THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

Effective 1/1/03 

 

CMHS, Inc. is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information.

 

CMHS, Inc. is required to abide by the terms of the notice currently in effect; and

 

CMHS, Inc. reserves the right to change the terms of its notice and to make the new notice provisions effective for all protected health information that it maintains and provide all individuals with the revised notice either by mail or in person.

 

Complaints: Individuals may request further information or make a complaint of any alleged violations of privacy rights to the Privacy Officer at CMHS, Inc. 254-3652 or file a complaint in writing and within 180 days of occurrence to the Secretary of DHHS, Office of Civil Rights, Washington, D.C. 20201.    Individuals will not be retaliated against for filing a complaint.

 

Uses and disclosures

 

With consent:  Protected health information (PHI) may be disclosed as authorized by you, the client/resident.  Only information requested on the written authorization will be disclosed unless limited by law. This includes the following:

 

• Other healthcare facilities responsible for providing health care services to you. e.g. your primary care physician.

• Insurance carriers for the purpose of reimbursement

• Attorney

• Employers

• School referrals

 

Without consent:  PHI shall be disclosed upon request to:

 

• The parent of a minor client or resident (exception minor requesting drug or alcohol services)

• The guardian or other person having legal custody of same

• The attorney of a client/resident who is a ward of the juvenile court, an alleged incompetent person as evidenced by court orders of an attorney’s appointment.

• The courts upon receipt of an official court order

• The appropriate local authorities of a threat of harm to self or others

• Government agencies for purpose of audits, licensure, etc.

• MO Advocacy agency authorized to protect the rights of persons with a mental illness.

• Medicare and Medicaid recipients as authorized by Federal law

• Worker’s Compensation claims (MO law)

• Public Health Laws pertaining to certain vital statistics, public health safety

• Internal Revenue audits by qualified personnel

• Medical personnel in a life-threatening situation

 

 

 

 

 

                                   

 

 

 

 

 

 

 

 

 

Your Rights:  Federal law 45 CFR Parts 160 and 164 give you the right to privacy of your personal  health information  maintained by CMHS, Inc., with some exceptions mandated by law.  You may exercise your rights as follows:

 

• Request restrictions on certain uses and disclosures of PHI, however, CMHS is not required to agree to a requested restriction.

• Inspect and copy PHI

• Amend PHI

• Receive an acknowledgement of disclosures of PHI

• To obtain a paper copy of this Notice, upon request, if you agreed to receive the notice electronically.