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Overview of privacy practices

This Notice of Privacy Practices (“Notice”) describes how you, your legally authorized representative, or your minor child’s health information can be used and shared, and how you can get copies of your health information.

We are required by law to maintain the privacy of Public Health Information (“PHI”) and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice at any time. Any new Notice will be effective for all PHI that we maintain at that time. This Notice applies to all of the products, services, and web sites offered by Upbring and its affiliated companies. If you are currently receiving active services from this agency, a copy of the revised Notice of Privacy Practices will be provided to you. A copy of our most current Notice of Privacy Practices will be maintained on our website at www.upbring.org. Copies can also be requested by calling our Privacy Official at 512-459-1000.

In all situations, Upbring is committed to providing excellent, confidential care for our clients and residents. Our policy is that all demographic, medical or psychiatric information about those whom we serve is confidential and to be guarded carefully.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

The routine ways we use and disclose your protected health information is described in this section, in order to provide treatment, order medications or medical equipment.

Information about you will be shared with other health care providers in order to provide you with excellent care.

A. Treatment

Our employees and physicians, counselors or other medical professionals with whom we contract to provide care will have access to your medical records. These other providers include but are not limited to pharmacies, hospitals, ambulance drivers or attendants, or specialty physicians. We may send or receive information about your if you are being admitted to or discharged from this facility or program.

B. Payment

Your protected health information will be used as needed to obtain payment for your health care services as arranged at admission. In some cases additional information may be released in order to approve payment. Information may be given to a collection agency if required.

C. Health Care Operations

Upbring may use or disclose your protected health information in order to support the business activities of our organization. These activities include quality assessment and improvement activities, employee review activities, licensing surveys or other activities. In the event that this Upbring facility is sold, the minimum amount of your protected health information necessary to assure the continuity of your care will be given to the new owners.

Your protected health information may be used or disclosed in order to provide you with information about treatment alternatives, or other health related benefits or services.

D. Business Associates

Upbring will use and disclose your protected health information with a third party known as a business associate for some activities, such as billing and collections, or for audit or insurance purposes. In these cases, a contract exists between Upbring and the other agency that requires careful and confidential management of your information. Business associates are not to disclose your information for activities other than those specified in the contract.

OTHER USES

Upbring may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of this information.

A. Donations

Upbring is a nonprofit organization and we seek donations to assist in the provision of our services. You may be contacted by Upbring staff about making a donation if you are over the age of 18 and express a desire to donate. Only your name and residence address will be given to another Upbring department in that process. We may send you newsletters or other letters seeking donations. Any donations made to Upbring are completely voluntary. If you tell us that you do not wish to be contacted about donating, we will respect your wishes.

B. Newsletter

If you are an adult resident in a facility, your photograph, name and month and day of birth may be included in a facility newsletter or on bulletin boards or in activities. This is done to advise other residents, staff and family members of your admission, upcoming birthday, other special events, or your death. You must be over the age of 18 and give written permission to be included in our newsletter or other posted materials.

C. Appointment reminders and treatment alternatives

Upbring may send you appointment reminders, or information regarding treatment alternatives. You can request that we mail these items to another address, or in another format if you desire.

D. Facility directories

Unless you object, Upbring will use and disclose in our facility directory your name, the location at which you are receiving care, your condition (in general terms), and your religious affiliation, provided you are over the age of 18. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Members of the clergy will be told your religious affiliation.

USES OR DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION

Federal law requires your written authorization in order to use and disclose your protected health information in some circumstances. This written authorization can be revoked at any time. However, the revocation does not cover information used and disclosed prior to the signature terminating the authorization. Authorizations can only be signed by those who have the ability to make their own medical decisions, or their legally appointed representatives.

A. Psychiatric notes

Express written authorization is required for the release of psychiatric notes, unless the information is needed for treatment, payment or health care operations.

B. Marketing

An authorization is required if we use or disclose your protected health information for marketing activities. This could include sending information about programs operated by outside agencies and providers. Upbring agency policy prohibits the sale of client or resident names to any third party for marketing purposes.

C. Sale of protected health information

A written authorization is required for Upbring to constitute a sale of your PHI.

