HIPAA PRIVACY POLICY

NOTICE OF PRIVACY PRACTICES

OF

Universal Mental Health Services, Inc.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

OUR RESPONSIBILITIES:
We are required by law to protect the privacy of your health information. This health information may be information about health care we provide, payment for health care provided, or other health care operations. We are required by law to inform you of our legal duties and privacy practices with respect to health information through this Notice of Privacy Practices. This Notice describes the ways we share past, present and future health information, ensuring that we use and/or disclose this information only as we have described in this Notice. We do however, reserve the right to change our privacy practices and the terms of this Notice, and to make the new Notice provisions effective for all health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us.  

FOR ADDITIONAL INFORMATION OR TO REPORT A PROBLEM:
If you have questions and would like additional information, contact the Supervisor that works with you or the Quality Improvement Dept. or with the Secretary of Health and Human Services. You have the right to make a complaint without fear of retaliation.

USE AND DISCLOSURE OF HEALTH INFORMATION:

• Treatment
  Universal Mental Health Services, Inc. may use health information, as needed, in order to provide, coordinate or manage health care and related services. This includes sharing health information with other health care providers. We will disclose health information outside of Universal Mental Health Services, Inc. for treatment purposes only with your consent, or when otherwise allowed under state or federal laws.
  
• Payment for Services
  We may use and disclose medical information about a client in order to obtain payment for services received by the client. This means that we may use medical information about a client to arrange for payment. For example; a bill may be sent to you or a third –party payer. The information on or accompanying the bill may include information that identifies you, along with your diagnosis, services and supplies used.
  
• Other Circumstances
  Universal Mental Health Services, Inc. may disclose a client’s health information when circumstances have been determined to be so important that your authorization may not be required. Prior to disclosing any health information, we will evaluate each request to ensure that only necessary information will be disclosed. These circumstances include disclosures that are: Required by law: For public health activities. For example, we may disclose health information to public health authorities if a client has a communicable disease and we have reason to believe, based upon information provided to us, that there is a public health risk. Communicable disease such as tuberculosis or HIV/AIDS, will be treated as confidential unless otherwise specified by law. Other than circumstances described to you in other sections of this Notice, we will not release any information about communicable diseases except as required to protect public health or the spread of a disease, or at the request of the State or Local Health Director;
  • Regarding abuse, neglect or domestic violence
  • For health oversight activities such as licensing
  • For law enforcement purposes unless otherwise prohibited by state or federal law
  • For court proceedings such as court orders to appear
  • Related to death such as disclosure to a funeral director
  • Related to donation of organs or tissue
  • To avert a serious threat to the health or safety of a person or the public
  • Related to specialized government activities such as national security
  • To correction institutions or other law enforcement officials if a resident is in their custody
  • For Worker’s Compensation in cases pending before the Industrial Commission

• Disclosure of Health Information That Requires Your Authorization
  Universal Mental Health Services, Inc. will not disclose health information about a client without authorization, except as allowed or required by state or federal law. For all other disclosures, we will ask you to sign a written authorization that allows us to share or request your health information. Prior to signing an authorization, you will be fully informed of the exact information you are authorizing to be disclosed/request and to/from whom the information will be disclosed/requested.
  
• Prohibited Disclosure of Health Information
  Universal Mental Health Services, Inc. will never disclose protected health information in the following manners:
  • Universal Mental Health Services, Inc. shall not sale protected health information without an individual authorization. Sale of protected health information includes any disclosure of protected health information in exchange for remuneration, even if ownership of the protected health information remains with Universal Mental Health Services, Inc. 
  • Universal Mental Health Services, Inc. shall not use protected health information without individual authorization for marketing purposes. Under no circumstances will Universal Mental Health Services, Inc. accept payment from a third party whose product or service is promoted in marketing communication (with narrow exceptions such as for refill reminders where the payment is limited to the cost of making the communication). 
  • Universal Mental Health Services, Inc. shall not use protected health information without individual authorization to make fundraising communications, unless each communication provides a means for the recipient to opt out of receiving any further such communications and the opt-out mechanism entails no more than the normal cost for the recipient. 
  • Universal Mental Health Services, Inc. shall not sell or otherwise disclose any protected health information for marketing-related purposes. 

