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[1]NOTICE OF PRIVACY PRACTICES
OF
New Mountain Medicine, P.A.[2]
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.
Effective:
January 01, 2006
If you
have any questions or requests, please contact:
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|
Carlos A. Vargas, M.D.
1573
Highlands Road
Franklin, NC
28734
Phone/Fax: (828) 349-4747
vargasca1@verizon.net
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Table
of Contents
(Please refer to full document for details)
A.
We have
a legal duty to protect health information about you.
B.
We may
use and disclose Protected Health Information (PHI) about you without your
authorization in the following circumstances.
1. We may use and disclose PHI about you to
provide health care treatment to you.
2.
We may use and disclose PHI about you to obtain
payment for services.
3.
We may use and disclose PHI about you for health care
operations.
4.
We may use and disclose PHI under other circumstances
without your authorization or an opportunity to agree or object.
5.
You can object to certain uses and disclosures.
6.
We may contact you to provide appointment reminders.
7.
We may contact you with information about treatment,
services, products or health care providers.
8.
We may contact you for fundraising activities.
C.
You have
several rights regarding PHI about you.
1. You have the right to request restrictions on
uses and disclosures of PHI about you.
2. You have the right to request different ways
to communicate with you.
3. You have the right to see and copy PHI about
you.
4. You have the right to request amendment of
PHI about you.
5. You have the right to a listing of
disclosures we have made.
6. You have a right to a copy of this Notice.
D.
You may
file a complaint about our privacy practices.
E. Effective
date of this Notice
A.
We Have A Legal Duty to Protect Health Information About You
We are required by law to protect the
privacy of health information about you and that can be identified with you,
which we call “protected health information,” or “PHI” for short. We must give you notice of our legal duties
and privacy practices concerning PHI:
§
We must protect PHI that we
have created or received about: your past,
present, or future health condition; health care we provide to you; or payment
for your health care.
§
We must notify you about how we
protect PHI about you.
§
We must explain how, when and
why we use and/or disclose PHI about you.
§
We may only use and/or disclose
PHI as we have described in this Notice.
This Notice describes the types of
uses and disclosures that we may make and gives you some examples. In addition, we may make other uses and
disclosures which occur as a byproduct of the permitted uses and disclosures
described in this Notice. If we
participate in an “organized health care arrangement” (defined in subsection
B.3 below), the providers participating in the “organized health care
arrangement” will share PHI with each other, as necessary to carry out
treatment, payment or health care operations (defined below) relating to the
“organized health care arrangement”.
We are required to follow the
procedures in this Notice. We reserve the right to change the terms of this
Notice and to make new notice provisions effective for all PHI that we maintain
by first:
§
Posting the revised notice in
our offices;
§
Making copies of the revised
notice available upon request (either at our offices or through the contact
person listed in this Notice); and
§
Posting the revised notice on
our website.
B.
We May Use
and Disclose PHI About You Without Your Authorization in the Following
Circumstances
1.
We may use
and disclose PHI about you to provide health care treatment to you.
We may use and disclose PHI about you to provide, coordinate
or manage your health care and related services. This may include communicating with other
health care providers regarding your treatment and coordinating and managing
your health care with others. For
example, we may use and disclose PHI about you when you need a prescription,
lab work, an x-ray, or other health care services. In addition, we may use and disclose PHI
about you when referring you to another health care provider.
EXAMPLE[3] [HOSPITAL EXAMPLE]: A doctor treating you for a broken leg may
need to know if you have diabetes because diabetes may slow the healing
process. In addition, the doctor may
need to tell the dietitian if you have diabetes so that we can arrange for
appropriate meals. Departments of the hospital
and/or physicians may also need to share PHI about you in order to coordinate
different services you may need, such as prescriptions, lab work and
x-rays. We may also disclose PHI about
you to people outside the hospital who may be involved in your medical care
after you leave the hospital, such as home health providers or others who may
provide services that are part of your care.
EXAMPLE [PHYSICIAN PRACTICE EXAMPLE]: Your doctor may share
medical information about you with another health care provider. For example, if you are referred to another
doctor, that doctor will need to know if you are allergic to any
medications. Similarly, your doctor may
share PHI about you with a pharmacy when calling in a prescription.
