department of Health and Human Services
Office of Civil Rights
200 Independence Ave SW
Washington, DC 200201
Please see information at the HHS web site: www.hhs.gov
Youth Development, Inc. supports your right to the privacy of your PHSPI. Youth Development, Inc. will not retaliate in any way if you choose to file a compliant with us or with the U.S. Department of Health and Human Services.
This notice was published and becomes effective on April 14, 2000