Privacy Policy
Privacy Notice:
This notice describes how medical information about you may be used or disclosed and how you can get access to this information. Please review this notice carefully.
Federal law requires Family Service Association (FSA) to inform service recipients ahead of time about the following:
- How the organization will manage your Protected Health Information
- Our legal responsibilities regarding your privacy
- Your rights with regard to your medical information
How FSA May Use and Disclose Your Protected Health Information
The information we obtain from you and your health providers, along with the record of care that you receive from FSA, is considered to be ‘Protected Health Information’ or PHI.
Depending on the nature of the information to be disclosed, you may or may not have to give written Authorization for the disclosure or “sharing” of your Protected Health Information.
1. Treatment, Payment, and Health Care Operations: in many circumstances, FSA may legally use and share your PHI for treatment, payment, and health care operations. FSA does not have to ask for your specific permission (or written Authorization) to use and disclose your information for these purposes.
- Treatment: FSA may use and share your health information to provide and manage your health care and social service needs. For example, FSA may need to share information to coordinate care with your primary care physician, visiting nurses, home health care workers, or emergency technicians.
- Payment: FSA will use and share your information to bill and collect payment for the health services provided. For example, our billing staff will contact your insurance company to ensure that the company will authorize payment for services.
- Health Care Operations: FSA will use and disclose your information to facilitate our health care operations. Examples of FSA health care operations are:
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Monitoring quality of care and making improvements when needed
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Contacting individuals for appointment reminders
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Managing and analyzing your health data
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Sharing information with other health care FSA personnel for supervision or consultation. FSA employees act as a team, and at times, your primary provider/caregiver may not be available to respond to an inquiry about your care.
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2. Other Uses and Disclosures (No written Authorization required): FSA may legally share your Protected Health Information without your specific permission. Some examples of this are:
- As required by state and federal law and regulation
- For health oversight activities, such as licensing
- Responding to a medical emergency
- Reporting abuse and/or neglect of children, elders, or the disabled
- With regard to people who have died; to coroners, medical examiners, and funeral directors
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To avert a serious threat to health or safety (threat to self or someone else)
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Specialized government (intelligence) activities
3. Disclosures to your family, friends, and others involved in your care: FSA requires that you give written Authorization for these types of disclosures. Upon admission and periodically throughout the course of your care, our staff will ask you if you would like to provide Authorization for certain disclosures that are related to your care. FSA will not disclose information to your family and friends without your written Authorization to do so.
4. Psychotherapy Notes: FSA does not maintain psychotherapy notes (notes maintained outside of your medical record, for the therapist’s own use).
5. Disclosures prohibited by state or federal law: There are some uses and disclosures that require your written Authorization, even if the disclosure is for treatment, payment, or health care operations
- Substance abuse diagnosis, prognosis, or treatment
- AIDS, ARC, or HIV status
- ‘Confidential communication’ between you and your licensed social worker, psychotherapist, psychologist, psychiatrist, or other licensed allied mental health professional
- Results of genetic testing
- Sexually transmitted disease
Your rights with respect to your Protected Health Information
1. Confidential Communications
- You have the right to ask that your Protected Health Information be sent to you in different ways. Upon admission, FSA will note your preferences for telephone and mailed communications. FSA must agree to any reasonable request and cannot ask you to explain the reason for your request. FSA can require you to give information as to how payment will be handled and to what address a bill should be mailed.
2. Restrictions of Disclosures Related to Treatment, Payment, and Health Care Operations
- You have the right to request a restriction on the use and disclosure of Protected Health Information for treatment, payment, and healthcare operations and should inform your provider if you would like to request such a restriction. FSA is not obligated to honor the request and will inform you of its decision.
3. Revoking an Authorization
- All service recipients have the right to revoke an Authorization. The FSA authorization form includes a space to document revocation of the authorization, including signature of the individual served. Individuals may also contact FSA’s Privacy Officer to revoke authorization.
4. Access
- As a recipient of services from FSA, you have the right to access your Designated Record Set, which includes all information stored within your Client Record and associated billing documentation.
- FSA requires all requests for record access to be made in writing using FSA’s “Access to DRS Request Form” which can be obtained by contacting Family Service Association’s Privacy Officer at (508) 677-3822. FSA will respond to your request as soon as possible. If your request is denied. FSA will explain the reasons in writing and inform you of your rights in the situation as they apply.
5. Amendment
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As a recipient of services from FSA, you have the right to amend any record in your Designated Record Set if your request is submitted in writing and gives the reason why you want to make the change
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If your request is denied you will receive notification in writing, which includes the reason for denial, and other steps that are available to you
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FSA shall act upon all amendment requests no later than 60 days after receipt of such request. The organization may extend response time an additional 30 days and must provide you with a written statement with the reason for delay and the date by which FSA will complete your request.
6. Accounting
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As an FSA service recipient,you have the right to request an accounting of all disclosures made from your Designated Record Set including (1) a description of the information disclosed (2) to whom the information was disclosed (3) for what purpose the information was disclosed (4) and the date the information was disclosed. The accounting must be in writing and cover the preceding six-year period,
- The following disclosures are not accounted for:
- Disclosures for treatment, payment, and health care operations
- Disclosures made to you, the service recipient
- Disclosures made for national security, to correctional institutions, or law enforcement officials
Safeguarding Your Protected Health Information
1. FSA ensures that all Case Records are secured in a locked area.
2. Retention of records is in keeping with organizational policy and varies, depending on program-specific requirements:
- Clinical Services (Behavioral Health Center, Children’s Behavioral Health Initiative services including Community Service Agency, In-Home Therapy, and Therapeutic Mentoring) - 20 Years
- Executive Office of Elder Affairs Guardianship – 7 years after final judgment
- Conservator – 7 years after final judgment
- Guardian of the Person – 1 year after the death of the Ward
- Adult Family Care, Adult Day Health, and Home Assistance Programs - 7 years
- After School Day Care, Kids Academy – 15 years
- Representative Payee – 2 years 2 months, (if tax forms are on file, record must be retained 7 years)
3. All confidential discussions regarding service recipients are held in secure settings to avoid prohibited disclosures.
4. Only individuals authorized to have access to your Case Record for treatment, payment, or healthcare operations are granted access.
If you think that FSA may have violated your privacy rights or you disagree with any action FSA may have taken with regard to your Protected Health Information, please contact your FSA Program directly or call the organization’s Privacy Officer using the information provided at the end of this notice.
Family Service Association reserves the right to change the Privacy Notice to accommodate changes in state and federal law or organizational practice. All updated notices will be available on the organization’s website, within all program sites, and by outreach employees to those individuals who receive home-based services.
For additional information regarding any aspect of this Notice, please contact: