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Area Agency on Aging for North Florida, Inc.
NOTICE OF PRIVACY PRACTICES
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.
This Notice of Privacy Practices is provided to you as a
requirement of the Health Insurance Portability and Accountability
Act (HIPAA). It describes how we may use or disclose your
protected health information, with whom that information may
be shared, and the safeguards we have in place to protect
it. This notice also describes your rights to access and amend
your protected health information. You have the right to approve
or refuse the release of specific information outside of our
system except when the release is required or authorized by
law or regulation.
Acknowledgment of Receipt of This Notice
You will be asked to provide a signed acknowledgment of receipt
of this notice. Our intent is to make you aware of the possible
uses and disclosures of your protected health information
and your privacy rights. The delivery of your health care
services will in no way be conditioned upon your signed acknowledgment.
If you decline to provide a signed acknowledgment, we will
continue to provide your services, and will use and disclose
your protected health information for provision, payment,
and reporting of services, when necessary.
Our Duties and Responsibilities Regarding Your Protected
Health Information
“Protected Health Information” (PHI) is individually
identifiable health information. This information includes
demographics, for example, age, address, social security number,
e-mail address, and relates to your past, present, or future
physical or mental health or condition related health care
services. The Area Agency on Aging for North Florida, Inc.
(AAANF) is required by law to do the following:
- Maintain the privacy of your health information
- Provide this notice that describes the ways that we may
use and share your protected health information
- Follow the terms of the notice currently in effect
We reserve the right to change this notice. The effective
date of this notice is April 14, 2003. We reserve the right
to make the revised or changed notice effective for health
information we already have about you as well as any information
we receive in the future. Should the Notice of Privacy Practices
change, you may obtain a revised copy by visiting our website
at www.aaanf.org or by calling the AAANF Privacy Officer to
request a copy be sent to you.
HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH
INFORMATION FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS
The following are examples of permitted uses and disclosures
of your protected health information. These examples are not
exhaustive.
Treatment
We will use and disclose your protected health information
to provide, coordinate, or manage your health care and any
related service. This includes the coordination or management
of your health care with a third party. For example, we would
disclose your protected health information, as necessary,
to a subcontractor, such as a home health agency, that provides
care to you. This would also apply to other AAANF personnel
who are involved with providing your services.
Payment
Your protected health information will be used, as needed,
to obtain payment for your health care services. This may
include certain activities the AAANF might undertake before
it approves or pays for the health care services recommended
for you such as determining eligibility or coverage of benefits,
reviewing services provided to you for medical necessity,
and undertaking utilization review activities. For example,
your information may be shared with a business associate,
such as a lead agency to arrange payment for personal care
services.
Health Care Operations
We may use or disclose, as needed, your protected health information
to support the daily activities related to health care. These
activities include, but are not limited to, quality assessment
activities, investigations, oversight of staff performance
reviews, training volunteers or student interns, communications
about a service, conducting or arranging for other health
care related activities, case management and care coordination.
For example, we may release your name and phone number to
a subcontractor or other provider to arrange a health program
or service that you have requested.
We may share your protected health information with third-party
“business associates” who perform various activities
for the AAANF. The business associates will also be required
to protect your health information.
We may use or disclose your protected health information,
as necessary, to provide you with information about other
health-related programs and services that might interest you,
to provide you with appointment reminders or to provide you
with information on alternative treatment. For example, your
name and address may be used to send you notices of events
that the AAANF is sponsoring in your area.
Individuals Involved in Your Health Care
We may use and disclose PHI about you in some situations where
you have the opportunity to agree or object to certain uses
and disclosures of PHI about you. If you do not object, then
we may make these types of uses and disclosures of PHI to
individuals involved in your health care. We may disclose
to a member of your family, a caregiver, a close friend, or
others identified by you, protected health information that
directly relates to that person’s involvement with the
services and support you receive. We may also give information
to someone who helps pay for those services and support. Additionally,
we may use or disclose protected health information to notify
or assist in notifying those persons of your location, general
condition, or death. Finally, we may use or disclose your
protected health information to an authorized public or private
entity to assist in disaster relief efforts and coordinate
uses and disclosures to family or other individuals involved
in your health care. If there is a family member, caregiver,
or other person you do not want us to disclose health information
about you to, please notify the AAANF Privacy Officer.