• Your Rights Regarding Health Information
  You have the following rights regarding the health information created and maintained by Universal Mental Health Services, Inc.
  • Right to receive a copy of this Notice All Universal Mental Health Services, Inc. clients and their guardians have a right to have a paper copy of our Notice of Privacy Practices at any time. In addition, a copy of this Notice is posted on our internet web sit (www.umhs.net) and in our offices. 
  • Right to request different ways to communicate with you You have the right to request to be contacted at a different location or by a different method. 
  • Right to request to see and copy health information If you are a Universal Mental Health Services, Inc. client or the guardian of a client, you have the right to request to see and receive a copy of health information in medical, billing and other records that are used to make decisions. Your request must be in writing to our Quality Improvement Dept. You can expect a response to your request within 30 days. If your request is approved, and if you wish copies (paper or electronic), you will be charged a fee to cover the cost of making the copies or creating electronic media. We may provide you with a summary or explanation of heath information (instead of providing you with a full copy of a person’s health information record), if you agree in advance to that format and to the cost of preparing such information. A physician may deny your request or a professional designated by our agency director under certain circumstances. If we do deny your request, we will explain our reason for doing so in writing and describe any rights you may have to request a review of our denial. In addition, you have the right to contact our Quality Improvement Dept. to request that a copy of a client’s health information be sent to a physician or psychologist of your choice.
  • Right to request amendment of health information You have the right to request changes in the health information in medical, billing and other records used to make decisions concerning Universal Mental Health Services, Inc. clients. If you believe that we have information that is either inaccurate or incomplete, you may request in writing to our Quality Improvement Dept. and explain your reasons for the amendment. We must respond to your request within 30 days of receipt. If we accept your request to change the client’s health information, we will add the amendment but will not destroy the original record. In addition, we will make reasonable efforts to inform others of the changes, including persons you name who have received the health information and who need the changes. We may deny your request if the information was not created by Universal Mental Health Services, Inc. or the information is not part of the records used to make decisions. If we deny your request to change the health information, we will explain in writing to you the reasons for denial and describe your rights to give us a written statement disagreeing with the denial. If you provide a written statement, the statement will become a permanent part of the client’s record. Whenever disclosures are made of the information in question, your written statement will be disclosed as well.

• Violations/Complaints If anyone believes that privacy rights have been violated by Universal Mental Health Services, Inc., or is anyone is dissatisfied with our privacy policies or procedures, they may file a complaint with us, with CARE-LINE or with the federal government. We will not take any action against any person or change our treatment of any person based on the filing of a complaint. To file a written complaint with Universal Mental Health Services, Inc., you may bring your complaint to any Universal Mental Health Services, Inc. office or you may mail it to the following address:
  Universal Mental Health Services, Inc.
  Quality Improvement Dept.
  839 Wilkesboro Blvd
  Lenoir, NC 28645
  
  The North Carolina Department of Health and Human Services operates an information and referral service located in the Office of Citizen Services, known as the CARE-LINE, which has been designated to receive and document complaints and concerns regarding the privacy practices, policies, and procedures related to the protection of individually identifiable health information. Contact information is as follows:
  CARE-LINE
  2012 Mail Service Center Raleigh, NC 27699-2012
  Voice Phone (English and Spanish) 1-800-662-7030 (Toll Free)
  Email: care.line@dhhs.nc.gov
  
  You may also send a written complaint to the United States Secretary of the Department of Health and Human Services. Contact information is as follows:
  Office for Civil Rights
  U.S. Department of Health and Human Services Atlanta Federal Center, Suite 3B70 61 Forsyth Street, S.W. Atlanta, GA 30303-8909
  Voice Phone: (404) 562-7886
  Fax: (404) 562-7881
  TDD: (404) 331-2867