Privacy Practices

UNISON HEALTH

NOTICE OF PRIVACY  PRACTICES

 

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

 

About this Notice: The Notice of Privacy Practices describes how, when, and why Unison Health may use and disclose your protected health information (PHI) in order to carry out treatment, payment, healthcare operations, and other purposes permitted or required by law and your rights to access and control your PHI.  We have a legal duty to protect your health information.  We are required by law to maintain the privacy of your PHI and to give you this Notice explaining Unison's privacy practices with regard to that information.  Unison staff must abide by the terms of the current version of this Notice of Privacy Practices and it applies to all Unison Health operated facilities.

 

What is Protected Health Information?  PHI is information that individually identifies you and we create or get from you or from another health care provider, health plan, your employer, or a health care clearinghouse and that relates to (1) your past, present, or future physical or mental health or conditions; (2) the provision of health care to you; or (3) the past, present, or future payment for your health care.

 

You can request a copy of this notice from the staff of our Medical Records department at any time or your primary clinician.

 

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

Unison collects mental health, alcohol and drug, and general health information and stores it in a paper chart and in electronic format.  We may use and disclose your PHI in the following circumstances:

  1. Use and disclosure that do not require your consent or authorization:
  2. For treatment: We may give your PHI to internal and external health care providers to provide, coordinate, or manage your care. Examples: A Unison therapist may coordinate with a Unison physician regarding your care; or a Unison nurse may share your medication information with an external physician involved in your ca
  3. To obtain payment for treatment: We may give portions of your information to our billing department, your health plan, the Mental Health & Recovery Services Board of your County, if applicable and other payer sources to get paid for the services we provided to For example, we may give your information including your name, birth date, treatment dates, and diagnosis to your insurance company, or our business associates, such as billing companies, claims companies, law firms, collection agencies, and others that process our health care claims.
  • For regular health care operations: We may disclose information about you to operate our Examples: We may review your progress notes, treatment plans, and diagnostic assessment to evaluate the quality of services that you received or to review the performance of the professionals who provided services to you; and we may provide information about you to our accountants, attorneys, consultants, and others in order to make sure we are complying with the laws.
  1. When required by federal, state, or local law, judicial or administrative proceedings, or law enforcement: We may use and disclose PHI

When required by law. For example, we give out your information when a law requires that we report information to government agencies and law enforcement  personnel about suspected child abuse/neglect, elder abuse/neglect, victims of abuse, neglect, or domestic violence, when dealing with gunshot or other wounds, or when ordered by the court.

  1. For public health activities: We may use and disclose PHI to report information to government officials in charge of collecting the i Example: information to report reactions to drugs; and information to prevent or control disease.
  2. Relating to decedents: We may use and disclose PHI related to a death to coroners, medical examiners or funeral directors, and to organ procurement organizations relating to organ, eye, or tissue donations or Example: we give coroners and medical examiners information, such as medication orders and diagnosis, relating to a death.
  3. For health oversight activities: We may use and disclose PHI to a health oversight agency for activities authorized by law. For example, we will provide information to assist such entities as the ODMH, ODADAS, ODJFS, Secretary of the Department of Health and Human Services when conducting an investigation, inspection, audits, surveys, and evaluation and research.
  4. To avoid a threat to health or safety: We may use and disclose PHI in order to avoid a serious threat to your health and safety and to the health or safety of another person or the public. For example, we may give your information to law enforcement personnel and crisis assessment agency to prevent or lessen such harm and to evaluate for crisis support services.

9      For specific government functions: We may give PHI to authorized government agencies.  Examples: information may be required to given by a military command authority if you are a member of the United States armed forces or foreign military forces (including veterans); PHI may disclosed to federal officials for intelligence, counterintelligence and other national security purposes such as protecting the President of the United States; or PHI may be given to government benefit programs relating to eligibility determination and enrollment.

