Chelan-Douglas Regional Support Network/
Prepaid Health Plan

For Mental Health

   
Notice of Privacy Practices
Part II 		 
 
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Chelan-Douglas RSN/PIHP
636 Valley Mall Parkway,
Suite 200
East Wenatchee, WA 98802

509-886-6318
1-877-563-3678
Fax: 509-886-6320

Monday - Friday
8 AM - 5 PM

 

Effective Date: April 14, 2003

II. How We Will Use and Disclose Your Health Information

We will use and disclose your health information as described in each category listed below. For each category, we will explain what we mean in general, but not describe all specific uses or disclosures of health information.

A. Uses and Disclosures That May Be Made With Your Written Consent

  1. For Treatment. We will use and disclose your health information to coordinate and manage your health care and related services. For example, we may need to disclose information to a case manager who is responsible for coordinating your care. We may also disclose your health information among our clinicians and other staff who work at contracted provider agencies. For example, our staff may discuss your care at a case conference. In addition, we may disclose your health information to another health care provider (e.g., your primary care physician or a laboratory) working outside of Chelan-Douglas Regional Support Network.

  2. For Payment. Once you have signed our Consent to Use and Disclose Health Information, we may use or disclose your health information so that the treatment and services you receive are billed to, and payment is collected from, your health plan or other third party payer. By way of example, we may disclose your health information to permit your health plan to take certain actions before your health plan approves or pays for your services. These actions may include:
    • making a determination of eligibility or coverage for health insurance;
    • reviewing your services to determine if they were medically necessary;
    • reviewing your services to determine if they were appropriately authorized or certified in advance of your care; or
    • reviewing your services for purposes of utilization review, to ensure the appropriateness of your care, or to justify the charges for your care.

     

  3. For Health Care Operations. Once you have signed our Consent to Use and Disclose Health Information, we may use and disclose health information about you for our operations. These uses and disclosures are necessary to run our organization and make sure that our consumers receive quality care. These activities may include, by way of example, quality assessment and improvement, reviewing the performance or qualifications of our clinicians, training students in clinical activities, licensing, accreditation, business planning and development, and general administrative activities. We may combine health information of many of our consumers to decide what additional services we should offer, what services are no longer needed, and whether certain new treatments are effective. We may also combine our health information with health information from other providers to compare how we are doing and see where we can make improvements in our services. When we combine our health information with information of other providers, we will remove identifying information so others may use it to study health care or health care delivery without identifying specific clients.
  4. Health-Related Benefits and Services. We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you. If you do not want us to provide you with information about health-related benefits or services, you must notify the Privacy Officer in writing at Chelan-Douglas Regional Support Network/Prepaid Health Plan, 636 Valley Mall Parkway, Suite 200, East Wenatchee WA 98826. Please state clearly that you do not want to receive materials about health-related benefits or services.
  5. Fundraising Activities. We may use or disclose health information about you to contact you about raising money for our programs, services and operations. If you do not want us to contact you for fundraising purposes, you must notify the Privacy Officer in writing at Chelan-Douglas Regional Support Network/Prepaid Health Plan, 636 Valley Mall Parkway, Suite 200, East Wenatchee WA 98826. Please state clearly that you do not want to receive any fundraising solicitations from us.

B. Uses and Disclosures That May be Made Without Your Consent or Authorization, But For Which You Will Have an Opportunity to Object.

  1. Facility Directory. We do not maintain a facility directory at any of our exclusive outpatient units. If asked, we will not confirm orally, in writing or through any other medium that you are our current or former client, with the exceptions listed below under “Person’s Involved in an Individual’s Care.”

  2. Persons Involved in Your Care. We may provide health information about you to someone who helps pay for your care. We may use or disclose your health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. We may also use or disclose your health information to an entity assisting in disaster relief efforts and to coordinate uses and disclosures for this purpose to family or other individuals involved in your health care. In limited circumstances, we may disclose health information about you to a friend or family member who is involved in your care. If you are physically present and have the capacity to make health care decisions, your health information may only be disclosed with your agreement to persons you designate to be involved in your care. But, if you are in an emergency situation, we may disclose your health information to a spouse, a family member, or a friend so that such person may assist in your care. In this case we will determine whether the disclosure is in your best interest and, if so, only disclose information that is directly relevant to participation in your care. And, if you are not in an emergency situation but are unable to make health care decisions, we will disclose your health information to:
    • a person designated to participate in your care in accordance with an advance directive validly executed under state law,
    • your guardian or other fiduciary if one has been appointed by a court, or
    • if applicable, the state agency responsible for consenting to your care.

C. Uses and Disclosures That May be Made Without Your Consent, Authorization or Opportunity to Object.

  1. Emergencies. We may use and disclose your health information in an emergency treatment situation. By way of example, we may provide your health information to a paramedic who is transporting you in an ambulance. We will attempt to obtain your Consent as soon as reasonably practicable after we provide you with emergency treatment. If a clinician is required by law to treat you and your treating clinician has attempted to obtain your Consent but is unable to do so, the treating clinician may nevertheless use or disclose your health information to treat you.

