HIPAA Notice of Privacy Practices Effective Date: April 14, 2003 FOR YOUR PROTECTION, THIS NOTICE DESCRIBES HOW HEALTH AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Your Health Information is Private WRAAA understands that information we collect about you and your health is personal. Keeping your health information private is one of our most important responsibilities. We are committed to protecting your health information and following all laws regarding the use of your health information. The law says: We must keep your health information from others who do not need to know it. You may ask that we not share certain health information. In some instances, we may not be able to agree with your request. Who Sees and Shares My Health Information? We have a limited right to use and share your health information for the purposes of providing you treatment, obtaining payment for your care, and conducting healthcare operations. We have established policies and procedures to guard against unnecessary disclosure of your health information. Your health information may be used by healthcare providers such as doctors, nurses and social workers who take care of you. They may need your health information in order to determine your plan of care. This may cover health care services you had before now or services you may receive in the future. Why is it Necessary to Share My Health Information? We may use or share health information about you in order to help you get services you may need. We may also share your information to coordinate your care and services with other healthcare providers, such as your doctor and the other agencies that help you. We also may use or share health information about you with other agencies, for example with the Ohio Department of Aging and the Ohio Department of Job and Family Services, in order to obtain payment for your services. Additionally, we may use or share health information about you in order to conduct the work of our organization. This includes: Quality improvement activities Contacting you to remind you of an upcoming appointment or visit Contacting you to tell you about service and care options available to you Supervision, evaluation and training activities for our staff Program reviews, financial audits, legal and compliance monitoring activities conducted by other agencies and organizations Conducting our general business and administrative activities May I See My Health Information? You may ask to see your health information unless it is restricted for clear and documented treatment reasons. You also have the right to ask for a copy of your health information, including your billing records. We may charge you a reasonable fee to cover the cost of copying and assembling your information. If you think some of your health information is wrong, you may ask in writing that it be changed or that new information be added. We may deny your request to change your health information if: You do not include a reason for your request We did not create your health information The health information you want changed is restricted We believe that your health information is already accurate and complete What if My Health Information Needs to Go Somewhere Else? So that we can determine your eligibility, and then arrange and coordinate services for you, we will ask you to sign a form to give us permission to share your health information with other healthcare providers and agencies that are also involved in your care. The form explains what health information we need to share, why we need to share it and whom we will share it with. Before we share your health information with anyone other than those healthcare providers and agencies that are or will be involved in your care and services, we will ask you to sign a separate form that tells us what to share, why your health information is being shared, and where to send your health information. There are times when we are either permitted or required to share your health information without obtaining your permission, including: When required by federal, state or local law When there are risks to public health To report suspected abuse, neglect, exploitation or domestic violence To conduct oversight activities, such as audits, civil administrative or criminal investigations, inspections, licensure or disciplinary actions (unless you are the subject of an investigation and your health information is not directly related to your receipt of health care) In response to a subpoena, discovery request, court order or other lawful process related to a judicial or administrative proceeding (we will make a reasonable effort to either notify you about the request or to obtain an order to protect your health information) To remind you of upcoming appointments and visits To tell you about other programs and services that may be of interest to you For law enforcement purposes as permitted or required by law To prevent or lessen a serious threat to your health and safety, or to the health and safety of someone else To the Workers Compensation program To the federal government when they are investigating something important to protect our country, the President and other government workers What Other Rights Do I Have? You can ask us to restrict the use and sharing of your health information to others involved in your care. However, we are not required to agree to the restriction. You can ask us to communicate with you in a confidential way. For example, you might not want us to talk about your care and services with other family members or when other family members are present. We will try to honor your special requests and you do not have to give us a reason why. You can ask us for an account of when we have shared your health information without obtaining your permission. This request must be in writing, must state the time period (not before April 14, 2003) for which the information is requested and may not be made for periods of time in excess of six (6) years. We will provide the first account you request during any 12-month period at no charge to you. However, subsequent accounting requests may be subject to a reasonable fee to cover the cost of copying and assembling your information. Is This Notice Current? If we change anything in thisnotice, we will update this page. You may receive other notices of privacy practices from organizations and agencies that have your private health information. This notice applies only to WRAAA practices. Questions or Complaints We encourage you to ask questions and share any concerns youhave with the information in the notice. If you have any questions about WRAAA’s privacy practices or if you want to make any kind of request about your health information, please contact: Attention: Privacy OfficerWestern Reserve Area Agency on Aging925 Euclid Avenue, Suite 550Cleveland, Ohio 44115-1405800-626-7277 If you think that we have not protected your private health information and you wish to complain, please contact the above address or: Office for Civil RightsU.S. Department of Health and Human Services200 Independence Avenue, S.W.Room 509F, HHH BuildingWashington, D.C. 20201-0004800-368-1019 What Will Happen to Me and My Services if I Complain? It is against the law for us to take any negative action against you for filing a complaint, and your care and services will not be affected in any way. We encourage you to ask questions and to express any concerns you may have about how well your information is protected by the Western Reserve Area Agency on Aging. Contact WRAAA with questions, or view other available resources.