YOUR PRIVACY AND RIGHTS ARE IMPORTANT TO US
As a consumer of Highlands Community Services, you have the right to:
- Be informed of your rights
- Get help with your rights
- Be treated with dignity and respect
- Get services without fear of discrimination
- Be told about your treatment and services
- Consent to or refuse treatment or services
- Ask to review your records
- Ask how your records are used
- File a complaint
- Have your treatment remain private
- Notify the person of choice of your general condition
If you have questions, need assistance or wish to file a complaint, please contact:
John Counts, HCS Office of Consumer Services, 276-525-1550
Jennifer Kovack, Regional Human Rights Advocate, 1-804-248-8043
Secretary, U.S. Department of Health and Human Services, 1-202-690-7000
HIGHLANDS COMMUNITY SERVICES NOTICE OF PRIVACY PRACTICES AND RIGHTS
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.
Your Privacy is Important
Highlands Community Services (HCS) understands your privacy is important. We are required by law to maintain the privacy of protected health information and to provide you with a notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this notice. We will handle this information only as allowed by federal and state law and agency policy, adhering to the most stringent law that protects your health information.
If at any time you believe your rights have been violated, you may verbally or in writing contact:
- HCS Privacy Officer
- Regional Human Rights Advocate
- Secretary of Health and Human Services
Contact information is available at the end of this notice. You will not suffer any change in services or retaliation for filing a complaint.
Each time you receive services from us, the provider makes a record of the visit. Typically, this record contains your assessment, service plan, progress notes, diagnoses, treatment and plan for future care or treatment.
Your federally defined rights under 45 CFR Parts 160 and 164 (HIPAA Privacy Standards) and under The Commonwealth of Virginia Administrative Code, Title 12, sections 35-115-80 and 35-115-90 (Human Rights)
There are several rights concerning your protected health information that you should be aware of:
- You have the right to inspect or to request copies of your medical records. This process will be kept confidential. This right is not absolute. In certain situations, such as if access would cause harm, we can deny access. You must make this request in writing to your Primary Service Coordinator or to the HCS Privacy Officer. If denied access, you will receive a timely, written notice of the decision and reason, and a copy of this notice becomes a part of your record.
- You have the right to request an amendment of your medical records if you believe information in the records is inaccurate or incomplete. This request must be made in writing to your Primary Service Coordinator or to the HCS Privacy Officer. We may deny the request for proper reasons but you will be provided with a written explanation of the denial.
- You have the right to receive an accounting of the agency’s disclosures of your protected health information that were not for the purpose of treatment, payment, health care operations or that were not otherwise authorized by you. You also have the right to be given the names of anyone, other than employees of HCS, who received information about you from HCS.
- You have the right to request from your Primary Service Coordinator a restriction with regards to the use or disclosure of your protected health information. This request will be given serious consideration by the Privacy Officer and you will be informed promptly whether we will be able to honor the requested restriction and still offer effective services, receive payment and maintain health care operations. Legally, we are not required to agree to any restrictions you request, but if we do agree, we are bound by that agreement except under certain emergency circumstances.
- You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Such requests must be made in writing to your Primary Service Coordinator. We will agree to all reasonable requests.
- You have the right to obtain a paper copy of this Privacy Notice at any time upon request.
Use and Disclosure of Your Information
Upon signing the HCS Consent to Treatment/Service form, you are allowing us to use and disclose necessary information about you within HCS and with business associates in order to provide treatment/service, receive payment of provided treatment/service and conduct our day-to-day health care operations.
EXAMPLES:
In order to effectively provide treatment/service, your Primary Service Coordinator may consult with various service providers within the agency. During those consultations, health information about you may be shared.
In order to receive payment of services provided, your health information may be sent to those companies or groups responsible for payment coverage, and a monthly bill is sent to the responsible party identified by you and noted on the financial form.
In day-to-day health care operations, trained staff may handle your physical medical record in order to have the record assembled, available for review by the Primary Service Coordinator or for filing of documentation. Certain data elements are entered into our computer system are used to process billing and for state statistical reporting to the Department of Behavioral Health and Development Services (DBHDS). As a part of our continuous quality improvement efforts to provide the most effective services, your record may be reviewed by professional staff to assure accuracy, completeness and organization.