2.
We may use
and disclose PHI about you to obtain payment for services.
Generally, we may use and give your
medical information to others to bill and collect payment for the treatment and
services provided to you by us or by another provider. Before you receive scheduled services, we may
share information about these services with your health plan(s). Sharing information allows us to ask for
coverage under your plan or policy and for approval of payment before we
provide the services. We may also share
portions of medical information about you with the following:
§
Billing departments;
§
Collection departments or
agencies, or attorneys assisting us with collections;
§
Insurance companies, health
plans and their agents which provide you coverage;
§
Hospital departments that
review the care you received to check that it and the costs associated with it
were appropriate for your illness or injury; and
§
Consumer reporting agencies
(e.g., credit bureaus).
EXAMPLE: Let’s say
you have a broken leg. We may need to
give your health plan(s) information about your condition, supplies used (such
as plaster for your cast or crutches), and services you received (such as
x-rays or surgery). The information is given to our billing department and your
health plan so we can be paid or you can be reimbursed. We may also send the same information to our
hospital department which reviews our care of your illness or injury.
3.
We may use
and disclose PHI about you for health care operations.
We may use and disclose PHI in performing business
activities, which we call “health care operations”. These “health care operations” allow us to
improve the quality of care we provide and reduce health care costs. We may also disclose PHI for the “health care
operations” of any “organized health care arrangement” in which we
participate. An example of an “organized
health care arrangement” is the care provided by a hospital and the physicians
who see patients at the hospital. In
addition, we may disclose PHI about you for the “health care operations” of
other providers involved in your care to improve the quality, efficiency and
costs of their care or to evaluate and improve the performance of their
providers. Examples of the way we may
use or disclose PHI about you for “health care operations” include the
following:[4]
§
Reviewing and improving the quality, efficiency and
cost of care that we provide to you and our other patients. For example, we may use PHI about you to
develop ways to assist our health care providers and staff in deciding what
medical treatment should be provided to others.
§
Improving health care and lowering costs for groups
of people who have similar health problems and to help manage and coordinate
the care for these groups of people.
We may use PHI to identify groups of people with similar health problems
to give them information, for instance, about treatment alternatives, classes,
or new procedures.
§
Reviewing and evaluating the skills, qualifications,
and performance of health care providers taking care of you.
§
Providing training programs for students, trainees,
health care providers or non-health care professionals (for example, billing
clerks or assistants, etc.) to help them practice or improve their skills.
§
Cooperating with outside organizations that assess
the quality of the care we and others provide. These organizations might include government
agencies or accrediting bodies such as the Joint Commission on Accreditation of
Healthcare Organizations.
§
Cooperating with outside organizations that evaluate,
certify or license health care providers, staff or facilities in a particular
field or specialty. For example,
we may use or disclose PHI so that one of our nurses may become certified as
having expertise in a specific field of nursing, such as pediatric nursing.
§
Assisting various people who review our activities. For example, PHI may be seen by doctors
reviewing the services provided to you, and by accountants, lawyers, and others
who assist us in complying with applicable laws. [5]
§
Planning for our organization’s future operations,
and fundraising for the benefit of our organization.
§
Conducting business management and general
administrative activities related to our organization and the services it
provides.
§
Resolving grievances within our organization.
§
Reviewing activities and using or disclosing PHI in
the event that we sell our business, property or give control of our business
or property to someone else.
§
Complying with this Notice and with applicable laws.
4.
We may use and disclose PHI under other circumstances
without your authorization or an opportunity to agree or object.
 We may use and/or disclose PHI
about you for a number of circumstances in which you do not have to consent,
give authorization or otherwise have an opportunity to agree or object. Those circumstances include:
§
When the use and/or disclosure is required by law. For example, when a disclosure is required by
federal, state or local law or other judicial or administrative proceeding.
§
When the use and/or disclosure is necessary for
public health activities. For
example, we may disclose PHI about you if you have been exposed to a
communicable disease or may otherwise be at risk of contracting or spreading a
disease or condition.
§
When the disclosure relates to victims of abuse,
neglect or domestic violence.
