Privacy Policy

NOTICE OF PRIVACY PRACTICES GREEN COUNTRY BEHAVIORAL HEALTH SERVICES

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 applies to

all of Green Country Behavioral Health facilities. A copy of this may be found

in the Administrative Office of each GCBHS facility. If you have any questions

about this notice, please contact the Privacy Officer at 918-682-8407.

WHO WILL FOLLOW

THIS NOTICE

This notice describes our organization’s practices and that of:

· Any health care professional authorized to enter information into your

medical record.

· All departments and units of GCBHS.

· All employees, staff and other GCBHS personnel, including physicians,

psychologists, and therapists who are independent contractors of GCBHS.

· GCBHS, Inc. includes community mental health clinics and stabilization center

services. All these entities, sites, and locations shall follow the terms of this

notice and may share medical information with each other for treatment, payment

or health care operation purposes described in this notice.

OUR PLEDGE

REGARDING MEDICAL INFORMATION

We understand that medical information about you and

your health is personal and we are committed to protecting your medical

information. We create a record of the care and services you receive at GCBHS.

We need this record to provide you with quality care and to comply with certain

legal requirements. This notice applies to all of the records of your care

generated by GCBHS.

This notice will tell you

about the ways in which we may use and disclose medical information about you.

We also describe your rights and certain obligations we have regarding the use

and disclosure of medical information.

We are required by law to:

· make sure that medical information that identifies you is kept private;

· give you notice of our legal duties and privacy practices with respect to

medical information about you; and

· follow the terms of the notice that is currently in effect.

*Medical information

includes all protected health information: medical, mental health and substance

abuse.

HOW WE MAY USE AND

DISCLOSE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that

we may use and disclose medical information without obtaining your

authorization in advance. For each category of uses or disclosures we will

explain what we mean and try to give an example. Not every use of disclosure in

a category will be listed. However, all of the ways we are permitted to use and

disclose information will fall within one of the categories.

Routine Uses

· For Treatment. We may

use medical information about you to provide you with medical treatment or

services. We may disclose medical information about you to doctors, nurses,

clinicians or other GCBHS personnel who are involved in taking care of you at

GCBHS. For example, a doctor prescribing medicine for you would need to know

other medications that you are taking and the reason for taking these medicines

to help prevent any medication interaction problems. Different areas of GCBHS

also may share medical information about you in order to coordinate the

different things you need, such as lab work, prescriptions and other testing.

This would also include the sharing of information among students of a

professional training program that GCBHS may sponsor. Information may also be

shared for purposes of treatment and follow-up with the Department of Mental

Health and Substance Abuse and their contractors if the client’s services are

being paid for by DMHSAS.

· For Payment. We may use

and disclose medical information about you so that the treatment and services

you receive at the GCBHS may be billed and payment may be collected from you,

an insurance company or a third party. We may disclose medical information to

your health plan, insurance company, HMO, or their utilization review

contractor to obtain prior approval or to determine whether your plan will

cover a particular treatment.

· For Healthcare

Operations. We may use and disclose medical information about you for

healthcare operations. These uses and disclosures are necessary to run GCBHS

and make sure that all of our clients receive quality care. For example, we may

use medical information to review our treatment and services and to evaluate

the performance of our staff in caring for you. We may also combine medical

information about many GCBHS clients to decide what additional services GCBHS

should offer, what services are not needed, and whether certain new treatments

are effective. We may also disclose information to doctors, nurses, clinicians

and other GCBHS personnel for review and learning purposes. We may also combine

the medical information we have with medical information from other healthcare

organizations to compare how we are doing and see whether we can make

improvements in the care and services we offer. We will remove information that

identifies you from this set of medical information so others may use it to

study health care and health care delivery without learning who the specific

patients are.

· Appointment Reminders.

We may use and disclose medical information to contact you as a reminder that

you have an appointment for services at GCBHS.

· Treatment Alternatives.

We may use and disclose medical information to tell you about or recommend

possible treatment options or alternatives that may be of interest to you.

