Effective January 1, 2002
The Addison County Parent/Child Center is a non-profit organization working to provide support and education to families and assure that our community is one in which all young children get off to the right start with the opportunity to grow up healthy, happy and productive.
The Addison County Parent/Child Center
Privacy Officer: Rik Poduschnick
126 Monroe Street
P.O. Box 646
Middlebury, VT 05753
Phone: (802) 388-3171
Fax: (802) 388-1590
Notice of Privacy Practices
This notice describes how medical information about you may be used or disclosed, and how you can get access to this information. Please review it carefully. If you have any questions, please contact our Privacy Officer at the address or phone number above.
Who will follow this notice?
The Parent/Child Center provides childcare, parent training, playgroups, outreach and other activities in partnership with other professionals and organizations. The information in this Notice will be followed by:
- Any health care professional associated with the Center who works with you,
- All employed associates, or volunteers of our organization, including our staff,
- Any business associate or partner of the Agency with whom we share health information.
Our Pledge to You
We understand that anything about you or your child’s mental or physical health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive to provide quality care and to comply with legal requirements. This notice applies to all of the records of your care that we maintain, whether created by facility staff or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office. We are required by law to:
- keep medical information about you private.
- give you this notice of our legal duties and privacy practices with respect to medical information about you.
- follow the terms of the notice that is currently in effect.
Changes to this Notice
We may change our policies at any time. Changes will apply to medical information we already hold, as well as new information after the change occurs.
Before we make a significant change in our policies, we will change our notice and post the new notice in public areas and on our Web site at www.addisoncountypcc.org. You can receive a copy of the current notice at any time. The effective date is listed just below the title.
How we may use and disclose medical information about you
We may use and disclose medical information about you for the following reasons:
- Treatment (such as sending medical information about you to a specialist as part of a referral),
- To obtain payment for treatment (such as sending billing information to your insurance company or Medicaid), and
- To support our health care operations (such as comparing client data to improve treatment methods).
Other uses of medical information
In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing medical information about you. If you choose to authorize a disclosure, you can later take back that authorization by notifying us in writing of your decision.
We may use or disclose medical information about you without your prior authorization for several reasons. Subject to certain requirements, we may give out medical information about you without prior authorization for:
- Public health purposes
- Reporting abuse or neglect
- Health oversight audits or inspections
- Research studies
- Workers’s compensation purposes
- Or other specified cases
We also disclose medical information when required by law, or in response to valid judicial or administrative orders. In Vermont, this would include: victims of child abuse; the abuse, neglect or exploitation of vulnerable adults; or where a child under the age of sixteen is a victim of a crime.
We also may contact you for appointment reminders, or to tell you about or recommend possible treatment options, alternatives, health-related benefits or services that may be of interest to you, or to support fundraising efforts.
We may disclose medical information about you to a friend or family member who is involved in your medical care (or to disaster relief authorities so that your family can be notified of your location and condition).
Your Rights Regarding Medical Information About You
In most cases, you have the right to look at or get a copy of medical information that we use to make decisions about your care, when you submit a written request. If you request copies, we may charge a fee for the cost of copying, mailing or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision.
If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the records, by submitting a request in writing that provides your reason for requesting the change. We could deny your request to change a record if the information was not created by us; if it is not part of the medical information maintained by us; or if we determine that record is accurate. You may appeal, in writing, a decision by us not to change a record.
You have the right to a list of those instances where we have disclosed medical information about you, other than for treatment, payment, health care operations or where you specifically authorized a disclosure, when you submit a written request. The request must state the time period desired for the accounting, which must be less than a 6-year period and starting after April 14, 2003. You may receive the list in paper or electronic form. The first disclosure list request in a 12-month period is free; other requests will be charged according to our cost of producing the list. We will inform you of the cost before you incur any costs.
If this notice was sent to you electronically, you have the right to a paper copy of this notice. You have the right to request that medical information about you be communicated to you in a confidential manner, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you.
You may request, in writing, that we not use or disclose medical information about you for treatment, payment or healthcare operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency. We will consider your request but we are not legally required to accept it. We will inform you of our decision on your request. All written requests or appeals should be submitted to our HPAA Privacy Officer at the address on the front of this brochure.
If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to your records or amendment of your records, you may contact our Privacy Officer, who works out of our offices at the address at the top of thepage.
You may also contact one of the Co-Directors at the same location and telephone number.
Finally, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our Privacy Officer can provide you with the address.
Under no circumstance will you be penalized or retaliated against for filing a complaint.