About Us
Privacy Practices for Anne Carlsen Center for Children
This notice contains policy information for individuals
at ACCC and families and/or guardians of the individual, concerning information disclosure and the rights of the individual and their families.
Meaning of “You” and “We”
In this notice, when "we" is used, it references the
ACCC. When "you" is used it references you as an individual
and your family and/or guardian.
How will we use and disclose information about you?
Treatment: ACCC may use information about you to provide
you with medical services and supplies. We may disclose information
about you to others that need the information to treat you, such
as doctors, physician assistants, nurses, medical and nursing students,
technicians, therapists, emergency service and medical transportation
providers, medical equipment providers, and others involved in
your care. For example, we will allow your physician to have access
to your medical record to assist in your treatment and for follow-up
care.
We may also provide your physician or a subsequent healthcare
provider with copies of various reports that may assist him or
her in treating you once you are discharged from ACCC.
Facility Directory: Unless you object,
ACCC will use and disclose in our facility directory your name,
location in the facility, your general condition (e.g., fair, stable,
critical) and your religious affiliation. This information may
be provided to members of the clergy and, except for religious
affiliation, to other people who ask for you by name. If you would
like to opt out of being in the ACCC directory, please complete
the section in the Student Handbook's Admission/Annual Consent
and Release Forms.
Individuals Involved in Your Care or Payment for Care: ACCC
may disclose information about you to a family member or friend
who is involved in your medical care and helps pay for your care.
If you do not want ACCC to disclose information about you to family
members or others, you must notify the ACCC records department.
In the event of a disaster, we may disclose information about you
to help locate a family member or friend in a disaster.
Payment: ACCC may use and disclose information
about you to receive payment for the medical services and supplies
we provide to you. For example, your health plan or health insurance
company may request to see parts of your medical record before
they will pay us for your treatment.
Health Care Operations: ACCC may use and
disclose information about you, if necessary, to improve the quality
of care we provide to students/resident/therapy outpatients or
to run the health care operations. We may use information about
you to conduct quality improvement activities, to obtain audit,
accounting or legal services, or to conduct business management
and planning. For example, we may use medical information to review
our treatment and services and to evaluate the performance of our
staff in caring for you.
Fundraising: Many of our former students
and their families and outpatients like to make contributions to
a ACCC. An ACCC Foundation representative may contact you
in the future to raise money for the Facility. ACCC does not give
medical information to the foundation staff.
Research: ACCC may use or disclose information
about you for research projects, such as studying the effectiveness
of a treatment you received. These research projects must
go through a special process that protects the confidentiality
of your information.
Required by Law: Federal, state, or local
laws do NOT require student/guardian/therapy outpatient consent
to disclose information which is REQUIRED to be reported. For instance,
we are required to report child abuse and neglect, gunshot wounds,
etc. Public policy has determined that these types of needs outweigh
the student/resident/therapy outpatient's right to privacy. ACCC
is also required to give information to the state workers' compensation
program for work-related injuries.
Public Health: ACCC also may report certain
medical information for public health purposes. For instance,
we are required by law to report births, deaths, and communicable
diseases to the state. We may disclose to the FDA health information
relative to adverse events with respect to food, supplements, product
recalls, repairs or replacement.
Public Safety: ACCC may disclose medical
information for public safety purposes in limited circumstances.
We may disclose medical information to law enforcement officials
or to the court in response to a search warrant or a valid subpoena. We
also may disclose medical information to assist law enforcement
officials in identifying or locating a person, to prosecute a crime
of violence, to report deaths that may have resulted from criminal
conduct, and to report criminal conduct at the facility. We also
may disclose information about you to law enforcement officials
and others to prevent a serious threat to health or safety.
Health Oversight Activities: ACCC may disclose
medical information to a government or oversight agency that oversees
ACCC such as the state’s department of health services, or
other federal agencies that oversee Medicaid, or licensing agencies
who govern physicians and other healthcare professionals.
