THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
The confidentiality of alcohol and drug abuse patient records maintained by Boyd Andrew Community Services is protected by Federal law and regulations. Generally, Boyd Andrew Community Services may not say to a person outside Boyd Andrew that a patient attends Boyd Andrew, or disclose any information identifying a patient as an alcohol or drug abuser unless:
(1) You authorize the disclosure in writing;
(2) The disclosure is allowed by a court order; or
(3) The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation.
WHO WILL FOLLOW THIS NOTICE.
This notice describes Boyd Andrew’s practices and that of:
- Any health care professional authorized to enter information into your treatment records.
- All departments and units of Boyd Andrew Community Services.
- All employees, staff and other Boyd Andrew personnel.
- All Boyd Andrew Community Services entities, sites and locations will follow the terms of this notice and may share health information with each other for treatment or operations purposes described in this notice.
OUR PLEDGE REGARDING HEALTH INFORMATION:
We are committed to protecting health information about you. We create a record of the care and services you receive at Boyd Andrew Community Services. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Boyd Andrew Community Services. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of health information.
We are required by law to:
- make sure that health information that identifies you is kept private;
- give you this notice of our legal duties and privacy practices with respect to health information about you; and
- follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.
The following categories describe different ways that we use and disclose health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall into one of the categories.
- For Treatment. We may use health information about you to provide you with treatment or services. We may disclose health information about you to counselors, student interns, or other Boyd Andrew Community Services personnel who have a need for the information in connection with their duties that arise out of the provision of diagnosis, treatment, or referral for treatment.
- For Health Care Operations. We may use and disclose health information about you for Boyd Andrew Community Services operations. These uses and disclosures are necessary to run Boyd Andrew and make sure that all of our patients receive quality care. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many Boyd Andrew patients to evaluate trends in drug and alcohol use and to assess the effectiveness of our treatment services. We may also disclose information to other Boyd Andrew personnel for review and learning purposes. We may also combine the health information we have with health information from other treatment centers to compare how we are doing and see where we can make improvements in the care and services we offer. We will remove information that identifies you from this set of health information so others may use it to study treatment services without learning who the specific patients are.
- Medical Emergencies. Medical information may be disclosed to medical personnel who have a need for information about you for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention.
- Food and Drug Administration. Medical information may be disclosed to medical personnel of the Food and Drug Administration who assert a reason to believe that the health of any individual may be threatened by an error in the manufacture, labeling, or sale of a product under FDA jurisdiction, and that the information will be used for the exclusive purpose of notifying patients or their physicians of potential dangers.
- Audit and Evaluation. Health information may be disclosed for the purpose of audit or evaluation by any federal, state, or local government agency which provides financial assistance to Boyd Andrew Community Services or is authorized by law to regulate our activities. Health information may also be disclosed for audit and evaluation purposes to a third party payer which covers our patients, to a peer review organization performing utilization or quality control review, or is determined by our program director to be qualified to conduct the audit or evaluation activities.
- Child Abuse or Neglect. We may report any information about suspected child abuse or neglect to appropriate state or local authorities.
- Law Enforcement. We may disclose information about you to law enforcement officers concerning a crime committed on Boyd Andrew Community Services premises or against any person who works for Boyd Andrew Community Services or a threat to commit such a crime.
- Vital Statistics. We may disclose information about you relating to cause of death under laws requiring the collection of death or other vital statistics or permitting inquiry into the cause of death.
- Subpoena and Court Order. If we receive a subpoena to disclose information about you, we will not do so unless a court of competent jurisdiction enters an authorizing order. A court order may authorize disclosure only if the court finds that the disclosure is necessary:
1. to protect against an existing threat to life or of serious bodily injury;
2. to investigate or prosecute an extremely serious crime; or
3. in connection with litigation or an administrative proceeding in which you offer testimony or other evidence relating to the information.
OTHER USES OF HEALTH INFORMATION.
Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU.
You have the following rights regarding health information we maintain about you:
1. Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.
To inspect and copy health information that may be used to make decisions about you, you must submit your request in writing to: Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed health care professional chosen by Boyd Andrew Community Services will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
2. Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by Boyd Andrew Community Services. To request an amendment, your request must be made in writing and submitted to: Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the health information kept by Boyd Andrew Community Services.
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
3. Right to an Accounting of Disclosures. You have the right to request an Accounting of Disclosures. This is a list of the disclosures we made of health information about you, other than disclosures to you or which you authorized.
To request an Accounting of Disclosures, you must submit your request in writing to: Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003.
The first Accounting of Disclosures you request within a 12 month period will be free. For additional requests, we may charge you for the costs of providing the Accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
4. Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment or health care operations. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to: Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
5. Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at home or by mail.
To request confidential communications, you must make your request in writing to: Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
6. Right to a Paper Copy of This Notice. You have the 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 agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice, please contact the Administrative Office, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624.
You may obtain a copy of this notice at our website, www.boydandrew.com.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at the Receptionist Desk at Boyd Andrew Community Services. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you are admitted to Boyd Andrew Community Services for treatment or health care services as an outpatient client, we will offer you a copy of the current notice in effect.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with Boyd Andrew Community Services or with the Secretary of the Department of Health and Human Services. To file a complaint with Boyd Andrew Community Services, contact our Deputy Administrator, Boyd Andrew Community Services, P.O. Box 1153, Helena, MT 59624, phone number: 443-2343. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.
Violation of the federal laws and regulations by Boyd Andrew Community Services is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations.
FEDERAL STATUTES AND REGULATIONS
This notice is issued pursuant to the following federal statutes and regulations:
Statutes: 42 U.S.C. 290dd-2
42 U.S.C. 1320d-1329d-8, 42 U.S.C. 1320d-2
Regulations: 42 C.F.R. Part 2, 45 C.F.R. Subtitle A, Subchapter C,
Part 160, Sections 160.101 – 164.534
If you have any questions about this notice, please contact the Boyd Andrew Community Services Administrative Office, P.O. Box 1153, Helena, MT 59624. Our phone number is (406) 443-2343.