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Notice of Privacy Practices

Notice of Privacy Practices

Effective April 14, 2003

Hale ‘Ōpio Kaua‘i, Inc.

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS CAREFULLY.

Understanding Your Child’s Health Record/Information

Hale ‘Ōpio Kaua‘i, Inc. must keep information about your child’s health care confidential. Information regarding your health care is protected by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). This Notice describes how Hale ‘Ōpio Kaua‘i, Inc. will use and disclose your health information generated by this Agency, whether recorded in your medical record, invoices, payment forms, videotapes or other ways. Similarly, these policies apply to the health information gathered from other Organizations by any health care professional, employee or volunteer who participates in your care. This information serves as a:

  • Basis for planning your child’s care and treatment;

  • Means of communication with other health professionals involved in your child’s care;

  • Legal document describing the care you received;

  • Means by which you or a third party payer can verify that services billed were actually provided;

  • A tool in educating health care professionals;

  • A source of data for facility planning and

  • A tool with which your treatment provider can assess and continually work to improve the care they render and the outcomes they achieve.

Understanding what is in your record and how your health information is used helps you to:

  • Ensure its accuracy

  • Better understand who, what, when, where and why others may access your child’s health information

  • Make more informed decisions when authorizing information which is given to others

Your Child’s Health Information Rights:

Although your child’s record is the physical property of Hale ‘Ōpio Kaua‘i, Inc. and the contracting state agency, the information belongs to you. Acting on behalf of your child, you have the right to:

  • Request restrictions on the use and disclosure of your child’s health information;
  • Authorize disclosures of your child’s health information;

  • Receive confidential communication of your child’s protected health information;

  • Inspect and copy your child’s health record;

  • Request amendment of your child’s health record;

  • Be informed of any disclosures of your child’s health information;

  • Request communications of your child’s health information by alternative means or at alternative locations and

  • Withdraw, in writing, regarding disclosures of your child’s health information at any time.

Hale ‘Ōpio Kaua‘i, Inc. Responsibilities:

Hale ‘Ōpio Kaua‘i, Inc. is required to:

  • Ensure the privacy of your child’s health information;

  • Notify you about our legal duties and privacy practices regarding information we collect and maintain about your child;

  • Honor the terms of this notice and

  • Accommodate any reasonable requests you may have to communicate health information by alternative means or at alternative locations.

Hale ‘Ōpio Kaua‘i, Inc. reserves the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our practices change, we will mail a revised notice within 60 days to your address on record.

Hale ‘Ōpio Kaua‘i, Inc. will not use of disclose your child’s health information without your permission except as described in this notice or required by law.

Examples of Disclosures for Treatment, Payment and Health Operations:

Your child’s health information will only be used when it is necessary for Hale ‘Ōpio Kaua‘i, Inc. to carry out the functions of our tasks. If your child’s health information needs to be shared with other agencies or providers Hale ‘Ōpio Kaua‘i, Inc. will require those agencies or providers to protect this health information. Only the minimum necessary amount of your child’s health information will be released in order for that entity to carry out the functions of their tasks. Hale ‘Ōpio Kaua‘i, Inc. will use and share your child’s health information for:

Treatment. For example: Information obtained by your child’s therapist, youth worker, or other member of his/her treatment team will be recorded in his/her record and used to determine the most appropriate course of care for your child. Hale ‘Ōpio Kaua‘i, Inc. will document in your child’s record his/her expectations of your child and the members of your treatment team. Members of your child’s treatment team will then record the actions they took and their observations. In that way we will know if your child is attaining the goals developed by the team.

Payment. For example: A bill may be sent to a state agency or a third party payer. The information on or accompanying the bill may include information that identifies your child, as well as your child’s diagnosis, procedures, and services that were provided by Hale ‘Ōpio Kaua‘i, Inc.

Health Care Operations. For example: A member of the fiscal staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your child’s health record to assess the care and outcomes in your child’s case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the services we provide.

Other Uses and Disclosures Not Requiring Consent:

  • Business associates, service providers contracted by Hale ‘Ōpio Kaua‘i, Inc.;

  • When required by law;

  • For public health purposes;

  • To disclose information about victims of abuse, neglect, or domestic violence;

  • For health oversight activities, such as audits or civil, administrative or criminal investigations;

  • For judicial or administrative proceedings;

  • For law enforcement purposes;

  • To avert a serious threat to health or safety; and

  • For specialized governmental functions, such as military, national security, criminal corrections, or public benefit purposes.

For More Information or to Report a Problem:

If you have questions and would like additional information, you may call the Hale ‘Ōpio Kaua‘i, Inc. Privacy Contact at 808-245-2873. Or you may write to: Hale ‘Ōpio Kaua‘i, Inc. Privacy Contact, 2959 Umi St., Lihue HI 96766.

If you believe your privacy rights have been violated, you can file a complaint with the Secretary of Health and Human Services at:

Office of Civil Rights

Medical Privacy, Complaint Division

U.S. Department of Health and Human Services

200 Independence Avenue, S.W., HHH Bldg., Room 509H

Washington, DC 20201

Phone: 866-627-7748

TTY: 866-788-4989

E-mail: www.hhs.gov/ocr

There will be no retaliation for filing a complaint.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a workforce member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more consumers, workers or the public.

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