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Patient Privacy & Client Rights
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PATIENT PRIVACY
The Counseling Center of Wayne and Holmes Counties
HIPAA-- Health Insurance Portability and Accountability Act: Privacy Notice
I. 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.
II. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION.
A. We are required to protect the privacy of your health information. We call this information "protected health information," or "PHI" for short, and it includes information that can be used to identify you. We must provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure.
B. However, we reserve the right to change the terms of this notice and our privacy practices as the law or agency protocols change. Any changes will apply to the PHI we already have. You will be notified in writing at the time of your next appointment following any such changes. A copy of this notice is available from the any office during normal business hours.
III. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
We use and disclose health information for many different reasons. For some of these uses or disclosures, we need your prior consent (Treatment Consent Document) or specific authorization (Release of Information Document). Below, we describe the different categories of our uses and disclosures and give you some examples of each category.
A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Require Your Prior Consent.
We may use and disclose your PHI with your consent for the following reasons:
1. For treatment. We may disclose your PHI to physicians, nurses, pharmacies, medical students, and other health care personnel who provide you with health care services or are involved in your care. For example, if you're being treated for diabetes, we may disclose your PHI to your primary care physician in order to coordinate your care.
2. To obtain payment for treatment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to our billing department and your health plan to get paid for the health care services we provide you. We may also provide your PHI to our business associates, such as billing companies, claims processing companies, and others that process our health care claims.
3. For health care operations. We may disclose your PHI in order to operate this facility. For example, we may use your PHI in order to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided health care services to you. We may also provide your PHI to our accountants, attorneys, consultants, and others in order to make sure we're complying with the laws that affect us.
B. Certain Uses and Disclosures Do Not Require Your Consent.
We may use and disclose your PHI without your consent or authorization for the following reasons:
1. Coordination and continuity of care. As allowed by law, and unless you specifically object, we may use your PHI in treatment to assure service coordination and continuity of care both within the organization and between the Counseling Center and other professionals or organizations involved in your overall healthcare.
To help assure continuity of care, the agency participates in the Clinisync Health Information Exchange so your medical records can be electronically shared among your doctors and healthcare providers. You can opt out of this exchange at any time by filling out the front page of this document.
2. When a disclosure is required by federal, state, or local law, judicial or administrative proceedings, or law enforcement. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with gunshot and other wounds; or when ordered in judicial or administrative proceedings.
3. For public health activities. For example, we report information about births, deaths, and various diseases, to government officials in charge of collecting that information, and we provide coroners, medical examiners, and funeral directors necessary information relating to an individual's death.
4. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.
5. To avoid harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.
6. For emergency situations.
7. For specific government functions. We may disclose PHI of military personnel and veterans in certain situations. And we may disclose PHI for national security purposes, such as protecting the president of the United States or conducting intelligence operations.
8. For workers' compensation purposes. We may provide PHI in order to comply with workers' compensation laws.
9. Fundraising activities. We may use PHI to raise funds for our organization. The money raised through these activities is used to expand and support the health care services and educational programs we provide to the community. If you do not wish to be contacted as part of our fundraising efforts, please contact the person listed in section VI below.
C. Additional Uses of PHI.
In addition, unless you specifically object, we may contact you from time to time by email, text, regular mail or by telephone to confirm appointments, provide information about related services, inquire about your satisfaction with services, or inform you about the status of your account.
D. For Service paid out-of-pocket and in full.
You have the right to request that services you have paid for out-of-pocket and in full are not disclosed to your health plan, except where we are required by law to make a disclosure.
E. All Other Uses and Disclosures Require Your Prior Written Authorization.
In any other situation not described in sections III A, B, and C above, we will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures (to the extent that we haven't taken any action relying on the authorization).
IV. WHAT RIGHTS DO YOU HAVE REGARDING YOUR PHI?
You have the following rights with respect to your PHI:
A. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
B. The Right to Choose How We Send PHI to You. You have the right to ask that we send information to you to an alternate address or by alternate means (for example, e-mail instead of regular mail). We must agree to your request so long as we can easily provide it in the format you requested.
C. The Right to See and Get Copies of your PHI. In most cases, you have the right to view and/or obtain copies of your PHI that we have, but you must make the request in writing. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed. There may be charges for copies made.
D. The Right to Correct or Update your PHI. If you believe there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct the existing information or add the missing information. You must provide the request and your reason for the request in writing. Special forms are available for this purpose from the Privacy Officer. We will respond within 60 days of receiving your request. We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, or (iv) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI.
If we approve your request, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI.
E. The Right to Opt Out of Clinisync Health Information Exchange. Sharing records electronically is a simple, fast way for your healthcare provider to get a “whole” picture of your health in one record. Only doctors and staff who treat you can look at your health information. Your records remain private in a secure network that is audited.
