Notice of Privacy Practice

This notice describes how Health Information about you may be used and disclosed and how you can get access to this information.

Please review this Notice carefully

Our Pledge Regarding Information About Our Services to You

NorthCare creates a record of the services we provide you. We are committed to protecting information we create or receive about you.  We want you to be fully informed about this information, how we protect it and how we use it.  Stated in this Notice are some ways that NorthCare may use or disclose your health information. This Notice covers records from NorthCare and all NorthCare programs.

Our Uses and Disclosures.

The following describes the ways we may use and share health information that identifies you (“Health Information”). We may disclose information as we:

• Treat you. This may include disclosing health information with staff or other health care professionals in planning and/or providing services to you. For example: information shared between your psychiatrist and your case manager; information shared with a pharmacist to fill a prescription prescribed by one of our psychiatrist; and information shared in an emergency to help you receive care.
• Bill for your services. We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment and services you received.  For example, we may give your health plan information about you so that they will pay for your treatment.
• Run our organization. We may use and disclose Health Information our Agency operations purposes.  These uses and disclosures are necessary to make sure that all clients receive quality care and to operate and manage our organization.  For example, we may use your information to review and improve the quality of care we provide. We may also share your information with business associates who perform other services with Northcare, as well as with representatives from our accrediting bodies and funding sources. NorthCare has confidentiality agreements with these entities to protect your information.
• Remind you of appointments. We may telephone you at home to remind you of an appointment. If you do not answer, we may leave a message including appointment date and time, but we will not identify ourselves as NorthCare with anyone or on an answering machine without your permission.
• Help with public health and safety issues. We may use and disclose your health information for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability or for other health oversight activities.  Your health information may be disclosed to appropriate persons to prevent or lessen a serious and imminent threat to the health and safety of a particular person or the general public.
• Do research. NorthCare may use and disclose your health information for research purposes when an Institutional Review Board (IRB) or Privacy Board has reviewed the research proposal and established protocols to ensure the privacy of your health information and has approved the research.
• Comply with the law. NorthCare will use and disclose your health information as required by federal, state or local law.  For example, in certain circumstances, we may be required to disclose information for the following purposes:
  • Reporting information related to victims of abuse, neglect or domestic violence;
  • Responding to judicial and administrative proceedings or, in the course of judicial proceedings, if you have waived your rights to confidentiality under Oklahoma law;
  • Complying with a court order or court-ordered warrant, a subpoena or summons issued by a judicial officer, or a grand jury subpoena;
  • Helping health oversight agencies during the course of audits, investigations, inspections, licensure, and other proceedings, subject to the limitations imposed by federal and Oklahoma law.
• Work with a medical examiner or funeral director. NorthCare may use and disclose your health information to the state medical examiners office, coroners or funeral directors for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law and as necessary to carry out their duties.
• Address workers’ compensation, law enforcement, and other government requests. NorthCare may use and disclose your health information as necessary to comply with laws and regulations related to workers’ compensation.
• Respond to lawsuits and legal actions. NorthCare may use and disclose your health information if you are involved in a lawsuit or a dispute.  If the lawsuit is a health negligence action, your health information may be disclosed without a court order.  We may also disclose your health information in response to a subpoena, discovery request, or other lawsuit process by someone else involved in a dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
• Respond to organ and tissue donation requests. If you are an organ or tissue donor, we may share health information with organ procurement organizations upon request.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you, with exceptions outlined by Oklahoma law.
• We will respond to your request within 30 days of your request. A reasonable fee may be charged for making copies of your records.  Under current Oklahoma law, advance fees of 25¢ per page are allowed.  We may also charge for postage if you request the information to be mailed. NorthCare may deny your request in certain circumstances.  If we deny your request for access or copies, you will be informed of your rights to appeal our decision.

Ask us to amend/correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete. Your request must be in writing and include the reasons you believe the information is inaccurate or complete. We will not erase original information. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legally authorized representative, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights. You will not be penalized for filing a complaint. Complaints about this Notice or how NorthCare handles your information should be directed to: NorthCare, Attention: Privacy Officer, 2617 General Pershing Blvd, Oklahoma City, OK 73107. Phone: 405.858.1700.
• You can also submit a formal complaint to: Regional Manager, Office for Civil Rights – DHHS, 1301 Young Street, Suite 1169, Dallas, Texas 75202. Phone: 214.767.4056 / 214.767.8940 (TDD)

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In the following cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In the following cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or disclose health information, which identifies you without your written authorization.  If you do authorize NorthCare to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time. We are unable to take back any disclosure we have already made with your authorization and we are required to retain our records of the care we provide to you.

Oklahoma law requires that we inform you that your health information used or disclosed as described in this Notice of Privacy Practices may include records which may indicate the presence of a communicable or venereal disease which may include, but are not limited to, diseases such as hepatitis, syphilis, gonorrhea and the human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).

Confidentiality of Alcohol and Drug Abuse Records

The confidentiality of alcohol and drug abuse client records maintained by NorthCare is protected by Federal law and regulations. Generally, we may not say to a person outside NorthCare that a client attends an alcohol or drug abuse program, or disclose any information identifying a client as an alcohol or drug abuser.

Exceptions to disclosures related to alcohol and drug abuse records may be made when:

1. The client consents in writing
2. The disclosure is allowed or required by a court order; or
3. The disclosure is made to healthcare personnel in a healthcare emergency or to qualified personnel for research, audit, or program evaluation.

Violation of the Federal law and regulations by NorthCare is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations. Federal law and regulations do not protect any information about a crime committed by a client either at NorthCare or against any person who works for NorthCare or about any threat to commit such a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.

Change of Ownership.

In the event that NorthCare is sold or merged with another organization, your health information will become the property of the new owner-organization.  You will maintain the right to request that copies of your health information be transferred to another agency or provider.

If you would like a more detailed explanation of these rights, or if you would like to exercise one or more of these rights, contact our Privacy Officer at the number listed in this document.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request.