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Notice of Privacy Practices

This document is protected by Copyright Laws.

© Copyright 2007, CHOICE Advisory Services, Inc.

This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review this information carefully. If you have additional questions, not answered in this document, please contact us at:
1-800-361-0138.

A Protected Health Information Communication Form is provide at the end of this document, should you request or require assistance.

Our commitment to Privacy

CHOICE Advisory Services, Inc. is committed to preserving privacy and confidentiality of your protected health information that is obtained while assisting your with locating housing, care or in obtaining other products or services. State and Federal laws require that we implement policies and procedures to safeguard health information. Laws also require that we provide you with this notice regarding our legal responsibilities and privacy practices with respect to your protected health information.

Protected health information is any information that is created or received by us that identities you, and that relates to your physical or mental condition. This notice does not apply to health information that does not identify you or anyone else.

This notice provides you with information regarding our privacy practices. It outlines the ways in which we may use or disclose your protected health information and also describes your rights and our obligations regarding any such uses or disclosures.

We reserve the right to change this notice and to make the revised or changed notice effective for protected health information we already have about you as well as any information we may receive in the future.

How does CHOICE obtain information?

CHOICE Advisory Services, Inc., its employees and representatives, obtain information from the individual requiring or requesting services and/or products. If the specific individual is not mentally or physically capable of providing information, CHOICE Advisory Services, Inc. will accept information from a legal Guardian or designated Durable Power of Attorney.

With your written permission, CHOICE Advisory Services, Inc. may also obtain information from family members, friends, neighbors, health care providers or other individuals who may have an understanding of the needs of an individual.

CHOICE Advisory Services, Inc. reserves the right to speak directly with the individual receiving products and/or services to verify that the individual does indeed wish to receive assistance and that the individual does indeed consent to the information outlined in this document.

How does CHOICE share information with service or product providers?

With your consent, CHOICE Advisory Services, Inc. primarily speaks with Providers by telephone or in person. In instances where information is shared electronically (fax or email), the information is assigned a code number. This code number ensures anonymity of information when provided to businesses and agencies that further provide services and/or products. CHOICE Advisory Services, Inc. requires that all contracted Providers comply with their own privacy policies and procedures.

How does CHOICE Advisory Services, Inc. use or disclose your protected health information?

When you request assistance in locating housing, care or other products and services for older adults, CHOICE Advisory Services, Inc. may contact you by telephone or may arrange to see you in person. In the process of speaking with you and assessing your needs, CHOICE is likely to make written notes about your health condition, your possible mental health and other information about your physical, financial and psychosocial needs and status. This information may be transferred to an electronic file, or it may be stored in a standard filing system. In instances where CHOICE has successfully assisted you in locating services, or in instances where CHOICE determines the agency cannot be of help to you, all electronic and physical records may deleted or shred to avoid the possibility of making such information available to the public.

Communication with individuals involved in your care.

When you ask for CHOICE to assist you in locating appropriate housing, care or other products or services, we may disclose to a family member, close personal friend or any other person you identify, protected health information relevant to that person's involvement in your care, unless you notify us that you object in whole or part.

Assessment

In instances where you request CHOICE to assist you in defining which housing and/or care options best meet your specific needs, CHOICE may disclose your protected health information with doctors, rehab specialists, pharmacists, home health agencies, private duty aides, nurses, lab technicians, medical supply providers or other businesses or agencies involved in providing you with products and/or services. CHOICE may also disclose your protected health information with a family member, close personal friend or any other person you identify, protected health information relevant to that person’s involvement in your care, unless you notify us that you object in whole or part.

Treatment

In instances where you arrange to have CHOICE Advisory Services, Inc. provide short-term or on-going care or case management, we may disclose your protected health information in providing and/or coordinating or in verifying proper treatment or services for you. We may disclose your protected health information to doctors, rehab specialists, pharmacists, home health agencies, private duty aides, nurses, lab technicians, medical supply providers or other businesses or agencies involved in providing you with products and/or services. CHOICE may also disclose your protected health information with a family member, close personal friend or any other person you identify, unless you notify us that you object in whole or part.

Health Care Operations

We may disclose your protected health information to perform certain functions of our referral services, marketing functions and/or our private case/care management services. These uses or disclosures are necessary to provide you with quality care and service. For example, employees or representatives of CHOICE Advisory Services, Inc. may review your information in order to determine what information is relevant or important to share with a housing, care or service provider.

