notice is also posted at all CMHSLC locations.
Click Here to view the
Notice as a .pdf file (requires Adobe Reader). This would
be a good choice if you wish to Print the document.
MENTAL HEALTH SERVICES OF LIVINGSTON COUNTY
OF PRIVACY PRACTICES
notice describes how medical, mental health and substance
abuse information about you may be used and disclosed
and how you can get access to this information. Please
review it carefully.
Mental Health Services of Livingston County (LCCMHA)
is committed to protecting the privacy of your medical,
mental health and substance abuse information. We are
required by law to maintain the privacy of your health
information, to provide you with this notice and to comply
with its terms. The privacy practices in this notice
apply to all staff, students and volunteers and to all
contract providers and affiliates.
reserve the right to change the terms of this notice
and will post the revised notice and, upon your request,
we will give you a copy of the revised notice. The new
notice would be effective for any health information
that we hold at that time or receive from that time on.
RIGHTS REGARDING YOUR HEALTH INFORMATION
WE WILL USE AND DISCLOSE YOUR HEALTH INFORMATION
Communications. You may ask that we communicate
with you in a particular way, or at a certain location,
such as calling you at work rather than at home,
to maintain your confidentiality.
and Copy. You have the right to review and/or
receive a copy of the information in your record.
Under limited circumstances we may deny access
to the record or to portions of the record (for
instance, if disclosing information would endanger
you or someone else). You could request a review
of this decision.
- Addendum. You
may ask us to add an addendum to the information
in your records if you feel that the information
is incorrect or incomplete. You may prepare a correcting
statement that will be included in your record.
of Disclosures. You may request a list of disclosures
that we have made of your protected health information
with the exceptions of treatment, payment and healthcare
operations described in this notice, or information
that was released with your authorization.
Restrictions. You may ask us to limit our use
or disclosure of your health information. We are
not required to agree to your request, but if we
do agree to it, we will honor your request unless
the information is needed to provide emergency
treatment to you.
a Copy. You may receive a paper copy of this
notice at any time upon request.
and disclosures for Treatment, Payment and Healthcare
Treatment. We may use and disclose your health
information to provide, coordinate and manage your
services. Information about you may be shared with
staff, students or volunteers, and with contract
providers or affiliation members who may be involved
in your or your family’s treatment. For example,
a staff person may need to review your record in
order to respond to your emergency. We also may
use your health information to remind you about
an appointment or to provide information about
treatment alternatives or other health-related
benefits and services that may be of interest to
Payment. Your health information will be used
and disclosed as needed to obtain payment for your
services. For example, a bill for services sent
to you or to a third-party payer such as Medicaid
might include identifying information about you
such as your name, your diagnosis and services
Health Care Operations. We will use or disclose,
as needed, your health information to support and
improve the activities of Community Mental Health
Services of Livingston County. For example, staff
may use information in your clinical record to
evaluate the care that you received.
and Disclosures That May Be Made Only With Your Specific
uses and disclosures of your protected health information
will be made only with your written authorization,
unless otherwise permitted or required by law as
and Disclosures That May Be Made Without Your Authorization
Required by Law. We may be required by federal,
state or local law to disclose your health information.
Public Health Activities. We may need to disclose
your health information to a public health authority
that is required by law to receive the information.
Such disclosures would be made for the purpose
of controlling disease, injury or disability.
or Neglect. We may be required to disclose
your health information if we suspect that you
or another person has been abused or neglected.
Oversight. We may be required to disclose your
health information for an audit, inspection, investigation
or other health care oversight activity.
and Administrative Proceedings. We may have
to disclose your health information if we receive
a court order or subpoena or for risk management
Enforcement. We may have to disclose your health
information in connection with a criminal investigation
by a federal, state or local law enforcement agency,
or to authorized federal officials who provide
protective services for the President or other
Threat to Health or Safety. We may be required
to disclose information about you to prevent a
serious threat to your health and safety or that
of another person or of the public.
or Medical Examiner. We may need to disclose
your health information to help identify a deceased
person or to determine a cause of death.
- Research. We
may disclose your health information to researchers
if their research proposal includes protocols to
insure the privacy of your health information and
has been approved by the LCCMHA review board.
you believe that your rights have been violated, contact
the LCCMHA Privacy Officer or the Office of
Civil rights. Your services will not be affected
in any way if you file a complaint.
file a complaint with LCCMHA or if you have any questions
or want more information, call or write: Privacy
Officer, LCCMHA, 2280 E. Grand River, Howell, MI
file a complaint with the Office of Civil Rights,
call or write: Office of Civil Rights, U.S. Dept.
Of Health & Human Services, 200 Independence
Ave., SW, Washington DC 20201 or toll-free telephone
Copyright © 2007
CMHSLC. All rights reserved.