· Health-Related Benefits

and Services. We may use and disclose medical information to tell you about

health-related benefits or services that may be of interest to you.

· As Required By Law. We

will disclose medical information about you when required to do so by federal,

state or local law such as those circumstances listed below under “Public

Health Risks”.

· To Avert a Serious

Threat to Health or Safety. We may use and disclose medical information about

you when necessary to prevent a serious threat to your health and safety or the

health and safety of the public or another person. Any disclosure, however, would

only be to someone able to help prevent the threat.

Special Situations

· Pharmaceutical Services.

We may release pertinent information about you to pharmacies for the purpose of

filling your GCBHS prescription.

· Workers’ Compensation.

We may release medical information about you to your employer or his/her

designee for workers’ compensation or similar programs. These programs provide

benefits for work-related injuries or illness.

· Public Health Risks. We

may disclose medical information about you for public health activities. These

activities generally include the following:

1. to prevent or control disease, injury or disability;

2. to report deaths;

3. to report child abuse or neglect;

4. to report reactions to medications or problems with products;

5. to notify people of recalls of products they may be using;

6. to notify a person who may have been exposed to a disease or may be at risk

for contracting or spreading a disease or condition;

7. to notify the appropriate government authority if we believe a patient has

been the victim of abuse or neglect.

· Health Oversight

Activities. We may disclose medical information to a health oversight agency

for activities authorized by law. These oversight activities include, for

example, audits, investigations, inspections, and licensure. These activities

are necessary for the government to monitor the health care system, government

programs, and compliance with civil rights laws.

· Accrediting

Organizations. We may disclose medical information to an organization that

GCBHS has contracted with for purposes of accreditation such as CARF, JCAHO,

the Department of Mental Health, and the Oklahoma Health Care Authority, etc. Lawsuits and Disputes. If you are involved in a lawsuit or a

dispute, we may disclose medical information about you in response to a court

order.

· Law Enforcement. We may

release medical information if asked to do so by a law enforcement official:

1. In response to a court order, warrant, summons or similar process;

2. To identify or locate a suspect, fugitive, material witness, or missing

person;

3. About the victim of a crime if, under certain limited circumstances, we are

unable to obtain the person’s agreement;

4. About a death we believe may be the result of criminal conduct;

5. About criminal conduct at the facility; and

6. In emergency circumstances to report a crime; the location of the crime or

victims; or the identity, description or location of the person who committed

the crime.

· Coroners, Medical

Examiners and Funeral Directors. We may release medical information to a

coroner or medical examiner. This may be necessary, for example, to identify a

deceased person or determine the cause of death. We may also release medical

information about patients of GCBHS to funeral directors as necessary to carry

out their duties.

· National Security and

Intelligence Activities. We may release medical information about you to

authorized federal officials for intelligence, counterintelligence and other

national security activities authorized by law.

· Protective Services for

the President and Others. We may disclose medical information about you to

authorized federal officials so they may provide protection to the President,

other authorized persons or foreign heads of state or conduct special

investigations.

YOUR RIGHTS REGARDING MEDICAL

INFORMATION ABOUT YOU:

You have the following rights regarding medical information we maintain about

you:

· Right to Inspect and

Copy. You have the right to request to inspect and copy medical information

that may be used to make decisions about your care. This request must be made

in writing to GCBHS. If you request a copy of the information, we may charge a

fee for the cost of copying, mailing or other supplies associated with your

request. The fee would be at the Oklahoma

statutory rate of .25 per copied page plus postage. If your request is denied

by the Clinical Director or Practitioner, you will receive a written

explanation for the denial.

· Right to Amend. If you

feel that medical information we have about you is incorrect or incomplete, you

may ask us to amend the information. You have the right to request an amendment

for as long as the information is kept by or for GCBHS.

To request an amendment,

your request must be made in writing and submitted to the Clinical Director for

GCBHS, 619 N. Main Street,

Muskogee, OK  74401. In addition, you must provide

a reason that supports your request.