§
When the use and/or disclosure is for health
oversight activities. For example,
we may disclose PHI about you to a state or federal health oversight agency
which is authorized by law to oversee our operations.
§
When the disclosure is for judicial and
administrative proceedings. For example,
we may disclose PHI about you in response to an order of a court or
administrative tribunal.
§
When the disclosure is for law enforcement purposes. For example, we may disclose PHI about you in
order to comply with laws that require the reporting of certain types of wounds
or other physical injuries.
§
When the use and/or disclosure relates to decedents. For example, we may disclose PHI about you to
a coroner or medical examiner for the purposes of identifying you should you
die.
§
When the use and/or disclosure relates to organ, eye
or tissue donation purposes.
§
When the use and/or disclosure relates to medical
research. Under certain
circumstances, we may disclose PHI about you for medical research.
§
When the use and/or disclosure is to avert a serious
threat to health or safety. For example,
we may disclose PHI about you to prevent or lessen a serious and imminent
threat to the health or safety of a person or the public.
§
When the use and/or disclosure relates to specialized
government functions. For example,
we may disclose PHI about you if it relates to military and veterans’
activities, national security and intelligence activities, protective services
for the President, and medical suitability or determinations of the Department
of State.
§
When the use and/or disclosure relates to
correctional institutions and in other law enforcement custodial situations. For example, in certain circumstances, we may
disclose PHI about you to a correctional institution having lawful custody of
you.
5.
You can
object to certain uses and disclosures.
Unless you object, we may use or
disclose PHI about you in the following circumstances:
§
We may share your name, your room number, and your
general condition (critical, serious, etc.) in our patient listing with clergy
and with people who ask for you by name.
We also may share your religious affiliation with clergy.
§
We may share with a family member, relative, friend
or other person identified by you, PHI directly related to that person’s
involvement in your care or payment for your care. We may share with a family member, personal
representative or other person responsible for your care PHI necessary to
notify such individuals of your location, general condition or death.
§
We may share with a public or private agency (for
example, American Red Cross) PHI about you for disaster relief purposes. Even if you object, we may still share the
PHI about you, if necessary for the emergency circumstances.
If you would like to object to our use or disclosure of PHI
about you in the above circumstances, please call or write to our contact
person listed on the cover page of this Notice.
6.
We may
contact you to provide appointment reminders.
We may use and/or disclose PHI to contact you to provide a
reminder to you about an appointment you have for treatment or medical care.
7.
We may contact you with information
about treatment, services, products or health care providers.
We may use and/or disclose PHI to manage or coordinate your
healthcare. This may include telling you
about treatments, services, products and/or other healthcare providers. We may also use and/or disclose PHI to give
you gifts of a small value.
EXAMPLE: If you are diagnosed with
diabetes, we may tell you about nutritional and other counseling services that
may be of interest to you.
8. We may contact you for fundraising
activities.
We may use and/or disclose PHI about you, including
disclosure to a foundation, to contact you to raise money for our facility and
its operations. We would only release
contact information and the dates you received treatment or services at our
facility. If you do not want to be
contacted in this way, you must notify in writing our contact person listed on
the cover page of this Notice.
** ANY
OTHER USE OR DISCLOSURE OF PHI
ABOUT YOU
REQUIRES YOUR WRITTEN AUTHORIZATION **
Under any circumstances other than those
listed above, we will ask for your written authorization before we use or
disclose PHI about you. If you sign a
written authorization allowing us to disclose PHI about you in a specific
situation, you can later cancel your authorization in writing by contacting Carlos
A. Vargas, MD at New
Mountain Medicine, P.A.
If you cancel your authorization in writing, we will not disclose PHI about you
after we receive your cancellation, except for disclosures which were being
processed before we received your cancellation.[6]
C.
You Have
Several Rights Regarding PHI About You [7]
1.
You have
the right to request restrictions on uses and disclosures of PHI about you.[8]
You have the right to request
that we restrict the use and disclosure of PHI about you. We are not required to agree to your
requested restrictions. However, even if
we agree to your request, in certain situations your restrictions may not be
followed. These situations include
emergency treatment, disclosures to the Secretary of the Department of Health
and Human Services, and uses and disclosures described in subsection B.4 of the
previous section of this Notice. You may
request a restriction by contacting Carlos A. Vargas, MD at New Mountain
Medicine, P.A.
