Patient Confidentiality Policy
We will not confirm to anyone that a patient attends the clinic or disclose any information (including patient contract, identification sheet, grievance policy, releases, purpose for seeking treatment, intake/ screening information, psychosocial history, drug screens, physician notes, staff notes, plan of care, disposition, assigned staff members, etc.) unless:
- The clinic is given consent by a signed release form or verbal consent
- The disclosure of information has been made to other medical personnel during a medical emergency, research, audit, or program evaluation/quality assurance
- Records have been cited by federal law or subpoena
- Records have been requested by the Cabinet for Health and Family Services
- In the event of a life-threatening physical danger to the patient or others
In such case, 2nd Chance will consult with other professionals and limit the release to only what is necessary by law.
The nature of group counseling makes it difficult to maintain confidentiality. Your counselor cannot guarantee that other group members will maintain your confidentiality. However, your counselor will make every effort to maintain your confidentiality by reminding group members frequently of the importance of keeping group therapy confidential. The counselor has the right to remove any member from group therapy should they discover a member has violated the confidentiality rule.
All patient treatment records are the property of 2nd Chance and may not be removed from the premises. The original record shall not be removed from the clinic without a court order or subpoena. Only authorized individuals will be permitted to view confidential records, including clinical staff and the multidisciplinary team. They will be kept in a safe and secure place when not in use. A patient may request to review the contents with the multidisciplinary team.
In accordance with state and federal laws for maintaining records, 2nd Chance is required to maintain records for a period of seven (7) years after the last date of treatment or service of the patient.
Limitations of Confidentiality:
Protected health information regarding a patient is only released to those with the appropriate consent of the patient. Any information will only be disclosed without the patient’s consent as mandated by law, or where permitted by law for a valid purpose in order to protect the patient or others from harm. Clinicians will not disclose in their writings, lectures, or other public media, confidential, personally identifiable information concerning their patients that they obtained during the course of their work, unless the patient has consented in writing or unless there is other ethical or legal authorization for doing so.
In certain situations it is required BY LAW to provide information to third parties without the patient’s permission. These situations are:
Duty to Report Child Abuse:
- KRS 620.030 requires any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused to report this to local law enforcement or Kentucky State Police. The most direct route of reporting is to contact the Child Protective Services unit of the Community-Based Services office in the county in which the alleged acts have occurred.
- In making this report of suspected child abuse, neglect or dependency, clinicians provide information only to the extent necessary to achieve the purposes of the report and they document in the appropriate record(s).
- Clinicians are not required to report cases of abuse of adults that occurred when they were children unless a continued issue of child protection exists, in which case a report is made of the current risk situation. (ex. Younger children still reside in the home of the alleged perpetrator)
Duty to Report Adult Abuse:
- Kentucky law requires any person who has reasonable cause to suspect that an adult has suffered abuse, neglect, or exploitation to report this to the Adult Protective Services unit of the Community-Based Services office in the county in which alleged acts have occurred.
- In making a report of suspected adult abuse, neglect or exploitation, clinicians provide information only to the extent necessary to achieve the purpose of the report and they document the report in the appropriate record(s).
- If a professional has reasonable cause to believe that a victim with whom he or she has had a
professional interaction has experienced domestic or dating violence and abuse, the professional shall
provide the victim with educational materials related to domestic or dating violence and abuse
including information about how he or she may access regional domestic violence programs or rape
crisis centers and information about how to access protective orders.
- Upon the request of a victim, a professional shall report an act of domestic or gang violence and
abuse to law enforcement, after first discussing the making of such a report with the victim.
- A professional shall also report to law enforcement his or her belief that the death of a victim with
whom he or she had a professional interaction is related to domestic or dating violence and abuse.
Duty to Warn:
- KRS 202A.400 places a duty on mental health professionals to warn of or take reasonable precaution to provide protection from a patient’s violent behavior if the patient has communicated an actual threat of physical violence against a clearly identified or reasonably identified victim, or if the patient makes an actual threat of some specific violent act.
- To discharge a duty to warn/protect, the clinician must make reasonable efforts to communicate the threat to the intended victim if identified, notify the police closest to the intended victim’s residence, and notify the police closest to the patient’s residence.
Other situations may arise during or after the course of treatment in which confidentiality may not be guaranteed to a patient. This includes certain types of civil litigation, subpoenas, and court orders.
Patient Initiated Litigation:
- If a patient asserts his or her own mental condition as an element of a claim or defense, then no protection of the record exists. Patients are encouraged to discuss with their attorney the benefits and risks of introducing their own mental condition into any legal proceeding in which they are involved.
Child Custody Litigation:
- This may occur when two parents or guardians are in dispute over the custody of a child or when CBS is petitioning for the permanent termination of parental rights, the medical records of either or both parents or guardians can be disclosed in court. Each instance of this calls for a careful review of the legal circumstances and procedures that the court is following. Under the provisions of KRS 403.300, a court can bring these records into the proceedings as a way of assisting the court in determining the fitness of a parent or guardian.
