Life Skills Star

privacy policy

Notice of Privacy Practices
This Notice is effective on April 14, 2003

This Notice Describes How Medical Information About You
May Be Used And Disclosed, And How You Can Get Access
To This Information
PLEASE REVIEW CAREFULLY

We Are Required By Law to Protect Medical Information about You

Southern Worcester County Rehabilitation Center, Inc., is required by law to protect the privacy of medical information about you and that identifies you. This medical information may be information about your health care or payment for care provided to you. It may also be information about your past, present, or future medical condition.

We are also required by law to provide you with this Notice of Privacy Practices explaining our legal duties and privacy practices with respect to medical information. We are legally required to follow the terms of this Notice. In other words, we are only allowed to use and disclose medical information in the manner that we have described in this Notice.

We may change the terms of this Notice in the future. We reserve the right to make changes and to make the new Notice effective for all medical information that we maintain. If we make changes to the Notice, we will:

  • Post the new Notice
  • Have copies of the new Notice available upon request (you may contact our Privacy Officer at (508) 943-0700 x 103 to obtain a copy of the current Notice)

The rest of this Notice will:

  • Discuss how we may use and disclose medical information about you
  • Explain your rights with respect to medical information about you
  • Describe how and where you may file a privacy related complaint

If, at any time, you have questions about information in this Notice or about our privacy policies, procedures or practices, you can contact our Privacy Officer at 508-943-0700 ext. 103.

WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU IN SEVERAL CIRCUMSTANCES

This section of our Notice explains in some detail how we may use and disclose medical information about you in order to provide care, obtain payment, and operate our business efficiently. For more information about any of these uses or disclosures, or about any of our privacy policies, procedures or practices, contact our Privacy Officer at 508-943-0700 ext. 103.

Treatment:

We may use medical information about you to provide health care treatment to you. In other words, program staff may use and disclose medical information about you in order to provide, coordinate or manage your health care. This may include communicating with other agency professionals, associated DMR personnel, your family members or your health care providers regarding your treatment. All efforts will be made to disclose the minimum amount of information necessary to accomplish the intended purpose. Individual records will remain confidential subject to the Policy on Access to Records and Record Privacy.

Example: Jon lives in a residence and attends a day program operated by SWCRC. Staff at each site may use medical information to work with Jon; to coordinate medical appointments, consultations or referral services; to work with Jon’s interdisciplinary team that includes agency staff, DMR personal and parents/guardians (could also include staff members from another agency who share the responsibility of caring for Jon).

Payment:

We may use and disclose medical information about you to obtain payment for health care services that you received. This means that, within SWCRC, our accounting department may use information about you to arrange for payment from the Department of Mental Retardation and the Division of Medical Assistance (such as preparing bills and managing accounts).

Health Care Operations:

We may use and disclose medical information about you in performing a variety of business activities that we call "health care operations." These ‘health care operations" activities allow us to, for example, improve the quality of care we provide and reduce health care costs. We may use or disclose information about you in performing the following activities:

  • Provider staff, as necessary and appropriate, including the human rights officer and associated professional consultants providing habilitation services and supports to the individuals.
  • Person’s authorized to monitor the quality of services and supports offered to the individual including the human rights committee.
  • Persons approved and authorized under the Department of Mental Retardation regulations to engage in research.
  • Agencies that require specified information as a prerequisite for third party reimbursement of essential services.
  • Department investigators appointed to conduct an investigation. Agencies or attorneys who are authorized by statue, by court decision, or by the Department of Mental Retardation to represent, advocate for, or protect the legal rights of the individual.
  • Tracking specific MBS referrals and outcomes for service improvement.

Persons Involved In Your Care:

We may disclose information about you to a relative or guardian or any other person you identify if that person is involved in your care and the information is relevant to your care.

We may disclose medical information about you to a relative, guardian, DMR personal involved with your care, or emergency personal in the event that we need to notify someone about your location or condition.

Required By Law:

We will use and disclose medical information about you whenever we are required by law to do so. For example SWCRC staff are mandated reporters and are required by law to report suspected physical or mental abuse. We will comply with all applicable state and federal laws.