Enhancing Your Health Care
Some HCS services provide the following support to enhance your overall health care and may contact you to provide:
- Appointment reminders by call or letter;
- Information about treatment alternatives;
- Information about health-related benefits and services that may be of interest to you.
Individuals Involved in Your Care or Payment for that Care
Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.
Specific Circumstances for Disclosure
This agency is allowed by federal and state law in certain circumstances to disclose specific health information about you.
These specific circumstances are:
- As required by law (ex: reports required for public health purposes, such as reporting certain contagious diseases);
- Judicial and Administrative proceedings (ex: order from a court or administrative tribunal, or legal counsel to the agency or the Inspector General);
- Law enforcement purposes (ex: reporting of gunshot wounds; limited information requested about suspects, fugitives, material witnesses, missing persons; criminal conduct on HCS premises);
- To avert a serious threat to the health and safety of another person (ex: in response to a specific threat made by a person receiving services to harm another);
- Children or incapacitated adults who are victims of abuse, neglect or exploitation;
- Specialized government functions;
- Military Services (ex: in response to appropriate military command to assure the proper execution of the military mission);
- National Security and Intelligence activities (ex: in relation to protective services to the President of the United States);
- State Department (ex: medical suitability for the purpose of security clearance);
- Correctional Facilities (ex: to correctional facility about an inmate);
- Workers’ Compensation to facilitate processing and payment;
- Coroners and Medical Examiners for identification of a deceased person or to determine cause of death;
- To the Department of Health and Human Services in connection with an investigation of us for compliance with federal regulations
Other Uses and Disclosures of Your Information by Authorization Only
We are required to get your authorization to use or disclose your protected health information for any reason other than for treatment/services, payment or health care operations and those specific circumstances outlined previously. We use an Authorization to Disclose Confidential Information form that specifically states what information will be given to whom, for what purpose and is signed by you or your legal representative. You have the ability to revoke the signed authorization at any time by a written statement except to the extent that we have acted on the authorization.
Changes to Privacy Practices
HCS reserves the right to change any of its privacy policies and related practices at any time, as allowed by federal and state law, and to make the change effective for all past, present and future protected health information that we maintain.
Revised Privacy Notices will be posted at all service sites, and available upon request by mailing or discussion with an agency representative or electronically or a combination of the three. We will review any changes with you on your first visit after the revised Privacy Notice is posted.
Privacy of Substance Abuse Records
A greater degree of confidentiality is afforded consumers who receive substance abuse services or who have a substance abuse diagnosis. Generally, no information may be shared about participation in substance abuse services without the consumer’s authorization, unless otherwise authorized by law. The legal means by which substance abuse information may be released include:
- the consumer’s written authorization;
- response to a valid court order;
- disclosure to emergency or medical personnel in a medical emergency;
- disclosures for audits or program evaluation purposes;
- minimal information may be given to law enforcement in an event of a crime or threats against HCS service providers.
Other Rights
YOU HAVE A RIGHT TO NOTIFICATION
You have the right to be informed of your rights annually while you continue to receive services from HCS. You have a right to request and be given a paper or electronic copy of the Community Regulations to Assure the Rights of Individuals Receiving Services from Providers of Behavioral Health and Developmental Services. You also have a right to be told about and be given a copy of any Program Rules or Rules of Conduct established for specific services you may receive as a consumer of HCS.
YOU HAVE A RIGHT TO TREATMENT
You have the right to receive treatment and services from HCS without being discriminated against. HCS may not deny services to you based upon your race, national origin, sex, age, religion or handicap. If you think your rights have been violated or that you have been discriminated against, contact the HCS Office of Consumer Services or the Regional Human Rights Advocate.
YOU HAVE A RIGHT TO CONFIDENTIALITY
You have the right for your health information to be kept private and confidential and disclosed only with your authorization or when allowed by federal or state laws or regulations. HCS has a responsibility to keep your protected health information confidential and to use and disclose information about you only as authorized by law or with your written consent or authorization.
