NOTICE OF PRIVACY PRACTICES
Effective
June 1, 2005
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.
EAP believes
in confidentiality and privacy to the fullest extent allowed by applicable law.
Protecting health information is very important to us and we therefore want you
to have a solid understanding of how we use and safeguard your information. If
this Notice leaves you with any questions or concerns, please call us at
530-891-5571.
Protected
Health Information (PHI) is individually identifiable information (including
demographic information) relating to your health, to the health care provided
to you or to payment for health care. This Notice of Privacy Practice describes
how EAP may use and disclose your PHI in order to carry out treatment, payment
and health care operations, and for other purposes permitted or required by
law. It also describes your rights to access and control your PHI.
OUR DUTIES
EAP is
required by law to maintain the privacy of your PHI and to abide by the terms
of this Notice. We may modify our policies at any time and any material change
will be paired with a modification of the terms in this Notice. The new policy
and Notice will be effective for all PHI we create, receive or maintain,
including any received or created prior to the date of such change. Upon
request, we will provide you with any revised Notice or you can review the
Notice by accessing our website at www.eap4u.com.
USE AND DISCLOSURE OF PROTECTED
HEALTH INFORMATION
EAP uses PHI
about you for treatment, payment, and operational purposes. We do not require
authorization to use your PHI for these purposes. We may also use or disclose
your PHI without your authorization for several other reasons. Subject to certain
requirements, we may disclose health information without your authorization for
public health reasons, for auditing purposes, and for emergency situations.
Treatment
EAP may use
and disclose your PHI (public health information) to assist your health care
providers in your diagnosis and treatment. For example, we may disclose your
PHI to providers to facilitate appropriate referrals.
Payment
EAP may use
and disclose your PHI in order to pay for the services and items you may
receive. For example, we may contact your health provider to certify that you
received treatment (and for what range of benefits), and we may request details
regarding your treatment to determine if your benefits will cover, or pay for,
your treatment.
Health Care Operations
EAP may use
and disclose your PHI to perform health care operations. For example, we may
use your PHI to provide pre-certification to health providers or to obtain
pre-certification from a third party on your behalf. In addition to the
above-mentioned uses of your PHI related to treatment, payment, and health care
operations, EAP may also use your PHI for the following purposes:
Appointment Reminders
EAP has the
right to use and disclose your PHI to contact you and remind you of
appointments. Health Related Benefits and Services: EAP may use and disclose
PHI to inform you of health related benefits or services that may be of
interest to you.
Release of Information to Family
and Friends
EAP may
release your PHI to a friend or family member identified by you that is helping
you pay for your health care, who participates in health services with you, or
who assists in taking care of you.
Disclosures Required by Law
EAP will use
and disclose your PHI when we are required to do so by federal, state, or local
law. In addition to the above described uses and disclosures of your PHI, EAP
may also use and disclose your PHI under the following unique circumstances:
Public Health Risks
EAP may
disclose your PHI to public health authorities that are authorized by law to
collect information for the purpose of: Reporting child or elder abuse or
neglect, Notifying appropriate government agencies and authorities regarding
the potential abuse or neglect of an adult patient (including domestic
violence); however, we will only disclose this information if the client agrees
or we are required or authorized by law to disclose this information,
Preventing or controlling disease, injury, or disability, Notifying a person
regarding potential exposure to a communicable disease, Notifying a person
regarding the potential risk for spreading or contracting a disease or
condition; and Notifying your employer under limited circumstances related to
safety or security of the workplace.
Serious Threats to Health or
Safety
EAP may use
and disclose your PHI when necessary to reduce or prevent a serious threat to
your health and safety or the health and safety of another individual or the public.
Under these circumstances, we will only make disclosures to a person or
organization as mandated by law or that we reasonably perceive to be able to
help prevent the threat.
Law Enforcement
EAP may
disclose PHI if asked to do so by a law enforcement official: regarding a crime
victim in certain situations, if we are unable to obtain the client’s
agreement, concerning a death we believe might have resulted from criminal
conduct, regarding criminal conduct at our offices, in response to a warrant,
summons, court order, subpoena, or similar legal process, to identify and/or
locate a suspect, material witness, fugitive, or missing person; and in an
emergency to report a crime (including the location or victim(s) of the crime,
or the description, identity, or location of the perpetrator).
Health Oversight Activities
EAP may
disclose your PHI to a health oversight agency for activities authorized by
law. Oversight activities can include, for example, investigations,
inspections, audits, surveys, licensure, and disciplinary actions; civil,
administrative, and criminal procedures or actions; or other activities
necessary for the government to monitor government programs, compliance with
civil rights laws, and the heath care system in general.
Lawsuit and Similar Proceedings
EAP may use
and disclose your PHI in response to a court or administrative order. We may
also disclose your PHI in response to a discovery request, subpoena, or other
lawful process but only if we have made an effort to inform you of the request
or to obtain an order protecting the information the party has requested.
Military and Veterans’
Activities
EAP may use
and disclose your PHI if you are a member of the United States or foreign
military forces (including veterans) and if required by the appropriate
military command authorities.
National Security
EAP may use
and disclose your PHI to federal officials for intelligence and national
security activities authorized by law. We also may disclose your PHI to federal
officials in order to protect the President, other officials, or foreign heads
of state, or to conduct investigations.
