This notice describes how medical information about you may be used, disclosed and how you can get access to this information. Please read it   carefully.  When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you protect them.

You have the right to:

1. Get a copy of your records: You can ask to see or get a copy of your protected health information (PHI) records and other health information we have about you. Ask us how to do this. We will provide a copy of a summary of your records, usually within 30 days of your request.

2. Ask us to correct health and claim records: You can ask us to correct your protected health information records if you if you think they are incorrect or incomplete. We may decline to do so but will let you know the reason in writing within 60 days.

3. Get a list of those with whom we’ve shared information: You can ask for a list of the times we’ve shared your protected health information when necessary, with whom we shared it and why.

4. 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 a paper copy promptly.

5. Your Choices: For certain protected 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 these cases, you have the right and choice to tell us to: share your information with your family, close friends or others involved in your care or share information in a disaster relief situation. In these cases, we NEVER share your information unless you give us written permission: Advertising, Newsletter/website, with outside organizations such as Social Security, VA, Family Support Division, etc.

6. Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or send mail to a different address. We will consider all reasonable requests.

7. Ask us to limit what we use or share: You can ask us NOT to use or share certain protected health information for services. We are not required to agree to your request, and we would say “no” if it would affect your service and make you aware of the consequences of such action.

8. Choose someone to act for you: If you have given someone an appropriate power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has the authority and can act for you before we take any action.

9. File a complaint if you feel your rights are violated: You can complain if you feel we have violated your rights by contacting us. You can file a complaint with the U.S. Department of Health and Human Services or call at 1-877-696-6775.

10. Our Uses and Disclosures: How do we typically use or share your protected health information? We typically use or share your protected health information in the following ways:

  • To provide services: We may use your protected health information to complete care coordination and/or customer care services.
  • To obtain payment: To provide care and services such as assessments and screenings for services and benefits, case management and care coordination, contacting providers and consumers with information about services, care, problem solving and other functions that do not include treatment, professional review and performance evaluation and quality control, review and auditing including compliance reviews, compliance programs and legal reviews, and strategic planning and program development and general administrative activities.
  • For alternative and referrals:  We may use and disclose your protected health information to tell you about or recommend possible service options, benefits or alternatives for which you may be eligible or of interest to you.
  • To report abuse, neglect or domestic violence: As mandated reporters, we are required to report if we suspect you are a victim of abuse, neglect or domestic violence. The Agency would report to the State Elder Abuse Neglect hotline.
  • Comply with the law: We will share information about you if state or federal laws require it, including the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
  • Respond to lawsuits and legal actions: We can share health information about you in response to a court or administrative order or in response to a subpoena.
  • Address Worker’s compensation, law enforcement and other government request: For workers’ compensation claims, for law enforcement purposes or with law enforcement officials, with health oversight agencies of activities authorized by law, and for special government functions such as military, national security, and presidential protective services.

We can change the terms of this notice and the changes will apply to all information we have on file about you. The new notice will be available upon request, on our website, or we can mail it to you.

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 offer you a copy of it. We will not use or share your protected information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind. For more information see: