Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective as of April 14, 2004
Our Responsibilities
We understand that information about you and your health is personal. This Notice describes your rights and certain obligations the Faculty and Staff Assistance Program (the "Plan") has regarding the use and disclosure of your health information. This Notice applies to all records of your benefits created or received by the Plan.
It is the Plan's responsibility to safeguard your health information. The Plan is required by state and federal law to maintain the privacy of your health information. The Plan must also give you this Notice of its legal duties and its privacy practices, and it must follow the terms of the Notice that is currently in effect.
The Plan reserves the right to change this Notice and to make the new provisions effective for all health information it maintains as well as any health information it receives in the future. The Plan will post a copy of the current Notice at the Faculty and Staff Assistance Program Office, and it will also be available on the Plan's link on the University's website.
For purposes of this Notice, the term "PHI" means "Protected Health Information". Protected Health Information, or PHI, includes all individually identifiable health information transmitted or maintained by the Plan, without regard to what form (oral, written or electronic) it may be.
Permitted Uses and Disclosures
The following categories describe different ways that the Plan may use and disclose your PHI. The Plan has not listed every use or disclosure within the categories, but describes some of the types of uses and disclosures it may make. It, however, is the policy of the Plan to limit the disclosure of PHI to those few situations where, in the Plan's discretion, it is necessary.
Treatment - The Plan may use and disclose your PHI to provide you with the mental health benefits provided for under the Plan. For example, as part of the Plan's referral benefit, your PHI may be disclosed to other healthcare providers who perform mental health services.
Payment - For those individuals who, in the discretion of the Plan Administrator, are eligible to receive assistance in paying for necessary healthcare co-pays, the Plan may use your PHI to review your claim for the payment of a co-pay incurred for treatment and services rendered by a third party provider.
Health Care Operations - The Plan may use and disclose your PHI for its healthcare operations. For example, the Plan may use your PHI for the purposes of meeting accreditation requirements, compiling statistics, and conducting or arranging for legal and auditing services.
The University as Plan Sponsor - The Plan may disclose PHI to the University (the sponsor of the Plan) for plan administration functions such as providing the counseling benefits provided for under the Plan, where the University, as it has done or will do, amends its Plan documents to protect your PHI consistent with federal law.
At no time, however, will the Plan disclose PHI to the University for employment-related actions or decisions unless otherwise authorized by you.
In addition, the Plan may disclose "summary health information" to the University for modifying, amending or terminating the Plan. Summary health information is information that summarizes the claims history, claims expenses or type of claims experienced by individuals for whom the Plan has provided health benefits under a health, medical or similar plan, and from which identifying information has been deleted. This material will be provided in a manner that is consistent with federal law.
Business Associates - There are some services the Plan provides through contracts or arrangements with business associates. These contracts or arrangements may require the disclosure of PHI to the business associate by the Plan. For example, the University may hire a third party to provide counseling benefits under the Plan. To protect your PHI, the Plan requires its business associates to sign written agreements which state that they will protect the privacy of your PHI.
As Required by Law - The Plan may use or disclose your PHI as required by state or federal law.
Public Health Activities - The Plan may use or disclose your PHI for public health activities that are permitted or required by law. For example, the Plan may use or disclose your PHI for the purpose of preventing or controlling disease, injury, or disability.
Abuse, Neglect or Domestic Violence - The Plan may disclose your PHI to a government authority that is authorized by law to receive reports of abuse, neglect, or domestic violence.
Legal Proceedings - The Plan may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process. Under limited circumstances (such as a court order, warrant or grand jury subpoena), the Plan may also disclose your PHI to law enforcement officials.
Law Enforcement - The Plan may disclose your PHI for law enforcement purposes. For example the Plan may disclose your PHI to provide information about the victim of a crime, or to report criminal conduct.
Public Health and Safety - The Plan may, when necessary, disclose your PHI to avert a serious or imminent threat to your health or safety or the health or safety of others.
Military and National Security - The Plan may disclose the PHI of armed forces personnel to military authorities under certain circumstances. The Plan may also disclose to authorized federal officials any PHI required for lawful intelligence, counterintelligence and other national security activities.
Workers' Compensation - The Plan may disclose your PHI to comply with workers' compensation laws and other similar programs that provide benefits for work-related injuries or illnesses.
