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   Arapahoe House Administrative Offices   •   8801 Lipan Street   •   Thornton, Colorado 80260   •   303.657.3700


 
ARAPAHOE HOUSE, INC. NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL [INCLUDING MENTAL HEALTH] INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. During the process of providing services to you, Arapahoe House will obtain, record, and use mental health and medical information about you that is protected health information. "Protected health information" means any information that we have which identifies you and relates to your health or payment for health care services that we provide to you. Ordinarily that information is confidential and will not be used or disclosed, except as described below. I

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

A General Uses and Disclosures Without Your Consent. Arapahoe House will use and disclose protected health information about you in the following ways.

  1. Treatment. Treatment refers to the provision, coordination, or management of health care [including substance abuse treatment and mental health care] and related services by one or more health care providers. For example, Arapahoe House staff involved with your care may use your information to plan your course of treatment and consult with other staff to ensure the most appropriate methods are being used to assist you. We may also disclose your information to other entities or the staff of other entities for treatment purposes. For example, if we obtain a specimen from you, we will send the specimen to an outside laboratory for analysis. Information about you will accompany the specimen.

  2. Payment. Payment refers to the activities undertaken by a health care provider [including a substance abuse treatment or mental health provider] to obtain or provide reimbursement for the provision of health care. For example, Arapahoe House will use your information to develop accounts receivable information, bill you and collect payment from you. Information will be provided to your insurance company or another entity which may pay for some or all of your care only with your written permission. The information provided to insurers and other third party payers will include information that identifies you, as well as your diagnosis, types of service, dates of service, names of persons who provided services to you, and other information about your condition and treatment.

  3. Health Care Operations. Health Care Operations refers to activities undertaken by Arapahoe House that are regular management and administrative functions. For example, Arapahoe House may use your health information in monitoring service quality, staff training and evaluation, medical reviews, legal services, auditing functions, compliance programs, business planning, and accreditation, certification, licensing and credentialing activities.

  4. Contacting You. Arapahoe House may contact you before, during or following enrollment in one of our programs for a variety of reasons, including to:
    (a) remind you of appointments;
    (b) tell you about treatments or other services that might be of benefit to you;
    (c) inquire about your present health status;
    (d) ask if you are in need of additional services; and
    (e) ask your opinion about the quality and effectiveness of the services treatments you have received.

  5. Required by Law. Arapahoe House will disclose protected health information about you when required by law. This includes, but is not limited to:
    (a) reporting child abuse or neglect;
    (b) when court ordered to release information;
    (c) when there is a legal duty to warn or take action regarding imminent danger to others;
    (d) when you are considered to be a danger to yourself or others or you are gravely disabled;
    (e) when required to report certain communicable diseases and certain injuries; and,
    (f) if you should die and a Coroner is investigating your death.

  6. Health Oversight Activities. Arapahoe House will disclose protected health information to health oversight agencies for oversight activities authorized by law and necessary for the oversight of the health care system, government health care benefit programs, regulatory programs or determining compliance with program standards.

  7. Crimes on program premises or threats against staff. Arapahoe House will report to the appropriate law enforcement agency crimes that occur on our premises or where we may be providing services and threats against our staff. This report will include only information necessary to identify and locate the suspected perpetrator or that is directly relevant to the reported activity.

  8. Business Associates. Some of the functions of Arapahoe House are provided through contracts with other entities, which are referred to as business associates. For example, some administrative, clinical, quality assurance, billing, legal, auditing, and practice management services may be provided by contracting with outside entities to perform those services. In those situations, protected health information will be provided to those contractors as is needed to perform their contracted tasks. In some cases, business associates may obtain or receive protected health information about you directly from you or from other sources on our behalf. Business associates are required to enter into an agreement maintaining the privacy of the protected health information which we disclose to them or which they receive on our behalf.

  9. Research. Arapahoe House may use or disclose protected health information for research purposes if the relevant limitations of the Federal HIPAA Privacy Regulation are followed. 45 CFR ¤ 164.512(i).

  10. Involuntary Clients. Information regarding clients who are being treated involuntarily, pursuant to law, will be shared with other treatment providers, legal entities, third party payers and others, as necessary to provide the care and management coordination needed.

