HIPAA Notice
Effective Date: April 14, 2003
The law requires us to:
- Make sure that any protected health information that identifies you is kept private;
- Give you this notice of our legal duties and privacy policy practices with respect to your protected health information; and
- Follow the terms of the notice that is currently in effect.
The following categories describe different ways that we use and disclose your protected health information. For each category we will explain what we mean and try to give some examples. We will not list every use or disclosure in the examples. However, all of the ways we are permitted to use and disclose protected health information will fall within one of the categories.
For example:
- The staff may need to know that you are taking a certain medication or have a condition such as seizures that may effect your program.
- We may disclose your protected health information to doctors, nurses or other health providers who are involved in taking care of you. For instance, a doctor taking care of you for an injury may need to know if you have diabetes because diabetes may affect treatment.
- We may disclose your protected health information to people such as family members or others who take part in your support outside the DDS.
For example:
- People who live in DDS operated facilities are billed to pay for a portion of their room and board.
- We bill Medicaid for services provided to people enrolled in the Home and Community Based Services Waiver.
- We provide information to the Department of Administrative Services, Fiscal Services Center so they can act as DDS’s billing agent.
For example:
- We may use your protected health information to review our programs and services and to evaluate the performance of our staff or the performance of a contracted provider.
- We may combine health information about many individuals to decide what changes in service might be needed.
- We may also use combined information to evaluate how we are managing changes in resources or services.
5. Service Alternatives: We may use or disclose your protected health information to inform you about or recommend possible service or program alternatives that may be of interest to you.
All research projects are subject to a special approval process. This process evaluates a proposed research project and its use of health information. Before we use or disclose health information for research, the project will have been approved through the research approval process.
- To prevent or control disease, injury or disability;
- To report births and deaths;
- To report abuse or neglect;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- To notify a person who may haven been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- To notify the appropriate government authority if we believe a person has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness, or missing person;
- About the victim of a crime if, under limited circumstances, we are unable to obtain the person's agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct within one of our programs; and
- In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
15. Coroners, Medical Examiners and Funeral Directors: We may disclose health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also disclose health information about individuals to funeral directors, as necessary, to carry out their duties.
16. National Security and Intelligence Activities: We may disclose your protected health information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
17. Protective Services for the President and Others: We may disclose your protected health information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state; or to conduct special investigations.
18. Inmates: If you are an inmate of a correctional institution or under custody of a law enforcement official, we may disclose health information about you to the correctional institution or law enforcement official.
1. for the institution to provide you with health care
2. to protect your health and safety or the health and safety of others; or
3. for the safety and security of the correctional institution.
You have the following rights regarding health information we maintain about you:
Right to Inspect and Copy: You have the right to inspect and copy health information that may be used to make decisions about your services. Usually, this includes health and billing records but does not include psychotherapy notes.
To request an amendment, your request must be made in writing and submitted to your Regional Director of Quality Improvement. In addition, you must provide a reason that supports your request.
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the health information kept by or for DDS;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
To request this list or accounting of disclosures, you must submit your request in writing to your Regional Director of Quality Improvement. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations.
To request restrictions, you must make your request in writing to your Regional Director of Quality Improvement. In your request, you must tell us:
Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to your Regional Director of Quality Improvement. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of this Notice: You have a right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our web site: www.ct.gov/dds.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facilities. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you receive new services from us, we will offer you a copy of the current notice in effect.
If you receive services from DDS, and believe your privacy rights have been violated by DDS, you may contact the DDS Ombudsperson in writing at shannon.jacovino@ct.gov, or you may file a complaint with the Secretary of the Department of Health and Human Services here. ** Please note the DDS Ombudsperson can only provide assistance to those who receive support from DDS. All others needs to seek assistance from the US Department of Health & Human Services. **
OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us written permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the services that we provided you.
If you have any questions about this notice please contact the Director of Quality Improvement in your region. Your case manager can also assist you.