Notice of Privacy Practices

This Notice Describes How Medical, Drug, Alcohol, Gambling, and Mental Health Related Information About You May Be Used and Disclosed And How You Can Get Access To This Information.  Please Review It Carefully.

General Information

Information regarding your health care, including payment for health care, is protected by state and federal laws.  These laws include:  the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C § 1320d et seq., 45 C.F.R. Parts 160 and 164, and the Confidentiality Law, 42 U.S.C § 290dd-2, and Iowa Code Ch. 228.  Under these laws, Community and Family Resources/The Richmond Center may not say to a person outside Community and Family Resources/The Richmond Center that you attend the program, nor may Community and Family Resources/The Richmond Center disclose any information identifying you as having been diagnosed with or receiving services related to a mental health, substance use, or gambling disorder; or disclose any other protected information except as permitted by state and federal law.

Billing for Services

We can use and share your health information to bill and get payment from health plans or other entities.  For Example, we will give information to your health insurance plan so it will pay for your services.  
Generally, you must also sign a written consent before Community and Family Resources/The Richmond Center can share information for treatment purposes or for health care operations.  However, federal law permits Community and Family Resources/The Richmond Center to disclose information without your written permission under the following circumstances:
1. Pursuant to an agreement with a qualified service organization/business associate;
2. For research;
3. For audit or evaluations;
4. To report a crime committed on Community and Family Resources/The Richmond Center premises or against Community and Family Resources/The Richmond Center personnel;
5. To medical personnel in a medical emergency;
6. To appropriate authorities to report suspected child or dependent adult abuse or neglect;
7. As allowed by a court order.

For example, Community and Family Resources/The Richmond Center can disclose information without your consent to obtain legal or financial services or to another medical facility to provide health care to you, as long as there is a qualified service organization/business associate agreement in place.

Before Community and Family Resources/The Richmond Center can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure.  Any such written consent may be revoked by you by notifying a staff member either verbally or in writing.

Your Rights

Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information.  Community and Family Resources/The Richmond Center is not required to agree to any restrictions you request, but if it does agree, then it is bound by that agreement and may not use or disclose any information which you have restricted, except as necessary in a medical emergency.  

You have the right to request that we communicate with you by alternative means or at an alternative location. For example, you may choose whether we may provide appointment reminders via phone, text, email, or voice message.  Community and Family Resources/The Richmond Center will accommodate such requests that are reasonable and will not request an explanation from you.  If you choose to receive a reminder by an alternative method, Community and Family Resources/The Richmond Center is not responsible if another party sees or hears the communication.  Community and Family Resources/The Richmond Center cannot be held responsible for the accuracy of contact information you provide us.  

Under HIPAA you also have the right to inspect and copy your own health information maintained by Community and Family Resources/The Richmond Center except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal, or administrative proceeding or in other limited circumstances.
Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in Community and Family Resources/The Richmond Center records, and to request and receive an accounting of disclosures of your health related information made by Community and Family Resources/The Richmond Center during the six years prior to your request.  You also have the right to receive a paper copy of this notice.

Community and Family Resources/The Richmond Center Responsibilities

Community and Family Resources/The Richmond Center is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information.  Community and Family Resources/The Richmond Center is required by law to abide by the terms of this notice.  Community and Family Resources/The Richmond Center reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains.  Any revision to this notice will be posted in the waiting rooms at Community and Family Resources/The Richmond Center’s offices.   Copies of this notice will be provided at no charge when requested.  Community and Family Resources/The Richmond Center will notify you in writing at your last known address of any breach in your PHI.

Complaints and Reporting Violations

You may express any concern or complaint to Community and Family Resources/The Richmond Center and the Secretary of the United States Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA. A complaint can be filed with Community and Family Resources/The Richmond Center by providing a written summary to the Compliance Officer. Every effort will be made by the staff to resolve the complaint once it is received. You will not be retaliated against for filing such a complaint.  

Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.

Contact:  For further information, contact the HIPAA Compliance Officers or the Executive Director at Community and Family Resources/The Richmond Center, 211 Avenue M West, Fort Dodge, IA 50501, phone number (515) 576-7261.  

Effective Date: The effective date of this notice is 2/3/2020