Casa Esperanza, Inc.
Notice of Privacy Practices
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.
Casa Esperanza, Inc. (Casa) keeps a record of your health information. This includes health information about you that is collected during the course of your treatment at Casa, and includes information that may be kept in paper or electronic form. Information such as your symptoms, test results, diagnoses, treatment, care plan, demographic, and payment information are examples of your health information that may be a part of your health record. We are legally required to keep this health information private. This Notice is being given to you because Casa is required by federal law to tell you ahead of time about:
• How Casa will handle your health information
• Casa’s legal duties related to your health information
• Your rights with regard to your health information.
This Notice applies to Casa and the following individuals/organizations:
• Any provider who is a member of Casa’s behavioral health or case management staff.
• All Casa workers, including employees, volunteers, and interns
• Any staff member authorized by Casa to enter information into your health record.
• Any health care provider that is part of Casa’s integrated care clinic in partnership with Boston Health Care for the Homeless Program (BHCHP).
• Casa and BHCHP share medical information for treatment, payment, and health care operations purposes as described in this Notice.
A. USE AND DISCLOSURE OF HEALTH INFORMATION WITHOUT AUTHORIZATION
1. Treatment: Your Clinician, Treatment Coordinator, Case Manager, Recovery Support Staff, Nurse, and Psychiatrist involved in taking care of you at Casa may use your health information to provide you with treatment or related services. Different departments and your interdisciplinary care team—including, without limitation, medical, behavioral health, and care management staff—may share your health information for purposes of care coordination. This helps to make sure that everyone caring for you has the information they need. Casa believes that sharing your information is critical in order to provide you with the best health care and is necessary given the complexities of co-occurring substance use and mental health needs and various other health conditions.
2. Payment: Casa may use your protected health information to bill for services provided to you and to collect payment for our services. For instance, your insurance company or third party payor, such as Medicare or Medicaid, may request to see copies of your record to verify services which you received or to determine if you are eligible for benefits or if the services you received were medically needed.
3. Health care operations: Health Care Operations are the functions that all health care facilities and agencies perform to verify that the delivery of care to patients is being properly performed and that the facility or agency is functioning properly. Some of the information is shared with outside parties who perform these health care operations or other services on behalf of Casa (“business associates”). These business associates must also take steps to keep your health information private. Examples of activities that make up health care operations include:
• Monitoring the quality of care and making improvements where needed
• Making sure health care providers are qualified to do their jobs
• Reviewing medical records for completeness and accuracy or as required by law
• Meeting standards set by agencies who regulate Casa
• Supervising health professionals
• Using outside business services, such as auditing, legal or other consulting services
• Storing your health information on our computers
• Managing and analyzing health information
4. To contact you regarding your care: Casa may use your health information to contact you:
• At the contact information you give to us (including leaving messages at the telephone numbers): about scheduled or cancelled appointments, registration/insurance updates, billing or payment matters (if applicable), or test results
• With information about patient care issues, treatment choices, and follow up care instructions
• To discuss health related benefits or services that may be of interest to you.
5. In medical emergencies:
Information may be disclosed to medical personnel who need such information about a client in order to treat a condition that poses an immediate threat to the client’s health and that requires immediate intervention.
6. As required by law or legal authorities: BCasa is either permitted or required by law to disclose your health information to the following types of entities and for the following reasons, including but not limited to:
• Public Health: Casa may disclose your health information for public health activities, including to prevent, lessen or control disease, injury, disability, or other serious threats to your or the public’s health or safety; to report child abuse, or neglect, or as otherwise authorized by law; to report reactions to medicine or problems with products; to notify a person exposed to a contagious disease.
• Victims of Abuse, Neglect or Domestic Violence: Casa staff are permitted to disclose your health information to an appropriate agency(ies) authorized by law to make an initial report of abuse or neglect of a child, an elder or a person with a disability. Any additional information requested in relation to such a report needs a court order and subpoena as described above.
• Health Oversight: Casa may be required to disclose health information to oversight agencies for activities such as audits or inspections to oversee the health care system and/or government programs.
• Legal Proceedings: Casa may be required to disclose health information as part of a judicial or administrative proceeding, such as in response to a legal order or subpoena.