D. Fundraising

Upbring will require your written authorization to share your protected health information for fundraising purposes.

E. Disclosure to you

Upbring may disclose your medical information to you or to a third party to whom you request with written authorization.

USES AND DISCLOSURES THAT MAY BE MADE WITHOUT YOUR AUTHORIZATION

Following is a list of the categories of uses and disclosures permitted by HIPAA without an authorization. Applicable law and ethical standards permit Upbring to disclose information about you without your authorization only in a limited number of situations. Many of these reports must be made to comply with state or federal laws. You will be notified, if required by law.

A. Child abuse, neglect or exploitation

Upbring may disclose your PHI to a state or local agency that is authorized by law to receive reports of child abuse or neglect, or the abuse, neglect or exploitation of the elderly or disabled.

B. Judicial and administrative proceedings

Upbring may disclose your PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is

C. Deceased patients

Upbring may disclose PHI regarding deceased patients as mandated by state law, or to a family member or friend that was involved in your care or payment for care prior to death, based on your prior consent. A release of information regarding deceased patients may be limited to an executor or administrator of a deceased person’s estate or the person identified as next-of-kin. PHI of persons that have been deceased for more than fifty (50) years is not protected under HIPAA.

D. Medical emergencies

Upbring may use or disclose your PHI in a medical emergency situation to medical personnel only in order to prevent serious harm. Our staff will try to provide you a copy of this notice as soon as reasonably practicable after the resolution of the emergency.

D. Others involvement in your care

Upbring may disclose information to close family members or friends directly involved in your treatment based on your consent or as necessary to prevent serious harm. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.

E. Health oversight

If required, we may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors based on your prior consent) and peer review organizations performing utilization and quality control.

F. Law enforcement/national security

Upbring may disclose PHI to a law enforcement official as required by law, in compliance with a subpoena (with your written consent), court order, administrative order or similar document, for the purpose of identifying a suspect, material witness or missing person, in connection with the victim of a crime, in connection with a deceased person, in connection with the reporting of a crime in an emergency, or in connection with a crime on the premises. Your information may be disclosed as required for national security or intelligence activities as required by law.

G. Specialized government functions

Upbring may review requests from U.S. military command authorities if you have served as a member of the armed forces, authorized officials for national security and intelligence reasons and to the Department of State for medical suitability determinations, and disclose your PHI based on your written consent, mandatory disclosure laws and the need to prevent serious harm.

H. Public health

If required, Upbring may use or disclose your PHI for mandatory public health activities to a public health authority authorized by law to collect or receive such information for the purpose

I. Public safety

Upbring may disclose your PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

J. Research

PHI may only be disclosed after a special approval process or with your authorization.

K. Fundraising

Upbring may send you fundraising communications at one time or another. You have the right to opt out of such fundraising communications with each solicitation you receive.

L. Verbal Permission

Upbring may also use or disclose your information to family members that are directly involved in your treatment with your verbal permission.

M. Food and Drug Administration (FDA)

Federal law requires that the FDA monitor certain medical equipment, devices and products. Injury or death related to these products must be reported. Upbring must disclose your protected health information to a person or company as required by the Food and Drug Administration to report adverse events, product defects or problems or biologic product deviations. This information is used to track products; enable product recalls; make repairs or replacements, or to conduct post marketing surveillance, as required.

N. Employers/worker’s compensation

Upbring will use and disclose protected health information if this agency provides health care to employees at the request of the agency in order to conduct an evaluation of the workplace or to evaluate whether or not the employee has a work related injury. Your information may be disclosed by our staff as authorized to comply with workers’ compensation laws, or investigations and other similar legally established programs.

O. Coroners, funeral directors, and organ donation

Upbring may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. Upbring may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. Upbring may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes. Funeral directors and cadaver or organ donation centers will only be contacted if you have first given us specific instructions on the proper agency to contact. Your family will be notified.

P. Criminal Activity

Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Q. Military activity and national security

When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

R. Inmates

We may use or disclose your protected health information if you are an inmate of a correctional facility and UPBRING created or received your protected health information in the course of providing care to you.