  11. Family Members. Except for certain minors, incompetent clients, or involuntary clients, protected health information cannot be provided to family members without your written consent. In situations where family members are present during a discussion with you, and it can be reasonably inferred from the circumstances that you do not object, information may be disclosed in the course of that discussion. However, if you object, protected health information will not be disclosed.

  12. Fund Raising. Arapahoe House, or its fund raising Foundation, may contact clients as a part of its fund raising activities.

  13. Emergencies. In life threatening emergencies, Arapahoe House staff will disclose information we consider necessary to avoid serious harm to you or your death.



B. Client Authorization. Arapahoe House may not use or disclose protected health information in any other way without a signed authorization. When you sign an authorization, you may later revoke it. The revocation must be in writing. The revocation may be hand delivered to any Arapahoe House staff member or mailed to the Arapahoe House Clinical Records Manager, 8801 Lipan Street, Denver, CO 80260. The revocation will apply from the time of revocation, except to the extent Arapahoe House or others have already taken action in reliance on it.

II YOUR RIGHTS AS A CLIENT

A) Access to Protected Health Information. You have the right to inspect and obtain a copy of the protected health information Arapahoe House has regarding you, in the designated record set. There are some limitations to this right, which will be provided to you at the time of your request, if any such limitation applies. To make a request, ask Arapahoe House staff for the appropriate request form.

B) Amendment of Your Record. You have the right to request that Arapahoe House amend your protected health information. Arapahoe House is not required to amend the record if it is determined that the record is accurate and complete. There are other exceptions, which will be provided to you at the time of your request, if relevant, along with the appeal process available to you. To make a request, ask Arapahoe House staff for the appropriate request form.

C) Accounting of Disclosures. You have the right to receive an accounting of certain disclosures Arapahoe House has made regarding your protected health information. However, that accounting does not include disclosures that were made for the purpose of treatment, payment, or health care operations. In addition, the accounting does not include disclosures made to you, disclosures made pursuant to a signed Authorization, or disclosures made prior to April 14, 2003. There are other exceptions that will be provided to you, should you request an accounting. To make a request, ask Arapahoe House staff for the appropriate request form.

D) Additional Restrictions. You have the right to request additional restrictions on the use or disclosure of your health information. Arapahoe House does not have to agree to that request, and there are certain limits to any restriction, which will be provided to you at the time of your request. To make a request, ask Arapahoe House staff for the appropriate request form.

E) Alternative Means of Receiving Confidential Communications. You have the right to request that you receive communications of protected health information from Arapahoe House by alternative means or at alternative locations. For example, if you do not want Arapahoe House to mail bills or other materials to your home, you can request that this information be sent to another address. There are limitations to the granting of such requests, which will be provided to you at the time of the request process. To make a request, ask Arapahoe House staff for the appropriate request form.

F) Copy of this Notice. You have a right to obtain another copy of this Notice upon request.

III ADDITIONAL INFORMATION

A) Privacy Laws. Arapahoe House is required by State and Federal law to maintain the privacy of protected health information. In addition, Arapahoe House is required by law to provide clients with notice of its legal duties and privacy practices with respect to protected health information. That is the purpose of this Notice.

B) Terms of the Notice and Changes to the Notice. Arapahoe House is required to abide by the terms of this Notice, or any amended Notice that may follow. Arapahoe House reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all protected health information that it maintains. When the Notice is revised, the revised Notice will be posted in Arapahoe HouseÕs service delivery sites. In addition, you will be given a copy upon request.

C) Complaints Regarding Privacy Rights. If you believe Arapahoe House has violated your privacy rights, you have the right to complain to Arapahoe House management. To file your complaint, call the Clinical Director at 303-657-3700. It is the policy of Arapahoe House that there will be no retaliation for your filing of such a complaint. You also have the right to complain to the United States Secretary of Health and Human Services.

D) Additional Information. If you desire additional information about your privacy rights at Arapahoe House, please call the Clinical Records Manager at 303-783-0245.

IV Effective Date. This Notice is effective April 14, 2003