  1. For workers' compensation purposes: We may give out your information in order to comply with workers' compensation Worker's Compensation and other similar programs provide benefits for work-related injuries or illnesses.
  2. For continuation of care: To facilitate continuation of care information may be exchanged with other internal and external providers of treatment and health Examples: medication information may be exchanged between Unison and an inpatient psychiatric unit to coordinate medication needs upon admission and discharge; or PHI may be provided to a correctional institution, if you are an inmate, to ensure continuation of care while incarcerated.
  3. For emergency situations: We may use and disclose PHI to obtain/render emergency treatment to Unison will attempt to obtain your consent as soon as possible. For example, Unison may provide medication information to 911 responders; or may provide medical information to a public or private entity authorized by law to assist in disaster relief efforts for the purpose of coordinating your treatment.
  4. For communication from Unison: We may use and disclose information to contact you by phone, text, mail, and/or email to remind you of appointments, notify you of appointment changes, provide treatment documentation, and/or to provide you with information about                 treatment alternatives or other health-related benefits and services that may be of interest to you.  Examples, you may receive appointment reminder phone messages left on a voicemail or with a person answering the call; or you may receive agency/program newsletters           via  mail. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties. If you consent to receive SMS messages from Unison Health related to appointment reminders and healthcare services, message and data rates may apply. Message frequency varies. You can opt-out at any time by replying STOP. Reply HELP for support.
  5. For electronic prescription software: We may use electronic software/programs to coordinate Example: Unison may access prescription history from other healthcare providers for the purpose of providing clinical care and promoting patient safety; or Unison may submit prescription orders electronically to a pharmacy.
  6. Minors. We may disclose PHI of minor children to their parents or guardians unless such disclosure is otherwise prohibited by
  7. For Research. We may use and disclose your PHI for research purposes, but we will only do that if the research has been specially approved by an authorized institutional review board or a privacy board that has reviewed the research proposal and has set up protocols to ensure the privacy of your Even without that special approval, we may permit researchers to look at PHI to help them prepare for research, for example, to allow them to identify clients who may be included .in their research project, as long as they do not remove, or take a copy of any PHI. We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research. However, we will only disclose the limited data set if we enter into a data use agreement with the recipient who must agree to: (1) use the data set only for the purposes for which it was provided; (2) ensure the confidentiality and security of the data; and (3) not identify the information or use it to contact any individual.
  8. For Business Associates. We may disclose PHI to our business associates who perform functions on our behalf or provide us with services if the PHI is necessary for those functions or For example, we may use another company to do our billing, or to provide transcription or consulting services for us. All of our business associates are obligated, under contract with us, to protect the privacy and ensure the security of your PHI.
  9. For Data Breach Notification Purposes. We may use or disclose your PHI to provide legally required notices of unauthorized access to or disclosure of your health
  10. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose PHI to the correctional institution or law enforcement official if the disclosure is necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) to protect the safety and security of the correctional
  11. 20. Lawsuits and Legal Actions. If you are involved in a lawsuit or a dispute, we may disclose PHI in response to a court or administrative We also may disclose PHI in response to a subpoena, discovery request, or other legal process from someone else involved in the dispute, but only if efforts have been made to tell you about the request or to get an order protecting the information requested.

 

  1. Uses and disclosures that require your written consent or authorization: The following uses and disclosures of your PHI will be made only with your written authorization:
    1. Disclosures related human immunodeficiency virus (HIV) status, and alcohol/drug treatment will not be made without your authorization except as required or allowed by
  2. Uses and disclosures of PHI for marketing
  3. Disclosures that constitute a sale of your

 

Other uses and disclosures of PHI not covered by this Notice or the laws that apply to Unison will be made only with your written consent. With your consent, Unison may use and disclose your PHI to anyone you chose with your written authorization.  If requested, Unison will fax or email documents to the recipient identified on the authorization.  If you authorize us.to use or disclose your information, you ca n revoke your authorization i n writing at any time.  Once your authorization is revoked, Unison will no longer use or disclose your PHI, however, except to the extent the program or person who was to make the disclosure already acted in reliance on it.

 

  1. Uses and disclosures that require you to have an opportunity to object and opt out:
    1. Involved in Your Care or Payment for Your Care. We may use and disclose limited PHI to a family member, friends, or others involved in your care if you are present at the disclosure or prior to informed about the disclosure and you do not object. The information used and disclosed is limited to information directly related to the person's involvement in your care and the payment for your care. Your PHI may also be used and disclosed to notify the person about your location, general condition, or death. If it is an emergency situation and you cannot be given an opportunity to object, disclosure will be made if it is consistent with any prior expressed wishes and/or disclosure is determined to be in your best interest. You must be informed and given the opportunity to further disclosure as soon as you are able to do so.
    2. Disaster Relief. We may disclose your PHI to disaster relief organizations that seek your PHI to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practicably ca n do so.
    3. Fundraising Activities. We may use or disclose your PHI, as necessary, in order to contact you for fundraising activities. You have the right to opt out of receiving f undraising communications.

 

YOUR HEALTH INFORMATION RIGHTS

  1. The Right to Request Restrictions On How We Use And Disclose Your Health Information: You have the right to ask that we limit how we use

and give out your information. We will carefully consider your request, but we are not required to accept it. If we accept your request, we will put it in writing and abide by it except in emergency situations or required by law. Exchange of psychiatric records and other pertinent information may be shared with other providers of treatment and health services if the purpose of the exchange is to facilitate continuity of care; (ORC 5122.31(A)(7)).

