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.
Who We Are
This notice describes the privacy practices of The Hope House and its family of facilities.
Our Privacy and Confidentiality Obligations
This notice describes:
• HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
• YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
• HOW TO FILE A COMPLAINT CONCERNING A VIOLATION OF THE PRIVACY OR SECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTS CONCERNING YOUR INFORMATION
• YOU HAVE A RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC FORM) AND TO DISCUSS IT WITH THE PRIVACY OFFICER AT 480-585-2595 OR PRIVACY@THEHOPEHOUSE.COM IF YOU HAVE ANY QUESTIONS.
YOUR HEALTH INFORMATION
THE HOPE HOUSE is committed to protecting your medical information. The THE HOPE HOUSE is required by law to maintain the privacy of records, to provide patients with notice of its legal duties and privacy practices with respect to records, and to notify affected patients following a breach of unsecured records.
We are required to abide by the terms of the Notice currently in effect. We reserve the right to change our privacy practices and the terms of this Notice at any time and we will provide a revised Notice to you as follows:
– Upon Request;
– Electronically via our website or via other electronic means; and
– As posted in our place of business.
As per 45 CFR 164.520, this Notice of Privacy Practices (the Notice) describes how medical information about you may be used or disclosed and how you can access this information. Your personal health record contains private and confidential information about you and your health. Both State and Federal laws protect the confidentiality of this information. Protected Health Information (PHI) relates to your past, present or future physical or mental health or condition and any related health care services.
WHICH US LAWS PROTECT A PERSON’S PRIVACY IN THE US?
In the United States, your medical records are protected through these laws:
– Protected Health Information in connection with alcohol or drug services:
The Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR Part 2) issued in 1975 and revised in 1987: This regulation specifies that substance abuse treatment programs are not allowed to share any patient information that would directly or indirectly identify someone having previous or current alcohol or drug abuse problems, unless the patient gives written consent. A few exceptions to the law’s requirement of written consent exist, involving certain circumstances that are listed in this notice.
– All Protected Health Information, including alcohol or drug services:
The Health Insurance and Portability and Accountability Act of 1996 (HIPAA): HIPAA protects all identifying information about a person who has applied for, been given a diagnosis of, or received treatment for alcohol or drug abuse at a federally assisted program. Programs cannot legally disclose any patient information unless the patient has given written consent or unless their case qualifies for another exception specified in the HIPPA policy. If medical information is disclosed, it must only be the minimum required to carry out its purpose. The same regulations apply to minors who must give written consent before a program will release information to their parent or guardian. 45 CFR Parts 160 and 164 protect your health information when you are applying for or receiving services for drug or alcohol abuse.
CONFIDENTIALITY PRACTICES AND USES
PROTECTED HEALTH INFORMATION (PHI) — PHI is information we obtain and create in providing our services to you. Such information may include documentation of your symptoms, examination and test results, diagnosis, and treatment. It also includes billing documents for those services.
If we disclose your PHI to a business associate for that entity to perform a function on our behalf, we must have in place an agreement from the business associate that it and its subcontractors will extend the same degree of privacy protection to your information that we do.
If a use or disclosure is not described in this Notice, we will not make that use or disclosure without your written authorization.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
Below are examples of uses and disclosures of your Protected Health Information (PHI). These examples are not exhaustive but describe the uses and disclosures made.
USES AND DISCLOSURES PER LAW NOT REQUIRING YOUR PERMISSION
(You may have further protections if your treatment is for SUD as described in the section USES AND DISCLOSURES REQUIRING AUTHORIZATION)
– Treatment — To appropriately determine approvals or denials of your medical. For example, your PHI will be shared among members of your treatment team.
– Example: Your Care Team, composed of staff such as doctors, nurses, and other medical and clinical workers will need to review your treatment and discuss plans for your discharge. We will disclose your health information outside of this agency only with your consent or when otherwise allowed under state or federal law. If you request treatment and rehabilitation for drug dependence, your request will be treated as confidential. We will not refer you to another person for treatment and rehabilitation without your authorization.
– Example: We may share your health information with a health care provider for emergency services or to notify a treating physician of a medication change.
– Payment — We may use or disclose your PHI in order to bill and collect payment for your health care.
– Example: We will send claims for payment to your health plan for the services provided to you, if applicable. If they require proof of your admission, we may be asked to share that information with them.
– Health Care Operations — We may use or disclose your PHI, as needed, in order to improve the quality of your treatment.
