Notice of Privacy Practices
Richard J. Caron Foundation — Wernersville, Pennsylvania
Caron Counseling Services, LLC — Wyomissing, Pennsylvania
Caron of Florida, Inc. — Boca Raton, Florida
Caron of Georgia, LLC — Atlanta, Georgia
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
Caron is required by law to provide you with this Notice of Privacy Practices and to abide by its terms. A violation of the applicable laws or regulations is a crime. If you suspect a violation you may file a report as set forth under "Complaints" below. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will make available a revised Notice of Privacy Practices by posting a copy on our website www.caron.org, sending a copy to you in the mail upon request or providing one to you upon request.
How We May Use and Disclose Health Information About You
Listed below are examples of the uses and disclosures that Caron may make of your protected health information. In a number of cases, we will get your consent (authorization) for a use or disclosure of PHI. Below are several examples that describe the types of uses and disclosures that may be made but are not made to be exhaustive.
Uses and Disclosures for Treatment, Payment and Health Care Operations
For Treatment. Your PHI may be used and disclosed by your physician, counselor, program staff and others outside of our program that are involved in your care for the purpose of providing, coordinating or managing your health care treatment and any related services with your written authorization. This includes coordination or management of your health care with a third party, consultation with other health care providers or referral to another provider for health care treatment. For example, your protected health information may be provided to the state agency that referred you to our program to ensure that you are participating in treatment. In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of the program, becomes involved in your care. When applicable, we may disclose your PHI for treatment purposes without your authorization to third parties known as QSO/BAs (see explanation below).
To Obtain Payment for Services. Caron will use and disclose your PHI to obtain payment for your health care services with your written authorization (except in limited circumstances such as; PA 255.5 regulation prohibiting health care providers from disclosing entire substance abuse records to third party payers). Examples of payment-related activities are by making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity or undertaking utilization review activities. Caron may condition your treatment on the receipt of written permission to disclose your PHI for payment purposes. When applicable, we may disclose your PHI for payment purposes without your authorization to third parties known as QSO/BAs (see explanation below).
For Healthcare Operations. We may use your PHI, as needed, within Caron in order to support the business activities of our program including, but not limited to, quality assessment activities, employee review activities, training of students, licensing and conducting or arranging for other business activities. We may share your PHI with third parties known as QSO/BAs (see below) that perform various business activities (e.g., billing or typing services) for Caron Foundation, provided we have a written contract with the QSO/BA.
Disclosures to You
We may contact you to remind you of your appointments or to provide information to you about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also contact you regarding programs and services offered by Caron, such as alumni events and workshops, or recovery newsletters. We may contact you or the individual who paid for your treatment to request a tax-deductible contribution to support Caron's important fundraising activities. (If you do not want to receive fundraising requests, call 1-800-678-2332, ext. 6193 or email at firstname.lastname@example.org.)
Other Uses of Your PHI
We may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician or counselor. We may also call you by first name in the waiting room when it is time to be seen.
Uses and Disclosures That Do Not Require Your Authorization
Pursuant to An Agreement with a Qualified Service Organization/Business Associate ("QSO/BA"). We may enter into a contract with a third-party QSO/BA to provide services to Caron. Examples of these services include data processing, bill collecting, dosage preparation, laboratory analysis, or legal, medical, accounting and professional services. The QSO/BA may access your PHI but only to fulfill the QSO/BA's function and may not redisclose your PHI.
As Required by Law. We may use or disclose your PHI to the extent that the use or disclosure is required by law, is limited to the relevant requirements of the law, and is permitted under the privacy laws applicable to Caron. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purposes of investigating or determining our compliance with applicable law.
For Audits and Investigations. We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include public and private agencies that provide financial assistance to the program (such as federal and state granting agencies), regulatory agencies, and peer review organizations performing utilization and quality control. If we disclose PHI to a health oversight agency, we will have an agreement in place that requires the agency to safeguard the privacy of your information.
In Medical/Psychiatric Emergencies. We may use or disclose your protected health information in a medical or psychiatric emergency situation to medical personnel. In addition, the individual designated by you at time of admission as your emergency contact will be notified of your condition and transfer to another facility.
Suspicion of Child Abuse or Neglect. We may disclose your PHI to a state or local agency that is authorized by law to receive reports of child abuse, or neglect. However, the information we disclose is limited to only that information which is necessary to make the initial mandated report.
For Deceased Patients. We may disclose PHI regarding deceased patients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics or permitting inquiry into the cause of death.
For Research Purposes. We may disclose PHI to researchers if there is no patient-identifying information associated with the disclosure.
Criminal Activity on Program Premises/Against Program Personnel. We may disclose your PHI to law enforcement officials if you have committed a crime on program premises or against program personnel.
Criminal Threat Against a Third Party. We may disclose to law enforcement officials or a third party any criminal threat made against a third party. Criminal threats will only be disclosed to the extent permitted by law.