2.
You have the right to request different ways
to communicate with you.
You have the right to request
how and where we contact you about PHI.
For example, you may request that we contact you at your work address or
phone number or by email. Your request
must be in writing. We must accommodate
reasonable requests, but, when appropriate, may condition that accommodation on
your providing us with information regarding how payment, if any, will be
handled and your specification of an alternative address or other method of
contact. You may request alternative
communications by contacting Carlos A. Vargas, MD at New Mountain
Medicine, P.A.
3.
You have the right to see and copy PHI about
you.
You have the right to request to
see and receive a copy of PHI contained in clinical, billing and other records
used to make decisions about you. Your
request must be in writing. We may
charge you related fees. Instead of providing you with a full copy of the PHI,
we may give you a summary or explanation of the PHI about you, if you agree in
advance to the form and cost of the summary or explanation. There are certain
situations in which we are not required to comply with your request. Under
these circumstances, we will respond to you in writing, stating why we will not
grant your request and describing any rights you may have to request a review
of our denial. You may request to see
and receive a copy of PHI by contacting Carlos A. Vargas, MD at New Mountain
Medicine, P.A.
4.
You have the right to request amendment of
PHI about you.
You have the right to request
that we make amendments to clinical, billing and other records used to make
decisions about you. Your request must
be in writing and must explain your reason(s) for the amendment. We may deny your request if: 1) the
information was not created by us (unless you prove the creator of the
information is no longer available to amend the record); 2) the information is
not part of the records used to make decisions about you; 3) we believe the
information is correct and complete; or 4) you would not have the right to see
and copy the record as described in paragraph 3 above. We will tell you in
writing the reasons for the denial and describe your rights to give us a
written statement disagreeing with the denial. If we accept your request to
amend the information, we will make reasonable efforts to inform others of the
amendment, including persons you name who have received PHI about you and who
need the amendment. You may request an
amendment of PHI about you by contacting Carlos A. Vargas, MD at New Mountain
Medicine, P.A.
5.
You have the right to a listing of
disclosures we have made.
If you ask our contact person in
writing, you have the right to receive a written list of certain of our
disclosures of PHI about you. You may
ask for disclosures made up to six (6) years before your request (not including
disclosures made prior to April 14, 2003).
We are required to provide a listing of all disclosures except the
following:
§
For your treatment
§
For billing and collection of payment for your
treatment
§
For health care operations
§
Made to or requested by you, or that you authorized
§
Occurring as a byproduct of permitted uses and
disclosures
§
Made to individuals involved in your care, for
directory or notification purposes, or for other purposes described in
subsection B.5 above
§
Allowed by law when the use and/or disclosure relates
to certain specialized government functions or relates to correctional
institutions and in other law enforcement custodial situations (please see
subsection B.4 above) and
§
As part of a limited set of information which does
not contain certain information which would identify you.
The list will include the date of
the disclosure, the name (and address, if available) of the person or
organization receiving the information, a brief description of the information
disclosed, and the purpose of the disclosure.
If, under permitted circumstances, PHI about you has been disclosed for
certain types of research projects, the list may include different types of
information.
If you request a list of
disclosures more than once in 12 months, we can charge you a reasonable
fee. You may request a listing of
disclosures by contacting Carlos A. Vargas, MD at New Mountain
Medicine, P.A.
6.
You have the right to a copy of this Notice.
You have the right to request a paper copy of this Notice at
any time by contacting Carlos A.
Vargas, MD at New
Mountain Medicine, P.A.
We will provide a copy of this Notice no later than the date you first
receive service from us (except for emergency services, and then we will
provide the Notice to you as soon as possible).
D.
You May
File A Complaint About Our Privacy Practices
If you think we have violated your
privacy rights, or you want to complain to us about our privacy practices, you
can contact the person listed below:
Carlos A. Vargas, MD at New Mountain Medicine, P.A. (1573 Highlands Road, Franklin, NC 28734); Phone: (828) 349-4747; email:
vargasca1@verizon.net.