YOU HAVE A RIGHT TO CONSENT
You have the right to consent to any treatment or service which poses a significant risk, that is, a risk that might cause injury or have a serious side effect. No medication may be prescribed for you without our providing you information about the possible side effects and your giving us written informed consent that you have been informed about the potential side effects or risk of injury and that you consent to take the medication or participate in the activity.
YOU HAVE A RIGHT TO BE TREATED WITH DIGNITY
You have the right to be called by your legal or preferred name, the right to be protected from abuse and the right to request and receive help in applying for services or benefits for which you are eligible.
YOU HAVE A RIGHT TO THE LEAST RESTRICTIVE TREATMENT OR SERVICE ALTERNATIVE
You have a right to be involved in decisions which limit your personal and physical freedom and the right to be told what has to happen before restrictions are removed. Your personal and physical freedom may be limited when necessary for your safety or for the safety of others. Your personal and physical freedom may also be restricted as part of treatment interventions.
YOU HAVE A RIGHT TO BE PAID FOR WORK FOR WHICH YOU SHOULD BE COMPENSATED
You have a right to be paid for work you do for HCS which federal or state laws require us to appropriately compensate you. Personal housekeeping and work which is done as part of treatment is not compensable work. Work which is not done primarily for the purpose of making money for the program or service area to be used for consumer activities is also not compensable work.
YOU HAVE A RIGHT TO RETAIN YOUR BASIC LEGAL RIGHTS
When you become an HCS consumer and begin receiving services, you have the right to retain all of your legal rights afforded you as a citizen of this country, including the right to enter into contracts, to marry or divorce, to register and vote, to make a will and to use the courts.
YOU HAVE THE RIGHT TO HEARINGS AND APPEALS
You may file a complaint that your rights have been violated with your Primary Services Coordinator or the HCS Office of Consumer Services. You may also file a complaint with the Regional Human Rights Advocate. You have a right to have a hearing regarding your claim that your rights have been violated. When we respond to your claims that your rights have been violated, you will be informed in writing regarding your right to appeal any decision regarding your claims that your rights have been violated. You may also file a claim that your rights have been violated with the Secretary of the United States Department of Health and Human Services.
YOU HAVE A RIGHT TO ASSISTANCE FROM THE REGIONAL HUMAN RIGHTS ADVOCATE AND THE VIRGINIA OFFICE FOR PROTECTION AND ADVOCACY
You have a right to call upon two state advocates for assistance: the Regional Human Rights Advocate of the DBHDS Office of Human Rights and the Virginia Office for Protection and Advocacy (VOPA).
For additional information about the HCS Privacy Policy, federal or state laws regarding privacy and confidentiality or to file a complaint about rights violations or services, please contact one of the individuals listed below:
HCS OFFICE OF CONSUMER SERVICES
John Counts
Quality Improvement Manager
610 Campus Drive, Abingdon, VA 24210
Phone: 276-525-1635
Fax: 276-669-9093
Email: jcounts@highlandscsb.org
Website: www.highlandscsb.org
REGIONAL HUMAN RIGHTS ADVOCATE
Jennifer Kovack
DBHDS Office of Human Rights,
Region III Southwest Satellite Office of Human Rights
340 Bagley Circle, Marion, VA. 24354
Phone: 276-248-8043
VA Toll Free: 877-600-7434
Website: www.dbhds.virginia.gov
VIRGINIA OFFICE FOR PROTECTION & ADVOCACY
1910 Byrd Avenue, Suite 5
Richmond, VA 23230
Phone: 804-225-2042
VA Toll Free: 800-552-3962
Website: www.vopa.state.va.us
HCS QUALITY & COMPLIANCE SERVICES
Lorie Horton
Privacy Officer, Director of Quality and Compliance Services
610 Campus Drive, Abingdon, VA 24210
Phone: 276-525-1539
Fax: 276-669-9093
Email: lhorton@highlandscsb.org
Website: www.highlandscsb.org
U.S. DEPT. OF HEALTH & HUMAN SERVICES
Immediate Office of the Secretary
Hubert Humphrey Building
200 Independence Avenue SW
Washington, DC 20201
Phone: 202-690-7000
Toll Free: 877-696-6775
Website: www.hhs.gov