– Examples: We could access your PHI to do the following:
– Review PHI to assess the care and outcomes in your case.
– Review your information to evaluate the skills, qualifications and performance of health care providers who are treating you.
– Cooperate with outside organizations or auditors that review and determine the quality of your treatment.
– Provide information to professional organizations that evaluate, certify or license health care providers, staff, or facilities.
– Provide information to your internal patient advocate who can represent your interests upon request.
– Monitor activities in hallways and outside buildings via camera/video for safety.
When Required by Law — We may disclose PHI when a law requires that we report information about suspected abuse, neglect, or domestic violence; for a crime committed on the premises; or in response to a court order. We must also disclose PHI to authorities that monitor compliance with these privacy requirements.
For Public Health Activities — We may disclose PHI when we are required to collect information about disease or injury; to report vital statistics; or to report the results of public health surveillance, investigations, or interventions.
For Health Oversight Activities — We may disclose PHI to a health oversight agency for activities authorized by These oversight activities may include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the behavioral health care system, government programs and compliance with civil rights laws.
Relating to Decedents — We may disclose PHI relating to a death to coroners, medical examiners, or funeral directors, and to organ procurement organizations regarding anatomical gifts. Unless an individual indicated otherwise before death, we also may disclose PHI
related to the individual’s death to family members, friends, or others who were involved in the individual’s care or payment for care before death.
For Research Purposes — We may use or disclose your medical information for research projects, such as studying the effectiveness of a treatment you received. These research projects must go through a special process that protects the confidentiality of your medical records. We will obtain your written authorization if the researcher intends to further use or disclose your medical information.
To Avert Threat to Health or Safety — In order to avoid a serious threat to health or safety, we may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm
For Specific Government Functions — We may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government benefit programs relating to eligibility and enrollment, and for national security reasons, such as protection of the President.
USES AND DISCLOSURES REQUIRING AUTHORIZATION
We must have your written authorization for the following. Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken action based upon your authorization.
- Substance Abuse Health Information — All PHI regarding substance abuse is to be kept strictly confidential and released only in conformance with the requirements of federal law (42 United States Code 290dd-2 and 42 Code of Federal Regulations, Part 2). Disclosure of any medical information referencing alcohol or substance abuse may be made only with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.
– Records, or testimony relaying the content of such records, shall not be used or disclosed in any civil, administrative, criminal, or legislative proceedings against the patient unless based on specific written consent or a court order;
– Records shall only be used or disclosed based on a court order after notice and an opportunity to be heard is provided to the patient or the holder of the record, where required by 42 U.S.C. 290dd-2 and this part; and
– A court order authorizing use or disclosure must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed.
– Records that are disclosed to a part 2 program, covered entity, or business associate pursuant to the patient’s written consent for treatment, payment, and health care operations may be further disclosed by that part 2 program, covered entity, or business associate, without the patient’s written consent, to the extent the HIPAA regulations permit such disclosure.
– A part 2 program may use or disclose records to fundraise for the benefit of the part 2 program only if the patient is first provided with a clear and conspicuous opportunity to elect not to receive fundraising communications.
– Treatment, Payment and Healthcare Operations (TPO) described above have further protections related to SUD, and a separate consent has been provided to allow for this information’s use. - HIV Information — All PHI regarding HIV is kept strictly confidential and released only in conformance with the requirements of State of Arizona. Disclosure of any medical information referring to HIV status may only be made with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.
- Other Uses or Disclosures Requiring Authorization — We may not use or disclose your PHI without your written authorization if the use or disclosure would constitute a sale of PHI. We may not use or disclose your PHI for marketing purposes without your written authorization.Most uses and disclosures of your psychotherapy notes will require your written authorization. There may be other uses and disclosures of
your PHI for which we will seek your written authorization.
You may provide a single consent for all future uses or disclosures for treatment, payment, and health care operations purposes.
THE HOPE HOUSE will make uses and disclosures not described in the notice only with your written consent.
USES AND DISCLOSURES REQUIRING YOU TO HAVE AN OPPORTUNITY TO OBJECT
In the following situations, we may disclose a limited amount of your PHI if we inform you about the disclosure in advance and you do not object, as long as the disclosure is not otherwise prohibited by law:
– To Families, Friends or Others Involved in Your Care — We may share with these people information directly related to their involvement in your care, or payment for your We may also share PHI with these people or notify them about your location and general condition, or death.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
– Right to Request Restrictions — You have the right to request that we restrict uses or disclosures of your health information to carry out treatment, payment, health care operations, or communications with family, friends, or others. In some situations, we are not required to agree to a restriction. If disclosure is required by law, we cannot agree to your request to restrict. If you request that we restrict specified disclosures of PHI to a health plan regarding a health care item or service for which you paid out of pocket in full, we must agree to the restriction.
