Privacy Practices

The following categories describe different ways we use and disclose health information that identifies you (“Health Information”). For each category we will explain what we mean and try to give some examples. Not every use or 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.

Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment­ related health care services. For example, we may disclose your Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who need the information to provide you with medical care.

Payment. We may use and disclose your Health Information so that we or others may bill and receive payment from you. an insurance company or a third party for the treatment and services you received. For example, we may give your health plan information about services you received at our office so your health plan will pay us or reimburse you for the services.

Health Care Operations. We may use and disclose Health Information for health care operations. These uses and disclosures are necessary to make sure that our patients receive quality care and to operate and manage our office. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you.

Business Associates. We may disclose Health Information to our contracted Business Associates that perform functions on our behalf. For example, we may use another company to perform billing services.

Appointment Reminders. Treatment Alternatiyes and Health-Related Benefits and Services. As part of treatment activities or health care operations, we may use your Health Information to contact you as a reminder that you have an appointment with us. We also may use Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.

Fundraising. We may use and disclose limited Health Information to send you fundraising communications. You have the right to “opt-out” of receiving these communications at any time.

Individuals involved In Your Care or Payment for Your Care. When appropriate, we may share your Health Information with a person who is involved in your medical care or payment of your care, such as your family or a close friend, so long as you have not objected and it is reasonable tor us to believe that such disclosure is in your best interest. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.

Research. Under certain circumstances, we may use and disclose Health Information for research activities. For example, a research project may involve comparing the health of patients who received another treatment for the same condition. Before we use or disclose Health Information tor research, the project will go through a special approval process.

Special Purposes When Permitted or Required by Law. We may disclose Health Information about you for special purposes when permitted or required by law, including the following:

• To avert a serious threat to health or safety against you, the public, or another person.
• For public health and administrative oversight activities such as disease control, abuse or neglect reporting, health and vital statistics, audits, investigations, and licensure reviews.
• For organ and tissue donation and transplant activities.
• For workers’ compensation or similar programs purposes, such as for the payment of benefits for work­ related injuries.
• To coroners, medical examiners, and funeral directors to identify a deceased person, determine cause of death, or to carry out duties.
• For judicial and administrative proceedings in response to a subpoena, court order. or administrative order, if certain requirements are met.
• For law enforcement activities, if the disclosure is required by law, necessary to identify or locate a suspect or missing person, about criminal conduct on our premises, about inmates, about victims of crime under certain circumstances, and in certain emergency situations.
• For U.S. military and veteran reporting obligations regarding members and veterans of the armed forces of U.S. or foreign military.
  • For national security and intelligence activities, such as protective services for the President and other authorized persons.
  • When otherwise required by law.

State and Other Federal Laws. We will comply with all applicable state and federal laws. For example, under Michigan law, there are more limits on the disclosure of mental health information, substance abuse information, and HIV and AIDS information. We will continue to abide by all applicable state and federal laws.

Other Uses of Medical Information Require an Authorization. Other uses and disclosures of your Health Information that are not covered by this Notice will be made only with your authorization, including for marketing purposes or sale of Health Information. A written authorization is also required for most uses or disclosures of psychotherapy notes.

If you provide us an authorization to use or disclose your Health Information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your Health Information for the reasons covered by the written authorization. You understand that we are unable to take back disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provide to you.

Rights: As a client/applicant of the HELP / CHC, you have the following rights:

• The right to receive considerate, dignified and respectful treatment by all HELP/ CHC staff.
• The right to receive an objective assessment of your eligibility for services.
• The right to be informed of what services HELP/ CHC provides, how to apply for services and to be notified of the reason(s) for any denial of services for which you apply.
• The right to a response from the HELP/ CHC in a timely manner regarding services for which you apply.
• The right to apply for and receive services without discrimination because of race, ethnicity, color, gender, sexual orientation/identity, religion, spirituality, veteran status, national origin, economic status or lifestyle.
• The right to expect that HELP/ CHC will maintain confidentiality regarding your information in accordance with applicable laws and contract requirements.
• The right to file a complaint regarding services provided or to file a grievance according to the HELP/ CHC grievance policy if you feel you have been mistreated or denied services unfairly.
• The right to refuse to participate in any programs provided by HELP/ CHC, to terminate participation or to withdraw your client status and consent(s) in writing at any time without recrimination.
• For clients of the Case Management Program, the right to review the steps of case management services with explanations for each step, and the right to view information on the Americans with Disabilities Act (ADA) and how it pertains to you.

Responsibilities: As a client/applicant of the HELP/ CHC, you have the following responsibilities:

• Provide prompt, accurate and honest information in applying for services and in verifying information related to eligibility.
• Keep scheduled appointments/commitments or call in advance to cancel or reschedule.
• Follow through with agreed upon plans of action for services.
• Inform HELP/ CHC of changes in your situation, for example your financial status, housing, address, medical conditions, etc. in a timely manner.
• Treat the HELP/ CHC staff, clients, visitors and all others in the HELP/ CHC office or other program/service locations with respect and dignity at all times. Threatening, aggressive or harassing behaviors are not acceptable.
• Abide by the following rules while in the HELP/ CHC office or on the organization premises – no cursing, no smoking, no alcohol, no drugs, no weapons, no littering, no loitering and no property destruction or theft.
• Respect the confidentiality and privacy of others you may encounter at the HELP/ CHC office/programs.
• Follow the program rules and processes required for any services you apply for and receive.
• For clients to provide proof of income and medical status within 30 days of completing an intake.