This notice describes how medical and drug and alcohol related information about you may be used and disclosed and how you can get access to this information. If you have any questions about this Notice, please contact Greater Nashua Mental Health’s (GNMH) Director of Quality and Compliance at (603) 889-6147.
GNMH is committed to ensuring the privacy and confidentiality of the personally identifiable protected health information (PHI) it creates and maintains regarding the clients we serve. Confidence in the privacy of the sensitive information clients share with staff promotes partnership, honest and open communication and facilitates appropriate clinical supports to aid the client in his or her recovery and healthy development.
GNMH takes steps to assure that only those individuals who have a legitimate need have access to your health information to accomplish the work of the agency. All staff in our programs and offices will follow this notice.
Information regarding your health care is protected and GNMH will not disclose any information identifying your treatment or disclose any other protected information except as permitted by federal law. Please review this Notice carefully.
General Information
GNHC must obtain your written consent before it can disclose information about you for payment purposes. However, federal law permits GNMH to disclose information without your written permission:
1. As required by law. We may disclose your health information when required by federal, state, or local law to do so. For example, we are required by the Department of Health and Human Services (DHHS) to disclose your health information in order to allow DHHS to evaluate whether we are in compliance with the federal privacy regulations.
2. Public Health Activities. We may disclose your health information to public health authorities that are authorized by law to receive and collect health information for the purpose of preventing or controlling disease, injury, or disability; to report births, deaths, suspected abuse or neglect, reactions to medications; or to facilitate product recalls.
3. Health Oversight Activities. We may disclose your health information to a health oversight agency that is authorized by law to conduct health oversight activities, including audits, investigations, inspections, or licensure and certification surveys. These activities are necessary for the government to monitor the persons or organizations that provide health care to individuals and to ensure compliance with applicable state and federal laws and regulations.
4. Judicial or administrative proceedings. We may disclose your health information to courts or administrative agencies charged with the authority to hear and resolve lawsuits or disputes. We may disclose your health information pursuant to a court order or other lawful process issued by a judge or other person involved in the dispute, but only if efforts have been made to (i) notify you of the request for disclosure or (ii) obtain an order protecting your health information.
5. Worker’s Compensation. We may disclose your health information to worker’s compensation programs when your health condition arises out of a work-related illness or injury.
6. Law Enforcement Official. We may disclose your health information in response to a request received from a law enforcement official to respond to a court order.
7. Research. We may use or disclose your health information for research purposes under certain limited circumstances. Because all research projects are subject to a special approval process, we will not use or disclose your health information for research purposes until the particular research project for which your health information may be used or disclosed has been approved through this special approval process. However, we may use or disclose your health information to individuals preparing to conduct the research project in order to assist them in identifying patients with specific health care needs who may qualify to participate in the research project. Any use or disclosure of your health information that is done for the purpose of identifying qualified participants will be conducted onsite at our facility. In most instances, we will ask for your specific permission to use or disclose your health information if the researcher will have access to your name, address, or other identifying information.
8. To Avert a Serious Threat to Health or Safety. We may use or disclose your health information when necessary to prevent a serious threat to the health or safety of you or other individuals.
9. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may use or disclose your health information to the correctional institution or to the law enforcement official as may be necessary (i) for the institution to provide you with health care; (ii) to protect the health or safety of you or another person; or (iii) for the safety and security of the correctional institution.
Uses and Disclosures Pursuant to Your Written Authorization
Except for the purposes identified, we will not use or disclose your health information for any other purposes unless we have your specific written authorization. You have the right to revoke a written authorization at any time as long as you do so in writing. If you revoke your authorization, we will no longer use or disclose your health information for the purposes identified in the authorization, except to the extent that we have already taken some action in reliance upon your authorization.
Your Rights Regarding Your Health Information
Under HIPAA you have the following rights regarding your health information. You may exercise each of these rights, in writing, by providing us with a completed form that you can obtain from each receptionist, or your healthcare provider. In some instances, we may charge you for the cost(s) associated with providing you with the requested information. Additional information regarding how to exercise your rights, and the associated costs, can be obtained from your healthcare provider.
1. Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care except to the extent that the information was compiled for use in a civil, criminal or administrative proceeding. We may deny your request to inspect and copy your health information in certain limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed.
2. Right to Amend. You have the right to request an amendment of your health information that is maintained by or for our clinic and is used to make health care decisions about you. We may deny your request if it is not properly submitted or does not include a reason to support your request. We may also deny your request if the information sought to be amended: (a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (b) is not part of the information that is kept by or for our clinic; (c) is not part of the information which you are permitted to inspect and copy; or (d) is accurate and complete.
3. Right to an Accounting of Disclosures. You have the right to request an accounting of the disclosures of your health information made by us. This accounting will not include disclosures of health information that we made pursuant to a written authorization that you have signed.
4. Right to Request Restrictions. You have the right to request a restriction or limitation on certain uses and disclosures of your health information. We are not required to agree to your request. If we do agree, that agreement must be in writing and signed by you and us.
5. Right to Request Confidential Communications. You have the right to request that we communicate with you about your health care in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
Greater Nashua Mental Health Responsibilities
We will abide by the terms of this Notice, including any future revisions that we may make to the Notice as required or authorized by law. We reserve the right to change this Notice and to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. The privacy practices described in this Notice will be followed by:
1. Any health care professional authorized to enter information into your medical record created and/or maintained at our agency; and
2. All employees, students, residents, and other service providers who have access to your health information at our agency.
The individuals identified above will share your health information with each other only for purposes described in the Notice.
Complaints
If you have any questions regarding this Notice or wish to receive additional information about our privacy practices, please contact GNMH Director of Quality and Compliance. If you believe your privacy rights have been violated, you may file a complaint with our agency or with the Secretary of the DHHS. To file a complaint with our agency, contact the GNMH Director of Quality and Compliance. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