USES AND DISCLOSURES WE CAN MAKE WITHOUT YOUR WRITTEN
AUTHORIZATION
Required by Law
We may use or disclose your protected health information if
law or regulation requires the use or disclosure.
Public Health
We may disclose your protected health information to a public
health authority that is permitted by law to collect or receive
the information. The disclosure may be necessary to do the
following:
- Prevent or control disease, injury, or disability
- Report births and deaths
- Report child abuse or neglect
- Notify a person who may have been exposed to a disease
or may be at risk for contracting or spreading a disease
or condition
- Notify the appropriate government authority if we believe
a patient has been the victim of abuse, neglect, or domestic
violence
Health Oversight
We may disclose protected health information to a health oversight
agency for activities authorized by law, such as audits, investigations,
and inspections. These health oversight agencies might include
government agencies that oversee the health care system, government
benefit programs, other government regulatory programs, and
the civil rights laws.
To Avert a Serious Threat to Safety
We may use or disclose PHI about you in limited circumstances
when necessary to prevent a threat to the health or safety
of a person or to the public. This disclosure can only be
made to a person who is able to help prevent the threat.
Coroners, Medical Examiners, Funeral Directors
We may disclose PHI to coroner or medical examiner to identify
a deceased person and determine the cause of death. In addition,
we may disclose PHI to funeral directors, as authorized by
law, so that they may carry out their jobs.
Organ and Tissue Donation
If you are an organ donor, we may use or disclose PHI to organizations
that help procure, locate, and transplant organs in order
to facilitate an organ, eye or tissue donation and transplantation.
Legal Proceedings
We may disclose protected health information during any judicial
or administrative proceeding, in response to a court order
or administrative tribunal and in certain conditions in response
to a subpoena, discovery request, or other lawful process.
Law Enforcement
We may disclose protected health information for law enforcement
purposes, including the following:
- Responses to legal proceedings
- Information requests for identification and location
- Circumstances pertaining to victims of crime
- Deaths suspected from criminal conduct
- Crimes occurring at the AAANF
Specialized Government Function
Under certain circumstances we may disclose PHI:
- For certain military and veteran activities, including
determination of eligibility for veterans benefits and where
deemed necessary by military command authorities
- For national security and intelligence activities
- To help provide protective services for the president
and others
- For the health or safety of inmates and others at correctional
institutions or other law enforcement, custodial situations
for the general safety and health related to correction
facilities
Criminal Activity
Under applicable federal and state laws, we may disclose your
protected health information if we believe that its use or
disclosure is necessary to prevent or lessen a serious and
imminent threat to the health or safety of a person or the
public. We may also disclose protected health information
if it is necessary for law enforcement authorities to identify
or apprehend an individual.
Research
We may disclose your PHI about you for research purposes under
certain limited circumstances. We must obtain a written authorization
to use and disclose PHI about you for research purposes except
in situations where a research project meets specific, detailed
criteria established by the HIPPA Privacy Rule to ensure the
privacy of PHI.
Disclosures Required by HIPAA Privacy Rule
We are required to disclose PHI to the Secretary of the United
States Department of Health and Human Services when requested
by the Secretary to review our compliance with the HIPAA Privacy
Rule. We are also required in certain cases to disclose PHI
to you upon request to access PHI or for accounting of certain
disclosures of PHI about you.
Workers’ Compensation
We may disclose PHI as authorized by workers’ compensation
laws or other similar programs that provide benefits for work-related
injuries or illness.