• Law Enforcement: Casa may be required to disclose health information if a patient has committed a crime or is threatening to commit a crime. Staff may only divulge: the client’s status, name, address, and last known whereabouts.
• Medical Examiners, Funeral Directors, and Organ Donation: Casa may be required to disclose health information to a coroner or medical examiner to identify a deceased person or to determine the cause of death. We may also disclose health information to a funeral director or their designee, as necessary to carry out their duties. Health information may also be disclosed to coordinate organ, eye or tissue donation at death.
• Research: Under certain circumstances, Casa may share health information about patients for research purposes; however, all individual identifying information is removed and we will request your consent to participate in any research and evaluation studies. If a researcher will have access to your name, address, or other information that reveals who you are, we will ask for your specific permission or get approval from an Internal Review Board.
• Specialized Government Functions: Under certain circumstances, Casa may be required to disclose health information to units of the U.S. government with special functions, such as the U.S. military or the U.S. Department of State.
• Workers’ Compensation: Casa may use and disclose health information as required to comply with workers’ compensation laws, and other programs that provide benefits for work-related injuries or illnesses.
Required By Law: Casa may be required to use or disclose your health information as required by federal, state or local law. This includes by means of a valid subpoena AND Court Order or Client Consent
• All disclosures of client information must be recorded in the patient file. Under HIPAA, clients have the right to obtain an accounting of certain disclosures made by a program during the preceding 6 years. To ensure Casa Esperanza, Inc. and its affiliates can meet this requirement, all disclosures of client information will be recorded.
B. USES OR DISCLOSURES THAT MAY BE LIMITED OR YOU MAY REQUEST NOT BE MADE
1. Emergency Situation
If you are in an emergency situation and not able to make your wishes known, we will use our best judgment to decide whether to share information. If it is thought to be in your best interest, we will only share information that others really need to know.
2. Disaster relief purposes: Including:
• To coordinate uses and disclosures to individuals involved in your care.
• To authorized public or private entities to assist in disaster relief efforts.
C. USE OR DISCLOSURES THAT REQUIRE YOUR WRITTEN PERMISSION
Using and/or disclosing your health information for most purposes other than those detailed above requires your written authorization. Under state and federal law, certain types of information in your medical record are considered to be highly sensitive and confidential. Releases of this sensitive information require you to provide a specific written authorization. Examples of sensitive medical information that requires an authorization include: HIV testing or test results, certain clinical therapy documentation, and behavioral health history and treatment (including both mental health and substance use).
Revocation of Your Written Authorization
If you provide written authorization for us to share your health information, you may revoke that authorization, in writing, at any time. Once revoked, we will no longer share your health information for the purpose(s) covered in the written authorization; however, we are unable to take back any information we have already shared prior to the time your authorization was revoked.
Sale of Protected Health Information and Marketing Efforts
Casa prohibits the sale of protected health information without your express written authorization. This means we will never sell or lease your health records without first obtaining your written authorization.
Casa’s direct marketing efforts to community members may include patients. As a patient, you have the right to “opt out” of receiving Casa marketing materials. In order to opt out, please contact the Privacy Officer; see section G below.
D. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
1. Right to inspect and copy: You have the right to inspect and copy health and billing information that may be used to make decisions about your care. This does not include psychotherapy notes, or information compiled in anticipation of or for use in a civil, criminal or administrative action or proceeding.
To inspect and copy your health information, you must complete an Authorization for the Release and/or Discussion of Medical Records and submit it to Casa Esperanza, Inc. Administrative Office, 302 Eustis Street, Roxbury MA 02119. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, and supplies used.
Casa may deny your request to inspect and copy your record in certain, very limited, circumstances. Casa may ask that you receive this information in a meeting with your provider, so that you can ask questions and receive explanations while you review your record. You may request that we release copies of your record for inspection to you through another provider or you may request that we release copies of your health record to you through your attorney.
2. Right to request an amendment: If you feel that health information we have about you is inaccurate or incomplete, you have the right to request an amendment to your record. You have the right to request an amendment for as long as the information is kept by (or for) Casa.
Casa has the right to deny your request for amendment of your medical records if it is not in writing or if it does not include a reason to support your request. Casa may also deny your request if you ask us to amend the following types of information:
• Information that was not created by Casa, unless the person or entity that created the information is no longer available to make the amendment;
• Is not part of the health information kept by or for Casa;
• Is not part of the information which you would be permitted to inspect and copy; or,
• Is accurate and complete.
