Confidentiality Policy

Notice of Privacy Practices
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
The term "you", as used in this document, refers to you personally or to the parent of a minor child or to a client's guardian.

Understanding your Health Record/Information
As part of your healthcare, this organization originates and maintains health records describing your health history, symptoms, examinations, test results, diagnoses, treatment, and any plans for future care or treatment. This information serves as:

• A basis for planning care and treatment;
• A means of communication among the health professionals who contribute to your care;
• A source of information for applying your diagnosis and procedure information to a bill;
• A means by which a third-party payer can verify that services billed were actually provided;
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve;
• A tool in educating health professionals;
• A source of information for public health officials charges with improving the health of the nation.
  

Your Health Information Rights
Although your health record is the physical property of Side By Side Supported Living, Inc., the information belongs to you.

You have the right to inspect and/or obtain a copy of your health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and/or obtain a copy of health information that may be used to make decisions about you, you must submit your request in writing.

A summary of your health information may be provided, and if you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

We may deny your request to inspect and/or copy your health information in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed health care professional will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

You have the right to amend. If you believe that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have a right to request an amendment for as long as the information is maintained by Side By Side Supported Living, Inc.

To request an amendment, your request must be made in writing. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• Was not created by us;
• Is not part of the health information kept by or for Side By Side Supported Living, Inc.;
• Is not part of the information which you would be permitted to inspect and/or copy;
• Is accurate and complete.

You have the right to an accounting of disclosures. To request this list of accounting of disclosures, you must submit your request in writing. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing that list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time.

You have the right to request restrictions or limitations on the health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment.

In your request, you must tell us 1) what information you want to limit; 2) whether you want to limit our use, disclosure, or both; and 3) to whom you want the limits to apply.

You have the right to request confidential communications. You may request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must be in writing and specify how or where you wish to be contacted.

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. You may also obtain a copy of this notice at our website, www.jfcsboston.org.

All requests to inspect and/or copy your health information, amend your health information, receive an accounting of disclosures, restrict or limit disclosures of health information, or requests for confidential communications must be in writing, must specify the dates of service or range of dates of service to which your request pertains, and should be directed to:

Keith A. Duclos M.M.H.S.
Side By Side Supported Living, Inc.
1470 Beacon Street
Suite 51
Brookline, MA 02446
617-283-3411

Our Responsibilities
Side By Side Supported Living, Inc. is required to:

• Maintain the privacy of your health information;
• Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a requested restriction;
• Accommodate reasonable requests you may have to communicate health information by alternative means or alternative locations.
  

We will not use or disclose your health information without your authorization, except as described in this notice.

Changes to This Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in Side By Side Supported Living, Inc. offices. The notice will contain the effective date. In addition, each time you register for health care services, we will offer you a copy of the current notice in effect.

Examples of Disclosures for Treatment, Payment, and Operations
We will use your health information for treatment. For example, information obtained by a nurse, physician, therapist, or social worker may be used to determine the course of treatment. We may also provide your physician or concurrent or subsequent healthcare provider with copies of various reports that will assist him/her in treating you.

We will use your health information for payment. For example, a bill may be sent to you or a third-party payer. The information on the bill may include information that identifies you, as well as your diagnosis and procedures.

We will use your health information for standard health operations. For example, members of the clinical staff, the utilization review committee, the quality improvement manager or quality improvement team may utilize information in your health record to assess the care and outcomes of your case and others like it. This information will be used to continually improve the effectiveness of the healthcare and services provided by Side By Side Supported Living, Inc.

Other Permitted or Required Uses and Disclosures
Business Associates: Some services are provided by Side By Side Supported Living, Inc. through contracts with business associates. Examples include transcription, auditing, and data aggregation. To protect your health information, we require the business associate to properly safeguard your information.

Communication with family:
Health professionals, using their best judgement, may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

Marketing and Fundraising:
We may contact you to provide information about Side By Side Supported Living, Inc. services that may be of interest to you. We may contact you as part of a fund-raising effort.

Workers' Compensation:
We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers' compensation or other similar programs established by law.

Public Health:
As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Law enforcement:
We may disclose health information for law enforcement purposes, mandated reporting, or in response to a valid subpoena.

To Report a Complaint:
If you believe that your privacy rights have been violated, you may contact the person listed below. You may also file a complaint with the Secretary of the Department of Health and Human Services. The person listed below can provide you with the appropriate address upon request.

Keith A. Duclos, Privacy Officer
Side By Side Supported Living, Inc.
1470 Beacon Street
Suite 51
Brookline, MA 02446
617-283-3411

All complaints must be submitted in writing. You will not be penalized for filing a complaint.