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
REQUIRE YOUR AUTHORIZATION
All other uses and disclosures of PHI about you will only
be made with your written authorization. If you have authorized
us to use or disclose PHI about you, you may revoke your authorization
at any time, except to the extent we have taken action based
on the authorization.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You may exercise the following rights by submitting a written
request to the AAANF Privacy Officer. Depending on your request,
you may also have rights under the Privacy Act of 1974. The
AAANF Privacy Officer can guide you in pursuing these options.
Please be aware that, in certain circumstances, the AAANF
might deny your request; however, you may seek a review of
the denial.
Right to Inspect and Copy
You may inspect and obtain a copy of your protected health
information that is contained in a “designated record
set” for as long as we maintain the protected health
information. A designated record set contains medical and
billing records and any other records that the AAANF uses
to provide services to you.
This right does not include inspection and copying of the
following records: psychotherapy notes; information compiled
in reasonable anticipation of, or use in, a civil, criminal,
or administrative action or proceeding; and protected health
information that is subject to law that prohibits access to
protected health information.
Right to Request Restrictions
You may request that we not use or disclose any part of your
protected health information. Your request must be made in
writing to the AAANF Privacy Officer where you wish the restriction
instituted. In your request, you must tell us (1) what information
you want restricted; (2) whether you want to restrict our
use, disclosure, or both; (3) to whom you want the restrictions
to apply, for example, disclosures to your spouse; and (4)
an expiration date.
If the AAANF believes that the restriction is not in the
best interest of either party, or the AAANF cannot reasonably
accommodate the request, the AAANF is not required to agree.
If the restriction is mutually agreed upon, we will not use
or disclose your protected health information in violation
of that restriction, unless it is needed to provide emergency
treatment. You may revoke a previously agreed upon restriction,
at any time, in writing.
Right to Request Confidential Communications
You may request that we communicate to you using alternative
means or at an alternative location. We will not ask you the
reason for your request. We will accommodate reasonable requests,
when possible.
Right to Request Amendment
If you believe that the information we have about you is incorrect
or incomplete, you may request an amendment to your protected
health information as long as we maintain this information.
While we accept requests for amendment, we are not required
to agree to the amendment.
Right to an Accounting of Disclosures
You may request that we provide you with an accounting of
the disclosures we have made of your protected health information.
This right applies to disclosures made for purposes other
than treatment, payment, or health care operations as described
in this Notice of Privacy Practices. The disclosure must have
been made after April 14, 2003, and no more than 6 years from
the date of request. This right excludes disclosures made
to you, to family members, caregivers, or close friends involved
in your care, or for notification. The right to receive this
information is subject to additional exceptions, restrictions,
and limitations as described earlier in this notice.
Right to Obtain a Copy of this Notice
You may obtain a paper copy of this Notice of Privacy Practice
at any time. To obtain a paper copy, send your written request
to the AAANF Privacy Officer or visit our website at www.aaanf.org.
FEDERAL PRIVACY LAWS
This AAANF Notice of Privacy Practices is provided to you
as a requirement of the Health Insurance Portability and Accountability
Act (HIPAA). There are several other privacy laws that also
apply including the Freedom of Information Act, the Privacy
Act, and the Alcohol, Drug Abuse, and Mental Health Administration
Reorganization Act. These laws have not been superseded and
have been taken into consideration in developing our policies
and this notice of how we will use and disclose your protected
health information.
COMPLAINTS
If you believe these privacy rights have been violated, you
may file a written complaint with the AAANF Privacy Officer
or the Office of Civil Rights of the United States Department
of Health and Human Services. There will be no retaliation
against you for filing a complaint.
CONTACT INFORMATION
You may contact the AAANF Privacy Officer for further information
about the complaint process, or for further explanation of
this document at:
Area Agency on Aging for North Florida, Inc.
2414 Mahan Drive
Tallahassee, Florida 32308
Phone: (850) 488-0055
Toll-Free: 1-866-467-4624
Fax: (850) 922-2420
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