Business Associates

There are some services provided within our organization that are provided by affiliate businesses and agencies. These relationships exist to broaden the scope of services and products offered. Additionally, we contract with service providers and agencies to provide a continuum of services and products to assist you. We may disclose your protected health information to our business associates so they can perform the job we've asked them to do. We do require the business associate to appropriately safeguard your protected health information.

Public health activities

We may disclose your protected health information to public health authorities that are authorized by law to receive and collect health information for the purpose of preventing or controlling disease, injury or disability.

Judicial or administrative proceedings

We may disclose your protected health information when ordered in judicial or administrative proceedings are required by state or federal law.

Law Enforcement

We may disclose your protected health information for law enforcement purposes as required by law, including but not limited to the investigation of possible abuse, neglect or domestic violence.

Research

We may disclose your protected health information for research purposes under certain limited circumstances as prescribed by law.

To ensure safety and health

We may disclose your protected health information in instances where possible harm may exist for you or for another person.

Change of ownership

In the event that CHOICE Advisory Services, Inc. is purchased by another agency or business, or in the event that CHOICE Advisory Services, Inc. purchases or merges with another business or agency, your protected health information will become property of the new owner, although you will maintain the rights under this notice.

Other uses or disclosures required by law

We may use or disclose your protected health information where such uses or disclosures are required by federal, state or local law.

You have the right to revoke a written authorization at any time as long as your revocation is provided to us in writing. If you revoke your written authorization, we will no longer use or disclose your protected health information for the purposes identified in the authorization. You understand that we are unable to retrieve any disclosures, which we have made pursuant to your authorization prior to its revocation.

Your rights regarding your protected health information

  1. Right to request restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment or health care operations. You also have the right to request a limit on the protected health information we disclose about you to someone, such as a family member, friend who is involved in your care or in the payment of your care and/or for the purposes of general business operations. For example, you may choose to ask that we not use or disclose information regarding a specific illness or treatment that you are receiving or that you have received.

    To request restrictions or limits on the uses and disclosures of your protected health information, you must make your request in writing, on a form provided by CHOICE Advisory Services, Inc. (See request form at the end of this document)

  2. Right to request confidential communications. If you are dissatisfied with the manner in which or location where you are receiving communications from us that are related to your protected health information, you may request that we provide you with such information by alternate means or at alternate locations. Such request must be made in writing on a form provided by CHOICE Advisory Services, Inc. We will attempt to accommodate all reasonable requests. (See request form at the end of this document)
  3. Rights to inspect a copy. In most cases you have the right to review or to obtain copies of your protected health information that CHOICE Advisory Services, Inc. has on file. In certain situations, CHOICE may deny your request. CHOICE Advisory Services, Inc. will respond within 30 days of receipt of the request, unless law requires us to respond sooner. If CHOICE Advisory Services, Inc. denies your request, you will be notified in writing describing the reasons for the denial. You will receive an explanation of how you may have your denial reviewed, if applicable. (See request form at the end of this document)
  4. Right to request an amendment. If you feel that the protected health information we have about you in incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing on a form provided by CHOICE Advisory Services, Inc. CHOICE Advisory Services, Inc. will respond to you within 30 days of receipt of your notice. 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 retained by CHOICE Advisory Services, Inc; is not part of the information which you would be permitted to inspect and copy; and/or is accurate and complete. (See request form at the end of this document)
  5. Right to an accounting of disclosures. You have the right to request an accounting of all disclosures of your protected health information made by us during the time period for which you request (not to exceed six years). Your request must be submitted on a form provided by CHOICE Advisory Services, Inc. CHOICE Advisory Services, Inc. will respond to your request within 30 days of receipt of the request. (See request for at the end of this document)
  6. Right to a paper copy of this notice. If you have received this notice electronically, you have the right to request a paper copy of this notice, even if you have agreed to receive this notice electronically. To obtain a copy, please sent a written request to the corporate address listed below.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Secretary of CHOICE Advisory Services, Inc. that acts as the Chief Compliance Officer of the corporation. You may also file a complaint with the Secretary of the United States Department of Health and Human Services. You will in no way be penalized for filing a complaint.

CHOICE Advisory Services, Inc.
PO Box 12494
Mill Creek, WA 98082-0494

Protected Health Information Communication Form (PDF)