– Right to Restrict Communication with your Health Plan –Y ou have the right to request and obtain restrictions of disclosures of records under this part to the patient’s health plan for those services for which the patient has paid in full, in the same manner as 45 CFR 164.522 applies to disclosures of protected health information.
– Right to Request Confidential Communications — You have the right to ask us to communicate with you in a way that you feel is more confidential. For example, you can ask us not to call your home, but to communicate only by mail. This request must be in writing. We must accommodate your request if it is reasonable, and you clearly state that the disclosure of all or part of the information could endanger you.
– Right to Inspect and Copy — You have the right to review your record (while a resident at THE HOPE HOUSE, only in the presence of THE HOPE HOUSE staff) and to get a copy of your record (the law requires us to keep the original record). This could include your medical record, your billing record, and other records we use to make decisions about your care. You may agree to a summary or explanation of any releases. To request your health information, submit a written request to your unit manager or program manager. We may charge a reasonable, cost- based fee for the costs of copying, including labor, postage, and the cost of preparing a summary or explanation if applicable. If you request a copy or a summary or explanation of your information, we will tell you in advance what this will cost. We may deny your request to inspect and copy in certain circumstances as defined by applicable THE HOPE HOUSE policy and as specified by law.
– Right to Amend — If you examine your medical information and believe that some of the information is incorrect, you may ask us to amend your records. The request must be in writing. Your request must include the reason or reasons that support your request. We may deny your request for an amendment if we determine that the record that is the subject of the request was not created by us, is not available for inspection as specified by law, or is accurate and complete.
– Right to Receive an Accounting of Disclosures — You have the right to receive an accounting of electronic disclosures of your health information for the past 3 years. This generally does not include disclosures made to carry out treatment, payment and health care operations; disclosures made to you; communications with family and friends; for national security or intelligence purposes; or to correctional institutions or law enforcement. We will respond to your written request for such a list within the time limit specified by law. Your first request for accounting in any 12-month period shall be provided without charge. A reasonable, cost-based fee shall be imposed for each subsequent request.
– You have the right to receive this Notice — You have the right to receive a paper or electronic copy of this Notice upon request.
– You have the right to be notified of a breach of your PHI — In the event of a breach of your PHI that is created, received, or maintained by us or by a business associate or the business associate’s subcontractor, you will receive written notification as specified by law.
– Right to Not Receive Fundraising Communications — You have the right to elect not to receive fund raising communications, as required by law (we do not send these).
– Right to Discuss the Notice — You have the right to discuss this Notice with a designated office identified in the title section above.
HOW TO CONTACT THE HOPE HOUSE REGARDING YOUR PRIVACY RIGHTS:
Mail all written forms, requests and correspondence to:
THE HOPE HOUSE, Attn: Privacy Officer
7904 E CHAPARRAL RD #A110-473, Scottsdale, AZ, 85250-7370
Phone: 480-666-1112
HOW TO FILE A COMPLAINT IF YOU BELIEVE YOUR RIGHTS HAVE BEEN VIOLATED
If you have questions about this Notice or any complaints about our privacy practices, please contact the THE HOPE HOUSE’s Privacy Office by calling 480-666-1112. You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services. Send correspondence to:
THE HOPE HOUSE, Attn: Privacy Officer
7904 E CHAPARRAL RD #A110-473, Scottsdale, AZ, 85250-7370
Phone: 480-666-1112
OR
U.S. Department of Health and Human Services
200 Independence Avenue, SW
HHH Building, Room 509F
Washington, D.C. 20201
Toll Free: 1-(800) 368-1019
Online Complaint: www.hhs.gov/ocr/privacy/hipaa/complaints
OR
The Joint Commission (JC) accredits this entity. If you have a complaint about the quality of care you have received, you may contact the Joint
Commission by email at complaint@ jointcommission.org or by mail at:
Office of Quality Monitoring, The Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, Illinois 60181
If you make such complaints, retaliatory action is not permitted.
Effective Date: This Notice is effective on June 23, 2023.