Notice of Client Privacy Practices
Effective Date - March 1, 2003
In compliance with HIPAA - The Health Insurance Portability and Accountability Act of 1996 [45 CFR]
If you are a client of Lutheran Family Services of Nebraska, 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.
I. UNDERSTANDING YOUR HEALTH RECORD/INFORMATION
When you visit Lutheran Family Services, Inc. ("Agency") or other health care providers, a record of your visit is made.
Typically, this record contains your symptoms, diagnosis and your treatment plan for future care. This information, often
referred to as your case record, serves as a basis for planning your care and treatment. Your health information is also used
by third-party payers to verify that billed services were provided.
II. USES AND DISCLOSURES
The Agency will not disclose your health information without your authorization, except as described in this notice.
Treatment. The Agency will use your health information for treatment; for example, information obtained by a therapist/worker
will be recorded in your record and used to determine the course of treatment. Your therapist/worker and other health care professionals
will communicate with one another personally and through the case record to coordinate care provided. You may receive more
than one service (program) during your treatment period with such information shared between programs.
Payment. The Agency will use your health information for payment for services rendered. For example, a bill may be
sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well
as your diagnosis and treatment procedures.
Health Care Operations. The Agency will use your health information for health care operations. For example, Agency therapist,
workers, supervisors and support staff may use information in your case record to assess the care and outcomes of your case
and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of
services we provide. Regulatory and accrediting organizations may review your case record to ensure compliance with their requirements.
Notification. In an emergency, the Agency may use or disclose health information to notify or assist in notifying
a family member, personal representative or another person responsible for your care, of your location and general condition.
Workers´ Compensation. The Agency may disclose health information to the extent authorized by and to the extent
necessary to comply with laws relating to workers´ compensation or other similar programs established by the law.
Public Health. As required by federal and state law, the Agency may disclose your health information to public health
or legal authorities charged with preventing or controlling disease, injury or disability.
Law Enforcement. As required by federal and state law, the Agency will notify authorities of alleged abuse/neglect;
and risk or threat of harm to self or others. We may disclose health information for law enforcement purposes as required by
law or in response to a valid subpoena.
Correctional Institution. Should you be an inmate of a correctional institution, the Agency may disclose to the institution,
or agents thereof, health information necessary for your health and the health and safety of other individuals.
Charges against the Agency. In the event you should file suit against the Agency, the Agency may disclose health
information necessary to defend such action.
Duty to Warn. When a client communicates to the Agency a serious threat of physical violence against himself, herself
or a reasonably identifiable victim or victims, the Agency will notify either the threatened person(s) and/or law enforcement.
The Agency may also contact you about appointment reminders, treatment alternatives or for public relations activities.
In any other situation, the Agency will request your written authorization before using or disclosing any identifiable health
information about you. If you choose to sign such authorization to disclose information, you can revoke that authorization to
stop any future uses and disclosures.
III. INDIVIDUAL RIGHTS
You have the following rights with respect to your protected health information:
1. You may request in writing that the Agency not use or disclose your information for treatment, payment or administration purposes
or to persons involved in your care except when specifically authorized by you, when required by law, or in emergency situations.
The Agency will consider your request; however, the Agency is not legally required to accept it.
You have the right to request that your health information be communicated to you in a confidential manner such as sending
mail to an address other than your home.
2. Within the limits of the Nebraska statutes and regulations, you have the right to inspect and copy your protected health
information. If you request copies, the Agency will charge you a reasonable amount, as allowed by statute.
3. If you believe that information in your record is incorrect or if important information is missing, you have the right to
submit a request to the Agency to amend your protected health information by correcting the existing information or adding
the missing information.
4. You have the right to receive an accounting of disclosures of your protected health information.
5. If this notice was sent to you electronically, you may obtain a paper copy of the notice upon request to the Agency.
IV. AGENCY´S DUTIES
1. The Agency is required by law to maintain the privacy of protected health information and to provide individuals with
notice of its legal duties and privacy practices with respect to protected health information.
2. The Agency is required to abide by the terms of the Notice currently in effect, and
3. The Agency reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all
protected health information that it maintains. Prior to making any significant changes in our policies, Agency will change its
Notice and post the new Notice in the waiting area and on our web site. You can also request a copy of our Notice at any time.
For more information about our privacy practices, please contact the LFS office nearest you.
If you are concerned that the Agency has violated your privacy rights, or you disagree with a decision the Agency made about
access to your records, you may contact the LFS office nearest you. You may also send a written complaint to the federal Department
of Health and Human Services. The LFS office staff can provide you with the appropriate address upon request. Under no circumstances
will you be retaliated against for filing a complaint.
VI. CONTACT INFORMATION
The Agency is required by law to protect the privacy of your information, provide this Notice about our information practices,
and follow the information practices that are described in this Notice.
If you have any questions or complaints, please contact the LFS office nearest you.