To request information about the steps to be taken if you wish us to amend your record or if you wish to submit an amendment, you must submit your request in writing to the Privacy Officer; see section G, below.
3. Right to an accounting of disclosures (shared information): You have the right to request an accounting of disclosures, which is a list of the health information about you which we have shared.
To request an accounting of disclosures (shared information), submit your request in writing to the Privacy Officer; see section G, below. Requests for an accounting of disclosures may be for a period of up to six years and requests may not include requests for information released (shared) before August 4, 2014. Your request should indicate if you prefer to receive the list on paper or electronically. The first list you request within a 12-month period will be free. For additional lists, we may charge you. We will notify you of the cost involved and you may choose to withdraw or modify your request before any costs are incurred.
4. Right to request restrictions: You have the right to request a restriction or limitation on the health information we share about you for treatment, payment, or health care operations. The right to request restrictions does not apply to or limit uses and disclosures required by law. You also have the right to request a limit on the health information we share about you to someone who is involved in your care or payment for your care, like a family member or friend.
To request restrictions, contact the Privacy Officer; see section G, below. In your request you must tell us 1.) what information you want to limit and 2.) to whom you want the limits to apply. We may use or disclose restricted information for emergency treatment or as defined in Section A and B above.
5. Right to request confidential communications: You have the right to request that we communicate with you about health information in a certain way or at a certain location. For example, you can ask that we only contact you by telephone or by email.
To request confidential communications, contact the Privacy Officer; see section G, below. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
6. Right to a paper copy of this notice: You have the right to obtain a paper copy of this Notice. You may obtain a copy of this Notice at our website (www.casaesperanza.org) or by other electronic means (e-mail). Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
You may obtain a paper copy of this Notice on admission, on your first in person visit after the effective date, or you may contact the Privacy Officer (see section G, below) for a copy of this Notice at any time.
7. Right to access PHI electronically: You have a right to obtain a copy of your protected health information in electronic format where it is maintained in an Electronic Health Record (“EHR”). This means you may request a PDF copy of your health information and we must provide you with one for the information that was stored in our EHR.
8. Right to complain: If you feel that your privacy rights have been violated, you may file a complaint with Casa by notifying the Director of Compliance by filing a Grievance in accordance with the Casa Grievance Procedure. If the complaint/grievance is about a violation of privacy, it will be forwarded to the Privacy Officer.
You may also file a complaint with the Secretary of the Department of Health and Human Services.
You will not be penalized for filing a complaint. Casa will not retaliate against you for filing a complaint.
E. CASA’S RESPONSIBILITY TO RETAIN MEDICAL RECORDS
Casa maintains outpatient health records for a period of up to 20 years from a patient’s last date of service. Residential health records are maintained for up to 7 years from a patient’s last date of service.
Patient access to health records will not change with this change in the law. Patients continue to have the right to inspect their health records upon request at any time during the period for which we are required to maintain medical records.
When the record retention time period has expired, Casa is required to notify the Department of Public Health, 30 days prior to the intended date of destruction, of our intention to destroy the records. Destruction of records is done by a vendor who has signed an agreement to transport and destroy the records in a manner which protects confidentiality at all times.
You may obtain a full copy of the Casa Esperanza, Inc. Records Retention and Destruction Policy by contacting the Privacy Officer; see section G, below.
F. CHANGES TO THIS NOTICE
We reserve the right to revise or change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about you or any information we receive in the future. The effective date will be at the top of the first page.
G. CONTACT INFORMATION
If you have any questions about this Notice, please contact:
Casa Esperanza, Inc.
Attn. Privacy Officer
302 Eustis Street
Roxbury, MA 02119
PROGRAMS/LOCATIONS OF CARE AND COLLABORATIONS
A list of Casa programs/locations of care and collaborations includes the following:
1. 291 Eustis Street (Men’s Residential Program
2. 263 Eustis Street (Latinas y Niños Residential Program)
3. 245 Eustis Street (Familias Unidas Outpatient Services)
4. 365 East Street, Tewksbury MA (Conexiones CSS Program)
5. 302 Eustis Street (Admin. Offices)
6. Boston Health Care for the Homeless Program, including, without limitation, its programs and services
