Elder Services of Berkshire County, Inc.
Notice of Privacy Practices for Protected Health Information
Effective: 04/14/2003
Rev. 04/08/2003
I. How Elder Services of Berkshire County, Inc. (ESBCI) Uses and Discloses Your Health Information:
ESBCI provides a broad range of services through a wide variety of health and human services programs. If you receive services from ESBCI, we may use your protected health information and disclose it to other health and human services programs to:
a. plan and provide your care and treatment
b. communicate with health care professionals who care for you
c. describe the services & care you receive
d. obtain reimbursement from state and other government programs
e. verify that services billed were actually provided
f. educate health professionals
g. inform public health officials charged with improving healthcare
h. administer the ESBCI programs which provide benefits, and/or health or human services
i. assess and improve the services provided and the outcomes achieved
j. pay for services you receive
k. inform you about other programs and services
ESBCI and its contractors will not use or disclose your protected health information except as described in this notice, or otherwise authorized by law.
II. Your Health Information Rights:
You have the right to:
a. request a restriction on certain uses and disclosures of your protected health information
b. obtain a paper copy of this Notice of Information Practices upon request
c. inspect and copy your protected health information
d. request amendments to your protected health information
e. obtain an accounting of disclosures of your protected health information
f. request communications of your protected health information by alternative means or at an alternative address
g. revoke your permission to use and disclose protected health information with the understanding that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain your records of care that was provided to you.
h. file a complaint to ESBCI and/or the Secretary of the U.S. Department of Health and Human Service if you believe your privacy rights have been violated.
III. ESBCI Duties: ESBCI
ESBCI’s has a duty to:
ESBCI may change its privacy practices and make the new privacy practices effective for all protected health information we maintain. Should our privacy practices change, we will mail a revised notice to the address you have supplied us.
IV. For More Information or to Report a Problem:
If you have questions and would like additional information, you may contact the Privacy Officer at 413-499-0524 X707.
If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer or with the Secretary of the United States Department of Health and Human Services. There will be no retaliation for filing a complaint.
V. Examples of Disclosures for Treatment, Payment and Health Operations:
In order to provide Home Care Services under the Massachusetts Home Care Program, ESBCI must collect personal and health information to establish your eligibility for services. Family members or other organizations involved in your care may also be contacted in order to coordinate your services. All of the information collected will be maintained in confidence under the requirements of the Massachusetts General Laws. In order to provide you with adequate and appropriate care, the following parties may have access to pertinent information about you.
We will use your health information for treatment.
For example: Information obtained by a case manager, nurse, or other member of our agency will be recorded in your record and used to determine the services that should work best for you.
We will use your health information for payment.
For example: A bill may be sent to you or any private or public source of health coverage you have identified. The information on or accompanying the bill may include information that identifies you, as well as your services you've received.
· Appropriate personnel/contractor from the ESBCI, Elder Affairs or provider entity for the purpose of providing, managing, or studying the effectiveness of your services.
· If Medicaid is paying for some of your services, the Division of Medical Assistance will have access to certain information
· Some information will be provided to those who may be involved in your care so that they understand your needs. The information will likely include your name; address; telephone number; emergency contact; other household members; health conditions; ability to complete daily tasks; extent of family help provided; and type of assistance needed.
VI. Others who may receive your health information
Business Associates: there are some services provided in our organization through contracts with business associates. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we've asked them to do. We require the business associate to appropriately safeguard your information, and sign a Business Associate Agreement.
Research: We may disclose information to researchers when the information is de-identified or when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Public Health: We may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Law enforcement: We may disclose health information for law enforcement purposes.