Privacy Policy

Family Outreach, Inc.

Serving families in Southwestern Montana
Effective April 14, 2004

This notice describes how personal and medical information about you may be used and disclosed and how you can get access to this information.   Please review it carefully.

This Notice describes the privacy practices of Family Outreach, Inc. as required by HIPAA, the Health Insurance Portability and Accountability Act of 1996. The effective date for compliance with HIPAA is April 14, 2004.

Our Privacy Commitment to You
Privacy is very important to us. We feel responsible for treating consumers with respect and upholding their rights. We have taken many steps to make sure that any information that we have about a consumer is shared only with people who have a legal right and need to see the information.

Unless you give us permission in writing, we will only disclose your information for purposes of treatment/services, payment, business operations or when we are required by law to do so.

• Treatment/Services: We may disclose information about you to coordinate your services. For example, we give Information to a provider in order for you to receive the services that you have agreed to through your PSP or IFSP.

• Payment: We may use and disclose information so the care you get can be properly billed and paid for. For example, we have to complete and submit invoices through our State contract or through Medicaid before we can be paid for our service. We also have to pay for all the services provided to you.

• Business operations: We may need to use and disclose information for our business operations. For example, we may use information to review the quality of the services you get, including annual reviews by the State.         

• Exceptions: For certain kinds of records, your permission may be needed even for release for treatment, payment and business operations.

• As Required By Law: We will release information when we are required by law to do so. Examples of such releases would be for law enforcement or national security purposes, subpoenas or other court orders, incident reporting, review of our activities by government agencies, to avert a serious threat to health or safety or in other kinds of emergencies.         

• With Your Permission: Other uses and disclosures of your protected health information will be made only with your written authorization. You may revoke this authorization, at any time, in writing.

Your Privacy Rights
You have the following rights regarding the health information that we have about you. Your requests must be made in writing to the Privacy Officer at Family Outreach.      

• Your Right to Inspect and Copy: In most cases, you have the right to look at or get copies of your records. You may be charged a fee for the cost of copying records.         

• Your Right to Amend: You may ask us to change your records if you feel that there is a mistake. We can deny your request for certain reasons, but we must give you a written reason for our denial.

•  Your Right to a List of Disclosures:   You have the right to ask for a list of disclosures made after April 14, 2004.   This list will not include the times that information was disclosed for treatment, payment or business operations.   This list will not include information provided directly to you or your family, or information that was sent with your authorization.

• Your Right to Request Restrictions on our Use or Disclosure of Information: You have the right to ask for limits on how your information is used or disclosed, however, we are not required to agree to such requests.

• Your Right to Request Confidential Communications: You have the right to ask that we share information with you in a certain way or in a certain place. For example, you may ask us to send information to your work address instead of your home address. You do not have to explain the basis for your request.

How To Use Your Rights Under This Notice
If you have questions or would like more information, you may contact our Privacy Officer at 406-443-3083.

If you believe your privacy rights have been violated, you can file a complaint with:
•   Privacy Officer
•   Department of Health and Human Services.

Complaints and Communications to Us
You may write to:

Privacy Officer
Family Outreach, Inc.
110 E Lyndale Ave.
Helena, MT 59601
Phone:      406-443-3083
Fax:   406-443-3209

Complaints to the Federal Government
If you believe that your privacy rights have been violated, you have the right to file a complaint with the federal government. You may write to:

Office of Civil Rights
Dept.. of Health and Human Services
200 Independence Avenue, S.W.              
Washington, DC 20201
Phone:   866-927-7748
TTY:   886-788-4989
E-mail:   ocrprivacy@hhs.gov  

You will not be penalized for filing a complaint.

Changes to this Notice
We reserve the right to revise this notice. A revised notice will be effective for information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever notice is currently in effect. If the changes are material, a new notice will be mailed to you before it takes effect.

Family Outreach, Inc.

110 E Lyndale Ave

Administrative Office

Helena Mt  59601

443-3083

Web:   www.familyoutreach.org