THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS INFORMATION. 

PLEASE REVIEW IT CAREFULLY.

 Roy Maas' Youth Alternatives (RMYA) provides many types of services, such as counseling, residential and shelter services.  RMYA staff must collect information about you to provide these services. RMYA strongly believes in protecting the confidentiality and security of your information.  

 This Privacy Notice is being provided to you as a requirement of a federal law known as the Health Insurance Portability and Accountability Act (“HIPAA”).  This Privacy Notice describes how RMYA may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes permitted by law.  It also describes your rights to access and control of protected health information in some cases. Your protected health information (PHI) means any written and oral health information about you, including demographic data that can be used to identify you. 

 RMYA is required to follow the privacy practices that are described in this Notice while it is in effect.  This Notice takes effect on April 14, 2003, and will remain in effect until we replace it.

 As permitted by law, we reserve the right to change our privacy practices and the terms of this Notice at any time.  We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we made the changes.  Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available to you at your next visit to our agency.  You may request a copy of our Notice at any time.  You may also access a copy of this Notice at our website at rmya.org.

RMYA May Use and Disclose Information Without Your Authorization

For Treatment. RMYA may use or disclose information with health care providers who are involved in your health care.  For example, a Doctor to whom we refer you for ongoing or further care may need your protected health information. We also can provide other healthcare professionals or subsequent healthcare providers with copies of your records to assist them in treating you once we are no longer treating you.

For Payment. RMYA may use or disclose PHI to obtain payment for services we provide to you.  For example, RMYA may need to disclose your PHI, regarding treatment you received from us, to obtain payment or reimbursement for the care.   

For Health Care Operations. RMYA may use or disclose your PHI in connection with health care operations.  Health care operations include such activities as:  quality assessment and improvement activities, reviewing the competence, qualifications, and performance of health care professionals, training programs, medical reviews, and employee review activities, licensing and credentialing programs. 

We may also use and disclose protected health information:

• ¨     We may contact you by mail, telephone, and leave messages, on voicemail or message machines or with another person to provide appointment reminders;
• ¨     To assess your satisfaction with our services;
• ¨     To tell you about possible treatment alternatives; and
• ¨     We may also call you by name in the waiting areas when your therapist is ready to see you.

Public Health Activities. RMYA discloses PHI when required by federal or state law or by a court order.  An example of such mandatory disclosures includes notifying state or local health authorities regarding particular communicable diseases. 

Health Oversight Activities. RMYA may use or disclose information to inspect or investigate health care providers. 

For example, Medicaid fraud and whether RMYA is providing good care to our clients.

As required by Law and For Law Enforcement. RMYA will use and disclose information when required or permitted by federal or state law or by a court order.  

Specific Government Functions.  For example, RMYA may disclose information for the determination of Supplemental Security Income (SSI) benefits.

To Report Suspected Child Abuse or Neglect. If RMYA has cause to believe that a child has been abused or neglected or may be abused or neglected, or that a child is a victim of an offense under Section 21.11, Penal Code, RMYA will disclose to the authorized agency. 

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.

To Avoid Harm.  RMYA may also disclose PHI to medical or law enforcement personnel if we determine that there is a probability of imminent physical injury to self or to others, or when there is a probability of immediate mental or emotional injury to self.     

Research Purposes.  RMYA may use or disclose your PHI if information identifying you is removed from the health information.  Information that identifies you will be kept confidential.

To a Correctional Institution.  If you are in the custody of a correctional institution, RMYA may disclose your PHI to the institution in order to provide health care to you.

The Federal Department of Health and Human Services (DHHS).  Under the privacy standards, we must disclose your PHI to DHHS as necessary for them to determine our compliance with those standards. 

Other Uses and Disclosures Require Your Written Authorization

For other situations, RMYA will ask for your written authorization before using or disclosing information. You may cancel this authorization at any time in writing. RMYA cannot take back any uses or disclosures already made with your authorization.

Your PHI Privacy Rights

The following are your various rights as a client under HIPAA concerning your PHI. 

Right to Request to See and Get Copies of Your Records. You have the right to request to inspect and obtain a copy of the PHI that we maintain about you.  To inspect and copy PHI, you must submit your request in writing.  You may be charged a fee for the cost of copying, mailing or other supplies associated with your request.  In very limited circumstances we may deny your request to inspect and obtain a copy of your PHI.  You do not have a right of access to the following:

• Psychotherapy notes.   
• Information compiled in reasonable anticipation of or for use in civil, criminal, or administrative actions or proceedings.
• Information was obtained from someone other than a healthcare provider under a promise of confidentiality and the access requested would be reasonably likely to reveal the source of the information.
• Information that, in good faith, RMYA believes can cause harm to the individual or to any other person; and
• Information where release is prohibited by State or Federal Laws.

Right to Request a Correction or Update of Your Records. You may ask RMYA to change or add missing information to your records if you think there is a mistake. You must make the request in writing, and provide a reason for your request.  We may deny your request if it is not in writing or does not include a reason that supports the request.  In addition, we may deny your request if you ask RMYA to amend PHI that:

• ·       is accurate and complete;

• ·       is not part of the PHI kept by or for us;
• ·       is not part of the PHI which you would be permitted to inspect and copy; or
• ·       we did not create the record.  If, as in the case of a consultation report from another provider, we did not create the record, we cannot know whether it is accurate or not.

Right to Request a List of Disclosures. You have the right to ask RMYA for a list of disclosures made after April 14, 2003. You must make the request in writing. This list will not include the times that information was disclosed for treatment, payment, and health care operations.  The list will not include information provided directly to you or your family, or information that was sent with your authorization. Your request must state the time period from which you want to receive a list of disclosures.  The time period 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.  We may charge you for responding to any additional requests. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Limits on Uses or Disclosures of PHI. You have the right to ask that RMYA limit how your information is used or disclosed.  You must make the request in writing and tell RMYA what information you want to limit and to whom you want the limits to apply. RMYA is not required to agree to the restriction.

Right to Request Confidential Communications.  You have the right to request that we communicate with you about PHI in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.  To request confidential communications, you must make your request in writing and specify how or where you wish to be contacted.  We will accommodate all reasonable requests.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with RMYA’s Privacy Officer or with the Secretary of the Department of Health and Human Services.  To file a complaint with RMYA, please contact the RMYA Privacy Officer at (210) 340-7971.  We will provide you with the address to file a complaint with the United States Department of Health and Human Services upon request. You will not be penalized for filing a complaint. 

Right to Get a Paper Copy of this Notice:  You have the right to ask for a paper copy of this notice at any time.

How to contact RMYA to Review, Correct, or Limit your Protected Health Information (PHI)

Please submit your request in writing to

Roy Maas' Youth Alternatives, Attn:  Privacy Officer, 3103 West Avenue, San Antonio, TX 78213.

For More Information

If you have any questions about this notice or need more information, please contact the RMYA Privacy Officer at the address listed on this notice or at (210) 340-7971.