Privacy Statement
Challenges Privacy Statement
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI)
We are legally required to protect the privacy of your health information.
We call this information "protected health information," or "PHI" for short,
and it includes information that can be used to identify you that we've created
or received about your past, present, or future health or condition, the provision
of health care to you, or the payment of this health care. We must provide you
with this notice about our privacy practices that explains how, when, and why
we use and disclose your PHI. With some exceptions, we may not use or disclose
any more of your PHI than is necessary to accomplish the purpose of the use
or disclosure. We are legally required to follow the privacy practices that
are described in this notice.
However, we reserve the right to change the terms of this notice and our privacy
policies at any time. Any changes will apply to the PHI we already have. Before
we make an important change to our policies, we will promptly change this notice
and post a new notice in the lobby of the admission's area. You can also request
a copy of this notice from the contact person listed in Section VI below at
any time and can view a copy of the notice on our Web site at www.challenges-program.com .
Along with Challenges , there are health care providers that share in this
joint notice under an Organized Health Care Arrangement or OHCA. Those providers
are listed in the addendum to this notice, entitled, "Health Care Providers
Covered By This Notice". Please understand that Challenges will not be responsible
in any manner for actions of the members of the OHCA unrelated to the activities
of the OHCA.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION.
We use and disclose health information for many different reasons. For some
of these uses or disclosures, we need your prior consent or specific authorization.
Below, we describe the different categories of our uses and disclosures and
give you some examples of each category.
- Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations
Require Your Prior Written Consent.
We may use and disclose your PHI with your consent for the following reasons:
- For treatment.
We may disclose your PHI to physicians, nurses, medical students, and
other health care personnel who provide you with health care services
or are involved in your care. For example, if you require a special diet
for an eating disorder, we may disclose your PHI to the food services
department in order to coordinate your care.
- To obtain payment for treatment.
We may use and disclose your PHI in order to bill and collect payment
for the treatment and services provided to you. For example, we may provide
portions of your PHI to our billing department and your health plan to
get paid for the health care services we provided to you. We may also
provide your PHI to our business associates, such as billing companies,
claims processing companies, and others that process our health care claims.
- For health care operations.
We may disclose your PHI in order to operate this hospital. For example,
we may use your PHI in order to evaluate the quality of health care services
that you received or to evaluate the performance of the health care professionals
who provided health care services to you. We may also provide your PHI
to our accountants, attorneys, consultants, and others in order to make
sure we're complying with the laws that affect us.
- Exceptions to consent requirement for treatment, payment, and health
care operations.
Although your consent is required for numbers 1-3 of this section, above,
we may disclose your PHI to others without your consent in certain situations.
For example, your consent isn't required if you need emergency treatment,
as long as we try to get your consent after treatment or we try to get
your consent but you are unable to communicate with us (for example, if
you are unconscious or in severe pain) and we think you would consent
if you were able to do so.
- Certain Uses and Disclosures Do Not Require Your Consent.
We may use and disclose your PHI without your consent or authorization for
the following reasons:
- When a disclosure is required by federal, state or local law, judicial
or administrative proceedings, or law enforcement.
For example, we make disclosures when a law requires that we report information
to government agencies and law enforcement personnel about victims of
abuse, neglect, or domestic violence; when dealing with gunshot and other
wounds; or when ordered in a judicial or administrative proceeding.
- For public health activities.
For example, we report information about births, deaths, and various diseases,
to government officials in charge of collecting that information, and
we provide coroners, medical examiners, and funeral directors necessary
information relating to an individual's death.
- For health oversight activities.
For example, we will provide information to assist the government when
it conducts an investigation or inspection of a health care provider or
organization.
- For purposes of organ donation.
We may notify organ procurement organizations to assist them in organ,
eye, or tissue donation and transplants.
- For research purposes.
In certain circumstances, we may provide PHI in order to conduct medical
research.
- To avoid harm.
In order to avoid a serious threat to the health or safety of a person
or the public, we may provide PHI to law enforcement personnel or persons
able to prevent or lessen such harm.
- For specific government functions.
We may disclose PHI of military personnel and veterans in certain situations.
Also, we may disclose PHI for national security purposes, such as protecting
the president of the United States or conducting intelligence operations.
- For workers' compensation purposes.
We may provide PHI in order to comply with workers' compensation laws.
- Appointment reminders and health-related benefits or services.
We may use PHI to provide appointment reminders or give you information
about treatment alternatives, or other health care services or benefits
we offer.
- Two Uses and Disclosures Require You to Have the Opportunity to Object.
- Patient directories.
