Protected Health Information Policy

Easterseals Delaware & Maryland’s Eastern Shore

NOTICE OF PRIVACY PRACTICES

This notice describes how protected health information about you may be used and disclosed and how you can get access to this information.

Please review it carefully.

The privacy of your protected health information is important to us.

OUR LEGAL DUTY

We are required by applicable federal and state law to maintain the privacy of your protected health information.  We are also required to give you this Notice about our privacy practices, our legal duties and your rights concerning your protected health information.  We must follow the privacy practices that are described in this Notice while it is in effect.  This Notice takes effect April 14, 2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law.  We reserve the right to make the changes in our privacy practices and the new terms of our Notice are effective for all protected health information that we maintain, including protected health information we created or received before we made the changes.  Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon request.

You may request a copy of our Notice at any time.  For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

We use and disclose health information about you for treatment, payment activities and Easterseals operations.  Examples:

Treatment: We may use or disclose your protected health information to a physician or healthcare provider providing treatment to you.

Payment: We may use or disclose your protected health information to obtain payment for services we provided to you.

Easterseals Operations:  We may use and disclose your protected health information in connection with our operations.  These operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities.

Your Authorization: In addition to our use of your protected health information for treatment, payment or Easterseals operations, you may give us written authorization to use your protected health information or to disclose it to anyone for any purpose.  If you give us an authorization, you may revoke it in writing at any time.  Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect.  Unless you give us written authorization, we cannot use or disclose your protected health information for any reason except those described in this Notice.

To Your Family and Friends: We must disclose your protected health information to you, as described in the Patients Rights section of this Notice.  We may disclose your protected health information to a family member, friend or other person to the extent necessary to help with your services/treatment or with payment for your services, but only if you agree that we may do so.

Persons Involved in Care: We may use or disclose protected health information to notify, or assist in the notification of (including identifying or locating) a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death.  If you are present, then prior to the use of disclosure of your protected health information, we will provide you with an opportunity to object to such uses or disclosures.  In the event of your incapacity or emergency circumstances, we will disclose protected health information based on a determination using our professional judgment, disclosing only protected health information that is directly relevant to the person’s involvement in your treatment.

Marketing Health-Related Services:  We will not disclose your protected health information for marketing communications without your written authorization.

EASTER SEALS NOTICE OF PRIVACY PRACTICES

Required by Law:   We may use or disclose your protected health information when we are required to do so by law.

Abuse or Neglect: We may disclose your protected health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect or domestic violence, or the possible victim of other crimes.  We may disclose your protected health information to the extent necessary to avert a serious threat to your health or safety or the health or safety of others.

Appointment Reminders:  We may use or disclose your protected health information to provide you with appointment reminders (such as voicemail messages, postcards, letters and/or e-mail messages.)

PATIENT RIGHTS

Access:  You have the right to look at or get copies of your protected health information, with limited exceptions.  You may request that we provide copies in a format other than photocopies.  We will use the format you request unless we cannot practicably do so. (You must make a request in writing to obtain access to your health information.  You may obtain a form to request access by using the contact information listed at the end of this Notice.  We will charge you a reasonable cost-based fee for expenses such as copies and staff time.  You may also request access by sending us a letter to the address at the end of this Notice.  If you request copies, we will charge you $.25 for each page, $12.00 per hour for staff time to locate and copy your health information, and postage if you want the copies mailed to you. If you request an alternative format, we will charge a reasonable cost-based fee for providing your protected health information in the requested format.  If you prefer, we will prepare a summary or an explanation of your protected health information for a fee.  Contact us using the information listed at the end of this Notice for a full explanation of our fee structure.)

Disclosure Accounting: You have the right to receive a list of instances in which we or our business associates disclosed your protected health information for purposes other than treatment, payment, healthcare operations and certain other activities, for the last 6 years, but not before April 14, 2003.  If you request this accounting more than once in a 12-month period, we may charge you a reasonable cost-based fee for responding to these additional requests.

Restriction: You have the right to request that we place additional restrictions on our use or disclosure of your protected health information.  We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in an emergency).

Alternative Communication: You have the right to request that we communicate with you about your protected health information by alternative means or to alternative locations.  (You must make your request in writing.)  Your request must specify the alternative means or location, and provide a satisfactory explanation of how payments will be handled under the alternative means or location you request.

Amendment:  You have the right to request that we amend your protected health information. (Your request must be in writing, and it must explain why the information should be amended.)  We may deny your request under certain circumstances.

Electronic Notice:  If you receive this Notice on our website or by electronic mail (e-mail), you are entitled to receive this Notice in written form.

QUESTIONS AND COMPLAINTS

If you want more information about our privacy practices or have questions or concerns, please contact us.

If you are concerned that we may have violated your privacy right, or you disagree with a decision we made about access to your protected health information, or in response to a request you made to amend or restrict the use or disclosure of your protected health information, or to have us communicate with you by alternative means or at alternative locations, you may complain to us using the contact information listed at the end of this Notice.  You may also submit a written complaint to the U.S. Department of Health and Human Services (HHS).  We will provide you with the address to file your complaint to HHS upon request.

We support your right to the privacy of your protected health information.  We will not retaliate in any way if you choose to file a complaint with us or the U.S. Department of Health and Human Services

Contact Information:    

Privacy Officer

Easterseals

61 Corporate Circle

New Castle, DE  19720-2405

Confidential HIPAA Hotline Phone: 302-324-4444, ext. 1040

Confidential Fax:  302-324-4480