Privacy Notice

YOUR PRIVACY IS IMPORTANT

Henrico Area Mental Health & Developmental Services (HAMHDS) understands your privacy is important. By law, we are required to maintain the privacy of protected health information and to provide you with notice of our legal duties and privacy practices. We are required to abide by the terms of this notice.

Some HAMHDS programs or units provide substance use disorder (SUD) services and are subject to additional federal confidentiality protections under 42 CFR Part 2 (“Part 2”). Those protections apply only to records created or maintained by Part 2–covered programs and not to all HAMHDS records.

Each time you receive services from us, the provider makes a record of the visit. This record typically contains your assessment, service plan, progress notes, diagnoses, treatment, and plan for future care or treatment. We will handle this information only as allowed by federal and state law and agency policy.

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU

Right to Inspect and Copy

You have the right to inspect or request copies of your medical record set. This process will be kept confidential. You also have the right to request copies in an electronic format; if records are available in that format, they will be provided electronically. If not, HAMHDS will provide an alternative format.

Denial of Request to Inspect and Copy

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 Case Manager/Clinician or the Privacy Officer. If denied, you will receive a timely, written notice of the decision and reason, and a copy of this notice becomes part of your record.

Right to Amend

You have the right to request amendment of your medical records if you believe information is inaccurate or incomplete. Requests must be made in writing to your Primary Case Manager/Clinician or the Privacy Officer. We may deny the request for proper reasons, but you will be provided a written explanation of the denial.

Right to an Accounting of Disclosures

You have the right to receive an accounting of the agency’s disclosures of your protected health information that were not for treatment, payment, or health care operations, or that were not otherwise authorized by you. You also have the right to know the names of anyone outside the agency who received information about you.

Right to Request Restrictions

You have the right to restrict disclosure of health information to your health plan for services paid out of pocket in full prior to the service being provided. This restriction applies only when the disclosure is to a health plan for payment or health care operations purposes, and HAMHDS has been paid in full prior to the service.

You may also request other restrictions from your Primary Case Manager/Clinician. Your request will be given serious consideration by the Privacy Officer, and you will be promptly informed whether we can honor the restriction while still offering effective services, receiving payment, and maintaining health care operations. Legally, we are not required to agree to all restrictions, but if we do agree, we are bound by that agreement except under certain emergency circumstances.

Right to Request Alternative Communications

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 Case Manager/Clinician. We will accommodate all reasonable requests.

Right to Receive Notice of Breach

You have the right to receive written notification of any breach of your identifiable health information, including Part 2 records. Virginia also has a separate notice law for breaches of unsecured protected health information stored on computers. See Virginia Code § 18.2-186.6.

Right to a Paper or Electronic Copy of This Notice

You have the right to obtain a paper or electronic copy of this Privacy Notice at any time upon request and to discuss it with the HAMHDS Privacy Officer.

USE AND DISCLOSURE OF YOUR INFORMATION (HIPAA)

Upon signing the agency’s Consent to Treat form, you are allowing us to use and disclose necessary information about you within the agency and with business associates in order to provide treatment/service, receive payment, and conduct day-to-day health care operations.

Treatment

Your Treatment Team may use health information about you to provide medical and mental health treatment or services and may share this information with various service providers within the agency or with other health care providers to help them treat you. Unless you object, HAMHDS may also release medical information to a friend or family member who is involved in your medical care. Disclosures are also permitted in accordance with the Consent to Treat form.

Payment

Your health information may be sent to companies or groups responsible for payment coverage. A monthly bill is sent to the Responsible Party identified by you on the financial form. We may also give information to someone who helps pay for your care.

Health Care Operations

Trained staff may access and manage your health record to ensure it is complete and available for review by your treatment team. Certain data elements are entered into our computer system for billing and for state statistical reporting to the Department of Behavioral Health and Developmental Services (DBHDS). Your record may be reviewed as part of continuous quality improvement efforts, and during accreditation surveys by CARF or DBHDS.

Use and Disclosure to Enhance Your Healthcare

Some agency programs 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

Fundraising Communications

HAMHDS does not intend to send fundraising communications to you, but in the event such communications are considered, you have the right to opt out.