Authorizations
In all situations other than those described above, the Plan can ask for your written authorization (on forms provided by the Privacy Officer) before using or disclosing PHI about you, even when you are requesting the disclosure to a third party. You may always refuse to sign an authorization. Please be aware that once your PHI has been disclosed, the Plan has no control over any re-disclosure by the recipient. You may always revoke an authorization in writing. Except to the extent that the PHI has already been used or disclosed, the Plan will abide by your request to revoke your authorization.
Minimum Necessary
Except when providing PHI to you, the Secretary of Health and Human Services, anyone authorized by you or anyone authorized by law, in those limited situations of using, disclosing or requesting your PHI, the Plan will make reasonable efforts to limit the disclosure or use of PHI to the minimum necessary for the intended use, disclosure or request.
Your PHI Rights
The following describes your rights concerning your PHI. You may contact the Plan using the information at the end of this Notice to exercise your rights, obtain the forms described here, get an explanation on how to submit a request, or receive other additional information.
Right to Access Your PHI - You have the right to inspect and get copies of or receive a summary of certain portions of your health record. You must make a request in writing, and may obtain a request form from the Plan. You may be charged a fee for the costs of copying, mailing, or other supplies associated with your request. Under limited circumstances, the Plan can deny you the right to your medical records.
Right to Amend Your PHI - You have the right, with limited exceptions, to request that the Plan amend your health record. Your request must be in writing, and it must explain why the information should be amended. The Plan may deny the request if your request is not in writing, if it does not provide a reason for the amendment, if your PHI was not created by the Plan or is not part of the information maintained by the Plan, if the amendment pertains to information you are not permitted to copy and inspect under applicable law, or if the information in your medical record is complete and accurate. If the Plan denies your request for an amendment, you may file a statement of disagreement with the Plan, which the Plan has the right to rebut.
Right to an Accounting - You have the right to receive a list of instances since April 14, 2004 in which the Plan disclosed your PHI except for those disclosures exempted by law, for example, those for payment or healthcare operations purposes, and those authorized by you or your representative. Your request must state a time period which may not be longer than six (6) years (you may request a shorter time period) and may not be for disclosures before April 14, 2004. If you request this accounting more than once in a 12 month period, the Plan may charge a reasonable fee for responding to these additional requests.
Right to Request Restrictions - You have the right to request that the Plan place additional restrictions on the situations when it can use or disclosure your PHI. The Plan is not required to agree to these restrictions, but if it does, the Plan will abide by the agreement (except in an emergency). You must make your request in writing. Any agreement the Plan may make to your request for additional restrictions must be in writing signed by a person authorized to make such an agreement on behalf of the Plan. The Plan will not be bound unless the agreement is in writing.
Right to Confidential Communications - You have the right to request that the Plan communicate with you about your PHI by alternative means or to alternative locations. You do not have to explain the basis for your request. You must make this request in writing and specify how or where you wish to be contacted and the Plan will accommodate all reasonable requests.
Right to Revoke - You have the right to revoke your authorization to use or disclose PHI except to the extent that the Plan or others have relied on your prior authorization.
For More Information or to Report a Problem
If you would like more information about the privacy practices of the Plan or if you have questions or concerns, please contact the Plan's Privacy Officer, Cecily Sawyer-Harmon, 413 Academy Street, Newark, DE 19716, telephone 302/831-2414.
If you believe your privacy rights have been violated, you also have the right to file a complaint with the Plan's Privacy Officer/Complaint Officer, Cecily Sawyer-Harmon, 413 Academy Street, Newark, DE 19716, telephone 302/831-2414. All complaints must be in writing and should be marked "Confidential" on the outside of the envelope. You will not be penalized in any way for making a complaint. You may also submit a written complaint to the U.S. Department of Health and Human Services.
No Guarantee of Employment
Nothing contained in this Notice shall be construed as a contract of employment between the University of Delaware and any employee, nor as a right of any employee to continue in the employment of the University of Delaware, nor as a limitation of the right of the University of Delaware to discharge any of its employees, with or without cause.
No Change to the Plan
Except for the privacy rights described in this Notice, nothing contained in this Notice shall be read in a way that results in a change to any rights or obligations you may have under the Plan. You should refer to the applicable Plan documents for complete information regarding any rights or obligations you may have under the Plan.
Prepared: February 4, 2005
Reproduction without permission is strictly prohibited.