NOTICE OF PRIVACY PRACTICES
THE GUIDANCE CENTER -
NOTICE OF PRIVACY PRACTICES
This Notice describes how health information about you may be
used and disclosed and how you can get access to this information. Please review it carefully.
We have a legal duty to safeguard your
protected health information. We will protect the privacy of the health information that we
maintain that identifies you, whether it deals with the provision of health care to you or
the payment for health care. We must provide
you with this Notice about our privacy practices. It
explains how, when and why we may use and disclose your health information. With some exceptions, we will avoid using or
disclosing any more of your health information than is necessary to accomplish the purpose
of the use or disclosure. We are legally
required to follow the privacy practices that are described in this Notice, which is
currently in effect.
However, we reserve the right to change the terms of this Notice
and our privacy practices at any time. Any
changes will apply to any of your health information that we already have. Before we make an important change to our
policies, we will promptly change this Notice and post a new Notice in our waiting room
areas. You may also request, at any time, a
copy of our Notice of Privacy Practices that is in effect at any given time, from the
receptionist. You may view and obtain an
electronic copy of this Notice on our web site at www.penn.com/~guidance.
We would like to take this opportunity to answer some common
questions concerning our privacy practices:
Question: How Will this Organization Use and Disclose My
Protected Health Information?
Answer: We use and disclose health information for many
different reasons. For some of these uses or
disclosures, we need your specific authorization. Below,
we describe the different categories of our uses and disclosures and give you some
examples of each.
A. Uses
and Disclosures Relating to Treatment, Payment or Healthcare Operations. We may, by federal law, use and disclose your
health information for the following reasons:
- For Treatment: We do not release information to other
treatment services without your authorization unless in an emergency. For example, we may disclose your mental health
information to a hospital in order to implement an involuntary committal to a psychiatric
unit.
- To Obtain Payment for
Treatment: We may use and disclose
necessary health information in order to bill and collect payment for the treatment that
we have provided to you. For example, we may
provide certain portions of your health information to your health insurance company,
Medicare or Medicaid, in order to get paid for taking care of you.
- For Health Care
Operations: We may, at times, need to use
and disclose your health information to run our organization. For example, we may use your health information to
evaluate the quality of the treatment that our staff has provided to you. We may also need to provide some of your health
information to our accountants, attorneys and consultants in order to make sure that
we’re complying with law; if this information concerns mental health disorders and/or
treatment, drug and alcohol abuse and/or treatment, and/or HIV status, we may be further
limited in what we provide and may be required to first obtain from you specific
authorization.
B. Certain Other Uses and Disclosures are
Permitted by Federal Law. We may use and
disclose your health information without your authorization for the following reasons:
- When a Disclosure is
Required by Federal, State or Local Law, in Judicial or Administrative Proceedings or by
Law Enforcement. For example, we may
disclose your protected health information if we are ordered by a court, or if a law
requires that we report that sort of information to a government agency or law enforcement
authorities, such as suspected child abuse or in response to a court order.
- For Health Oversight
Activities. For example, we will need to
provide your health information if requested to do so by the County and/or the State when
they oversee the program in which you receive care.
We will also need to provide information to government agencies that have the right
to inspect our offices and/or investigate healthcare practices.
- To Avoid Harm. If one of our counselors or physicians
believes that it is necessary to protect you, or to protect another person or the public
as a whole, we may provide protected health information to the police or others who may be
able to prevent or lessen the possible harm.
- For Workers’
Compensation. We may provide your health
information as described under the workers’ compensation law, if your condition was
the result of a workplace injury for which you are seeking workers’ compensation.
- Appointment Reminders. Unless you tell us that you would prefer not
to receive them, we may use or disclose your information to provide you with appointment
reminders.
C. Certain Uses and Disclosures Require You to
Have the Opportunity to Object.
1. Disclosures
to Notify a Family Member, Friend or Other Selected Person.
When you first started in our program, we asked that you provide us with
an emergency contact person in case something should happen to you while you are at our
facilities. Unless you tell us otherwise, we
will disclose certain limited health information about you (your general condition,
location, etc.) to your emergency contact or another available family member, should you
need to be admitted to the hospital, for example. (This
information may not contain information about mental health disorders and/or treatment
without your specific authorization.)
