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Privacy

Area Agency on Aging 11, Inc.
NOTICE OF PRIVACY PRACTICES

This notice describes how medical and health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

About This Notice:
The federal Health Insurance Portability & Accountability Act (HIPAA), effective 4/14/03, requires that you be advised of certain circumstances about information concerning your health care - including services under the PASSPORT Medicaid and certain Older Americans Act Title III & State-funded programs - and your rights regarding how that information may or may not be used.

This notice will not affect your actual care plan or services that you receive. It is just for your information.

Use and Disclosure of Health Information:
Under HIPAA, the Area Agency on Aging 11, Inc. (Area Agency on Aging) has a limited right to use and disclose your Protected Health Information (PHI) for the purposes of providing your treatment, obtaining or providing payment for your care and conducting health care operations. The Area Agency on Aging has policies to guard against unnecessary disclosure of your health information. When use or disclosure is necessary, Area Agency on Aging is committed to revealing only the minimum necessary amount of information.

Summary of When and Why Your Health Information May Be Used and Disclosed:
To Provide Treatment. The Area Agency on Aging may use your Protected Health Information to coordinate or manage your care within the Area Agency on Aging and with other individuals or organizations outside of the Area Agency on Aging that are involved in your care, such as your attending physician, other health care professionals, contracted service providers or related organizations. For example, certain service providers involved in your care may need information about your medical condition in order to deliver services properly and appropriately.

To Obtain or Provide Payment. The Area Agency on Aging may include your Protected Health Information in invoices to collect or provide payment to or from third parties for the care you receive through the Area Agency on Aging. For example, some health information is transmitted to the Ohio Department of Aging and the Ohio Department of Job and Family Services when billing transactions are conducted.

To Conduct Health Care Operations. The Area Agency on Aging may use and disclose Protected Health Information for its own operations and as necessary to provide quality care to all of the Area Agency on Aging's service recipients. Health care operations including but not limited to such activities as: Quality assessment and improvement activities; Activities designed to improve health or reduce health care costs; Protocol development, case management and care coordination; Contacting health care providers and consumers with information about treatment alternatives and other related functions that do not include treatment; Professional review and performance evaluation; Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs; Business management and general administrative activities of the Area Agency on Aging; and, where appropriate, Fundraising for the benefit of the Area Agency on Aging, unless otherwise prohibited as with Medicaid.

For example, the Area Agency on Aging may use Protected Health Information to evaluate its staff performance or combine your health information with other Area Agency on Aging consumers to evaluate how to better serve all Area Agency on Aging consumers. Another example may be your information being disclosed to Area Agency on Aging staff or contracted personnel for certain limited training purposes or your participation in the program being revealed by applying mailing labels to send community information mailings.

For Appointment Reminders. The Area Agency on Aging may use and disclose your Protected Health Information to contact you as a reminder that you have an appointment for a home visit.

For Treatment Alternatives. The Area Agency on Aging may use and disclose your Protected Health Information to advise you or recommend possible service options or alternatives that may be of interest to you.

Summary of circumstances when your health information may also be used and disclosed:
When Legally Required. The Area Agency on Aging will disclose your Protected Health Information when required by any Federal, State or local law.

In the Event of a Serious Threat To Life, Health Or Safety. The Area Agency on Aging may, consistent with applicable law and ethical standards of conduct, disclose your Protected Health Information if the Area Agency on Aging, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your life, health or safety or to the health and safety of the public.

When There Are Risks to Public Health. The Area Agency on Aging may disclose your Protected Health Information for public activities and purposes allowed by law in order to: Prevent or control disease, injury or disability; Report disease, injury, vital events such as birth or death; Conduct public health surveillance, investigations and interventions; or, Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.

To Report Abuse, Neglect Or Domestic Violence. Under HIPAA standards, the Area Agency on Aging is allowed to notify government authorities if the Area Agency on Aging believes a consumer is the victim of abuse, neglect or domestic violence. The Area Agency on Aging will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

To Conduct Health Oversight Activities. The Area Agency on Aging may disclose your Protected Health Information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. The Area Agency on Aging, however, may not disclose your Protected Health Information if you are the subject of an investigation and your Protected Health Information is not directly related to your receipt of health care or public benefits.

In Connection With Judicial and Administrative Proceedings. The Area Agency on Aging may disclose your Protected Health Information: in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order; or, in response to a subpoena, discovery request or other lawful process, if Area Agency on Aging determines that reasonable efforts have been made by the party seeking the information to either notify you about the request or to secure a qualified protective order regarding your health information (HIPAA reg. Sec.164.512.e.1). Under Ohio law, some requests may require a court order for the release of any confidential medical information, which would be more protective than the federal requirements.

For Law Enforcement Purposes. Under HIPAA regulation section 164.512.f, and as permitted or required by State law, the Area Agency on Aging may disclose specific and limited Protected Health Information about you for certain law enforcement purposes when professional judgment finds it in your best interest, such as: Reporting certain types of wounds or other physical injuries; Relevant requirements of certain court orders, warrants, subpoenas, summons or similar legal process; For the purpose of identifying or locating a suspect, fugitive, material witness or missing person; Under certain limited circumstances, when you are the victim of a crime; To a law enforcement official if the Area Agency on Aging has a suspicion that your death was the result of criminal conduct including criminal conduct at the Area Agency on Aging; and, In an emergency in order to report a crime.