Other Circumstances for Disclosure

Federal and state law permit disclosure of specific health information in certain circumstances, including:

• As required by law (e.g., reporting certain contagious diseases for public health purposes)
• Judicial and administrative proceedings (e.g., court orders, lawfully issued subpoenas, or as required by legal counsel)
• Audit compliance (e.g., Inspector General or internal/independent auditors)
• Law enforcement purposes (e.g., limited information about suspects, fugitives, missing persons, or criminal conduct on premises)
• To avert a serious and immediate threat to your health and safety or the health and safety of the public or another person
• Children or incapacitated adults who are victims of abuse, neglect, or exploitation
• Health oversight activities (e.g., DBHDS)
• Military services (e.g., to assure proper execution of the military mission)
• National security and intelligence activities (e.g., protective services to the President)
• State Department (e.g., medical suitability for security clearance)
• Correctional facilities (e.g., information 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

Uses and Disclosures by Authorization Only

We are required to get your authorization to use or disclose your protected health information for any reason other than treatment/services, payment, health care operations, or the specific circumstances outlined above. Most uses for marketing purposes and most disclosures in return for payment require your authorization.

We use an Authorization form that specifically states what information will be given, to whom, and for what purpose, and is signed by you or your legal representative. You may revoke the signed authorization at any time by written statement, except to the extent we have already acted on it.

USE AND DISCLOSURE OF YOUR INFORMATION — SUBSTANCE USE DISORDER RECORDS (42 CFR Part 2)

Certain HAMHDS programs are subject to 42 CFR Part 2, which provides extra confidentiality protections for records relating to substance use disorder diagnosis, treatment, or referral for treatment, where applicable.

Uses and Disclosures Without Your Written Authorization

Part 2 programs may use or disclose records without your written authorization only as permitted or required by law, including:

• When required by law (such as by court order or other mandatory legal, audit, or oversight process)
• To medical personnel in a medical emergency
• To qualified personnel for research, audit, or program evaluation without identifying the patient
• To report a crime committed on HAMHDS’s premises or against HAMHDS personnel, or any threat to commit such a crime
• To report suspected child abuse or neglect to the Virginia Department of Social Services or the Local Department of Social Services

Uses and Disclosures Requiring Your Written Authorization

Except as expressly permitted above, HAMHDS Part 2 programs do not use or disclose Part 2 records without your written authorization. Examples requiring written authorization include:

• Disclosure to other providers for treatment
• Disclosure for payment or billing purposes
• Disclosure for health care operations
• Disclosure to family members or other individuals
• Disclosure to courts, employers, schools, or social service agencies

HAMHDS uses an Authorization form that specifically states what information will be given, to whom, and for what purpose, signed by you or your legal representative. You may revoke the signed authorization at any time by written statement, except to the extent we have already acted on it.

Consent for Treatment, Payment, and Health Care Operations

Federal law permits Part 2 programs to obtain a single written consent authorizing future uses and disclosures for treatment, payment, and health care operations.

Prohibition on Use in Legal Proceedings

Records protected by 42 CFR Part 2, or testimony relaying the content of such records:

• May not be used or disclosed in any civil, administrative, criminal, or legislative proceedings against you unless based on specific written consent from you or in accordance with a court order
• May only be used or disclosed based on a court order after notice and an opportunity to be heard is provided to you or HAMHDS, where required by 42 U.S.C. 290dd-2 and this part
• A court order authorizing use or disclosure must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed

HOW TO FILE A COMPLAINT

If at any time you believe your privacy rights have been violated, you may file a complaint with any of the organizations listed below. You will not suffer any change in services or retaliation for filing a complaint.

CHANGES TO PRIVACY PRACTICES

HAMHDS reserves the right to change any of its privacy policies and practices at any time, as allowed by federal and state law, and to make the change effective for all protected health information we maintain.

Revised Privacy Notices will be posted at all service sites and available upon request by mail, in discussion with an agency representative, electronically, or a combination of these methods.

For additional information, please contact your Primary Provider or the Privacy Officer at the address listed above.