Privacy

Notice of Privacy Practices

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.

We respect the confidentiality of Protected Health Information (PHI) and only release medical information about you in accordance with state and federal law. This notice describes our polices related to the use of medical records generated or kept by Challenge Unlimited, Inc. and Residential Options, Inc. (the “Company” or “we”), and is effective March 1, 2018.

Privacy Contact. If you have any questions about this policy or your rights as a client, contact the Executive Vice President of Program Services at 618-465-0044, extension 1008, or for employees with questions, contact the Director of Benefits, Compensation and Compliance at 618-465-0044, extension 1038. If you wish to contact a Privacy Contact in writing, address your letter to the Privacy Contact at #4 Emmie L. Kaus Lane, Alton IL 62002.

OUR RESPONSIBILITIES

We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

We follow the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, and any federal or state law that gives greater privacy protections than HIPAA. For example, we follow the Illinois Mental Health and Developmental Disabilities Confidentiality Act concerning mental health records; and the Illinois Personal Information Protection Act which protects “personal information” that is not otherwise lawfully made available to the general public from federal, state, or local government records.

USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION

In order to effectively provide services to our Clients or process medical information on employees or Clients for health insurance, workers compensation claims or medical leaves of absence, there are times when we will need to share your medical information with others beyond our Company. This includes for:

Treatment. We may use or disclose medical information about you to provide, coordinate, or manage your health care or any related services, including sharing information with others outside our Company such as physicians and nurses with whom we are consulting or to whom we are referring you.

Payment. Information may be used to obtain payment for the treatment and services provided. This may include contacting your health insurance company for prior approval of planned treatment or for billing purposes.

Healthcare Operations. We may use information about you to coordinate our business activities. This may include setting up your appointments, reviewing your care and training staff.

Information Disclosed Without Your Consent. Under state and federal law, information about you may be disclosed without your consent in the following circumstances:

Emergencies. Information may be shared to address the immediate emergency you are facing.

Follow Up Appointments/Care. We will be contacting you to remind you of future appointments or information about treatment alternatives or other health related benefits and services that may be of interest to you.

As Required by Law. This would include situations where we have a subpoena, court order, or are mandated to provide public health information, such as communicable diseases or suspected abuse and neglect such as child abuse, elder abuse, or institutional abuse, or helping with product recalls and reporting adverse reactions to medications. For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Coroners, Funeral Directors, Organ Donation and Research. We may disclose medical information to a coroner or medical examiner and funeral director to carry out their duties. When organs are donated sufficient information will be provided to the program as necessary to facilitate organ or tissue donation. In limited circumstances, we may share your information for health research.

Governmental Requirements. We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. There also might be a need to share information with the Food and Drug Administration related to adverse events or product defects. We are also required to share information, if requested with the Department of Health and Human Services to determine our compliance with federal laws related to health care.

Law Enforcement. We may share information for law enforcement purposes or with law enforcement officials, and for special government functions such as military, national security and presidential protetive services. We also have the right to involve law enforcement when we believe an immediate danger may occur to someone.

CLIENTS & EMPLOYEES RIGHTS

You have the following rights under state and federal law:

Copy of Record. You are entitled to a copy of the medical record our Company has generated about you, which we will ordinarily provide within 30 days of your request. We may charge you a reasonable fee for copying and mailing your record.

Release of Records. You may consent in writing to the release of your records to others, for any purpose you choose. This could include your attorney, employer, or others who you wish to have knowledge of your care. You may revoke this consent at any time, but only to the extent no action has been taken in reliance on your prior authorization.

Request Confidential Communication. You can ask us to contact you in a specific way (e.g., home or office phone) or to send mail to a different address. We will consider all reasonable requests and will agree to your request if you tell us you would be in danger if we do not.

Restriction on Record. You may ask us not to use or disclose part of your medical information. This request must be in writing. The Company is not required to agree to your request if we believe it is in your best interest to permit use and disclosure of the information. The request should be given to the Privacy Contact.

Get a Copy of this Notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. Your request for a paper copy of this notice will be complied with promptly.

Choose Someone to Act for You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

Contacting You. You may request that we send information to another address or by alternative means. We will honor such request if it is reasonable and we are assured it is correct. We have a right to verify that the payment information you are providing is correct. We also will be glad to provide you information by email if you request it. If you wish us to communicate by email you are also entitled to a paper copy of this privacy notice.

Amending Record. If you believe that something in your record is incorrect or incomplete, you may request we amend it. To do this contact the Privacy Contact and ask for the Request to Amend Health Information form. In certain cases, we may deny your request. If we deny your request for an amendment you have a right to file a statement that you disagree with us. We will then file our response, and your statement and our response will be added to your record.

Accounting for Disclosures. You may request an accounting of any disclosures we have made related to your medical information, except for information we used for treatment, payment, or health care operations purposes or that we shared with you or your family, or information that you gave us specific consent to release. It also excludes information we were required to release. To receive information regarding disclosure made for a specific time period no longer than six years, please submit your request in writing to the Privacy Contact. We will provide you one accounting per year without charge to you, but we will charge a reasonable cost-based fee if you request a second accounting within one year of the prior request.

Your Choices. You have both the right and choice to tell us to (i) share information with your family, close friends, or others involved in payment for your care, and (ii) share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. We never sell your information or share it for marketing purposes.

Questions and Complaints. If you have any questions, want a copy of this Policy or have any complaints, you may contact the Privacy Contact in writing at our office for further information. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Changes in Policy. The Company reserves the right to change its Privacy Policy based on the needs of the Company and changes in state and federal law. Any new notice will be available to you on our website, or we will mail a copy to you on request.

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