Federal and state laws prohibit us from maintaining a patient directory
for use by visitors.
- Disclosures to family, friends, or others.
We may provide your PHI to a family member, friend, or other person that
you indicate is involved in your care or the payment for your health care,
unless you object in whole or in part. The opportunity to consent may
be obtained retroactively in emergency situations.
- All Other Uses and Disclosures Require Your Prior Written Authorization.
In any other situation not described in sections IIIA, B, and C above, we
will ask for your written authorization before using or disclosing any of
your PHI. If you choose to sign an authorization to disclose your PHI, you
can later revoke that authorization in writing to stop any future uses and
disclosures (to the extent that we haven't taken any action relying on the
authorization).
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WHAT RIGHTS YOU HAVE REGARDING YOUR PHI
- You have the following rights with respect to your PHI:
- The Right to Request Limits on Uses and Disclosures of Your PHI.
You have the right to ask that we limit how we use and disclose your PHI.
We will consider your request but are not legally required to accept it. If
we accept your request, we will put any limits in writing and abide by them
except in emergency situations. You may not limit the uses and disclosures
that we are legally required or allowed to make.
- The Right to Choose How We Send PHI to You.
You have the right to ask that we send information to you to an alternate
address (for example, sending information to your work address rather than
your home address) or by alternate means (for example, e-mail instead of regular
mail). We must agree to your request so long as we can easily provide it in
the format you requested.
- The Right to See and Get Copies of Your PHI.
In most cases, you have the right to look at or get copies of your PHI that
we have, but you must make the request in writing. If we don't have your PHI
but we know who does, we will tell you how to get it. We will respond to you
within thirty (30) days after receiving your written request. In certain situations,
we may deny your request. If we do, we will tell you, in writing, our reasons
for the denial and explain your right to have the denial reviewed.
- The Right to Get a List of the Disclosures We Have Made.
You have the right to get a list of instances in which we have disclosed your
PHI. The list will not include uses or disclosures that you have already consented
to, such as those made for treatment, payment, or health care operations,
directly to you, to your family, or in our facility directory. The list also
won't include uses and disclosures made for national security purposes, to
corrections or law enforcement personnel, or before April 14, 2003.
We will respond within sixty (60) days of receiving your request. The list
we will give you will include disclosures made in the last six years unless
you request a shorter time. The list will include the date of the disclosure,
to whom PHI was disclosed (including their address, if known), a description
of the information disclosed, and the reason for the disclosure. We will provide
the list to you at no charge, but if you make more than one request in the
same year, we will charge you $5.00 for each additional request.
- The Right to Correct or Update Your PHI.
If you believe that there is a mistake in your PHI or that a piece of important
information is missing, you have the right to request that we correct the
existing information or add the missing information. You must provide the
request and your reason for the request in writing. We will respond within
60 days of receiving your request. We may deny your request in writing if
the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed
to be disclosed, or (iv) not part of our records. Our written denial will
state the reasons for the denial and explain your right to file a written
statement of disagreement with the denial. If you don't file one, you have
the right to request that your request and our denial be attached to all future
disclosures of your PHI. If we approve your request, we will make the change
to your PHI, tell you that we have done it, and tell others that need to know
about the change to your PHI.
- The Right to Get This Notice by E-Mail.
You have the right to get a copy of this notice by e-mail. Even if you have
agreed to receive notice via e-mail, you also have the right to request a
paper copy of this notice.
HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you think that we may have violated your privacy rights, or you disagree
with a decision we made about access to your PHI, you may file a complaint with
the person listed in the paragraph below. You also may send a written complaint
to the Secretary of the Department of Health and Human Services at Region IV,
Office for Civil Rights, U.S. Department of Health and Human Services, Atlanta
Federal Center, Suite 3B70, 61 Forsyth Street, SW., Atlanta, Georgia 30303-8909.
Voice Phone (404) 562-7886; Fax (404) 562-7881; TDD (404) 331-2867; E-mail:
OCRComplaint@hhs.gov. We will take no retaliatory action against you if you
file a complaint about our privacy practices.
PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR
PRIVACY PRACTICES
If you have any questions about this notice or any complaints about our privacy
practices, or would like to know how to file a complaint with the Secretary
of the Department of Health and Human Services, please contact: Clinical Director,
Ben Brafman, MS, NCC, LMHC, 5100 Coconut Creek Parkway, Pompano Beach, FL 33063;
(954) 917-3334 or (888) 755-3334 or email bbrafman@challenges-program.com
EFFECTIVE DATE OF THIS NOTICE:
This notice went into effect on April 14, 2003.
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