Privacy Notice
NOTICE OF PRIVACY PRACTICES
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Effective Date: April 14, 2003
Revised Date: September 15, 2009
Southeastern Center is the area authority that monitors the services and supports of the behavioral healthcare systems in Brunswick, New Hanover, and Pender Counties. Southeastern Center knows that information we and your provider collect about you and your health is private. Our agency and community providers are required to protect the information by Federal and State law. We call this information "protected health information" (PHI) whether oral, written, or electronic format.
The Notice of Privacy tells you how Southeastern Center may use or disclose information about you as required by law only the minimum necessary information will be disclosed. Not all situations are described. Southeastern Centers’ community of providers is required to give you a notice of our privacy practices for the information we collect and keep about you. Southeastern Centers’ community and providers is required to follow the terms of the notice currently in effect. Southeastern Center reserves the right to revise the terms of this notice.
Southeastern Center and Its Community of Providers May Use and Disclose Information Without Your Authorization.
Providers and Southeastern Center shall protect the confidentiality of any and all individuals and will not discuss, transmit, or narrate in any form other information, medical or otherwise, received in the course of providing services hereunder, except as authorized by the individual, his legally responsible person, or as otherwise permitted or required by law. The Providers and Southeastern Center shall, in addition, meet all confidentiality requirements promulgated by any applicable governmental authority.
The information we receive is confidential and our community of providers must protect confidential information.
- Consumer/legal representative has signed a valid authorization for release of information to a third party. (INFORMED CONSENT).
- Consumer is seeking treatment at another facility within the N.C. Division of Mental Health, DD., and Substance Abuse Services and it has been determined to be in the consumer’s best interest to disclose information to the facility where consumer is requesting services. (This excludes consumers receiving substance abuse treatment.) Information may be shared with service provider or contracted agency with Southeastern Center (if deemed to be in the best interest of the consumer). This excluded consumers receiving substance abuse treatment.
- In the interest of public safety. (It is determined by a clinical staff member that consumer presents as a danger to self or others).
- In response to a court order and/or subpoena.
- In response to a medical emergency, disclosure may be made to medical personnel.
- This agency may disclose healthcare information about you to a governmental authority that is authorized by law to conduct an investigation regarding abuse and/or neglect. For example, if you are an adult and we reasonably believe that you may be a victim of abuse, neglect or domestic violence. State and Federal Laws require disclosure when a law enforcement officer has a magistrate order to take an individual into custody for an involuntary commitment exam, Southeastern Center is permitted to disclose to the officer information about the individuals mental state when necessary to assure their health and safety and the health and safety of the officer transporting the individual.
- State and Federal Laws require reporting of child abuse, disabled adult abuse, gunshot/knife wounds, and communicable diseases.
- Crimes committed at the program. Crimes against any employee of the program, and any threat to commit such a crime.
- In the investigation of life-threatening threats to an elected official.
- Disclosure may be made to qualified personnel for research, audit, or program evaluation. For Health Care Operations, Southeastern Center may use or disclose information in order to manage its programs and activities. For example, this information may be used in Utilization Management to review the quality of service you are receiving from a provider agency.
When information is disclosed based on the "need to know", documentation to support this action shall be noted on the Accounting of Release/Disclosure Form in your provider record. Information disclosed without a signed consent indicates, “disclosed” on the form. As required by 164.514 of the Federal Regulations 45 C.F.R. Part 164, we will limit the protected health information disclosed to the amount minimum necessary to achieve the purpose for which the disclosure is sought.
Other Uses and Disclosures Require Your Written Authorization
For other situations, your provider will ask for your written authorization before using or disclosing information. You may cancel this authorization at any time in writing. Your provider cannot take back any uses or discloses already made with your authorization.
For Treatment and Payment purposes, federal regulations permit disclosure without your authorization (45C.F.R. Part 164). However, other laws require consents in writing, North Carolina G.S. 122C-53(a) states that a MH/DD/SA facility may disclose confidential information if the client or his legally responsible person consents in writing to the release of information to a specified person. The release is valid for a specified length of time and is subject to revocation.
Other Laws Protect PHI.Southeastern Center has other laws for the use and disclosure of information about you. (G.S. 122-C; 42 CFR Part 2: 45 CFR Parts 160 and 164; N.C. Division of MH/DD/SA Services Confidentiality Rules APSM 45-1)
Your Privacy Rights
When information is maintained by Southeastern Center other State and Federal laws govern the mental health records.
Right to Request Restrictions on Uses and Disclosures. You have the right to request that your provider limit the use and disclosure of health care information about you for treatment, payment, and health operations. Your provider is NOT required to agree to your request. If your provider does not agree to your request, your provider must follow your restrictions (except if the information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, your provider may cancel a restriction at any time as long as they notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.
Right to Request An Alternative Method of Contact. You have the right to be contacted at a different location of by a different method. For example, you may prefer to have all written information mailed to your work address rather than your home address. Your provider will agree to any reasonable request for alternative methods of contact. If you would like to request an alternative method of contact, you must provide your provider with a request in writing.
Right to See and Get Copies of Your Records. In most cases, you have the right to look at or get copies of your records. You must make the request in writing. You may be charged a fee for the cost of copying your records.
Right to Request to Correct or Update Your Records. You may ask your provider for a list of disclosures made after April 14, 2003. You must make the request in writing. This list will not include the times that information was disclosed for treatment, payment, or health care operations. The list will not include information provided directly to you or your family, or information that was sent with your authorization.
Right to Receive a Copy of the Notice of Privacy and Any Revision Thereafter. You have the right to receive a copy of the notice of privacy and any revisions made thereafter. The terms of this notice may be changed in the future, and these changes will be posted in the waiting room of the agency, and/or posted on the agency website (located at www.secmh.org). You may also request a copy of the new Notice by contacting the Privacy Officer at 910-738-5261.
YOU MAY FILE A COMPLAINT ABOUT OUR PRIVACY PRACTICES
If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies and procedures, you may file a complaint either with us or with the federal government. We will not take any action against you or change our treatment of you in any way if you file a complaint.
To file a written complaint with Southeastern Center, you may bring your complaint to the department or you may mail it to the following address:
| Privacy Officer | |
| Southeastern Center for MH/DD/SAS | |
| P.O. Box 4147 | |
| Wilmington, NC 28406-4147 |
To file a complaint with the federal government, you may send your complaint to the following address:
| Region IV – AL, FL, GA, KY, MS, NC, SC, TN | |
| Office for Civil Rights | |
| US Dept of Health & Human Services | |
| 61 Forsyth Street, SW | |
| Suite 3870 | |
| Atlanta, GA 30323 | |
| Phone: (404) 562-7886 | |
| Fax: (404) 562-7881 | |
| TDD: (404) 331-2867 |
If you need help in filing a complaint or have a question about the complaint form, please call this OCR toll free number: 1-800-368-1019.