You may also send a written complaint to
the United States Secretary of the Department of Health and Human Services.
If you file a complaint, we will not take
any action against you or change our treatment of you in any way.
E.
Effective
Date of this Notice
This Notice of Privacy Practices is effective on January 01,
2006.
APPENDIX A
NORTH CAROLINA STATE LAW AND OTHER ISSUES
This Appendix provides a general
discussion of some North Carolina
state law issues that pertain to the Notice of Privacy Practices. In compiling this Appendix, we have
identified some of the statutory provisions that generally apply to a variety
of health care organizations and individual practitioners, but have not addressed
provisions related to specialized functions or particular types of providers,
such as nursing homes, pharmacies, and home health agencies, with the exception
of mental health and substance abuse functions. Therefore, this Appendix should not be
considered or used as an exhaustive review of pertinent North Carolina law.
This Appendix also is not intended
to offer legal advice or guidance about whether any particular provision of
North Carolina State law is more stringent than the HIPAA Privacy Rule in
regulating the uses and disclosures of Protected Health Information; or whether
any provision of North Carolina law affords greater rights to patients than
those recognized under the HIPAA Privacy Rule.
In conducting a detailed analysis
of the impact and interaction of North
Carolina State
law requirements with the HIPAA Privacy Rule provisions, each health care
organization or individual practitioner should refer to, and obtain legal
guidance about, the following sources of pertinent State law provisions:
·
The North
Carolina state statutes and the pertinent
administrative rules governing the operation of various health care facilities
or organizations that are subject to licensing by the North Carolina Department
of Health and Human Services;
·
The North Carolina state statutes and the pertinent
administrative rules governing the conduct of individual licensed health care
professionals who are subject to licensing by the various health professional
licensing boards in North Carolina; and
·
Where applicable, ethical standards that have been
adopted by a North Carolina
state association of health care providers or by a national health care
provider association or organization, particularly where these standards of
conduct are incorporated by reference in the North Carolina General Statutes or
the North Carolina Administrative Code.
In summary, it is critical that
each health care organization or individual provider assess pertinent legal
requirements and, with the guidance of legal counsel and other professional
advisors, incorporate those provisions of North Carolina State law that are
relevant into the Notice of Privacy Practices.
With this important preface, we now turn to a review of some of the
provisions of the North Carolina General Statutes that have more general
applicability. We are including some
suggested insertions for the Notice of Privacy Practices which addresses the
state law provisions referenced below.
These insertions are not intended to be complete or applicable to every
covered entity, and all entities that use them should modify and integrate them
into your Notice of Privacy Practices as necessary.
GS 8-53 et seq.
Communications between certain health care professionals and patients
This statute establishes the physician-patient privilege (GS
8-53). North Carolina statutes also
create a testimonial privilege for communications between a psychologist and
patient (GS 8-53.3), a social worker engaged in private practice and client (GS
8-53.7), a licensed professional counselor and client (GS 8-53.8), and a marital
and family therapist and client (GS 8-53.5). Although these provisions apply to
the litigation context, some believe that they may create a broader duty of
confidentiality that obligates these professionals not to disclose client
communications without client authorization or a court order requiring
disclosure. A suggested provision
relating only to GS 8-53 (physician-patient privilege) is:
North
Carolina law protects not only your rights
of privacy, but also your relationship with your physician. State law generally restricts our disclosure
(and that of your physician) of your health information in most instances.
However, we may disclose health information about you under State law with your
permission, pursuant to a court order, or as otherwise may be permitted or
required by law. In instances in which
your permission is required, we will request that you sign a consent form
(which is different than an authorization that is mentioned in other parts of
this Notice).
A suggested provision for mental health professionals is:
These provisions allow an unemancipated minor to provide
consent, in lieu of a parent or guardian, for the prevention, diagnosis and
treatment of certain health care services, including: “(i) venereal disease and
other diseases reportable under G.S. 130A-135, (ii) pregnancy, (iii) abuse of
controlled substances or alcohol, and (iv) emotional disturbance.” When these services are provided pursuant to
the consent of the minor, the minor has any corresponding rights provided by
applicable laws regarding the information relating to these services. For example, when an authorization is
required for release of information, the minor would sign the authorization,
rather than the parent, under these circumstances. Section 90-21.5 does not
include consent for an abortion, which still requires the consent of the
parent, guardian or other listed individual except under certain circumstances
outlined in G.S. § 90-21.7. A suggested
provision regarding these sections is:
GS § 90-109.1 Treatment
for Drug Dependence
This statute addresses treatment and rehabilitation for drug
dependence and gives individuals the right to request such services from a
practitioner (defined under the North
Carolina statute).