F. Forms. All of the rights outlined above have forms available on our website at https://www.ccwhc.org/privacy-notice.html or you can contact Medical Records to obtain a copy of the form you desire.
V. HOW TO COMPLAIN IF YOU BELIEVE YOUR PRIVACY RIGHTS HAVE BEEN VIOLATED
If you think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section VI below. You also may send a written complaint to the Secretary of the Department of Health and Human Services. We will take no retaliatory action against you if you file a complaint about our privacy practices.
VI. WHO TO CONTACT TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you have any questions about this notice or any complaints about our privacy practices or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact:
Becky Mason, Chief Compliance Officer/Patient Rights Officer/Client Advocate is available to file a complaint or for assistance with filing a complaint. She may be reached at 330.264.9029, Monday – Friday from 9:00 am – 5:00 pm. Office Location: 2285 Benden Dr, Wooster, OH, 44691.
CLIENTS RIGHTS
STATEMENT OF CLIENT RIGHTS
All clients of The Counseling Center of Wayne & Holmes Counties are entitled to courteous, confidential, and professional treatment. In addition, all individuals receiving services from the agency have specific rights as defined in Ohio law.
CLIENT RIGHTS
1. The right to be treated with consideration and respect for personal dignity, autonomy and privacy.
2. The right to reasonable protection from physical, sexual or emotional abuse, neglect, and inhumane treatment;
3. The right to receive services in the least restrictive, feasible environment;
4. The right to participate in any appropriate and available service that is consistent with an individual service plan (ISP), regardless of the refusal of any other service, unless that service is a necessity for clear treatment reasons and requires the person's participation;
5. The right to give informed consent to or to refuse any service, treatment or therapy, including medication absent an emergency;
6. The right to participate in the development, review and revision of one's own individualized treatment plan and receive a copy of it;
7. The right to freedom from unnecessary or excessive medication, and to be free from restraint or seclusion unless there is immediate risk of physical harm to self or others;
8. The right to be informed and the right to refuse any unusual or hazardous treatment procedures;
9. The right to be advised and the right to refuse observation by others and by techniques such as one-way vision mirrors, tape recorders, video recorders, television, movies, photographs or other audio and visual technology. This right does not prohibit an agency from using closed-circuit monitoring to observe seclusion rooms or common areas, which does not include bathrooms or sleeping areas;
10. The right to confidentiality of communications and personal identifying information within the limitations and requirements for disclosure of client information under state and federal laws and regulations;
11. The right to have access to one's own client record unless access to certain information is restricted for clear treatment reasons. If access is restricted, the treatment plan shall include the reason for the restriction, a goal to remove the restriction, and the treatment being offered to remove the restriction;
12. The right to be informed a reasonable amount of time in advance of the reason for terminating participation in a service, and to be provided a referral, unless the service is unavailable or not necessary;
13. The right to be informed of the reason for denial of a service;
14. The right not to be discriminated against for receiving services on the basis of race, ethnicity, age, color, religion, gender, national origin, sexual orientation, physical or mental handicap, developmental disability, genetic information, human immunodeficiency virus status, or in any manner prohibited by local, state or federal laws;
15. The right to know the cost of services;
16. The right to be verbally informed of all client rights, and to receive a written copy upon request;
17. The right to exercise one's own rights without reprisal, except that no right extends so far as to supersede health and safety considerations;
18. The right to file a grievance;
19. The right to have oral and written instructions concerning the procedure for filing a grievance, and to assistance in filing a grievance if requested;
20. The right to be informed of one's own condition; and,
21. The right to consult with an independent treatment specialist or legal counsel at one's own expense.
Any client (or guardian) who believes that their rights have been violated may file a grievance. Information about filing a grievance and the Grievance Reporting form is available from any staff member and on our website –https://www.ccwhc.org/grievance-procedures.html
In addition, Becky Mason, Chief Compliance Officer/Patient Rights Officer/Client Advocate is available to file a grievance or for assistance with filing a grievance. She may be reached at 330.264.9029, Monday – Friday from 8:00 am –4:00 pm. Office Location: 2285 Benden Dr, Wooster, OH, 44691.
GRIEVANCE PROCEDURE
I. GENERAL
A. The following definitions are for client rights and grievances in rule 5122-24-01 of the Administrative Code:
1. "Client advocate" means the individual designated by a provider with responsibility for assuring compliance with the client rights and grievance procedure rule as implemented within each provider or board and shall have the same meaning as client rights officer or client rights specialist.
2. "Grievance" means a written complaint initiated either verbally or in writing by a client or by any other person or provider on behalf of a client regarding denial or abuse of any client's rights.
3. "Reasonable" means a standard for what is fair and appropriate under usual and ordinary circumstances.
