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Notice of Privacy Practices

This notice describes Junior Blind’s policies and practices to protect the privacy of your health information. Junior Blind is committed to keeping your information private, in accordance with Federal and State laws, including the Federal Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA). We may modify or change our privacy practices from to time to time, particularly as new laws and regulations become effective. When that occurs, we will provide you with a new notice advising you of the changes. For more information about our confidentiality and privacy practices, or for additional copies of this notice, please contact us at the address/telephone number listed above. In addition, Junior Blind will keep the most up-to-date notice posted on our website: www.juniorblind.org

This notice describes how your health information may be used and disclosed and how you can have access to this information. Please review it carefully.

Uses and Disclosures for Treatment, Payment, and Health Care Operations
Junior Blind may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes without your authorization. To help clarify these terms, here are some definitions:

  1. “PHI” refers to information in your health record that could identify you.
  2. “Treatment, Payment and Health Care Operations”
    • Treatment is when Junior Blind provides services to you and coordinates your mental health care with other related health care services. An example of treatment would be when we consult with another health care provider, such as your physician or another therapist.
    • Payment, when applicable, is submitted to the designated agency for reimbursement of services. Only the information necessary for payment reimbursement is provided.
    • Health Care Operations are activities that relate to the performance and operation of Junior Blind. Examples of health care operations are, quality assessment and improvement activities, and case management and care coordination.
  3. “Use” applies only to activities within Junior Blind, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
  4. “Disclosure” applies to activities outside Junior Blind, such as releasing, transferring, or providing access to information about you to other parties.
  5. “Authorization” means your written permission for specific uses or disclosures.

Uses and Disclosures Requiring Authorization
Junior Blind may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. In those instances when we are asked for information for purposes outside of treatment, payment and health care operations, we will obtain written authorization from you before releasing this information. The following are some instances that require an individual’s prior authorization: (1) most uses and disclosures of psychotherapy notes; (2) uses and disclosures of PHI for marketing purposes; and (3) disclosures of PHI that constitute a “sale.”

You may revoke or modify all such authorizations of PHI at any time by notifying Junior Blind in writing. You may not revoke an authorization to the extent that Junior Blind has already relied on it in making an authorized use or disclosure.

Uses and Disclosures with Neither Consent nor Authorization
Junior Blind may disclose information in accordance to federal, state or local laws without your authorization in the following circumstances:

Child Abuse or Neglect: If a counselor has knowledge of or observes a child in his or her professional capacity (or the judgment of a professional supervisor) or within the scope of his or her employment, whom he or she knows or reasonably suspects has been the victim of child abuse or neglect, that counselor is required by law to report this to the Department of Justice, a police or sheriff’s department, the county probation department or the county welfare department (Child Protective Services).

Elder or Dependent Adult Abuse: If Junior Blind has reasonable cause to believe that an older or dependent adult is in need of protective services due to abuse (e.g. physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment resulting in physical harm, pain or mental suffering or the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering), such may be reported to law enforcement or Adult Protective Services.

Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made about the professional services Junior Blind provided you or the records thereof, such information is privileged under state law, and Junior Blind will not release the information without the written authorization of you or your personal or legally-appointed representative, or a court order. This privilege does not apply when you are being evaluated for a third party or when the evaluation is court ordered. You will be informed in advance if this is the case.

Serious Threat to Health or Safety: If you express a serious threat, or intent to kill or seriously injure an identified or readily identifiable person or group of people, or make an actual threat of some specific violent act, Junior Blind has a duty to notify the potential victim and law enforcement authorities. If you are likely to harm yourself unless protective measures are taken Junior Blind will provide information to others involved in arranging hospitalization or other emergency services.

Workers’ Compensation: If you file a claim for workers’ compensation, you waive the psychotherapist-patient privilege and consent to the disclosure of your health information reasonably related to your injury or disease, to your employer, workers’ compensation insurer, special fund, uninsured employers’ fund and/or the administrative law judge.

Client Rights

Right to Breach Notification: You have the right to or will receive a breach notification in appropriate circumstances in the event of a breach of your unsecured PHI.

Right to Inspect and Copy: You have the right to inspect and/or obtain a copy of PHI in Junior Blind’s health records used to make decisions about you for as long as the PHI is maintained in the record. Junior Blind may deny your access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, Junior Blind will discuss with you the details of the request and the denial process.

Right to Amend: You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. Junior Blind may deny your request. On your request, Junior Blind will discuss with you the details of the amendment process.

Right to an Accounting of Disclosures: You generally have the right to receive an accounting of disclosures of PHI. On your request, Junior Blind will discuss with you the details of the accounting process.

Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of protected health information. However, Junior Blind is not required to agree to a restriction you request.

Right to Receive Confidential Communications by Alternative Means and at Alternative Locations: You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations.

Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of the notice from Junior Blind upon request, even if you have agreed to receive the notice electronically.

Right to Opt Out of Fundraising Communications: You have the right to opt out of fundraising communications. If you receive a fundraising communication, it will specify the opt out option(s) available or you can send a written correspondence to the following address, providing us with your name, postal address and/or e-mail address: Junior Blind, C/O Development Department, 5300 Angeles Vista Blvd, Los Angeles, CA 90043.

Questions and Complaints

If you have questions about this notice, disagree with a decision Junior Blind makes about access to your records, or have other concerns about your privacy rights, you may contact Junior Blind’s Privacy Officer at (323) 295 4555. If you believe that your privacy rights have been violated and wish to file a complaint with Junior Blind, you may send your written complaint to Junior Blind, Attn: Privacy Officer, 5300 Angeles Vista Blvd, Los Angeles, CA 90043.

A written complaint could also be sent to the Secretary of the U.S. Department of Health and Human Services. You have specific rights under the Privacy Rule. Junior Blind will not retaliate against you for exercising your right to file a complaint.