Under the statute, the practitioner and employees of the practitioner
“shall not disclose the name of such person to any law-enforcement officer or
agency…”. The name of the individual is
not admissible in court unless authorized by the individual. Any referral of such person to another
practitioner is subject to the same requirement of confidentiality. A suggested
provision regarding this section is:
If
you request treatment and rehabilitation for drug dependence from one of our
practitioners, your request will be treated as confidential. We will not disclose your name to any police
officer or other law-enforcement officer unless you consent to our sharing of
it. Even if we refer you to another
person for treatment and rehabilitation, we will continue to keep your name
confidential.
GS § 122C Mental Health, Developmental Disabilities, and Substance Abuse Facilities
North
Carolina law restricts the disclosure of
information obtained by facilities whose primary purpose is to provide mental
health, developmental disabilities, or substance abuse services (GS 122C-52
through 122C-56). You should review the definition of “facility” at GS 122C-3
to determine if your facility is subject to the confidentiality provisions of
GS 122C.
While HIPAA, in some instances, provides greater privacy
protections than GS 122C, there are many provisions of GS 122C that appear to
be “more stringent” than the HIPAA privacy rule. Certain provisions of GS 122C require written
consent of the patient before disclosing protected health information related
to mental health services. In addition,
GS 122C requires a facility to give clients access to information in situations
that are not required under HIPAA. The confidentiality provisions of GS 122C
are summarized below, but an identification and preemption analysis of each
“more stringent” provision of GS 122C is beyond the scope of this
Appendix.
Restrictions on use and disclosure. Any
information acquired in attending or treating a client of a facility is
confidential and must not be disclosed by the facility or any individual having
access to the information except as authorized by GS 122C-52 through 122C-56.
Confidential information may be disclosed:
·
With the written consent of the client or his or her
legally responsible person;
·
Within a facility among employees, students,
consultants, or volunteers when needed to carry out their responsibilities in
serving the client;
·
To other mental health, developmental disabilities,
and substance abuse facilities when necessary to coordinate appropriate and
effective care, treatment, or habilitation of the client and when failure to
share the information would be detrimental to the client;
·
When in the opinion of a responsible professional
there is an imminent danger to the health or safety of the client or other
individual or there is the likelihood of the commission of a felony or violent
misdemeanor;
·
When a court orders disclosure;
·
For purposes of filing a petition for involuntary
commitment, if disclosure is in the best interest of the client, and to courts
and attorneys involved in the cases of clients facing court hearings regarding
involuntary commitment or voluntary admission;
·
For purposes of filing a petition for the
adjudication of incompetency of a client, if disclosure is in the best interest
of the client;
·
To a client advocate providing monitoring and
advocacy services to clients of the facility;
·
To an attorney who represents the facility or an
employee of the facility;
·
To researchers if there is a justifiable documented
need for the information;
·
To the county department of social services when
there is reason to suspect that a child is being abused or neglected, is
dependent, or has died as a result of maltreatment;
·
To the county department of social services when
there is reason to believe that a disabled adult is being abused, neglected, or
exploited;
·
To report information about individuals with known or
suspected communicable diseases or conditions to the local health department;
·
To notify the local health director when there is
cause to suspect a patient infected with HIV is not following appropriate
safety control measures;
·
To the client’s next of kin, upon request, if the
next of kin plays a legitimate role in the therapeutic services provided to the
client; otherwise only the fact of admission to or discharge from a facility
may be disclosed to the next of kin;
·
To a health care provider who is providing emergency
medical services to the client;
·
To a physician or psychologist who referred the
client to a facility;
·
For other limited treatment purposes specified in the
statute;
·
To the Secretary of the N.C. Department of Health and
Human Services or other licensing agencies during the course of an inspection
or investigation of the facility;
·
To a “provider of support services,” which is similar
to a “business associate” under HIPAA.
