Notice of Privacy Practices

Aunt Martha’s Youth Service Center, Inc. is a covered entity under HIPAA (Health Insurance Portability and Accountability Act).  As a covered entity, Aunt Martha’s is committed to ensuring that your private health information is treated confidentially.  This notice describes instances when your health information may be disclosed (used outside of Aunt Martha’s).  Other than the disclosures described in this notice, your health information will not be disclosed without your signed authorization.

Use of Information for Treatment, Payment and Operations

• In order to provide good medical care to you (treatment), obtain payment for services (payment), and ensure quality and efficiency in our day to day functioning (operations), there will be times when we must share information outside of this organization.
  • An example which may occur under treatment would be calling a physician or hospital to which we are referring you and providing them with information about your condition.
  • For payment purposes, we might send information to your insurance company, required in order to process your bill.
  • For operations, we might allow your chart to be reviewed by an external reviewer or auditor.
• In the above instances, your personal health information may be disclosed.  Under each of these circumstances, the entities that review your information will be either bound by federal law or otherwise have a responsibility to keep your personal information confidential.
• Information that we may release under these circumstances would not be limited and could include information regarding HIV infection, substance abuse, and/or psychiatric illness.
• You may request restrictions beyond those stated in this notice but our organization is not required to abide by the restriction requested unless we agree to do so.

The Right to Inspect and Amend Records

• You have the right to inspect your medical/client record or any other document owned by Aunt Martha’s that contains your personal health information with rare exceptions.
• If you believe that any of the information inspected is inaccurate, you have the right to request that the information is changed so that it is accurate.
• A request to inspect or amend your health information must be made in writing.  Should you make such a request, it will be evaluated by Aunt Martha’s privacy officer or designee to determine if the request to inspect your health information and/or the requested change in your health information should be allowed.
• You will be informed of a decision (for inspection or amendment/change of record) within a reasonable time period.
• If a decision is made to change the information as requested, the change will be made and an effort will be made to inform other entities who may have received inaccurate information.
• However, if it is determined that no change is warranted, you will be informed of this decision as well.  You may appeal this decision by resubmitting your request for the change in writing and stating in that request that you are now appealing a previous decision.
• Upon receipt of the second request, the records will be reevaluated by a licensed physician who was not involved in your treatment or in the decision to deny the initial request.  The decision at this second level of review will be final.

Disclosures for Research

• It is possible that your health information might be accessed by a researcher.
• Such access will not be allowed under any circumstances unless the researcher has clearly demonstrated that your health information will be treated confidentially and that protective measures are put in place to ensure that unauthorized access does not occur.
• In these situations, if feasible, you will be contacted and your permission will be asked to allow your information to be utilized for this purpose.
• Whether you allow or don’t allow your information to be used, your services at Aunt Martha’s will in no way be effected.  Your treatment will in no way be conditioned upon your approval.
• In situations where it is not feasible to obtain your approval, your information may still be used (but not in instances where you have requested that your information not be used) provided that the researcher has demonstrated that appropriate steps will be taken to protect your identity, that protective measures are in place to prevent unauthorized access, and that any information pertaining to your identify will be destroyed as early in the research as possible.
• Because of strict protection afforded your identity, Aunt Martha’s may not know definitively if your information is used for this purpose.  If there is any possibility that such a use may have occurred, Aunt Martha’s will provide you with that information upon request including information on how to contact the researchers and information regarding what information was collected, how the information was used, and how confidentiality was maintained.
• Any disclosure beyond that described above will generally require you to sign an authorization form except under rare and extenuating circumstances.

Aunt Martha’s Corporate/HIPAA Committee

• Aunt Martha’s has formed a Corporate/HIPAA Compliance Committee which is responsible for overseeing the implementation of Aunt Martha’s HIPAA compliance efforts and ensuring that your personal health information is treated confidentially.  Members of the committee, including those who are responsible for investigating complaints, are listed below.

• Bob Richardson Chief Security Officer 708-747-7100

  Dr. Jennifer Byrd Chief Privacy Officer 708-756-1135

• You may submit a complaint verbally or in writing to either complaint recipient at any of the above locations.  If you leave a voice mail message, include your name, patient’s client’s name and details about the complaint.
• Furthermore, at your discretion, you may complain to any member of the committee listed above.  Additionally, if you believe that your rights to privacy have been violated, you have the right to complain to the Secretary of the Department of Health and Human Services in the Office of Civil Rights.
• This privacy notice may be subject to change.  If a change should occur, the change will be posted in our waiting area and on our web site at the time of implementation or as soon as possible after implementation.  You may request a current notice at any time verbally or in writing.