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HIPAA - Notice of Privacy Practices
HIPAA - Notice of Privacy Practices
Thunder Road is in compliance with the Health Insurance Portability and Accountability Act
(HIPAA) of 1996, 42 U.S.C. Sections 1230d-1230d-8 and applicable rules and regulations
issued under its authority. Following is Thunder Road's Notice of Privacy Practices,
effective April 14, 2003.
Thunder Road Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW TREATMENT AND MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED BY THUNDER ROAD, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
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(i) What is This Notice and Why It is Important
This notice is required by law to inform you of how your health information will be protected,
how Thunder Road may use or disclose your health information, and about your rights regarding your health information.
If you have any questions about this notice, please contact Thunder Road's Privacy Officer or a clinical manager at
510/653-5040.
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(ii) Understanding Your Health Information
Each time you visit a physician, health care provider or hospital, a record of your visit is made.
Typically, this record contains a description of your symptoms, medical history, examination and
test results, diagnoses, treatment, and a plan for future care and treatment.
This information, often referred to as your medical record, treatment record, or treatment
partnership plan, serves as a:
- Basis for planning your care and treatment
- Means of communication among the health professionals who contribute to your care
- Legal documents of the care you receive
- Means by which you or a third-party payer (e.g. health insurance company) can verify that services you received were appropriately billed
- A data source for medical research and public health
- A source of data for planning facilities, marketing health care services, and fund raising
- A tool for educating health professionals
- A tool with which we can assess and work to improve the care we provide
Understanding what is in your record and how your health information is used helps you to ensure its accuracy,
better understand how others may access and use your health information, and make more informed decisions
when authorizing disclosures to others.
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(iii) Your Health Information Rights
You have the following rights related to your treatment and billing records kept by Thunder Road:
Obtain a Copy of this Notice.
You will receive a copy of this notice the first time treatment services are rendered.
Thereafter you may request a copy of this notice or any revisions from the receptionist
at the front desk, by calling Thunder Road at
510/653-5040, or visiting our website at
www.thunder-road.org.
Authorization to Use Your Health Information.
Before we use or disclose your health information, other than as described below,
we will obtain your written authorization, which you may revoke at any time to stop
future use or disclosure.
Access to Your Health Information.
You may request a summary of your health information that Thunder Road keeps in your
treatment record or billing record. Your request must be submitted in writing.
We may charge for the costs of providing you access and for your copies.
Amend Your Health Information.
If you believe the information we have about you is incorrect or incomplete,
you may request that we correct or add information. Your request must be in writing
and you may pick up a form for this purpose at the Admissions Department.
Request Confidential Communications.
You may request that, when we communicate with you about your health information,
we do so in a specific way (e.g. at a certain mail address or phone number).
We will make every reasonable effort to agree to your request.
Limit Our Use or Disclosure of Your Health Information.
You may request in writing that we restrict the use or disclosure of your health information
for treatment, payment, health care operations, or any other purpose except
when specifically authorized by you, when we are required by law, or in an emergency situation
in order to treat you. We will consider your request and respond, but we are not
legally required to agree if we believe your request would interfere with our
ability to treat you or collect payment for our services.
Accounting of Disclosures.
You may request a list of disclosures of your health information that we have made
for reasons other than treatment, payment or health care operations.
Disclosures that we make with your authorization will not be listed.
We will provide one list per year free of charge, but may charge for subsequent lists
in the same year.
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(iv) Our Responsibilities
Thunder Road is required by law to protect the privacy of your health information, establish policies,
and procedures that govern the behavior of our workforce and businesses associates, and
provide this notice about our privacy practices, and abide by the terms of this notice.
We reserve the right to change our policies and procedures for protecting health information.
When we make a significant change in how we use or disclosure your health information, we will also change this notice.
The new notice will be posted in the waiting and admission areas, and on our website.
Except for the purposes related to your treatment, to collect payment for our services, to perform
necessary business functions, or when otherwise permitted or required by law, we will not use or disclose
your health information without your authorization. You have the right to revoke your authorization at any time.
We are unable to take back any disclosure we have already made with your permission.
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(v) Examples of Uses and Disclosures for Treatment, Payment and Health Care Operations
We will use your health information to facilitate your medical treatment, behavioral health care services, and rehabilitation.
For example: Information obtained by a counselor, nurse, physician, or other members of a treatment team will be recorded in your record and used to determine the course of your treatment. A Thunder Road staff member may document in your record his or her expectations of you and the members of your treatment team. Members of your treatment team will then record the actions they take and their observations as appropriate. In that way, the physician and the treatment team will know how you are responding to treatment. We will also provide your physician, Thunder Road staff, or other health care providers involved with your treatment (e.g. recovery counselors, consulting physicians, specialists, therapists, etc.) with copies of various reports that should assist them in treating you.
We will use your health information to collect payment for health care services that we provide.
For example: A bill may be sent to you, your parents, or your health insurance company. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used. In some cases, information from your medical record is sent to your insurance company to explain the need for or to provide additional information about your treatment.
We will use your health information to facilitate routine health care operations.
For example: Members of our medical staff or quality assurance committee may use information in your record to assess the care you have received and how your progress compares to others. This information will then be used in efforts to improve the quality and effectiveness of the treatment and other services we provide. Thunder Road is an affiliate of the Sutter Health network. We may permit Sutter Health to use your health information to support necessary business, financial, and clinical functions. Examples of these functions may include: auditing our clinical procedures, analyzing our cost of care, arranging for client satisfaction surveys, and determining the need for new health care services.
We will use your health information to help us educate interns, residency students, and medical staff.
