Beginning April 14, 2003 all health care organizations must comply with the provisions of federal legislation entitled “Health Insurance Portability and Accountability Act” (HIPAA). The purpose of this legislation is to safeguard the security of protected health information (PHI) while also standardizing the electronic transmittal of health information for payment, treatment and health care operations.

Child Guidance Center has historically protected the release of PHI by requiring that the official guardian of a child sign a release for each disclosure to an individual or organization.  This policy will continue for most disclosures.

There are situations when Child Guidance Center is required to release information.

1. State law requires that any suspicion of child abuse or neglect must be reported to the Department of Children and Families.
2. Laws covering public health require reporting public health risks when someone is exposed to a disease or is at risk for contracting or spreading a disease or condition.
3. Cases that are subpoenaed by the Court.

Information about your child is sent electronically for example: fax, e-mail, encoded Internet sites, data warehouses held by our funders or other business partners. This information is protected and is kept confidential by everyone involved as there are stiff federal fines and prison terms if someone is found guilty of misuse of PHI information.

Procedural Information Regarding Your Rights

1. Only the minimum necessary information is released to obtain payment, provide treatment or promote health care operations (HCO). HCO refers to quality improvement activities, employee performance evaluation, care coordination with the psychiatrist and other administrative needs.

   a)	If insurance or Medicaid is being billed for treatment, the diagnosis, method of treatment and dates of visits are submitted to the carrier. The carrier may also request other specific information such as expected length of treatment.
   b)	Your child’s PHI may be shared with the representatives of funding sources, i.e. The Alcohol, Drug and Mental Health division of the State of Florida Department of Children and Families and the Jacksonville Children’s Commission. Charts are also reviewed by the Commission on Accreditation of Rehabilitation Facilities (CARF) as part of our agency’s accreditation process. This information is used to receive payment or to assist with health care operations such as quality improvement clinical guidelines development
   c)	The Jacksonville Children’s Commission requests basic applicant information to determine who is accessing this program. The information you provide is for use by us and the Commission and will not be shared unless you specifically authorize it.
   d)	Your child’s case may be discussed in the course of clinical supervision.
   e)	If information is to be shared with the school, Department of Children and Families or any other person or agency you will be asked to sign an authorization called a Release/Exchange of Information Form for each person or agency.

2. You can revoke your authorization for the release of this information. This may result in Child Guidance Center not being able to provide services to your child.
3. You have the right to request restriction on the use or disclosure of your child’s protected health information. To request restrictions, you must submit a Request to Restrict the Use or Disclosure of Protected Health Information form to our Quality Improvement Department. Your request must specify the limitations you wish to place on any disclosure. You will be notified of approval/denial in writing.
4. You have the right to request to inspect and copy (at your expense) your child’s record, but not the notes made by the therapist. You need to put this request in writing and submit it to the Quality Improvement Specialist.
5. You have the right to request an amendment to the record. To request an amendment, you must complete a Request to Amend Protected Health Information form and submit it to our Quality Improvement Department. In addition, you must provide a reason that supports your request. The federal Privacy Standards allow Child Guidance Center to deny your request if you ask us to amend information that:

   a)	Was not created by Child Guidance Center
   b)	Is not part of the information kept by or for Child Guidance Center
   c)	Is not part of the information you would be permitted to inspect and copy, or
   d)	Your child’s case may be discussed in the course of clinical supervision.

   If your request is denied you will be informed in writing and be given the procedure to appeal the denial.

6. You have the right to know where PHI information has been sent. You may request an accounting of the disclosures made by submitting a Request for an Accounting of Disclosures form to the Quality Improvement Department. Your request can be for a history of disclosures after April 14, 2003 and can be for no longer than six years.
7. You will be notified of changes to the privacy notice by the posting of these changes at all our outpatient office sites and on our web site at www.childguidancecenter.org.
8. You have the right to confidential communication regarding where you want to receive communication and the method by which you receive it i.e. by mail at home, phone at work or only at home. If you have a preference, please let our staff know.

Child Guidance Center is required by law to protect your child’s health information in all forms: electronic, written or spoken as outlined in the policy notice. All of our employees and business partners that have access to your child’s protected health information are responsible for protecting that information.

If you have a concern about your child’s protected health information you can contact: CGC Privacy Officer at 448-4700 or the Secretary of the Department of Health and Human Services in Washington, D.C. at 1-877-696-6775 toll free.

Send mail to webmaster@childguidancecenter.org with questions or comments about this web site.  Read our Privacy Notice.
Last modified: 08/19/08