NOTICE OF PRIVACY INFORMATION
Stewart-Marchman-Act Behavioral Healthcare
Effectice October 1, 2008
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Keeping your health information secure is a top priority for everyone at Stewart-Marchman-Act Behavioral Healthcare (SMA). This privacy notice has been developed to help you understand what information we gather about you, how we use it, and the safeguards SMA has in place in order to protect this information.
Your Medical Record/Health Information
Each time you see or speak with a clinician employed by SMA, a record is made of the contact. Typically, this record may contain basic demographic data such as your name, age, and address, what was discussed, your symptoms, examination and test results, diagnosis, treatment, and plans for future care or treatment. This information is contained in your medical record and serves as a:
- Basis for planning your care and treatment
- Means of communication among the mental health professionals who contribute to your care
- Legal document describing the care you received
- Means by which you or a third party payer can verify that services billed were actually provided
- A tool in educating health professionals
- A source of data for medical research
- A source of information for public health officials charged with improving the health of the nation
- A source of data for facility planning and marketing
Understanding what is in your medical record and how this information is used helps you to:
- Ensure its accuracy
- Better understand who, what, when, where and why others may access your health information
- Make more informed decisions when authorizing disclosure to others
What SMA does With the Information Collected?
- We will use your health information for treatment. For example, information obtained by a member of your healthcare team will be recorded in your medical record and used to determine the course of treatment that should work best for you.
- 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 and procedures provided to you.
- We will use your health information for health care operations. For example, members of SMA’s medical staff may use information in your medical record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the services we provide.
Does SMA Share This Information with Anyone?
With your authorization, SMA will share this information with those individuals who must know information to provide you with adequate mental health care and to those insurance companies who require proof to pay a claim.
Florida law does provide for your information to be released without your permission under circumstances, which include the following:
- If you declare the intent to harm another person, such a declaration may be disclosed without your permission. Mental health professionals have a Duty to Warn and Protect Identified Victims.
- Mental health professionals who know or have reasonable cause to suspect abuse, neglect, or exploitation of children, disabled adults, and the elderly are required to report that abuse to the Central Abuse Registry of the Florida Department of Children and Families.
- The parent or legal guardian of a minor child or adolescent may receive limited verbal information related to the child’s/adolescent’s treatment plan and current physical and mental condition.
- Your record may be released to persons authorized by an order of the court when “good cause” for the release has been established.
- Your record may be disclosed to a member of the staff of SMA on a “need to know” basis.
- Your record may be disclosed to an authorized representative of the Florida Department of Children and Families when the administrator of that agency deems it necessary for your treatment, maintenance of adequate records, compilation of treatment data or evaluation of programs.
- Information from your record can be used for statistical and research purposes only if your identity is protected.
- When you have an attorney for your benefit while you are hospitalized involuntary, your attorney may have access to your record, related to the presentation of your case.
- Your records may be reviewed by the Agency for Health Care Administration, the Florida Department of Children and Families, or the Human Rights Advocacy Committee when they are evaluating a facility or investigating a complaint.
- Your records may be shared with a court appointed professional as part of your evaluation process.
- Information contained in your record may be shared with law enforcement official if it is believed you are in imminent danger of harming yourself.
Nothing in this section is intended to prohibit your parent or next of kin if you are held in or treated under a mental health facility or program from requesting and receiving information limited to a summary of your treatment plan and current physical and mental condition. Release of such information shall be in accordance with the code of ethics of the profession involved.
You shall have reasonable access to your clinical records, unless such access is determined by your physician to be harmful to you. If your right to inspect your clinical record is restricted by the facility, written notice of such restriction shall be given to you and your guardian, guardian advocate, attorney, and representative. In addition, the restriction shall be recorded in the clinical record, together with the reasons for it. The restriction of your right to inspect your clinical record shall expire after 7 days but may be renewed, after review, for subsequent 7-day periods.
We may contact you to provide appointment reminders, information about treatment alternatives or other health-related benefits and services that may be of interest to you. Examples of how we may contact you include mail and phone. Other uses and disclosures of your protected health information will be made only with your written authorization.
You have the right to revoke the authorization at any time, provided the revocation is in writing except to the extent SMA has taken action in reliance upon the authorization or if the authorization was obtained as a condition of obtaining insurance coverage and the insurer has rights to contest a claim under the policy. Although you do have the right to revoke authorization, please be advised that SMA is not required by law to treat you if your revocation conflicts with our ability to treat you.
SMA may share your information electronically by facsimile and e-mail to help facilitate treatment and or to receive payment for services.
How SMA Protects the Confidentiality and Security of Your Information
SMA follows strict policies and procedures to protect your protected health information. These policies and procedures restrict the unauthorized release of protected health information and outline sanctions that result if such policies and procedures are violated.
Your Rights Regarding Protected Health Information
Although your medical record is the physical property of SMA, you have the right to:
- Request restrictions on certain uses and disclosures of your protected health information; however, please be advised that SMA is not required by law to agree to a requested restriction.
- Receive confidential communications of your protected health information.
- Request to inspect and copy protected health information contained in your medical record, provided that the attending physician approves, at which a summary of treatment will be provided
- Request to amend protected health information contained in your medical record
- Receive an accounting of disclosures of your protected health information
- Receive a paper copy of any communications you receive from SMA electronically
Requests for the above must be made in writing and submitted to SMA’s Health Information Management Department.
SMA’s Responsibilities Regarding Your Protected Health Information
The Law requires SMA to:
- Maintain the privacy of your protected health information
- Provide you with this notice of SMA’s legal duties and practices with respect to protected health Abide by the terms of this notice. Accommodate reasonable requests you may have to communicate protected health information by alternative means or at alternative locations.
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, such changes are effective upon posting the revised notice in prominent locations throughout SMA facilities. Copies of revised notices will also be available at each location for your convenience.
For More Information or To File A Complaint
If you have questions regarding the information contained in this notice, please contact SMA’s Privacy Officer at the address or telephone number below.
If you believe that your privacy rights have been violated, you may file a complaint with either SMA, through its Privacy Officer or the Secretary of Health and Human Services. SMA will not retaliate against you for filing a complaint.
Stewart-Marchman-Act Behavioral Healthcare
1220 Willis Avenue Box # 30
Daytona Beach, FL 32114
Secretary of Health and Human Services
Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201