For example: Thunder Road has associations with a variety of schools involved in the education of health care professionals. All staff, interns, and residency students must sign a confidentiality agreement before accessing any health information maintained by Thunder Road.
We will use your health information to notify your family and friends about your condition.
For example: To protect the privacy of people who seek services related to drug, alcohol, and certain behavioral health care rehabilitation services, Federal law (Code of Federal Regulations, Section 42) prohibits Thunder Road from disclosing any information about you without your written consent. Thunder Road will not even disclose whether a client is in our program when a family members calls unless we have your consent. Thunder Road professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, relevant health information to facilitate the person's ability to assist in your treatment or make arrangements for payment of your care.
We may use your health information to inform persons about events after which you cannot provide informed consent or upon your death.
For example: We may disclose health information to legal custodians, guardians, funeral directors, coroners, and medical examiners consistent with applicable law to carry out their duties.
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(vi) Examples of Uses and Disclosures for Other Purposes
Appointment Reminders:
We may contact you to provide appointment reminders.
Alternative Treatments:
We may use your health information to provide you with information about alternative treatments such as acupuncture, biofeedback, stress reduction classes, and support groups.
Directory Information:
We do not make available to the general public your name, location, or general progress as part of a directory information service. This may cause some problems for Thunder Road to assist persons who wish to visit you, deliver gifts, or inquire about your condition. It is very important to cooperate with your assigned Recovery Counselor to maintain an accurate and authorized contact list of individuals as part of your treatment partnership plan at Thunder Road.
Marketing:
We may use your health information to inform you about our health care services, treatment alternatives or other health-related benefits and services that may be of interest to you.
Fund Raising:
Thunder Road is a community-based, not-for-profit program that depends extensively on charitable support. We may use limited information about you such as your name, address, demographic information, and the dates you received treatment, and we may disclose this information to Alta Bates Summit Medical Center fund raising foundation to inform you of opportunities to support Thunder Road and its services and programs. We will give you an opportunity to restrict this information.
Research:
We may contact you to request your participation in an authorized research study. If the study provides any type of health care treatment, the researcher will explain the benefits and risks of the treatment, how your health information will be used during the course of the study, and whether any of your health information rights are affected. You will need to authorize the use of your health information and agree to any suspension of your rights to participate in the study, however you may revoke this authorization at any time. In some cases, we may disclose your health information to researchers when an institutional review or privacy board has approved their research. Prior to giving any information, special procedures will be established to protect the privacy of your information.
Workers Compensation:
We may disclose your health information to the extent authorized by and necessary to comply with laws relating to worker's compensation or other similar programs established by law.
Organ Procurement Organizations:
Should you be an organ or tissue donor, we may disclose your donor status and health information to organizations engaged in the procurement, banking, or transplantation of organs, consistent with applicable laws.
Public Health:
We may disclose your health information as required by law to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
To Avert a Serious Threat to Health or Safety:
We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person. Any disclosure would be made only to someone able to help prevent the threat.
Correctional Institution:
Should you be detained in a correctional institution, we may disclose to the institution or their agents health information necessary for your health and the health and safety of other individuals.
Law Enforcement:
We may disclose your health information for law enforcement purposes as required by law or in response to a valid court or administrative order.
Food and Drug Administration (FDA):
We may disclose to the FDA your health information relating to adverse events with respect to food, nutritional supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs or replacement.
Device Manufacturers:
If you receive a medical device that is implanted or which is used for life support functions, we may disclose your name, address and other information as required by law to the device manufacturer for tracking purposes. You may refuse to authorize the disclosure of your name and contact information.
Business Associates:
There are some services provided at Thunder Road through contracts with business associates. Examples include transcribing your medical record, surveying for client satisfaction, and a copy service we use when making copies of your health record. When these services are provided by contracted business associates, we may disclose the appropriate portions of your health information to our business associates so they can perform the job we have asked them to do. To protect your health information, however, we require all business associates to sign a confidentiality agreement verifying they will appropriately safeguard your information.
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(vii) Special Situations
Military and Veterans:
If you are a member of the armed forces, we may disclose your health information as required by military command authorities. We may also disclose health information about foreign military personnel to the appropriate foreign military authority.
National Security and Intelligence Activities:
We may disclose your health information to authorized federal officials for intelligence, counter intelligence, and other national security activities authorized by law.
Protective Services for the President and Others:
We may disclose your health information to authorized officials so they may provide protection to the President and other governmental leaders, or conduct special investigations.
Regulatory Oversight:
We may disclose your health information to appropriate health oversight agencies, public health authorities or attorneys, when required by law. Your health information may also be disclosed if a workforce member or business associate believes in good faith that Thunder Road has engaged in unlawful conduct or has otherwise violated professional or clinical standards and are potentially endangering one or more clients, Thunder Road staff, medical staff, or the public.
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(viii) For More Information or to Report a Problem
If you have questions, would like additional information, or want to request an updated copy of this notice,
you may contact the Thunder Road Privacy Officer at the
510/653-5040.
If you believe we have not properly protected your privacy, have violated your privacy rights,
or you disagree with a decision we have made about your rights, you may contact Thunder Road's Privacy Officer.
You may also contact the Alameda County Behavioral Health Care Services' Consumer Assistance Office at
800/779-0787, or send a written complaint to the
U.S. Department of Health and Human Services.
| | The Office for Civil Rights |
| | 50 United Nations Plaza - Room 322 |
| | San Francisco, CA 94102 |
| | 415/437-8310 |
| | 415/437-8311 (TDD) |
| | 415/437-8329 FAX |
Thunder Road will ensure that the care provided at our facility will in no way be impacted if you file a complaint.
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