|
RMS
PRIVACY NOTICE
Effective April 14, 2003
THIS NOTICE
DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Important: If
you have any questions or if you need help with this Notice, speak to
RMS staff. We will help you.
Understanding
your Confidential Personal Information – called “records” in the
Notice.
We want to
keep your records private. We will do so, because that is the law ,
and it is the right thing to do.
Because you
receive services, records of these services you receive are
maintained. These records contain information about why you need
services, the services you receive, and what kind of services you may
need in the future. These records help:
·
To plan what kinds of
assistance you might need or want.
·
To allow the RMS
employees who provide your services to help you share important
information.
·
To make sure that there
is record of the services you received so that you get the right
services in the future.
·
To make sure that you
received the services that were paid for.
·
To help us do the best
job possible when helping you.
Knowing what
is in your record and how your records are used helps you to:
·
Make sure they are
right.
·
Understand who is
allowed to see your records and who is not.
·
Do a better job of
deciding with whom you will and will not share your records.
Your Rights:
The pieces of
paper that your records are kept on belong to RMS or other individuals
who help you. The information on the paper belongs to you.
You have the
right to:
·
Ask that the information
not be used for certain things or shared with certain people (see 45
CFR §164.522).
·
Look at and make copies
of your records (see 45 CFR §164.524).
·
Make changes in your
records, if you think it is wrong (as provided in 45 CFR §164.526).
·
Get a list of whom your
records were shared with and why it was shared (as provided in 45 CFR
§164.528).
·
Decide how and where
your records are shared.
·
Stop RMS or others from
sharing your records, if you do not want them to.
·
Ask that we tell you
about your records only the way you want us to.
Our
Responsibilities:
RMS is required
to:
·
Keep your records
private.
·
Tell you what the law
says we can do and need to do with your records.
·
Do the things it says we
have to do in this Notice.
·
Tell you if we cannot
stop sharing records for any reason.
·
Only share the records
you’ve approved, as long as what you’re asking is fair, and allowed by
the law.
·
Comply with the law
about your records.
RMS can change
how we handle your records at any time as long as the law allows the
change. If we change anything, you will receive a copy of the changed
Notice by mail or from your RMS staff.
We will not use,
or tell anybody what is in your records without your permission,
except as described in this Notice.
For More
Information or to Report a Problem: You or your guardian are
encouraged to start with RMS staff or the RMS Privacy Officer. The
telephone number of the Privacy Officer is (614) 880-6008. We hope to
help you with any questions, or to fix any problems you may show to
us. You always have the right to call the Secretary, United States
Department of Health and Human Services if we have not helped you the
way you want us to. We want to follow the law about your records, and
we will do everything the law wants us to do. If you complain to us
or to the Secretary, you will not get in trouble. We will continue to
help you.
If you have
additional questions or would like more information, you may contact
our Privacy Officer at (614) 880-6008, or your RMS staff.
Some Reasons
Why We Would Share Your Records:
We will use your
records to help us give you the best service possible.
·
For example, we may use
your records to ensure that the medication you are taking is
appropriate for your healthcare needs.
We will use your
records to make sure your bills are paid. We will use your records to
help us improve the type of help we provide.
Other Reasons
Why We Might Share Your Information If You Say It’s OK:
Business
Associates: Sometimes we
need to share records with someone other than our staff in order for
you to get the help you need. Anyone we share your records with
must also keep your information private. They have agreed with us to
keep your records private.
Notification:
We may share records about
you with a friend or family member who is involved in providing your
services. We may also give records to someone who helps pay for your
services. We may also tell your family or friends if you need to be
in the hospital. In addition, we may share records about you with any
person or organization assisting in a disaster relief effort so that
your family can be notified about your condition, status and location.
Communication
with Family: Your staff
and other people who provide you with help may share information with
your family, another relative, close friend or anyone else you say is
okay. Your staff and anyone else who provides you with services must
be sure that the person they are sharing the records with needs the
information to help you keep healthy and safe or to help you make sure
your bills are paid.
Funeral
Directors, etc.: We may
share records with funeral directors and others such as coroners and
medical examiners so they can do their jobs, as long as what is shared
is okay by law.
Organ
Procurement Organizations:
If you choose to donate any of your organs when you die, we can share
your records with the people or companies responsible for getting,
storing, or using organs you have donated, as long as the information
we share is okay by law.
Food and Drug
Administration (FDA): We
may share records with the Food and Drug Administration, if
necessary. The Food and Drug Administration is responsible for making
sure that the food you eat, the medicine you take and many other
products you use are safe to use. If there is a problem with any of
these things, it may be necessary to share your records so that the
Food and Drug Administration can fix the problem.
Workers
Compensation: We may share
your records if you are hurt at work and file a claim for Workers
Compensation. Workers Compensation helps you to pay your bills and
buy you the things you need if you are hurt at work and cannot work
for a while. We can only share records as much as the law allows.
(continued)
Marketing:
We may share records with other people as part of our efforts to tell
people about the services we provide in order to increase the number
of consumers we are serving. We do not tell these people your
name, and we do not do this without your consent.
Public Health
Risks: We may share
records about you to help keep other members of the community safe.
Examples of why we might share records include:
·
To prevent or control
disease, injury or disability;
·
To report births and
deaths;
·
To report child abuse or
neglect;
·
To report reactions to
medications or problems with products;
·
To notify people of
recalls of products they may be using;
·
To notify a person who
may have been exposed to a disease or may be at risk for contracting
or spreading a disease or condition;
·
To notify the
appropriate government authority if we believe a patient has been the
victim of abuse, neglect or domestic violence.
Jail or Prison:
If you are in jail or prison, we may share records to make sure you
receive any care you might need and to make sure the people around you
are safe.
Law
Enforcement: We may share
records if asked to do so by the police or other law enforcement
official if we are required to by law, in emergency situations, as
part of an investigation of a crime, or if a court orders us to.
Health
Oversight Activities: We
may share records with your case manager, the county board, the state
department of mental retardation, the Ohio Department of Jobs and
Family Services, service and support administrator, or any other
people, groups or government agencies responsible for making sure the
services you receive meet your needs and are correctly provided.
Lawsuits and
Disputes: We may share
records about you if a court or attorney sends us a letter or
something else saying we have to.
You can ask for
another copy of this Notice any time, and we always will give it to
you.
My signature below indicates that I have been provided with a copy of the
notice of privacy practices.
Signature of Consumer or Legal
Representative Date
If signed by legal representative,
relationship
to Consumer:
Distribution: Signed original to
consumer; signed copy in Consumer Book, signed copy in office
Questions or comments? Contact our Privacy Officer
Samuel Hoar-State
Operations Coordinator
402 E. Wilson Bridge Road,
Suite A
Worthington, Ohio 43085
614-880-6008
shoar@teamrms.com
|