B. The Counseling Center will have the following:
1. Written client rights policy that lists all of the client rights identified in this rule;
2. Written client grievance procedure;
3. Policy for maintaining for at least two years from resolution, records of client grievances that include, at a minimum, the following:
a) Copy of the grievance,
b) Documentation reflecting process used and resolution/remedy of the grievance; and,
c) Documentation, if applicable, of extenuating circumstances for extending the time period for resolving the grievance beyond twenty business days.
C. The Counseling Center post of Client Rights
1. The client rights policy and grievance procedure shall be posted in each location in which services are provided, unless the certified agency location is not under the control of the provider, i.e., a shared location such as a school, jail, etc. and it is not feasible for the provider to do so.
2. The client rights policy and grievance procedure shall be posted in a conspicuous location that is accessible to persons served, their family or significant others and the public.
3. When a location is not under the control of the provider and it is not feasible for the provider to post the client rights policy and grievance procedure, the provider shall assure that copies are available at the location for each person that may request a written copy.
II. PROVISION OF CLIENT RIGHTS
A. The Counseling Center will explain and maintain documentation in the client’s individual patient record an explanation of rights to each person served prior to or when beginning assessment or treatment services.
B. In a crisis or emergency situation, or when the client does not present for services in person such as through a hotline; The Counseling Center may verbally advise the client of at least the immediately pertinent rights only, such as the right to consent to or to refuse the offered treatment and the consequences of that agreement or refusal. Full verbal explanation of the client rights policy shall be provided at the first subsequent meeting.
C. Clients or recipients of referral and information service, consultation service, and prevention service as described in Chapter 5122-29 of the Administrative Code may have a copy and explanation of the client rights policy upon request.
D. Explanations of rights shall be in a manner appropriate for the person's understanding.
E. All staff shall be required to follow the client rights policy and client grievance procedure. There shall be documentation in each employee's personnel file, including contract staff, volunteers and student interns that each staff member has received a copy of the client rights policy and the client grievance procedure and has agreed to abide by them.
F. The client grievance procedure shall have:
1. Statement to whom the client is to give the grievance;
2. Designation of a client advocate who will be available to assist a client in filing of a grievance, the client advocate shall have their name, title, location, hours of availability, and telephone number included with the posting of client rights as required by paragraph (D) of this rule;
3. Requirement that the grievance must be put into writing; the grievance may be made verbally and the client advocate shall be responsible for preparing a written text of the grievance;
4. Requirement that the written grievance must be dated and signed by the client, the individual filing the grievance on behalf of the client, or have an attestation by the client advocate that the written grievance is a true and accurate representation of the clients grievance;
5. Requirement that the grievance include, if available, the date, approximate time, description of the incident and names of individuals involved in the incident or situation being grieved;
6. Statement that the provider will make a resolution decision on the grievance within twenty business days of receipt of the grievance. Any extenuating circumstances indicating that this time period will need to be extended must be documented in the grievance file and written notification given to the client;
7. Requirement that a written acknowledgment of receipt of the grievance be provided to each grievant. Such acknowledgment shall be provided within three business days from receipt of the grievance. The written acknowledgment shall include, but not be limited to, the following:
a) Date grievance was received;
b) Summary of grievance;
c) Overview of grievance investigation process;
d) Timetable for completion of investigation and notification of resolution;
e) Treatment provider contact name, address and telephone number.
III. GRIEVANCE PROCEDURE RESOURCES
A. To file a grievance with the agency or assistance with filing a grievance, please contact:
Becky Mason
Chief Compliance Officer/Patient Rights Officer/Client Advocate
Email: bmason@ccwhc.org
Office Location: 2285 Benden Dr. Wooster, OH 44691
Availability: Monday – Friday 8am – 4 pm
If complaint is regarding the Chief Compliance Officer, the CEO or designee will be assigned for investigation. Please contact (330) 264-9029 for assistance.
B. The client has the option to file a grievance with outside organizations, that include, but are not limited to, the following, with the mailing address and telephone numbers for each stated:
1. Mental Health and Recovery Board of Wayne & Holmes Co.
Address: 1985 Eagle Pass, Wooster, OH, 44691
Phone: (330) 264-2527
2. Ohio Department of Mental Health and Addiction Services (OhioMHAS)
Address: 30 East Broad Street, 36th Floor Columbus, Ohio 43215
Phone: (614) 466-2596
3. Disability Rights- Ohio
Address: 200 S. Civic Center Dr. #300 Columbus, OH. 43215
Phone: (800) 282-9181
4. U.S. Department of Health and Human Services, civil rights office
Address: Centralized Case Management Operations
U.S. Dept. of Health and Human Services
200 Independence Ave., SW
Room 509F HHH Bldg.
Washington, D.C. 20201
Phone: 1-877-696-6775