- The procedure typically begins with a court order or subpoena for the records of one or both parents. Either party in the dispute can issue a subpoena for the records. The clinician, upon receiving the subpoena should first contact the Center Director or his or her designee for advice on how to proceed. When a patient has signed a release to the court, the records can be disclosed in the legal proceeding. When a patient has signed a release to the court, the records can be disclosed in the legal proceedings.
- Subpoenas are a form of court order that can be issued by any officer of the court. The subpoena compels the presence of a party in a court proceeding. When a patient signs a release of information form, the clinician can appear and testify and bring a certified copy of the record and testify from it. The clinician should explain the nature of this release of information so that the patient can make a reasonably informed decision about the matter. Staff will obtain direction and advice from the Director of the center or their designee prior to any release of information when served with a subpoena.
- A subpoena is a court order, but one that simply compels appearance in court. Court order generally refers to a directive from a judge. The court order can impose specific duties on a witness or a defendant. A court order has greater weight than a subpoena and it provides greater immunity from litigation for the witness.
- In the event that there is a court-ordered evaluation, the clinician must inform the patient that the court has ordered the evaluation, inform the patient that the information obtained will not be privileged and explain to the patient the foreseeable uses of the information obtained, inform the patient that he/she may choose not to participate in the interview, and have the patient sign
authorization for the release of information to the court that ordered the evaluation if the patient has agreed to participate in the evaluation.
- In regards to being ordered by a court or CBS, the clinician should use a procedure that clarifies confidentiality and the clinician’s relationship with the referring parties. The clinician should obtain an authorization for a release of information and a permission for treatment before the patient reveals personal information. This ensures that any and all personal disclosures can be included in any evaluative reports to the referring court or other public sector protective agency. When a patient refuses to sign either or both forms, the session should be cancelled and the referring party should be notified that the clinician was unable to gain the participation of the patient in the assessment interview after he/she was informed of the waiver of privileged communication to the referring court or agency.
III. NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW CAREFULLY
This notice will tell you how we may use and disclose protected health information about you.
Protected health information means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. This notice also will tell you about your rights and our duties with respect to protected health information about you. In addition, it will provide information on how to file a complaint if you believe we have violated your privacy rights.
How We May Use and Disclose Protected Health Information About You
We use and disclose protected health information about you for a number of different purposes. Each of those purposes is described below.
We may use protected health information about you to provide, coordinate, or manage your health care and related services by both us and other health care providers. We may disclose protected health information about you to doctors, nurses, hospitals and other health facilities who become involved in your care. We may consult with other health care providers concerning you and as a part of the consultation share your protected health information with them. Similarly, we may refer you to another health care provider and as part of the referral share protected health information about you with that provider.
We may use and disclose protected health information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company, or a third party payer. We also may need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your medical condition and the health care you need to receive to obtain and determine if you are covered by that insurance or program.
For Health Care Operations
We may use and disclose protected health information about you for our own health care operations. These are necessary for us to operate and to maintain quality health care for our patients. We may use and disclose protected health information about you to train our staff. We may also use the information to study ways to more efficiently manage our organization.
How We Will Contact You
Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at your home. We may leave messages for you on the answering machine or voicemail. If you want to request that we communicate to you in certain way, please specify on the demographic form completed before your treatment begins.
We may use and disclose your protected health information to remind you of an appointment you have with us.
We may use and disclose your protected health information to contact you about treatment alternatives that may be of interest to you.
Health Related Benefits and Services
We may use and disclose your protected health information to contact you about health related benefits and services that may be of interest to you.
Required By Law
We may use or disclose your protected health information when we are required to do so by law.
Public Health Activities
We may disclose your protected health information for public health activities and purposes. This includes reporting medical information to a public health authority that is authorized by law to collect or receive the information for the purpose of preventing or controlling disease. Or, one that is authorized to receive reports of child abuse and neglect.
Victims of Abuse, Neglect, or Domestic Violence
We may disclose your protected health information to a government authority authorized by law to receive reports of abuse, neglect, or domestic violence, if we believe you are a victim of abuse, neglect, or domestic violence. This will occur to the extent the disclosure is: (a) required by law; (b) agreed to by you; (c) authorized by law and we believe the disclosure is necessary to prevent serious harm to you or to other potential victims, or, if you are incapacitated and certain other conditions are met, a law enforcement or other public official represents that immediate enforcement activity depends on the disclosure.
Health Oversight Activities
We may disclose your protected health information to a health oversight agency for activities authorized by law including audits, investigations, inspections, licensure or disciplinary actions. These and similar types of activities are necessary for appropriate oversight of the health care system, government benefit programs, and entities subject to various government regulations.
Judicial and Administrative Proceedings
We may disclose your protected health information in the course of any judicial or administrative proceeding in response to an order of the court or administrative tribunal. Also may disclose your protected health information about in response to a subpoena, discovery request, or other legal process but only if efforts have been made to tell you about the request or to obtain an order protecting the information to be disclosed.
Disclosures for Law Enforcement Purposes
We may disclose protected health information about you to a law enforcement official for law enforcement purposes:
- As required by law.
- In response to a court, grand jury, or administrative order, warrant or subpoena.