  1. The Right to Inspect And Get Copies Of Your Protected Health Information: Your request to inspect and/or get a copy of your PHI must be submitted in writing to the Privacy  You will receive a response within 30 days from Unison. We may charge you a reasonable fee to cover expenses associated with your request for a copy.  We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state or federal needs-based benefit program. In certain situations, we may deny your request to inspect and/or obtain a copy of any PHI. if we do, we will tell you, in writing, our reasons why and explain how you can have the denial reviewed. 

 

 

 

  1. Right to an Electronic Copy of Electronic Medical Records: If your PHI is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or We will make every effort to provide access to your PHI in the form or format you request, if it is readily producible in such form or format. If the PHI is not readily producible in the form or format you request your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.
  2. Right to Get Notice of a Breach: You have the right to be notified upon a breach of any of your unsecured
  3. The Right to Request Confidential Communication: You have the right to request how we send communications to you and where you would like those communications For example, you have the right to request that we send information to you at an alternative address such as your work address rather than your home address. Your request must be in writing to the Privacy Officer and specify how or where you want to be contacted.  We will accommodate all reasonable requests.
  4. The Right to Correct Or Update Your Health Information: If you believe that your PHI is incorrect or incomplete, you have the right to request that we amend the existing Your request must be submitted in writing to the Privacy Officer and must state a reason supporting your request. You will receive a written response within 60 days of the request. If we approve the request, we will make the changes to the information and tell you, in writing, that we have done it. If your request is denied, you will receive a written explanation why the request was denied and how you can have the denial reviewed by submitting a statement of disagreement. Some reasons why request are denied include: the request is not in writing; does not include a reason for the amendment; the information was not created by Unison; is not part of the health information kept at Unison; is not part of the information which you would be permitted to inspect or copy; or which we deem to be accurate and complete.
  5. The Right to an Accounting Of Non-Standard Disclosures: You have the right to obtain an accounting of the disclosures we have made of your health information, except for disclosures made for treatment, payment, or health care operations purposes described in this notice; certain disclosures required by law to be kept confidential; disclosures made to you; disclosures that occurred prior to April 14, 2003; and, disclosures you specifically Your request must be submitted in writing to the Privacy Officer and must specify the time period for which you are requesting information. Your request may be for a period of up to six (6) years starting after April 14, 2003. Your first request in a 12-month period will be provided free of charge. You will be charged a fee for additional requests within a 12-month period based upon our cost to produce the accounting.  You will be informed of the cost prior to producing the accounting.   Your request will be processed within 60 days of your written request submission.  An additional 30-day extension beyond the 60 days may be allowed with written explanation to you explaining the delay.
  6. Out-of-Pocket-Payments: If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have right to ask that your PHI with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
  7. The Right to a Paper Copy of This Notice: You have the right to request and obtain a paper copy of this Notice at any

 

How to Exercise Your Rights: To exercise you rights described in this Notice, send your request in writing, to our Privacy Officer at the address listed below under the section “Questions and Complaints." We may ask you to fill out a form that we will supply. To exercise your rights, you may also contact your Unison treatment provider for assistance to submit your request in writing.

CHANGES TO THIS NOTICE

Unison may revise the privacy policy at any time. Unison reserves the right to apply any changes to our privacy policy or this notice to all PHI that Unison maintains including any information collected before the date of the change. Whenever any changes are made to Unison’s privacy practices, a new revised Notice of Privacy Practices will be posted at each facility and copies will be available for distribution upon request.

REVOCATION

You may revoke your consent or authorization for Unison to use and disclose PHI. You must submit your revocation in writing to the Privacy Officer. Unison is permitted to use and disclose your PHI based on your consent until your revocation is received. If you revoke your consent, Unison reserves the right to refuse to provide further treatment to you, on the basis of your refusal to allow us to share information for the purposes of treatment, payment, and healthcare operations.

QUESTIONS AND COMPLAINTS

If you have any questions about this notice, any complaints about our privacy practices, or believe your privacy rights have been violated, you have the right to file a written complaint with our Privacy Officer:

Unison Health

Privacy Officer

                                                                                                                                                                                                                                                                                                                                                 1425 Starr Avenue

Toledo, Ohio 43605

419-693-0631

You may also file a written complaint with the Secretary of the United States Department of Health and Human Services:

The U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201, Toll Free 1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

We will not retaliate or take action against you for complaining about the use and disclosure of PHI.

 

 

EFFECTIVE DATE OF THIS NOTICE

April 14, 2003

 

 

Revised Date: 12/19/2023