Generally, entities and persons that receive
confidential information from facilities pursuant to the foregoing provisions
are prohibited from re-disclosing the information except as permitted or
required by law.
Patient access. Upon request, facilities
providing mental health, developmental disabilities, and substance abuse
services must give clients or their legally responsible persons access to
confidential information in their client record. However, the facility may deny access to
information that would be injurious to the client’s physical or mental well
being as determined by the attending physician or facility director. In this
circumstance, the client may request that the information be sent to a
physician or psychologist of the client’s choice.
A suggested insertion for the Notice of Privacy Practices
for facilities providing mental health, developmental disabilities or substance
abuse services is:
North Carolina law generally requires
that we obtain your written consent before we may disclose health information
related to your mental health, developmental disabilities, or substance abuse
services. There are some exceptions to
this requirement. We can disclose this
health information to members of our workforce, our professional advisors, and
to agencies or individuals that oversee our operations or that help us carry
out our responsibilities in serving you.
We also may disclose information to the following people: (i) a health
care provider who is providing emergency medical services to you and (ii) to
other mental health, developmental disabilities, and substance abuse facilities
or professionals when necessary to coordinate your care or treatment. If we determine that there is an imminent
threat to your health or safety, or the health or safety of someone else, we may
disclose information about you to prevent or lessen the threat. We also will disclose information about you
if the law requires us to do so, for example, when a court orders disclosure,
when we suspect abuse or neglect of a child or disabled adult, and when one of
our physicians believes that a client has a communicable disease or is infected
with HIV and is not following safety measures.
If we believe it is in your best interests, we may disclose information
about you for a guardianship or involuntary commitment proceeding that involves
you. When you are admitted to, or
discharged from, a mental health, developmental disabilities, or substance
abuse facility, we may disclose that fact to your next of kin if we believe the
disclosure is in your best interest, but only if you do not object. If you have
a next of kin who is substantially involved in your care, upon his or her
request we are required to provide this kin with information relating to your
admission or discharge from a facility, including the identity of the facility,
any decision on your part to leave a facility against medical advice, and
referrals and appointment information for treatment after discharge after we
notify you that this information was requested.
For health care providers that provide only (or primarily)
mental health, developmental disabilities, or substance abuse services, you may
consider amending the notice throughout—topic by topic and section by
section—to present a set of privacy practices that reflects a synthesis of HIPAA
and applicable state law. Where a use or disclosure permitted by HIPAA is
prohibited or materially limited by GS 122C, the description of each specific
type of use or disclosure in the notice must be modified to reflect the
applicable provision of state law.
Federal
Provisions regarding Substance Abuse Programs
Federal law restricts the use and disclosure of patient
information received or acquired by a federally assisted alcohol or drug abuse
program. See 42 U.S.C. 290dd-2 and
implementing regulations at 42 C.F.R. Part 2. The federal law applies to any
person or organization that, in whole or in part, holds itself out as providing
and does provide alcohol or drug abuse diagnosis, treatment, or referral for
treatment with direct or indirect federal financial assistance.
Restrictions on disclosure. Generally, alcohol or drug abuse information
obtained by an alcohol or drug abuse program for the purpose of treating or
diagnosing alcohol or drug abuse, or for making a referral for treatment, must
not be disclosed without the patient’s written authorization. The prohibition
against disclosure applies only to information that would identify a substance
abuse patient, directly or indirectly, as an alcohol or drug abuser or a
recipient of alcohol or drug services.
In addition to restricting disclosure, the federal regulations restrict
the disclosure of information to initiate or substantiate any criminal charges
against a patient or to conduct a criminal investigation of a patient. Written
authorization for the disclosure of records relating to a minor always requires
the signature of the minor and, in some circumstances, requires both the
signature of the minor and the minor’s legally responsible person.
Patient information may be disclosed without the patient’s
authorization:
·
Within a program for activities related to the
provision of substance abuse diagnosis, treatment, or referral for treatment;
·
To respond to a medical emergency;
·
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