BETTER LIFE COUNSELING CENTER, INC. NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

The Health Insurance Portability and Accountability Act, requires that we provide notice to each of our patients of how this information is used.

We safeguard information about your health and person. (Protected Health Information, “PHI”)

We collect information from you and store it in a medical record, which may be electronically stored on computer.  Our medical record charts are stored in a secure area and are available to designated staff and only for specific reasons.  If your record is computerized, we use security measures to protect it.

How we May Use and Disclose Your Protected Health Information

We use your PHI in many ways to help in treatment, payment and clinic operations.

Some examples include:

·         Contacting you about appointments -- reminders or to reschedule.

·         Obtaining your medical history and treatment and recording it in your chart.

·         Consulting with team members regarding your treatment.

·         Providing your PHI to an Emergency Room or Hospital.

·         Obtained approval/payment from your health insurer(s) for treatment.

·         We may use your PHI to create bills we submit to the insurance company.

We may be required by law to use or share your PHI, without your written authorization, for the following:

·         When required by federal, state and local law.

·         Reporting victims of abuse, neglect or domestic violence.

·         Judicial proceedings (valid Court Orders)

·         Emergencies or to avert a serious threat to any person or the community.

·         In a medical emergency, to permit you to receive needed treatment.

·         If you commit a crime on our premises or against any person who works for us, or  if you threaten to commit such a crime.

·         As required by the Secretary of the Department of Health and Human Services.

How to direct us to use and disclose your PHI: Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law.  YOU MAY REVOKE YOUR WRITTEN AUTHORIZATION AT ANY TIME, IN WRITING.  If you revoke your written authorization, it will apply to any future actions relating to the release of your PHI.  There may be cases where we have already released your PHI prior to receiving your revocation.

YOUR PATIENT PRIVACY RIGHTS

You have the right to:

Request restrictions of your PHI. You may ask us to limit how we use or disclose any part of your PHI as explained above, except for the typical uses and disclosures described above.  You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care.  You may request a specific restriction by writing the request and to whom the restriction applies on the authorization form.  We do not have to agree to your request.  In the event we agree, we will state the agreement in writing.  We have the sole right to deny a request if unreasonable.

Request to choose how we communicate with you. You have the right to ask that we send information to you in a specific manner.  For example: Work address rather than home, or e-mail rather than regular mail.  We must agree to your request as long as it would not be disruptive to our operations to do so.  We may condition our agreement to honor your request by asking you for specific information as to the alternate address, method of contact and the cost.  We will not request an explanation from you as to the basis for the request.  You must make the request in writing, addressed to the clinic Privacy Officer. 

Receive a list of disclosures we have made of your PHI.  Beginning April 14, 2003, you may make a written request for a list of all our uses and disclosures of your PHI other than: for treatment, payment, clinic operation: to yourself: or, those with valid authorization.  We must respond in sixty (60) days (or 90 days if extra time is needed). The list will be for a 12-month period unless you ask for a shorter time.  You are entitled to one (1) free accounting each year.  There will be a reasonable charge for any additional accounting requests during the year. The right to receive this information is subject to certain exceptions and restriction. 

If you want to exercise any of these rights and would like assistance, please contact our Clinic Privacy Officer in person or in writing during our normal clinic hours.

Mental Health Services

When you receive mental health care, including treatment for substance abuse, information related to that care may be more protected that other forms of health information.  Communications between a psychotherapist in treatment are privileged and may not be disclosed without your permission, except as required by law.  For example, psychotherapists still must report suspected child abuse and may have to breach confidentiality if you appear to pose an imminent danger to yourself or others, in order to reduce the likelihood of harm to you or others. If you tell us that you have committed a violent crime that caused serious harm to the victim in a counseling or psychotherapy session, we may not disclose the information to law enforcement officials.

