Microsoft Word version of privacy practices
Short Version
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.
Elizabeth Layton Center is dedicated to maintaining the privacy of your personal health information. We are required also by law to do this. These laws are complicated, but we must provide you with this important information. This is a short version of the full, legally required Notice of Privacy Practices. However, we can't cover all possible situations so please talk to our Privacy Officer about any questions or problems.
We will use the information about your health, which we get from you or from others, mainly to provide you with treatment, to arrange payment for our services or for some other business activities which are called, in the law, health care operations. After you have read this NPP we will ask you to sign a Consent Form to let us use and share your information. If you do not consent and sign this form, we cannot treat you.
If we or you want to use or disclose (send, share, release) your information for any other purposes, we will discuss this with you and ask you to sign an Authorization to allow this.
Of course, we will keep your health information private, but here are some
times when the laws require us to use or share it such as:
1) When there is a serious threat to your health and safety or the health
and safety of another individual or the public. We will only share information
with a person or organization who is able to help prevent or reduce the threat.
2) Some lawsuits and legal or court proceedings.
3) If a law enforcement official requires us to do so.
4) For Workers Compensation and similar benefit programs.
5) In some instances, for court ordered services, information re: treatment
and/or assessment may be shared with referring court personnel.
There are some other situations like these, but which don't happen very often.
They are described in the longer version of the NPP.
An additional exception to confidentiality is that in the event of an emergency,
the person(s) identified as your emergency contact(s) may be notified.
Your rights regarding your health information
1) You can ask us to communicate with you about your health and related issues
in a particular way or at a certain place. For example, you can ask us to
call you at home, and not at work to schedule or cancel an appointment. We
will try our best to do as you ask.
2) You have the right to ask us to limit what we tell certain individuals
involved in your care or the payment for your care, such as family members
and friends. While we don't have to agree to your request, if we do agree,
we will keep our agreement except if it is against the law, or in an emergency,
or when the information is necessary to treat you.
3) You have the right to look at the health information we have about you
such as your medical and billing records. The availability to examine psychotherapy
notes is at the discretion of the Executive Director or the Executive Director's
designee.
4) If you believe the information in your records is incorrect or incomplete,
you can ask us to make some kinds of changes (called amending) to your health
information. You have to make this request in writing and send it to our Privacy
Officer. You must tell us the reasons you want to make the changes.
5) You have the right to a copy of this notice. If we change this NPP we will
post it in our waiting room and you can always get a copy of the NPP from
the Privacy Officer.
6) You have the right to file a complaint if you believe your privacy rights
have been violated. You can file a complaint with our Privacy Officer and
with the Secretary of the Department of Health and Human Services. All complaints
must be in writing. Filing a complaint will not change the health care we
provide to you in any way.
If you have any questions regarding this notice or our health information
privacy policies, please contact our Privacy Officer, Donna Johnson, who can
be reached by phone at 913-557-9096 or 785-242-3780.
The original effective date of this notice was April 14, 2003/Revised February
25, 2009