- To identify or locate a suspect, fugitive, material witness or missing person.
- About an actual or suspected victim of a crime and that person agrees to the disclosure. If we are unable to obtain that persons agreement, in limited circumstances, the information may still be disclosed.
- To alert law enforcement officials to a death if we suspect the death may have resulted from criminal conduct.
- About crimes that occur at our facility.
- To report a crime in emergency circumstances.
Coroners and Medical Examiners
We may disclose your protected health information to a coroner or medical examiner for purposes such as identifying a deceased person and determining cause of death.
We may disclose your protected health information to funeral directors as necessary for them to carry out their duties.
Organ, Eye or Tissue Donation
To facilitate organ, eye or tissue donation and transplantation, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue.
We may use or disclose your protected health information for research. Before we disclose protected health information for research, the research will have been approved through an approval process that evaluates your need for privacy and the needs of the research project.
To Avert Serious Threat to Health or Safety
We may use or disclose your protected health information if we believe the use or disclosure is necessary to prevent or lessen a serious or imminent threat to, or safety of a person or the public. We also may release information if we believe it is necessary for law enforcement authorities to identify or apprehend an individual who admitted participation in a violent crime of who is an escapee from a correctional institution or from lawful custody.
If you are a member of the Armed Forces, we may use and disclose your protected health information for activities deemed necessary by appropriate military command to assure the proper execution of the military mission.
National Security and Intelligence
We may disclose your protected health information to authorized federal officials for the conduct of intelligence, counter-intelligence, and other national security activities authorized by law.
Protective Services for the President
We may disclose your protected health information to authorized federal officials so they can provide protection to the President of the United States, certain other federal officials, or foreign heads of state.
Inmates; Persons in Custody
We may disclose your protected health information to a correctional institution or law enforcement official having custody of you. The disclosure will be made if necessary: (a) to provide health care to you; (b) for the health and safety of others; (c) the safety, security and good order of the correctional institution.
We may disclose your protected health information to the extent necessary to comply with workers’ compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.
Other Uses and Disclosures
Other uses and disclosures will be made only with your written authorization.
You have the following rights with respect to protected health information that we maintain about you.
Right to Receive Confidential Communications
You have the right to request that we communicate protected health information about you to you in a certain way or at a certain location. For example, you can ask that we only contact you by mail.
Right to Inspect and Obtain a Copy
With very few limited exceptions, you have the right to inspect and obtain a copy of protected health information about you. We may deny your request to inspect and copy protected health information if the protected health information involved is:
- Psychotherapy notes;
- Information compiled in anticipation of, or use in, a civil, criminal or administrative action or proceeding.
Right to Amend (45 CFR 164.520 (b) (iv); 45 CFR 164.526)
You have the right to ask 2nd Chance to amend your protected health information. You have this right for as long as the protected health information is maintained by 2nd Chance. To request an amendment, you must submit your request in writing to: 2nd Chance Center for Addiction Treatment, 1420 North Broadway Lexington, KY 40505. Your request must state the amendment desired and provide a reason within 60 calendar days. If we grant your request, in whole or in part, we will inform you of our acceptance of your request and provide access and copying. Additionally, we will seek identification of an agreement to share the amendment with relevant other persons. We will also make appropriate amendments to protected health information be appending or otherwise providing a link to the amendment. We may deny your request to if it
is not in writing and does not provide a reason in support of the amendment. In addition, we may deny your request to amend protected health information if it is determined that the information:
- Was not created by us, unless the person or entity that created the information is no longer available to act on the requested amendment;
- Is not part of the protected health information maintained by us;
- Would not be available for you to inspect or copy;
- Is accurate or complete;
If we deny your request, we will inform you of the basis for denial. You will have the right to submit a statement of disagreement with our denial. Your statement may not exceed 10 pages. We may prepare a rebuttal to that statement. Your request for amendment, our denial of the request, your statement of disagreement, if any and our rebuttal, if any will then be appended to the protected health information involved or otherwise linked to it. All of that will then be included with any subsequent disclosure of the information, or at our election, we may include a summary of any of that information.
If you do not submit a statement of disagreement, you may ask that we include your request for amendment and our denial with any future disclosures of the information. We will include your request for amendment and our denial (or a summary of that information) with any subsequent disclosure of the protected health information involved. You also have the right to complain about our denial of your request.
Right to Accounting of Disclosures
You have the right to ask for an accounting of the times we’ve shared your health information for up to 7 years prior to the date you ask. This will include who we shared the information with and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures. We will provide one accounting per year for free but a fee will ensue if another one is requested within that 12 months.
We are required by law to maintain the privacy of protected health information about you and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
We are required to abide by the terms of our Notice of Privacy Practices in effect at this time.
Our Right to Change Notice of Privacy Practices
We reserve the right to change this notice of privacy practice. We reserve the right to make the new notice provisions effective for all protected health information that we maintain, including that created or received by us prior to the effective date of the new notice.
You may complain to us and to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated.
Questions and Information
If you have any questions or want more information concerning this Notice of Privacy please contact the Office Administrator at the 2nd Chance Clinic location.