Our Responsibilities

We reserve the right to make changes to this Notice, which will affect the PHI we maintain at that time.  Our duty, as your healthcare provider, is to maintain your privacy in accordance with law, abide by the terms of this privacy Notice, accommodate reasonable requests or notify you if we cannot, and provide you with a revised copy of this Notice.  You can obtain a copy of any revised Notice by calling our clinic or visiting our clinic and picking up a copy.

Notices are always available in our clinic for your review.

We have a designated a Privacy Officer to answer questions about our privacy practices and to ensure that we comply with applicable laws and regulations.  Our Privacy Officer is Tammy Evins.  You may contact her at (870) 935-4673 or 1-888-668-5433.

Complaints

If you believe your privacy rights have been violated, you may complain by providing a written statement to our clinic and to the Secretary of Health and Human Services (HHS) at Office of Civil Rights, US Department of Health and Human Services, 20 Independence Ave., S.W., Room 509F HHH Building, Washington, D.C. 20201.  We will not retaliate against you for filing a complaint.  We will not require you to waive the right to file a complaint with HHS as a condition to receive treatment from us.  You may also contact our Privacy Official if you have questions or comments about our privacy practices.

Privacy Practices

This privacy statement discloses the privacy practices for the Better Life Counseling Center (BLCC) Web site. If you feel that this organization is not abiding by its posted privacy policy, you should first contact us by writing to BLCC, 1605 James Street, Jonesboro, AR 72401, or by sending an email to tevins@betterlife.org.

Information Collection and Use
BLCC is the sole owner of the information collected on this site. We will not sell, share or rent this information to third parties for any reason whatsoever.

Registration
In order to use portions of this Web site, users first must complete the registration form. During registration users are required to give their contact information (such as name and email address). This information is used to contact users about the services on our site for which they have expressed interest.

Cookies
A cookie is a piece of data stored on the user's hard drive containing information about the user. Usage of a cookie is in no way linked to any personally identifiable information while on our site. Once the user closes his browser, the cookie simply terminates. For instance, by setting a cookie on our site, the user would not have to log in a password more than once, thereby saving time while on our site. If a user rejects the cookie, he may still use our site. The only drawback to this is that the user will be limited in some areas of our site.

Log Files
We use IP addresses to analyze trends, administer the site, track user's movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.

Sharing
BLCC is the sole owner of the information collected on this site. We will not sell, share or rent this information to third parties for any reason whatsoever.

Links
This Web site contains links to other sites. Please be aware that we are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of each and every site that collects personally identifiable information. This privacy statement applies solely to information collected by this site.

Choice/Opt-out
Users who no longer wish to receive e-mails or other information from BLCC may opt out of receiving these communications by replying with "unsubscribe" in the subject line in the e-mail.

Policies for Children Under 12 Years Old
While BLCC encourages parents and guardians to share this Web site with their children, we do not knowingly accept or use personal information from children 12 years old or younger.

Tammy Evins
Privacy Officer
Better Life Counseling Center

870-935-4673
tevins@betterlife.org

BetterLife.org Disclaimer

Better Life Counseling Center, Inc. (BLCC) cannot and does not warrant the accuracy, completeness, timeliness, correctness or fitness for a particular purpose of the information or views made available through this website or the material contained within. By using BetterLife.org, you are agreeing that under no circumstances will BLCC or its affiliates be responsible for (1) any information contained on or omitted from the BetterLife.org website, (2) any person's reliance on any such information whether or not the information is correct, current or complete, and (3) the consequences of any action you or any other person takes or fails to take, whether or not based on information provided by or as a result of the use of the website.

BLCC makes no representations or warranties of any kind regarding the content in the BetterLife.org website or that of any other website to which the BetterLife.org website provides a link. BLCC specifically disclaims any express or implied warranties, including without limitation, warranties of merchantability, of fitness for a particular purpose, or against infringement. BLCC shall in no event be liable for any consequential, indirect or special damages resulting from or caused by the decisions you, the user, or any other person(s) make as a result of viewing and/or applying the use of any content presented by BetterLife.org or to any information to which BetterLife.org provides a link, or the negligence of BLCC or its agents.