  2. Communication Barriers. We may use and disclose your health information if one of our clinicians attempts to obtain Consent from you, but is unable to do so due to substantial communication barriers. However, we will only use or disclose your health information if the clinician determines in his/her professional judgment that, absent the communication barriers, you likely would have consented to use or disclose information under the circumstances.

  3. Research. We may disclose your health information to researchers when their research has been approved by an Institutional Review Board or a similar privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

  4. As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.

  5. To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious and imminent threat to your health or safety or to the health or safety of the public or another person. Under these circumstances, we will only disclose health information to someone who is able to help prevent or lessen the threat.

  6. Organ and Tissue Donation. If you are an organ donor, we may release your health information to an organ procurement organization or to an entity that conducts organ, eye or tissue transplantation, or serves as an organ donation bank, as necessary to facilitate organ, eye or tissue donation and transplantation.

  7. Public Health Activities. We may disclose health information about you as necessary for public health activities including, by way of example, disclosures to:
    • report to public health authorities for the purpose of preventing or controlling disease, injury or disability;
    • report vital events such as birth or death;
    • conduct public health surveillance or investigations;
    • report child abuse or neglect;
    • report to the Food and Drug Administration (FDA) or to a person required by the FDA to report certain events including information about defective products or problems with medications;
    • notify consumers about FDA-initiated product recalls;
    • notify a person who may have been exposed to a communicable disease or who is at risk of contracting or spreading a disease or condition;
    • notify the appropriate government agency if we believe you have been a victim of abuse, neglect or domestic violence. We will only notify an agency if we obtain your agreement or if we are required or authorized by law to report such abuse, neglect or domestic violence.

  1. Health Oversight Activities. We may disclose health information about you to a health oversight agency for activities authorized by law. Oversight agencies include government agencies that oversee the health care system, government benefit programs such as Medicare or Medicaid, other government programs regulating health care, and civil rights laws.
  2. Disclosures in Legal Proceedings. We may disclose health information about you to a court or administrative agency when a judge or administrative agency orders us to do so. We also may disclose health information about you in legal proceedings without your permission when we receive a subpoena for your health information. We will not provide this information in response to a subpoena without your authorization. An attorney is required to provide advance notice to the health care provider and the client and the client’s attorney involved through service of process or first class mail. Notice must indicate the health provider from whom the information is sought, what information if is sought, and the date by which protective order must be obtained to prevent the health care provider from complying. Without the written consent of the client, the health care provider may not disclose the health information sought if the requestor has not complied with the identified requirements. In the absence of a protective order, the health care provider shall disclose the information. In the case of compliance, the request for discovery or compulsory process shall be made a part of the client record.
  3. Law Enforcement Activities. We may disclose health information to a law enforcement official for law enforcement purposes when:
    • a court order, subpoena, warrant, summons or similar process requires us to do so; or
    • the information is needed to identify or locate a suspect, fugitive, material witness or missing person; or
    • we report a death that we believe may be the result of criminal conduct; or
    • we report criminal conduct occurring on the premises of our facility; or
    • we determine that the law enforcement purpose is to respond to a threat of an imminently dangerous activity by you against yourself or another person; or
    • the disclosure is otherwise required by law.

We may also disclose health information about a client who is a victim of a crime, without a court order or without being required to do so by law. However, we will do so only if the disclosure has been requested by a law enforcement official and the victim agrees to the disclosure or, in the case of the victim’s incapacity, the following occurs:

  • the law enforcement official represents to us that (i) the victim is not the subject of the investigation and (ii) an immediate law enforcement activity to meet a serious danger to the victim or others depends upon the disclosure; and
  • we determine that the disclosure is in the victim’s best interest.

  1. Medical Examiners or Funeral Directors. We may provide health information about our consumers to a medical examiner. Medical examiners are appointed by law to assist in identifying deceased persons and to determine the cause of death in certain circumstances. We may also disclose health information about our consumers to funeral directors as necessary to carry out their duties.

  2. Military and Veterans. If you a member of the armed forces, we may disclose your health information as required by military command authorities. We may also disclose your health information for the purpose of determining your eligibility for benefits provided by the Department of Veterans Affairs. Finally, if you are a member of a foreign military service, we may disclose your health information to that foreign military authority.

  3. National Security and Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law. We may also disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or so they may conduct special investigations.

  4. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose health information about you to the correctional institution or law enforcement official.

  5. Workers’ Compensation. We may disclose health information about you to comply with the state’s Workers’ Compensation Law.

 

  1. Introduction

  2. How We Will Use and Disclose Your Health Information

  3. Uses and Disclosures of Your Health Information with Your Permission

  4. Your Rights Regarding Your Health Information

  5. Complaints

  6. Changes to this Notice

  7. Who will follow this Notice

 
   

Crisis Line - 509-662-7105 or 1-800-852-2923

  
   
 

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