By Court Order. We may disclose your PHI if the court issues an appropriate order and follows required procedures.
Prospective Patient/Tours. At times there may be prospective patients, family members or referrals who come on campus to tour the facility, meet staff, observe and/or participate in groups and other activities. Anyone coming on campus is required to sign an acknowledgement regarding his/her obligation to comply with federal and state laws and regulations around patient confidentiality and privacy in substance use disorder treatment.
Uses and Disclosures of PHI with Your Written Authorization
Other uses and disclosures of your PHI will be made only with your written authorization. You may revoke an authorization at any time, unless the program or its staff has taken an action in reliance on the authorization of the use or disclosure you permitted.
Your Rights Regarding Your Protected Health Information
Your rights with respect to your protected health information are explained below. Any requests with respect to these rights must be in writing. A brief description of how you may exercise these rights is included.
You have the right to inspect and copy your Protected Health Information
You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as we maintain the record. A "designated record set" contains medical and billing records and any other records that the program uses for making decisions about you but does not include psychotherapy notes. Your request must be in writing. We may charge you a reasonable cost-based fee for the copies. We can deny you access to your PHI in certain circumstances. You have a right to appeal the denial of access to your record. Please contact Caron’s Privacy Officer if you have questions about access to your substance abuse record.
You may have the right to amend your Protected Health Information
You may request, in writing, that we amend your PHI that has been included in a designated record set. You have the right to request the correction of inaccurate, irrelevant, outdated or incomplete information in your record. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and submit rebuttal data or a memorandum to your record. We may prepare a rebuttal to your statement and will provide you with a copy of it. Please contact the Caron's Privacy Officer if you have questions about amending your substance abuse records.
You have the right to receive an accounting of some types of Protected Health Information disclosures.
You may request an accounting of disclosures for a period of up to six years, excluding disclosures made to you, made for treatment purposes or made per your request and authorization. We may charge you a reasonable fee if you request more than one accounting in any 12-month period. Please contact Caron’s Privacy Officer if you have questions about accounting of disclosures.
You have a right to receive a paper copy of this notice.
You have the right to obtain a copy of this notice from us. Any questions should be directed to Caron’s Privacy Officer.
You have the right to request added restrictions on disclosures and uses of your Protected Health Information.
You have the right to ask us not to use or disclose any part of your PHI for treatment, payment or health care operations or to family members involved in your care. Your request for restrictions must be in writing and we are not required to agree to such restrictions. Please contact Caron’s Privacy Officer if you would like to request restrictions on the disclosure of your PHI.
You have a right to request confidential communications.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. Normally we will communicate with you through the phone numbers, postal address, and/or email addresses you provide. We will accommodate any reasonable request to communicate with you by alternative means or at an alternative location, but we may condition this accommodation by asking you for information regarding specification of an alternative address or other method of contact. We will not ask you why you are making the request. Please contact Caron’s Privacy Officer if you would like to make this request.
If you believe your privacy rights have been violated, you may file a complaint in writing to the attention of Caron’s Privacy Officer, Cheri Steeves at P.O. Box 150, Wernersville, PA 19565, Telephone (610) 743-6175 or e-mail at email@example.com. Retaliation by Caron personnel in response to verbal or written complaints is strictly prohibited.
You may also file a complaint with the following: U.S. Secretary of Health and Human Services: 200 Independence Avenue, S.W. Washington, D.C. 20201, (877) 696-677
Caron Georgia: U.S. Attorney for the Northern District of Georgia – The Honorable Byung J. Pak, The United States Attorney's Office, Richard B. Russell Federal Building, 75 Ted Turner Dr. SW, Suite 600, Atlanta, GA 30303-3309. Main Phone: (404) 581-6000
Caron Pennsylvania: U.S. Attorney for the Middle District of Pennsylvania – The Honorable David J. Freed, The United States Attorney's Office, Harrisburg Federal Building and Courthouse, 228 Walnut Street, Suite 220, P.O. Box 11754, Harrisburg, PA 17108-1754. Main phone: (717) 221-4482
Caron Renaissance and Ocean Drive: U.S. Attorney for the Southern District of Florida – Mr. Benjamin G. Greenberg, The United States Attorney's Office, 500 S. Australian Ave. Ste. 400, W. Palm Beach, Fl. 33401. Main Phone: (561) 820-8711
A list of active U.S. Attorney’s is found at the following link: https://www.justice.gov/usao/us-attorneys-listing
Opioid Treatment Program: Substance Abuse Mental Health Services Administration, Center for Substance Abuse Treatment, Division of Pharmacologic Therapies, Danielle Johnson Byrd, Director, 5600 Fishers Lane, Rockville, MD 20857 240-276-1660. Main phone: (240) 276-1660. Website: https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/medication-counseling-treatment/about-dpt