Correctional Institutions and
Inmates
EAP may
disclose your PHI to correctional institutions or law enforcement officials if
you are an inmate or under the custody of a law enforcement official.
Disclosure for these purposes would be necessary: (a) for the institution to
provide health care services to you, (b) for the safety and security of the
institution and/or, (c) to protect your health and safety or the health and
safety of other individuals.
Workers’ Compensation
EAP may
release your PHI for workers’ compensation and similar programs such as Dept.
of Transportation, Dept. of Defense, or Nuclear Regulatory Commission.
YOUR RIGHTS
The Right to Inspect and Copy
You have the
right to inspect and obtain a copy of your PHI that we maintain and have in our
possession, including health records (if we maintain any) and billing records,
but not including psychotherapy notes. If you request copies, we may charge you
a fee for the costs of copying, mailing, labor, and supplies associated with
your request. To inspect and copy your PHI, you must submit your request in
writing. Under certain circumstances, we may deny your request to inspect and
copy your PHI. If you are denied access to health information, you have a right
to have that determination reviewed. EAP’s Privacy Officer will review your
request and the denial. The Privacy Officer will not be the person who denied
your request. EAP promises to comply with the outcome of the review.
The Right to Amend Your PHI
If you feel
that any PHI EAP has about you is not correct or is incomplete; you may ask us
to amend the information. You have the right to request an amendment for us as
long as the information is kept by EAP. To request an amendment, your request
must be in writing. EAP reserves the right to deny your request for an
amendment if it is not in writing or does not include a reason to support the
request. In addition, we may deny your request if you ask us to amend
information that: was not created by EAP, unless the person or entity that
created the information is no longer available to make the amendment, is not
part of the health information kept by or for EAP, is not part of the
information which you would be permitted to inspect and copy; or is accurate
and complete.
The Right to an Accounting of
Disclosures
An
accounting of disclosures is a list of the disclosures we have made, if any, of
your PHI. You have the right to request an accounting of disclosures. This
right applies to disclosures for purposes other than those made to carry out
treatment, payment, and health care operations as described in this Notice. It
excludes disclosures made to you, or those made for notification purposes. Your
request must be in writing and state a period that cannot be longer than six
years and is not applicable to dates before June 1, 2005. Your request should
indicate in what form you want the list (e.g. paper, electronically). The first
response is free but we may charge you for the cost of providing an additional
list within 12 months. We will notify you of the costs involved and you may
choose to withdraw or modify your request at that time before you incur any
costs.
The Right to Request
Communications of PHI by Alternative Means or Alternative Locations
You have the
right to request that EAP communicate with you about your health and related
issues in a particular manner or at a certain location. For example, you may
ask that we contact you at work rather than at home. We will accommodate all
reasonable requests.
The Right to Request
Restrictions
You have the
right to request a restriction or limitation on the PHI we use or disclose
about you for treatment, payment, or health care operations as described in
this Notice. You also have the right to request a limit on the health
information we disclose about you to someone who is involved in your care or
the payment for your care (like a family member or friend), or for notification
purposes as described in this Notice. EAP is not required to agree to your
request. However, if we do agree, we will comply with your request until we
receive notice from you that you no longer want the restriction to apply
(except as required by law or in emergency situations). Any requests for a restriction
on our use and disclosure of your PHI must be in writing. Your request must
describe in a clear and concise manner: (a) the information you wish
restricted, (b) whether you are requesting to limit EAP’s use, disclosure, or
both, and (c) to whom you want the limits to apply.
The Right to Provide an
Authorization for Other Use and Disclosures
EAP will
obtain your written authorization for uses and disclosures that are not
identified by this Notice or permitted by applicable law. Any authorization you
provide to us regarding the use and disclosure of your PHI may be revoked at
any time in writing. After you revoke your authorization, we will no longer use
or disclose your PHI for the purpose described in the authorization, except to
the extent we have taken action in reliance upon your authorization before we
received your written revocation.
The Right to Obtain a Paper Copy
of This Notice
Upon
request, you have a right to a paper copy of this Notice, even if you have
agreed to accept this Notice electronically.
Rights of Clients to File
Complaints
Clients have
a right to submit a complaint if they believe that EAP has improperly used or
disclosed their protected information, or if they have concerns about the
privacy policies of EAP or concerns about EAP’s compliance with such policies.
Complaints may be filed with EAP Compliance Officer by calling 530-891-5571 in
Chico CA, by emailing us or by writing to EAP, 1068 East Ave., Suite A-1,
Chico, CA 95926, and Attention: Compliance Officer. Complaints may also be
filed with the US Department of Health and Human Services. For the address of
the appropriate regional office of DHHS, please contact the Compliance Officer.
EAP cannot and will not retaliate against you for filing a complaint with
either the Compliance Officer or DHHS.
How to Contact Us
If you have
any questions about this Notice or you want to submit a written request to EAP
as required in any of the previous sections of this Notice, please call calling
530-891-5571 in Chico CA, by emailing us or by writing to EAP, 1068 East Ave.,
Suite A-1, Chico, CA 95926, and Attention: Compliance Officer.