National Priority Uses and Disclosures:

When permitted by law, we may use or disclose medical information about you without your permission for various activities that are recognized as "national priorities." In other words, the government has determined that under certain circumstances (described below), it is so important to disclose medical information that it is acceptable to disclose medical information without the individual’s permission. We will only disclose medical information about you in the following circumstances when we are permitted to do so by law.  

  • Threat to health or safety: We may use or disclose medical information about you if we believe it is necessary to prevent or lessen a serious threat to health or safety.
  • Public health activities: We may use or disclose medical information about you for public health activities. Public health activities require the use of medical information for various activities, including, but not limited to, activities related to investigating diseases, reporting abuse and neglect, monitoring drugs regulated by the Food and Drug Administration, and monitoring work related illnesses or injuries.  
  • Abuse and Neglect: We may disclose medical information about you to a government authority (such as the DPPC) if we believe that you may be the victim of abuse or neglect.  
  • Court Proceedings: We may disclose medical information about you to a court or an officer of the court (such as an attorney), if a judge orders us to.  
  • Law Enforcement: We may disclose medical information about you to law enforcement official for specific law enforcement purposes. For example, we may disclose limited medical information about you to a police officer if the officer needs the information to help find or identify a missing person.
  • Workers Compensation: We may disclose medical information about you in order to comply with workers compensation laws.

Authorization:

Other than the uses and disclosures described above, we will not use or disclose medical information about you without the "authorization"- or signed permission- of you or your guardian. If you sign an "authorization" form, you may revoke (or cancel) your authorization at any time.

YOUR RIGHTS WITH RESPECT TO
MEDICAL INFORMATION ABOUT YOU

You have several rights with respect to medical information about you. This section of the Notice will briefly mention each of these rights. If you would like to know more about your rights, please contact our Privacy Officer at 508-943-0700 ext. 103.

Right To A Copy of This Notice:

You have a right to have a paper copy of our Notice of Privacy Practices at any time. If you would like to have a copy of our Notice, contact the privacy officer at (508) 943-0700 x 103.

Right Of Access to Inspect and Copy:

You have the right to see the medical information about you that we maintain in your confidential file. Your confidential file is available to you at each of your programs operated by SWCRC.

Right To Have Medical Information Amended:

You have the right to have us amend medical information about you that we maintain in your confidential file. If you believe that we have information that is either inaccurate or incomplete. If you would like us to amend information, you must provide us with a request in writing and explain why you would like us to amend the information. Requests can be given to the Program Manager who will transfer them to the Privacy Officer. We may deny your request in certain circumstances. If we deny your request, we will explain our reason for doing so in writing. You will have the opportunity to send us an explanation of why you disagree with our decision to deny your amendment request and we will include your statement with the information in question.

Right To an Accounting of Disclosures We Have Made:

You have the right to receive a detailed listing of disclosures that we have made for the previous six years. If you would like to receive an accounting contact our Privacy Officer at 508-943-0700 ext. 103. Be aware that the disclosures will not include disclosures for treatment, payment or health care operations. It will also not include disclosures made prior to April 14, 2003.

Right to Request Restrictions on Uses and Disclosures:

You have the right to request that we limit the use and disclosure of medical information about you for treatment, payment and health care operations. We are not required to agree to your request. If we do agree to your request, we must follow your restrictions (except if the information is necessary for emergency treatment). You may cancel a restriction at any time. In addition, we may cancel a restriction at any time as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation. Right to Receive Confidential Communication: You have the right to request to be contacted at a different location or by a different method. We will agree to any reasonable request for alternative methods of contact.

YOU MAY FILE A COMPLAINT ABOUT
OUR PRIVACY PRACTICES

If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint.

To file a written complaint you may either bring it to the Program Manager of the program or mail it to:
44 Morris St., Webster, MA 01570 Attn: Privacy Officer.

For all privacy complaints we will follow our grievance policies and procedures.

To file a complaint with the federal government, you may send your complaint to the following address:
CMS, 7500 Security Boulevard, Baltimore, MD 21244-1850.