For Research Purposes. The Area Agency on Aging may, under very select circumstances, use your Protected Health Information for research. Before the Area Agency on Aging discloses any of your health information for such research purposes in a way that you could be identified, the project will be subject to an extensive review & approval process, unless otherwise prohibited as with Medicaid.

For Specified Government Functions. Federal regulations may require or authorize Area Agency on Aging to use or disclose your Protected Health Information to facilitate specified government functions relating to military & veterans, national security & intelligence activities, protective services for the President & others, medical suitability determinations and inmates & law enforcement custody.

For Worker's Compensation. Area Agency on Aging may release your Protected Health Information for worker's compensation or similar programs.

Authorization to Use or Disclose Protected Health Information:
Other than is stated above, the Area Agency on Aging will not disclose your individually identifiable Protected Health Information except with your written authorization. If you authorize the Area Agency on Aging to use or disclose such information, you may revoke that authorization in writing at any time.

Your Rights with Respect to Your Protected Health Information:
You have the following rights regarding Protected Health Information that the Area Agency on Aging maintains:

Right to a personal representative. You may identify persons to Area Agency on Aging that may serve as your authorized 'personal representative' through applicable law, such as: a court-appointed guardian; a properly executed and specific power-of-attorney granting such authority; a Durable Power of Attorney for Health Care if it allows such person to act when you are able to communicate on your own; or other method recognized in law. Area Agency on Aging may, however, reject a representative if, in Area Agency on Aging professional judgment, it is not in the best interest of the consumer (HIPAA reg. Sec. 164.502.g.5).

Right to request restrictions. You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the Area Agency on Aging disclosure of your Protected Health Information to someone who is involved in your care or the payment of your care. The Area Agency on Aging is not required, however, to agree to your request. To request such restrictions, please contact your Area Agency on Aging case manager.

Right to receive confidential communications. You have the right to request that the Area Agency on Aging communicate with you in a confidential way. For example, you may ask Area Agency on Aging to only conduct communications pertaining to your health information with you privately, with no other family members present. If you wish to receive confidential communications, please contact your Area Agency on Aging case manager. The Area Agency on Aging cannot require that you provide an explanation for your request and will attempt to honor any reasonable requests.

Right to inspect and copy your protected health information. Unless your access to your records is restricted for clear and documented treatment reasons, you have a right to see your Protected Health Information upon request. You have the right to inspect and copy such health information, including billing records, at a reasonable time & place. A request to inspect and copy records containing your health information may be made to your Area Agency on Aging case manager. If you request a copy of such health information, the Area Agency on Aging is allowed to charge reasonable fees for certain copying, processing & personnel costs.

Right to amend health care information. You have the right to request that the Area Agency on Aging amend your records, if you believe that your Protected Health Information is incorrect or incomplete. That request may be made as long as the information is maintained by the Area Agency on Aging. A request for an amendment of records must be made in writing to your Area Agency on Aging case. The Area Agency on Aging may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by the Area Agency on Aging, if the records you are requesting are not part of the Area Agency on Aging records, if the health information you wish to amend is not part of the health information you are permitted to inspect and copy, or if, in the opinion of the Area Agency on Aging, the records containing your health information are accurate and complete. Area Agency on Aging takes the position that amendments may take the form of including a written statement from you and may not include changing, defacing or destroying any necessary information related to your health care.

Right to know what disclosures have been made. You have the right to request an accounting of disclosures of your Protected Health Information made by the Area Agency on Aging for certain reasons, including reasons related to public purposes authorized by law and certain research. The request for an accounting must be made in writing to your Area Agency on Aging case manager. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. The Area Agency on Aging would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

Right to a paper copy of this notice. You have a right to a separate paper copy of this Notice at any time, even if you have received this Notice previously. To obtain a separate paper copy, please contact your Area Agency on Aging case manager.

Duties of the Area Agency on Aging:
The Area Agency on Aging is required by law to maintain the privacy of your Protected Health Information and to provide to you with this Notice of its legal duties and privacy practices. The Area Agency on Aging is required to abide by the terms of this Notice, which may be amended from time to time. The Area Agency on Aging reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all Protected Health Information that it maintains. If the Area Agency on Aging changes its Notice, the Area Agency on Aging will provide a copy of the revised Notice to you.

Where to file a complaint
You have the right to express complaints to the Area Agency on Aging if you believe that your privacy rights have been violated, including any denial of rights under the HIPAA law. Any complaints to Area Agency on Aging 11, Inc. shall be made in writing to your Area Agency on Aging case manager or the Office of the Privacy Officer at Area Agency on Aging 11, Inc., 25 East Boardman St., Youngstown, OH 44503. Area Agency on Aging encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint. You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, D.C., 2201 or call toll-free (877) 696-6775, by e-mail to OCRComplaint @ hhs.gov, or to Region V, Office for Civil Rights, U.S. Department of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, Ill. 60601, Voice Phone (312) 886-2359, FAX (312) 886-1807, or TDD (312) 353-5693.

Contact Persons:
Area Agency on Aging 11, Inc. has designated a Privacy Officer as its contact point for all issues regarding consumer privacy and your rights under the federal or any other privacy standards. You may contact the privacy officer through your PASSPORT case manager, or at Area Agency on Aging 11, Inc., 25 East Boardman St., Youngstown, OH 44503.

Effective Date:
This Notice is effective April 14, 2003

. If You Have Any Questions Regarding This Notice, please contact your Area Agency on Aging Case Manager
or
The Privacy Officer at (330) 746-2938 or (800) 686-7367