5750-A Southland Drive   ::   Mobile, Al.  36693   ::   251-473-4423
Mobile Mental HealthMobile Mental Health
Mobile Mental Health

 

Privacy Statement

NOTICE OF HEALTH INFORMATION PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED

"THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE READ IT CAREFULLY. 

We have a legal duty  to safeguard your (PHI) Protected Health Information.  This PHI includes information that can be used to identify you that we have created or reviewed about your past, present or future health conditions.  It contains what healthcare we have provided to you, or the payment history on  healthcare related accounts.  We must provide you with notice about our privacy practices and explain how, when and why we use and disclose your PHI.

We will not use or disclose your health information without your authorization, except as described in this notice or otherwise required by law.  We are legally required to follow the privacy practices that are described in this notice.

CONFIDENTIALITY OF ALCOHOL AND DRUG ABUSE RECORDS:

The confidentiality of alcohol and drug abuse records maintained by this organization is protected by federal law and regulations.  Generally, the program may not communicate  to a person outside the program that you attend the program, or disclose any information identifying you as an alcohol or drug abuser unless one of the following conditions is met:

  • you  consent to it in writing       

  • the disclosure is allowed by a court order

  • the disclosure is made to medical personnel in a medical emergency or to qualified personnel for program evaluation

Violations of the federal law and regulations by a program is a crime.  Suspected violations may be reported to the appropriate authorities in accordance with federal regulations.

Federal law and regulations do not protect any information about a crime committed by you either at the program or against any person(s) 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.

YOUR HEALTH INFORMATION RIGHTS:

Although your medical record is the physical property of MMHC, the information belongs to you. You have the right to:

  • request in writing a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522

  • request in writing to obtain a paper copy of your health record as provided for in 45 CFR 164.524

  • request in writing  to amend your health record as provided in 45 CFR 164.528

  • obtain a paper copy of the notice of information practices upon request

  • request in writing to obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528

  • request in writing communication of your health information by alternative (other) means or at other locations

  • revoke in writing  your authorization to use and disclose health information except to the extent that action has already been taken

OUR RESPONSIBILITIES:

AltaPointe Health Systems is required to:

  •  maintain the privacy of your health information

  • provide you with notice as to our legal duties and privacy practices with respect to information we collect and maintain about you

  • abide by the terms of this notice

  • notify you if we are unable to agree to a requested restriction

  • accommodate reasonable requests you may have to communicate health information by other means or at other locations

  • train our personnel concerning privacy and confidentiality; implement a sanction policy to discipline those who breach privacy or confidentiality or our policy

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain.  Should our Information practices change, the revised notice will be available through your therapist and in the lobby of the facility.

We will not use or disclose your health information without your authorization, except as described in this notice.

FOR MORE INFORMATION OR TO REPORT A PROBLEM:

If you have questions and would like additional information, you may contact the Consumer Needs Specialist at 251-450-4303. If you believe your privacy rights have been violated you can file a complaint with the Consumer Needs Specialist  at MMHC or with the Secretary of Health and Human Services.  There will be no retaliation for filing a complaint. 

Your written statement to MMHC and/or the Office of Civil Rights must include your name; address; telephone number; your signature; how, why, and when you believe you were discriminated against; name and address of institution or agency you believe discriminated against you; and any other relevant information.

You may submit, in writing, a request for review of any discrepancy or complaint under HIPAA to any of the following:

Director                                                                       

Office of Civil Rights                                                     Consumer Needs Specialist

U.S. Department of Health & Human Service                MMHC

61 Forsyth St., SW – Suite 31370                                2400 Gordon Smith Drive

Atlanta, GA  30323                                                      Mobile, Al.  36617

(404) 562-7858 or 562-7884                                      (251) 450-4303

EXAMPLES OF DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS:

We will use your health information for treatment (fox example):

Information obtained by a, doctor, nurse or other mental health professional will be recorded in your record and used to determine the course of treatment that will  work best for you

Any service provided to you will be documented in the record we will use your health information for payment (for example)  A bill may be sent to you or a third party payer.  The information on or accompanying the bill may include information that identifies you, as well as your diagnosis We will use your health information for regular health operations (for example) Members of the medical staff, the risk or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it

Business Associates:  We provide some services through contracts with business associates. (Example: certain diagnostic tests)

Directory:  We do not have a directory that provides any information concerning your treatment here.

Notification:  We will not disclose any information to anyone about you without your written consent/authorization.

Communication with Family:  Only with your written authorization/consent will we disclose to a family member, another relative, a close friend, or any other person that you identify; health information relevant to that person’s involvement in your care or payment related to your care.

Research:  We may disclose information to researches when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.

Funeral Directors:  We may disclose health information to funeral directors consistent with applicable law to enable them to carry out their duties.

Marketing/continuity of care:   We may contact you to provide appointment reminders or information about treatment alternatives that may be of interest to you.

Fund raising:  We will not contact you concerning any fund raising activities.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse effects/events with respect to food, drugs, supplements, product or product defects, or postmarking surveillance  information to enable product recalls, repairs, or replacements.

Workers Compensation:   We may disclose information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health:  We may disclose your health information as required by law.

Correctional institution: If you are an inmate of a correctional institution, we may disclose to the institution health information necessary for your health and the health and safety of other individuals.

Law Enforcement: We may disclose your health information for law enforcement purposes as required by law or in response to a court order.

Health Oversight Agencies & Public Health Authorities:  By Federal law provisions your health information may be released provided that a work force 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.

WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY  "WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS EFFECTIVE FOR ALL INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (MEDICAL RECORDS) THAT WE MAINTAIN.  IF WE CHANGE OUR INFORMATION PRACTICES, WE

WILL HAVE THE REVISED NOTICE AVAILABLE IN THE THERAPIST’S OFFICE AS WELL AS HAVE A SUPPLY AVAILABLE IN THE LOBBY OF THE FACILITY.

           EFFECTIVE DATE: 04/14/03