Fairwinds Treatment Center

Notice of Information Practices
Effective date: 4/13/03

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.

Understanding Your [___ Mental Health/Chemical Dependency ___] Health Record Information.
Each time you visit a hospital, a doctor, or another health care provider, the provider makes a record of your visit. Typically, this record contains your health history, current symptoms, examination and test results, diagnoses, treatment, and plan for future care or treatment. This information, often referred to as your medical record, serves as the following:
    • Basis for planning your care and treatment.
    • Means of communication among the many health professionals who also care for your health needs.
    • Legal document describing the care that you received.
    • Means by which your insurance company can verify that you actually received the services billed for.
    • Tool in medical education.
    • Source of information for public health officials charged with improving the health of the regions they serve.
    • Tool to assess the appropriateness and quality of care that you received.
    • Tool to improve the quality of health care and achieve better patient results.
    Understanding what is in your health records and how your health information is used helps you to:
    • Ensure its accuracy and completeness.
    • Understand who, what, where, why, and how others may access your health information.
    • Make informed decisions about allowing disclosure to others.
    • Better understand the health information rights listed below.

Your Rights under the Federal Privacy Standard
    Although your health records are the physical property of the health care provider who completed it, you have the following rights with regard to the information contained therein:
    • Limit uses and disclosures of your health information for treatment, payment, and health care operations. “Health care operations” consist of activities that are necessary to carry out the operations of the provider, such as quality assurance and peer review. The right to limit uses or disclosures does not extend to uses or disclosures permitted or required under the federal privacy regulations: i.e., disclosures to you, or those required by law, such as required communicable disease reporting. In those cases, you do not have a right to request limits. The consent to use and disclose your individually identifiable health information provides the ability to request limits. We do not, however, have to agree to the limits you request. If we do, we will adhere to it unless you request otherwise or we give you advance notice. You may also ask us to communicate with you after discharge by other means, i.e. Mail, fax, e-mail, etc. and if the method of communication is reasonable, we must grant it. You need to request these limits or other forms of communications in writing.
    • Obtain a copy of this notice of information practices. Although we have posted a copy in noticeable locations throughout the facility and on our website, you have a right to a hard copy upon request.
    • Inspect and copy your health information upon request. Again, this right is (NOT ABSOLUTE). In certain situations, such as if access would cause harm, we can deny access. You do NOT have a right of access to the following:
      · Psychotherapy notes. Such notes consist of those notes that are recorded in any medium by a health care provider who is a mental health professional documenting or analyzing a conversation during a private, group, joint, or family counseling session and that are separated from the rest of your medical record.
      · Information compiled in reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings. (In court)
      · Protected health information (“PHI”) that is subject to the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”), 42 U.S.C. § 263a, to the extent that giving you access would be prohibited by law.
      · Information that was obtained from someone other than a health care provider under a promise of confidentiality and the requested access would be reasonably likely to reveal the source of the information.
    In other situations, we may deny you access, but if we do, we must provide you a review of our decision denying access. These “reviewable” grounds for denial include the following:
      · A licensed healthcare professional, such as your doctor, has decided, in his/her professional judgment, that the access is reasonably likely to endanger the life or physical safety of yourself or another person.
      · PHI makes reference to another person (other than a health care provider) and a licensed health care provider has decided, in his/her professional judgment, that giving access to such personal representative is reasonably likely to cause substantial harm to you or another person.
    For these reviewable grounds, another licensed professional must review the decision of the provider denying access within 60 days. If we deny you access, we will explain why and what your rights are, including how to seek review. If we grant access, we will tell you what, if anything, you have to do to get access. We can, by law, charge a reasonable fee, as outlined in Florida Statues, for making copies.
    • Request revision/correction of your health information. We DO NOT have to grant the request if the following conditions exist:
      · We did not create the record. If, as in the case of a consultation report from another provider, we did not create the record, we cannot know whether it is accurate or not. Thus, in such cases, you must seek revision/correction from the party creating the record. If the party revises or corrects the record, we will put the corrected record into our records.
      · The records are not available to you as discussed immediately above.
      · The record is accurate and complete as it is.
    If we deny your request for revision/correction, we will notify you why, how you can attach a statement of disagreement to your records (which we may reply to) and how you can complain. If we grant the request, we will make the correction and distribute the correction to those who need it and those whom you identify to us that you want to receive the corrected information.
Our Responsibilities under the Federal Privacy Standard
    In addition to providing you your rights, as detailed above, the federal privacy standard requires us to take the following measures:
    • Maintain the privacy of your health information, including putting in place reasonable and appropriate physical, administrative, and technical protections.
    • Provide you this notice as to our legal duties and privacy practices with respect to individually identifiable health information that we collect and maintain about you.
    • Abide by the terms of this notice.
    • Train our personnel concerning privacy and confidentiality.
    • Put in place a discipline policy to punish those who breach privacy/confidentiality or our policies with regard thereto.
    • Lessen the harm of any breach of privacy/confidentiality.
WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION THAT WE MAINTAIN. IF WE CHANGE OUR INFORMATION PRACTICES, WE WILL MAIL A REVISED NOTICE TO THE ADDRESS THAT YOU HAVE GIVEN US.
We will not use or disclose your health information without your consent or authorization, except as described in this notice or otherwise required by law.

Examples of disclosures for which we do not need your consent:

    A. When presented with s subpoena and/or court order requiring disclosure.
    B. Secretary of Department of Health & Human Services for compliance purposes.
    C. Treatment, payment or health operations re:
    1. Intra facility monitoring systems, performance improvement, and competency review training programs, auditing functions.
    2. Oversight activities: JCAHO, state MH/SA surveys, etc.
    3. To defend a legal action, i.e. Law suits, Workman’s Compensation requests.
    4. Florida Department of Corrections regarding inmates.
    5. Chemical dependency patients: Court order may release patients protected health information to protect loss of life/serious injury to identifiable persons. Mental Health patients: the facility administrator may authorize the release of protected health information to protect loss of life or serious injury to identifiable persons.
    6. Business associates i.e. transcription, laboratories, pharmacies, x-ray, etc.
    D. Emergency situations: i.e. overdose on medication only enough information is released to allay the emergency situation. A “call back” verification.
How to Get More Information or to Report a Problem

    If you have questions, complaints or concerns and/or would like additional information, you may contact the privacy officer at [phone number 727-449-0300], or you may contact the Secretary of Health & Human Services. You will in no way be retaliated against for voicing your complaints/concerns.
Examples of Disclosures for treatment, payment or health operations
    • Treatment - Your physician, physicians' assistant, your therapist, nursing, medical physician.
    • Payment - Send bills to your insurance company or clearing house.
    • Health Operations: Utilization services, risk management, performance improvement, peer review.
    • Business Associates - laboratories, pharmacies, x-ray, transcription, auditors, legal council, Workers Compensation, health over-sight agencies, public health authorities and the Department of Health & Human Services.


For More Information Or Assistance Please Call

1-800-226-0301
(toll free)
or
1-727-449-0300

Or Send Email Directly To
Fairwinds Treatment Center
Clearwater, Florida

fairwinds@fairwindstreatment.com