BROCKTON AREA MULTI-SERVICES, INC.

 

Notice of Privacy Practices

Use and Disclosures of Health Information

Brockton Area Multi-Services, Inc. (BAMSI) may use your health information for the purposes of providing you treatment and conducting health care operations.  Your health information may be used or disclosed only after BAMSI has obtained your written consent.  BAMSI has established a policy to guard against unnecessary disclosure of your health information.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AFTER YOU HAVE PROVIDED WRITTEN CONSENT:

To Provide Treatment:  BAMSI may use your health information to coordinate care with BAMSI and with others involved in your care, such as your attending physician, members of the BAMSI multi-disciplinary team and other health care professionals who have agreed to assist BAMSI in coordinating care.  For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.  BAMSI may also disclose your health care information to individuals outside of BAMSI involved in your care, including family members; clergy whom you have designated; pharmacists, suppliers of medical equipment, or other health care professionals that BAMSI uses in order to coordinate your care.

To Obtain Payment:  BAMSI may include your health information in invoices to collect payment from third parties for the care you may receive from BAMSI.  For example, BAMSI may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or BAMSI.  BAMSI may also need to obtain prior approval from your insurer and may need to explain to the insurer your need for the services that will be provided to you.

To Conduct Health Care Operations:  BAMSI may use and disclose health care information for its own operations in order to facilitate the function of BAMSI and as necessary to provide quality care to all of BAMSI’s persons served.  Health care operations include such activities as follows:

• Quality improvement and improvement activities.
• Activities designed to improve health or reduce health care costs.
• Protocol development, case management, and care coordination.
• Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
• Professional review and performance evaluation.
• Training of non-health care professionals.
• Accreditation, certification, licensing, or credentialing activities.
• Review and auditing, including compliance reviews, medical reviews, legal services, and compliance programs.
• Business planning and development including cost management and planning related analysis.
• Business management and general administrative activities of BAMSI.
• Fundraising for the benefit of BAMSI and certain marketing activities.

For example, BAMSI may use your health information to evaluate its staff performance, combine your health information with other BAMSI clients in evaluating how to more effectively serve all BAMSI clients, disclose your health information to BAMSI staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding an appointment with us, or contact you or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

Federal privacy rules allow BAMSI to use or disclose your health information without your consent or authorization for a number of reasons.

When Legally Required:  BAMSI will disclose your health information when it is required to do so by any federal, state, or local law.

When There Are Risks To Public Health:  BAMSI may disclose your health information for public activities and purposes in order to:

• Prevent or control disease, injury, or disability; report disease, vital events such as birth or death; and the conduct of public surveillance, investigations, and interventions.
• To report adverse events, product defects to track products or enable product recalls, repairs, and replacements.  To conduct post marketing surveillance and compliance with requirements of the Food and Drug Administration.
• To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
• To an employer about an individual who is a member of the workforce as legally required.

To Report Abuse, Neglect, or Domestic Violence:  BAMSI is allowed to notify government authorities if BAMSI believes a person served is a victim of abuse, neglect, or domestic violence.  BAMSI will make this disclosure only when specifically required or authorized by law when the person served agrees to the disclosure.

To Conduct Health Oversight Activities:  BAMSI may disclose your health information to a health oversight agency for activities including audits, civil administrative, or criminal investigations, inspections, licensure, or disciplinary action.  BAMSI, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of healthcare or public benefits.

In Connection With Judicial and Administrative Proceedings: BAMSI may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order in response to a subpoena, discovery request, or lawful process, but only when BAMSI makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

For Research Purposes:  Under certain circumstances, we may use and disclose medical information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all persons served who received one medication to those who received another, for the same condition.  Before we use or disclose medical information for research, the project will have been approved through a research approval process.

To Avert a Serious Threat to Health or Safety:  We may use and disclose medical information about you when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.  Any disclosure, however, would only be to someone able to help prevent the threat.

For Special Purposes:  We may disclose medical information about you for special purposes as permitted or required by law, including the following:

• Organ and tissue donation and transplant reports as required by regulatory organizations as necessary to facilitate organ or tissue donation and transplant.
• Military and veteran reporting on members of the armed forces ofU.S.or foreign military as required by military command authorities.
• Workers compensation or other rehabilitative activities reporting as required by law or insurers in order to provide benefits for work-related or victim injuries or illnesses.
• Law enforcement if asked to do so by a law enforcement official:
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain    the person’s agreement;
• About a death we believe may be the result of criminal conduct;
• About criminal conduct at BAMSI; and
• In emergency circumstances, to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.
• Coroners, medical examiners, and funeral directors:  We may release medical information to a coroner or medical examiner.  This may be necessary, for example, to identify a deceased person or determine the cause of death.  We may also release medical information about persons served by BAMSI to funeral directors as necessary to carry out their duties.
• National security and intelligence activities:  We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
• Protective services for the President and others:  We may disclose medical information about you to authorized federal officials so they may provide protection to the President or other authorized persons of foreign heads of state.
• Inmates:  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official.  This release would be necessary:

• For the institution to provide you with health care
• To protect your health and safety of others
• For the safety and security of the correctional institution

Your Rights Regarding Health Information About You

• Right To Inspect and Copy:  You have the right to inspect and copy medical information that may be used to make decisions about your care.  To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Director or Manager of the program in which you receive services, or to the BAMSI Privacy Officer.  If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.
• Right To Amend:  If you feel that medical information about you is incorrect or incomplete, you may ask us to amend the information.  You have the right to add a statement.  To request an amendment, your request must be made in writing and submitted to the Director or Manager of the program in which you receive services, or to the BAMSI Privacy Officer.  In addition, you must provide a reason that supports your request.
• Right to an Accounting of Disclosures:  You have the right to request an “accounting of disclosures”.  This is a list of certain disclosures we made of medical information about you.  To request this list or accounting of disclosures, you must submit your request in writing to the Director or Manager of the program in which you receive services, or to the BAMSI Privacy Officer.  Your request must state a time period, which may not be longer than six years and may not include dates beforeApril 14, 2003.  The first list you request within a 12-month period will be free.  For additional lists, we may charge you for the costs of providing the list.
• Right to Request Restrictions:  You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations.  We are not required by federal regulation to agree to your request.  If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.  To request restrictions, you must make your request in writing to the BAMSI Privacy Officer.
• Right to Request Confidential Communications:  You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.  To request confidential communications, you must make your request in writing to the Director or Manager of the program in which you receive services, or to the BAMSI Privacy Officer.  We will not ask you the reason for your request.
• Right to Paper Copy of this Notice:  You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Changes To This Notice

We reserve the right to change this notice.  We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future.  We will post a copy of the current notice throughout the Agency.  In addition, the next time you register or are admitted to a program for treatment or healthcare services as a resident or outpatient, we will offer you a copy of the current notice in effect.

Contact Person

BAMSI’s contact person for all issues regarding person served privacy and your rights under the federal privacy standards is the Privacy Officer.

If you have any questions regarding this notice, please contact:

BAMSI Privacy Officer

10 Christy’s Drive

Brockton, MA 02301

(508) 580-8700

You have the right to express complaints to BAMSI if you believe that your privacy rights have been violated.  BAMSI encourages you to express any concerns that you may have regarding the privacy of your information.  You will not be retaliated against in any way for filing a complaint.

Revised 10/20/11