We may 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 us, unless the person or entity that created the

information is no longer available to make the amendment;

· is not part of the medical information kept by or for GCBHS;

· is not part of the information which you would be permitted to inspect and

copy; or

· is accurate and complete.

Right to

an Accounting of Disclosures. You have the right to request an “Accounting of

Disclosures.” This is a list of the disclosures we made of medical information

about you.

To request this list or

accounting of disclosures, you must submit your request in writing to GCBHS.

Your request must state a time period which may not be longer that six years

and may not include dates before April 14, 2003. The first list you request

within a 12 month period will be free. For additional lists, we may charge you

for the cost of providing the list. We will notify you of the cost involved and

you may choose to withdraw or modify your request at that time before any costs

are incurred.

· Right to Request

Restrictions. You have the right to request a restriction of limitation on the

medical information we use or disclose about you for treatment, payment or

health care operations. You also have the right to request a limit on the

medical 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.

We are not required to

agree to your request. If we do agree, we will comply with your request unless

the information is needed to provide you emergency treatment.

To request restrictions,

you must make your request in writing to GCBHS. In your request, you must tell

us (1) what information you want to limit; (2) whether you want to limit our

use, disclosure or both; and (3) to whom you want the limits to apply, for

example, disclosures to your spouse.

· Right to Request

Confidential Communications. You have the right to request that we communicate

with you about medical matters in a certain way or at a certain location. For

example, you can ask that we only contact you at work or by mail.

To request confidential

communication, you must make your request in writing to GCBHS. We will not ask

you the reason for your request. We will accommodate all reasonable requests.

Your request must specify how or where you wish to be contacted.

· Right to a Paper Copy of

This Notice. You have the right to a paper copy of this notice. You may ask us

to give you a copy of this notice at any time. To obtain a paper copy of this

notice, please contact the Administrative office of any GCBHS facility.

CHANGES

TO THIS NOTICE.

We reserve the right to change this notice. We reserve the right to make the

revised or changed notice effective for medical information we already have

about you as well as any information we receive in the future. We will post a

copy of the current notice in the administrative office of each facility. The

notice will contain on the first page, in the top right-hand corner, the effective

date. In addition, each time you are admitted to the GCBHS for treatment or

health care services, we will offer you a copy of the current notice in effect.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint

with GCBHS or with the Secretary of the Department of Health and Human

Services. To file a complaint with GCBHS, contact the Privacy Officer at

918-682-8407. All complaints must be submitted in writing. You will not be

penalized for filing a complaint.

OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not covered by this notice or

the laws that apply to its use will be made only with your written permission.

If you provide us permission to use or disclose medical information about you,

you may revoke that permission, in writing, at any time. If you revoke your

permission, we will no longer use or disclose medical information about you for

the reasons covered by your written authorization. You understand that we are

unable to take back any disclosures we have already made with your permission,

and that we are required to retain our records of the care that we provide to

you.

SPECIAL

NOTICE REGARDING CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS

The confidentiality of

alcohol and drug abuse patient records maintained by GCBHS is protected by

Federal law and regulations. Generally, the program may not say to a person

outside the program that a patient attends the program, or disclose any

information identifying a patient as an alcohol or drug abuser UNLESS:

1. The patient consents in writing;

2. The disclosure is allowed by a court order; or

3. The disclosure is made to medical personnel in a medical emergency or to

qualified

personnel for research, audit, or program evaluation.

Violation of the Federal

law and regulations by a program is a crime. Suspected violations may be

reported to appropriate authorities in accordance with Federal regulations.

Federal law and

regulations do not protect any information about a crime committed by a patient

either at the program or against any person who works for the program or about

any threat to commit such a crime.

Federal laws and

regulations do not protect any information about suspected child abuse or

neglect from being reported under State law to appropriate State or local

authorities.

(See 42 U.S.C. 290dd-3 and

42 U.S.C. 290ee-3 for Federal laws and 42 CFR part 2 for Federal regulations.)