D. D.
Other Uses and Disclosures Require Your Prior Written Authorization. In situations other than those categories of uses
and disclosures mentioned above, or those disclosures permitted under federal law, we will
ask for your written authorization before using
or disclosing any of your protected health information.
In addition, we need to ask for your specific written authorization to
disclose information concerning your mental health.
If you choose to sign an authorization to disclose any of your
health information, you can later revoke it to stop further uses and disclosures to the
extent that we haven’t already taken action relying on the authorization, so long as
it is revoked in writing.
Question:
What Rights Do I Have Concerning My Protected Health Information?
Answer: You have the following rights with respect to your
protected health information:
A. The Right to Request Limits on Uses and Disclosures of
Your Health Information. You have the
right to ask us to limit how we use and disclose your health information. We will consider your request, however under
certain circumstances we are not required to agree to it.
If we do agree to your request, we will put the limits in writing and will
abide by them, except in the case of an emergency. Please
note that you are not permitted to limit the uses and disclosures that we are required or
allowed by law to make.
B. The Right to Choose How We Send Health Information to
You or How We Contact You. You have the
right to ask that we contact you at an alternate address or telephone number (for example,
sending information to your work address instead of your home address) or by alternate
means (for example, by mail instead of telephone). We
must agree to your request so long as we can easily do so.
C. The Right to See or to Get a Copy of Your Protected
Health Information. In most cases, you
have the right to look at or get a copy of your health information that we have, but you
must make the request in writing. A request
form is available at the reception desk. We
will respond to you within 30 days after receiving your written request. If we do not have the health information that you
are requesting, but we know who does, we will tell you how to get it. In certain situations, we may deny your request. If we do, we will tell you, in writing, our
reasons for the denial. In certain
circumstances, you may have a right to appeal the decision.
If you request a copy of any portion of your protected health
information, we will charge you for the copy on a per page basis, only as allowed under
Pennsylvania state law. We need to require
that payment be made in full before we will provide the copy to you. If you agree in advance, we may be able to provide
you with a summary or an explanation of your records instead. There will be a charge for the preparation of the
summary or explanation.
D. D. The Right to Receive a List of
Certain Disclosures of Your Health Information That We Have Made. You have the right to get a list of certain
types of disclosures that we have made of your health information. This list would not include uses or disclosures
for treatment, payment or healthcare operations, disclosures to you or with your written
authorization, or disclosures to your family for notification purposes or due to their
involvement in your care. This list also
would not include any disclosures made for national security purposes, disclosures to
corrections or law enforcement authorities if you were in custody at the time, or
disclosures made prior to April 14, 2003. You
may not request an accounting for more than a six (6) year period.
To make such a request, we require that you do so in writing; a
request form is available upon asking at our reception desk. We will respond to you within 60 days of receiving
your request. The list that you may receive
will include the date of the disclosure, the person or organization that received the
information (with their address, if available), a brief description of the information
disclosed, and a brief reason for the disclosure. We
will provide such a list to you at no charge; but, if you make more than one request in
the same calendar year, you will be charged $25 for each additional request that year.
E. E. The Right to Ask to Correct or
Update Your Health Information. If you
believe that there is a mistake in your health information or that a piece of important
information is missing, you have a right to ask that we make an appropriate change to your
information. You must make the request in
writing, with the reason for your request, on a request form that is available at the
reception desk. We will respond within 60
days of receiving your request. If we approve
your request, we will make the change to your health information, tell you when we have
done so, and will tell others that need to know about the change.
We may deny your request if the protected health information: (1)
is correct and complete; (2) was not created by us; (3) is not allowed to be disclosed to
you; or (4) is not part of our records. Our
written denial will state the reasons that your request was denied and explain your right
to file a written statement of disagreement with the denial. If you do not wish to do so, you may ask that we
include a copy of your request form, and our denial form, with all future disclosures of
that health information.
Question:
How Do I Complain or Ask Questions About This organization’s Privacy
Practices?
Answer: If
you have any questions about anything discussed in this Notice or
about any of our privacy practices, or if you have any concerns or complaints, please
contact our Complaints Officer at 814-362-6535. You
also have the right to file a written complaint with the Secretary of the U.S. Department
of Health and Human Services. We may not take
any retaliatory action against you if you lodge any type of complaint.
Question: When Does This Notice Take Effect?
Answer: This
Notice takes effect on April 14, 2003.
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