S. Communication barriers

Upbring may use and disclose your protected health information if our staff is not able to communicate effectively with you due to substantial communication barriers. UPBRING will work to obtain the services of an appropriate translator to assure your understanding of your situation.

T. Required uses and disclosures

Under the law, Upbring must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

U. Incidental disclosures

As most Upbring facility residents live in a home like environment, it is probable that other residents will come to know your name. It is up to you if you choose to share more personal information with other residents. Upbring staff will not share your medical records with other residents.

YOUR RIGHTS

Federal law establishes your rights to access and amend your protected health information. The following instructions tell you how you can exercise the rights. All requests must be made in writing to the Privacy Official listed on the last page, or the Program Executive Director. In some cases, your request might be denied. If this happens, you can file a grievance or complaint or ask that another professional review the record on your behalf.

A. You have the right to inspect and copy your protected health information.

You have the right, which may be restricted only in exceptional circumstances, to inspect and copy PHI that is maintained including mental health, medical health, billing records and any other records that are used to make decisions about your care. This right will be accommodated within the limits of state law and licensing regulations. Federal law limits and restricts your access to certain types of records, such as psychotherapy notes. You may also request that a copy of your PHI be provided to another person. We may charge a reasonable, cost-based fee for copies.

B. You have the right to request an amendment of your protected health information.

You may request an amendment or correction in your information. The request can ask that Upbring make the change in your record, or you may insert your own statement into the medical record.

C. You have the right to receive an accounting of certain disclosures made by Upbring of your protected health information.

This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. Certain exclusions apply.

D. You have the right to request a restriction of your protected health information.

You may ask Upbring to restrict some uses or disclosures of your protected health information. This can include requesting that Upbring not make disclosures to family members. Your written request must state the specific restriction requested and to whom you want the restriction to apply. Upbring will consider your request, but reserves the right to deny these requests.

Please discuss any restriction you wish to request with the Executive Director of your facility. Any restrictions requested by you and agreed to by UPBRING will be documented in a written agreement.

E. You have the right to request to receive confidential communications from us by alternative means or at an alternative location. Upbring will accommodate reasonable requests, but our staff may not agree if it prevents us from providing excellent care or receiving payment. This right can include sending information to you at an alternative address.

F. You have the right to obtain a paper copy of this notice from us. Upbring will provide a paper copy of this notice upon admission and any time significant changes are made. A paper copy will be given if requested, even if you have agreed to accept this notice electronically.

BREACH NOTIFICATIONS

Upbring makes every effort to secure your health information, including the use of encryption whenever possible. In the event that any of your medical information that has not been encrypted is the subject of a breach, Upbring will provide you a written or electronic notice about the breach as required by federal law.

EMPLOYEES

Upbring employees are trained and required to protect the privacy of health information that identifies you.

COMPLAINTS

You may file a complaint if you believe your privacy rights have been violated by Upbring. You may file an internal complaint by notifying our Privacy Official at the address below. You can also call the Privacy Official if you have questions about our complaint process or this Notice. We will not retaliate against you for filing a complaint.

Privacy Official
Upbring
Attn: Demereal Owens
8305 Cross Park
Austin, TX 78754
512-459-1000
Email: [email protected]

To obtain further information about the federal privacy rules or to submit a complaint to the Department of Health and Human Services, you may contact the Department by telephone at 1- 800-368-1019, by electronic mail at [email protected], or by regular mail addressed to:

Regional Manager, Region IV
Office of Civil Rights
US Department of Health and Human Services
1301 Young Street, Suite 1169
Dallas, TX 75202
800-368-1019
Fax 214-767-0432
TDD 800-537-7697

ELECTRONIC COPY OF THIS NOTICE

You may obtain an electronic copy of the most current version of this Notice at the following website: www.upbring.org.

RIGHT TO REVISE THIS NOTICE

Upbring reserve the right to change the terms of this Notice at any time. Upbring also reserves the right to make the revised noticed effective for medical information Upbring already has about you as well as any information received while such notice is in effect.

This notice was published by Upbring and becomes effective on March 1, 2014.

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