JOHNSON COUNTY MENTAL HEALTH CENTER

USE AND DISCLOSURE OF HEALTH INFORMATION

The Center may use your health information for purposes of providing your treatment, obtaining payment for your care and conducting health care operations. The Center has established policies to guard against unnecessary disclosure of your health information.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:

To Provide Treatment: We may use information about you to provide you with comprehensive mental health services. We may disclose health information about you to our staff who are involved in your treatment. For example, if you are referred to services provided by another program or office of JCMHC, health information that is necessary to facilitate the transfer will be shared between these programs. In an emergency we may also disclose health information about you to people outside of JCMHC who may be involved in your care. For example, if a medical emergency were to occur on the premises of JCMHC, necessary health information will be shared with emergency medical staff to assure you appropriate treatment (e.g. drug allergies, current medications, known medical history). In medical or psychiatric emergencies, health information will be shared with outside providers to the extent that is necessary to access additional services or to facilitate admission to services.

To Obtain Payment: The Center may include your health information in invoices to collect payment from third parties for the care you receive from the Center.

For example, the Center may be required by your health insurer to provide health information so that the insurer will reimburse you or the Center. The Center also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for mental health services that will be provided to you.

To Conduct Health Care Operations: The Center may use and disclose health information for its own operations in order to facilitate the function of the Center and as necessary to provide quality care to all of the Center’s clients. Health care operations include but are not limited to, such activities as:

Quality assessment and improvement activities.
Activities designed to improve health or reduce health care costs.
Protocol development, case management and care coordination.
Contacting health care providers and clients with information about treatment alternatives and other related functions that do not include treatment.
Professional review and performance evaluation.
Training programs including those in which students, trainees or practitioners in health care learn under supervision.
Training of non-health care professionals.
Accreditation, certification, scholarly research, licensing or credentialing activities.
Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
Business planning and development including cost management and planning related analyses and formulary development.
Business management and general administrative activities of the Center.

For example, the Agency may use your health information to evaluate its staff performance, combine your health information with other Center clients in evaluating how to more effectively serve all Center clients, or to disclose your health information to Center staff and contracted personnel for training purposes.

For Appointment Reminders: The Center may use and disclose your health information to contact you as a reminder that you have an upcoming appointment.

Other Uses and Disclosures

Emergencies: using our best judgment, we may disclose to another health care agency health information relevant to treating the emergent situation.

Reporting Agencies: we may disclose your health information to public authorities to report abuse or neglect, specific threats toward others, and other as allowed by law.

Law Enforcement: We may disclose your health information in the course of a judicial proceeding with your consent, a review by a coroner, or as directed by a valid court order.

Other uses and disclosures not described in this notice will be made only as authorized by law or with your written authorization. You may revoke any authorization in writing at any time.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights regarding your health information the Center maintains:

Right to request restrictions: You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the Center’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, the Center is not required to agree to your request. The Center may not be able to honor this request if you require emergent crisis treatment.

Right to receive confidential communications: You have the right to request that the Center communication with you in a certain way. For example, you may ask that we contact you only at work or by mail. The Center will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

Right to inspect and copy your health information: You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to Medical Records staff. If you request a copy of your health information, the Center may charge a reasonable fee for copying and assembling costs associated with your request. This right is not absolute. In certain situations, such as when access would cause harm to an individual, we have the right to deny access. In other situations, we may deny you access but we must provide you a review of our decision to deny access.

Right to amend health care information: You have the right to request that the Center amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by the Center. A request for an amendment of records must be made in writing to the Privacy Officer. The Center may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by the Center, if the records you are requesting to amend are not part of the Center’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of the Center, the records containing your health information are accurate and complete.
Right to an accounting: An “Accounting of Non-Routine Disclosures” is a list of disclosures we made of health information about you other than for treatment, payment, or healthcare operations, with certain exceptions specifically defined by law. This accounting includes a list of when, to whom, for what purpose, and what content of your PHI has been released. We do not need to provide an accounting of disclosures: provided to you; provided under your specific authorization; provided to others involved in your care; provided for national security or intelligence purposes (as specified by law); to correctional institutions or law enforcement officials (as specified by law); or that occurred before April 14, 2003. The first accounting that you request within a 12 month period will be at no cost to you. We reserve the right to charge a reasonable cost-based fee for additional accountings.

Right to a paper copy of this Notice: You may ask us to give you a copy of this notice at any time. Even if you have received this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy at our website, http://www.jocogov.org/mentalhealth/, or you may request a paper copy from our office nearest you.

Our Responsibilities

Johnson County Mental Health Center is required to:

Maintain the privacy of your health information as required by law
Provide you with a notice as to our legal duties and privacy practices regarding the information we gather and maintain about you
Abide by the terms of this notice
Notify you if we are unable to accommodate a requested restriction
Accommodate reasonable requests by you to communicate health information using alternative means or alternative locations

We reserve the right to amend, change, or eliminate our practices and to make the new provisions effective for all protected information we maintain. If our practices change, we will provide you with a revised notice. We will not use or disclose your protected health information without valid authorization, except as described in this notice.

For Additional Information or to Report a Problem

If you have questions or would like additional information you may contact the Centers Privacy Officer at (913) 831-2550 or at 6000 Lamar, Suite 130, Mission, Kansas 66202.

You have the right to file a complaint with respect to the implementation of this notice or if you believe your rights as a client have been violated by JCMHC. A verbal or written complaint may be filed directly with Johnson County Mental Health Center, attn: Administrative Assistant to the Executive Director, 6000 Lamar, Suite 130, Mission, Kansas 66202, telephone (913) 831-2550, or a written complaint may be filed with the Secretary of the Department of Health and Human Services.

Effective 4/14/2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED

DEFINITIONS

USE AND DISCLOSURE OF HEALTH INFORMATION

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION