NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
We respect client confidentiality and only release confidential information about you in accordance with the Illinois and federal law. This notice describes JVS’ policies related to the use of the records of your care generated by this agency.
USE AND DISCLOSURE OF PROTECTED INFORMATION
In order to effectively provide you care, there are times when JVS will need to share your confidential information with others beyond our agency. This includes:
- Treatment - We may use or disclose treatment information about you to provide, coordinate, or manage your care or any related services including sharing information with others outside JVS that we are consulting with or referring you to.
- Payment - With your written consent, information may be used to obtain payment for the treatment and services provided.
- Health Care Operations - JVS may use information about you to coordinate its business activities. This may include setting up your appointments, reviewing your care and training staff.
INFORMATION DISCLOSED WITHOUT YOUR CONSENT
Under Illinois and federal law, information about you may be disclosed without your consent in the following circumstances:
- Emergencies - Sufficient information may be shared to address the immediate emergency you are facing.
- Follow-Up Appointments/Care - We will be contacting you to remind you of future appointments or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We will leave appointment information on your answering machine/voice mail unless informed otherwise.
- As Required by Law - This would includes situations where we have a subpoena, court order or are mandated to provide public health information, such as communicable diseases, suspected abuse and neglect or institutional abuse.
- Coroners - We are required to disclose information about the circumstance of deaths to a coroner pending an investigation.
- Government Requirements - We may disclose information to a health oversight agency for activities authorized by law such as audits, investigators, inspectors and licensure. If requested we are required to share information with the U.S. Department of Health and Human Services to determine JVS’ compliance with federal laws related to health care and with the Illinois state agencies that fund our services.
- Criminal Activity or Danger to Others - If you are involved in a crime committed on JVS’ premises or against its personnel or we believe someone is in danger, information may be shared with law enforcement.
- Fundraising - As a non-profit provider of health care services, we need assistance in raising money to carry out JVS’ mission. JVS may contact you to seek a donation.
CLIENT RIGHTS
You have the following rights under Illinois and federal law:
- Copy of Record - You are entitled to inspect the client record JVS has generated. You may be charged a reasonable fee for copying and mailing your record.
- Release of Records - You may consent in writing to release your records to others for any purpose you choose. This could include your attorney, employer or others who wish to have knowledge of your care. You may revoke this consent at any time, but only to the extent no action has been taken in reliance of your prior authorization.
- Restriction of Record - You can request JVS not disclose part of the clinical information. This request must be in writing. Jewish Vocational Service is not required to agree to your request if it is believed that it is not in your best interest to withhold use and disclosure of the information. The request should be given to the Privacy Contact.
- Contacting You - You may request that JVS send information to another address or by alternate means. JVS will honor such a request as long as it is reasonable and we are assured it is correct. JVS has the right to verify that the information you are using for payment is correct.
- Amending Record - If you believe something in your record is incorrect or incomplete, you may request it be amended. To do this, contact the Privacy Contact and ask for the Request to Amend Health Information form. In certain cases, JVS may deny your request. If your request for amendment is denied and you disagree, you have the right to file a statement. Your statement and JVS’ response will be placed in your record.
CLIENT RIGHTS
Accounting for Disclosures
You may request an accounting of any disclosure JVS has made related to your confidential information, except for information used for treatment, payment or health care operations purposes, or that was shared with your family, or information you gave specific consent to release. It also excludes information JVS was required to release. To receive information regarding disclosures made for a specific time period, no longer than six years and after April 14, 2003, please submit your request in writing to JVS’ Privacy Contact. You will be notified of the cost involved in preparing this list.
Questions and Complaints
If you have any questions or complaints, or wish an additional copy of this Policy, you may contact the Privacy Contact in writing at the JVS office for further information. You may submit a complaint to the U.S. Department of Health and Human Services if you believe JVS has violated your privacy rights. There will be no retaliation against you for filing a complaint.
Changes in Policy
Jewish Vocational Service reserves the right to change its Privacy Policy based on the needs of the agency and changes in state and federal law.
If you have any questions about this policy or your rights, please contact:
Privacy Contact
Jewish Vocational Service
216 W. Jackson Boulevard, Suite 700
Chicago, Illinois 60606
(312) 673-3405
