Privacy Statement
The Ann Storck Center understands
and respects your right to privacy. All information contained in the
records of those individuals being served shall be considered
confidential and will be treated according to Florida Statutes,
Chapter 393 (3) and (4). The Ann Storck Center will safeguard health
information and will comply with all the provisions of the Health
Insurance Portability and Privacy Act (HIPAA) which describes how
health information about those receiving services from the Center may
be used and discloses and how persons served can access and request
changes to this information.
Summary Notice of
Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT THOSE RECEIVING SERVICES BY ASC MAY BE USED AND
DISCLOSED AND HOW THOSE WE SERVE CAN GET ACCESS TO THIS INFORMATION.
THIS NOTICE BECOMES EFFECTIVE APRIL 14, 2003.
It is important that you understand
how ASC collects, handles, and shares (discloses) medical information
regarding those we serve and that you are aware of their rights
relating to privacy and confidentiality. The following is a summary of
our Notice of Privacy Practices- the goal of which is to protect the
privacy, security, and confidentiality of our residents, day program
participants, and preschool students medical information.
1. ASC will safeguard medical
information regarding those we serve according to strict standards of
privacy, security and confidentiality as set-forth in the Health
Insurance Portability and Accountability Act of 1996, which is often
referred to as HIPAA Privacy Ruling. HIPAA does not apply to
employment records of employees at ASC.
2. ASC will not release medical
information regarding those we serve for reasons other than treatment,
payment, or health care operations unless we have received a signed
authorization.
3. ASC will, however, release
information in the following circumstances, unless a resident/day
program participant and/or their legal representative objects
verbally: to a relative, friend, or individual involved in their care,
or to assist in disaster relief efforts.
4. ASC may use medical information
regarding those we serve to provide, coordinate or manage the
services, supports, and health care those we serve receive from ASC
and other providers.
5. ASC may disclose health
information about those we serve to doctors, nurses, qualified mental
retardation professionals (QMRPs), psychologists, social workers,
direct support staff and other agency staff, volunteers and other
persons who are involved in supporting those we serve or providing
care.
6. ASC may consult with other health
care providers concerning those we serve and, as part of the
consultation, share their health information with them.
7. ASC staff may share information
to coordinate needed services, such as medical tests, transportation
to a doctor’s visit, physical therapy, etc. The Ann Storck Center,
Inc. staff may need to disclose health information to entities outside
of our organization (for example, another provider or a state/local
agency) to obtain services for those we serve.
8. ASC will permit only authorized
individuals who are trained in the proper handling of medical
information to have access to our residents, day program participants,
and preschool students medical information. Employees who violate our
privacy policy will be subject to disciplinary action as stated within
the Employee Handbook.
9. Whenever ASC hires other
organizations or individuals to provide support services, ASC will
require them to follow our privacy standards stated in a Business
Associate Agreement.
10. ASC will make every effort to
keep our residents, day program participants, and preschool students
records complete, accurate, and up to date. Any resident, day program
participant, or a legal representative of anyone served by ASC has the
right to request a change to the medical information and to request a
restriction on who may receive their medical information. The Ann
Storck Center, Inc however, reserves the right to deny request(s) if
it may prove harmful to hinder legal proceedings, or impedes
treatment, payment, or healthcare operations.
11. ASC will use reasonable efforts
to accommodate the request for confidential communications regarding
the health status, health care services, or billing of those we serve.
If those served and/or their legal representative want to be contacted
somewhere besides their home to protect their confidentiality, ASC’s
Privacy Officer can provide the proper form to use to request such
restrictions for communications.
12. ASC will make every reasonable
attempt to provide those served and/or their legal representative with
access to that medical information upon request. In most cases ASC
will honor the request within 30 days if the records are stored
onsite. The Ann Storck Center, Inc. may deny the request to under
certain limited circumstances. If ASC denies the request, those served
and/or their legal representative have the right to appeal the
decision to the Privacy Officer or a designated representative.
13. ASC will provide those served
and/or their legal representative with list of certain individuals
and/or organizations that ASC has released their medical information
to, upon the request of those served and/or their legal
representative. This request may be for up to six (6) years prior to
the date on which request the accounting. This request cannot be for a
period earlier than April 14, 2003. The Ann Storck Center, Inc. will
generally honor the request for this accounting within 60 days of
request. This request will be filled at no cost to those served and/or
their legal representative once every twelve (12) months. ASC may
charge a copying fee for additional requests made within the twelve
(12) month period.
Certain types of disclosures are not
included in such an accounting: Disclosures to carry out treatment,
payment and health care operations; Disclosures of their health
information made to those served and/or their legal representative;
Disclosures that are incidental to another use or disclosure;
Disclosures that have been authorized; Disclosures for our facility
directory or to persons involved in the residents, day program
participant, or preschool students care; Disclosures for disaster
relief purposes; Disclosures for national security or intelligence
purposes; Disclosures to correctional institutions or law enforcement
officials; Disclosures that are part of a limited data set for
purposes of research, public health, or health care operations (a
limited data set is where things that would directly identify you have
been removed); Disclosures made prior to April 14, 2003.
14. ASC is required by law to
provide you with the Notice of Privacy Practices and to comply with
the Notice currently in effect. The Ann Storck Center, Inc. reserves
the right to change its Notice of Privacy Practices as changes occur.
When such changes are made, ASC will notify you the changes. A copy of
the revised Notice of Privacy Practices will be posted within sixty
(60) days of the revisions.
15. If you have questions, wish to
make a request regarding health information, or would like another
paper copy of this notice, please contact ASC’s Privacy Officer at
(954) 584-8000 ext.306. Please make the request in writing.
16. If you believe privacy rights
have been violated, immediately notify your supervisor or manager; you
may also file a complaint with ASC’s Privacy Officer at the address
listed below. You will not be retaliated against for filing a
complaint.
Johanna Robertson
Privacy Officer
jrobertson@ascfl.org
Ann Storck Center
1790 SW 43rd Way Fort Lauderdale, FL 33317 (954)
584-8000 ext.306