Funeral Directors: ACCC may disclose health
information to funeral directors consistent with applicable laws
to carry out their duties.
Organ and Tissue Donation: ACCC may disclose
medical information to organizations that handle organ, eye or
tissue donation or transplantation.
Judicial Proceedings: ACCC may disclose
medical information in a lawsuit where your health status is an
issue. For example, ACCC may be ordered to do so by court order
or search warrant.
Information with Additional Protection: Certain
types of medical information may have additional protection under
state or federal law. For instance, medical information about
communicable disease and HIV/AIDS, drug and alcohol abuse treatment,
genetic testing, and court-ordered mental evaluation may be treated
differently than other types of medical information. For those
types of information, ACCC may obtain your authorization to release
this information except as required by law.
Other Uses and Disclosures: ACCC will honor
your requests to disclose medical information to others.
What are your rights?
Right to request information about you: You have the right
to look at information about you and to get a copy of that information.
This includes your medical record, your billing record, and other
records we use to make decisions about your care. To request information,
submit a written authorization to the Records Department for medical
information, and to the Business Office for your billing records.
If you request a copy of your information, we may charge you for
costs to copy the information. We will tell you in advance what
the cost will be. You can view at your record at no cost. The
law requires us to keep the original record.
Right to request to amend or supplement information
about you which you believe is incorrect or incomplete: If
you see information about you and believe that some of the information
is incorrect or incomplete, you may ask us to amend your record.
To do so, you must submit a written request to the Records Department
for medical information changes or to the Business Office for
your billing records.
Right to get a list of certain disclosures of information
about you: You have the right to request from
the Records Department a list of certain information disclosures
we made about you. We will provide the first list to you at no
charge, but we may charge you for any additional lists you request
during a calendar year. We will inform you in advance what this
list will cost.
Right to request confidential communications: You
have the right to request us to communicate with you in a way that
you feel is more confidential. We will accommodate reasonable
requests including alternative addresses or alternative means.
For example, you can ask us not to call your home, but to communicate
only by mail. To do this, submit your written request to
the Records Department.
Right to a copy of the Patient Notice of Privacy Practices: You
have the right to a paper copy of the Notice at any time. You may
obtain a copy of the Notice from our website, www.annecenter.org,
or you may obtain a paper copy of the Notice in the Records Department,
Home Life Services Nurses’ Station or Therapy Services registration
office.
Changes to this notice
We may amend or revise our practices concerning how we use or
your medical information, or how we will implement your rights
concerning your information. We reserve the right to change
this Notice and to make the provisions in our new notice effective
for all information about you we maintain. If we change these practices,
we will publish a revised Notice of Privacy Practices.
Which healthcare providers does this notice cover?
This Notice of Privacy Practices applies to ACCC and its
personnel, volunteers, students, and trainees. The Notice also
applies to other healthcare providers that come to the Facility
to care for you, including physicians, physician assistants, therapists,
other health care providers that are not employed by ACCC, emergency
service providers, medical transportation companies, and medical
equipment and suppliers. These health care providers will
follow ACCC's guidelines regarding your information. Other health
care providers may follow different guidelines at their own offices
or facilities.
Do you have concerns or questions?
Contact the Facility Privacy Officer if you have any concerns
with or questions about your privacy rights or how ACCC uses or
discloses information about you.
If, for some reason, ACCC personnel cannot
resolve your concern, you may also file a complaint with the federal
government. To file a complaint against ACCC, contact the Regional
Offices for Civil Rights at the following address:
Regional
Manager
Office of
Civil Rights
U.S. Dept
of Health and Human Services
1961 Stout
Street - Room 1185 FOB
Denver, CO
80294-3538
Voice Phone
(303)844-2024
FAX (303)
844-2025
TDD (303)
844-3439
We will not penalize you or take any retaliatory action
against you in any way for filing a complaint with the federal
government.
 |
