JFCS understands that medical information about you and your health are personal; we are committed to protecting your medical information. To provide you with quality care and to comply with certain legal requirements, JFCS creates a record of medical information about the care and services you receive from our agency.
 

This Notice of Privacy Practices applies to your medical information that is generated and/or maintained by JFCS. This Notice will tell you about the ways in which we may use and disclose your medical information. It also describes your rights and the specific obligations we have regarding the use and disclosure of your medical information.

JFCS is required by law to:

• Make certain that medical information that identifies you is kept private;
• Make certain that you are given notice of our legal duties and privacy practices with respect to your medical information;
• Make certain that JFCS follows the terms of the Notice of Privacy Practices that are currently in effect.

How We May Use or Disclose Your Medical Information

• Treatment
• Payment
• Health Care Operations
• Appointment Reminders
• Treatment Alternatives
• Individuals Involved in your Care
• Substance Abuse Health Information
• HIV Information
• Health and Safety for you and/or others/Public Health
• Health Oversight Activities
• Lawsuits and Disputes
• Research
• Coroners, Medical Examiners and Funeral Directors
• National Security and Intelligence Activities
• Law Enforcement
• As Required by Law

Note: If you are receiving services for the evaluation or treatment of substance abuse or Human Immunodeficiency Virus (HIV) conditions, specific rules apply to the use and disclosure of information related to those services. Please refer to the sections below entitled Substance Abuse Health Information and HIV Information for those specific rules.

The following describes different ways we use and disclose your medical information:

Treatment
We may use your medical information to provide you with behavioral health treatment or services. We may disclose your medical information to psychiatrists, your primary care physician, nurses, therapists, case managers or other behavioral health professionals who are involved in your care. Different departments within JFCS may also share your medical information to arrange services you may need. If you are receiving services through the Public Behavioral Health System, different departments of your CPSA provider network may also share your medical information in order to coordinate the services you need, such as medications, therapy, or case management. If you are incarcerated, JFCS may share your medical information with necessary medical personnel to coordinate your ongoing care. return to list

Payment
We may use and disclose your medical information so that the treatment and services you receive may be billed and payment may be collected from appropriate payors, such as an insurance company or a third party. JFCS may share your medical information with your insurance company or a third party payor to ensure that you qualify for services, or to obtain approval for the services requested.
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Health Care Operations
We may use and disclose your medical information for administrative functioning and to ensure our clients receive quality care. For example, we may use your medical information to review JFCS services and to evaluate our performance in caring for you. We may combine medical information about many clients to decide what additional services JFCS should offer, what services are needed, and whether certain new treatments are effective. We may use and disclose your medical information to assess JFCS’ compliance with standards established by the Arizona Department of Health Services, AHCCCS, or the Council on Accreditation for Children and Family Services. For example, this disclosure may be required to evaluate the quality of services we provide or to resolve a specific treatment issue you have raised.  return to list

Appointment Reminders
We may use and disclose information to contact you as a reminder that you have an appointment for treatment at JFCS.  return to list

Treatment Alternatives
We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.  return to list

Individuals Involved in Your Care
We may release your medical information to a family member actively involved in your care and treatment as allowed under Arizona state law and in accordance with JFCS policies and procedures. This information is limited and will not be disclosed without first obtaining your written authorization.  return to list

Substance Abuse Health Information
All medical information regarding substance abuse is kept strictly confidential and released only in conformance with the requirements of federal law (42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3) and regulation (42 C.F.R. part 2). Disclosure of any medical information referencing alcohol or substance abuse may only be made with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.  return to list

HIV Information
All medical information regarding HIV is kept strictly confidential and released only in conformance with the requirements of state law (A.R.S. 36-664). Disclosure of any medical information referencing HIV status may only be made with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.  return to list

Health and Safety for you and/or others/Public Health
We may disclose your medical information for public health activities. We may use and disclose your medical information to a public health authority, when necessary, to prevent a serious threat to your health and safety of the public or another person. These activities generally include the following:

• to avert a serious threat to the health or safety of you, another person or the public;
• to notify the appropriate government authority if we believe a client has been the victim of abuse, neglect or domestic violence. We will make this disclosure when required or authorized by law;
• to report child abuse or neglect;
• to prevent or control disease, injury or disability;
• to report births or deaths;
• to report reactions to medications;
• to notify people of recalls regarding medications they may be using;
• to notify a person who may have been exposed to a disease or may be at risk for contracting a disease.  return to list

Health Oversight Activities
We may disclose your medical information to a health oversight agency for activities authorized by law. These oversight activities may include audits, investigation, inspections, and licensure. These activities are necessary for the government to monitor the behavioral health care system, government programs, and compliance with civil rights laws.  return to list

Lawsuits and Disputes
If you are involved in a lawsuit or legal action, we may disclose your medical information in response to a valid court or administrative order, a valid subpoena, a discovery request, or other lawful process that complies with state law and JFCS policies and procedures.  return to list

Research
Under certain limited circumstances, we may use and disclose your medical information for research purposes. For example, a research project may involve the care and recovery of all persons who received one medication for the same condition. All research projects are subject to a special approval process. We will obtain your written authorization if the researcher will use or disclose your medical information.  return to list

Coroners, Medical Examiners and Funeral Directors
We may release your medical information to a coroner or medical examiner. This may be necessary for identification or to determine a cause of death. We may also release your medical information to funeral directors as necessary to carry out their duties.  return to list

National Security and Intelligence Activities
We may release your medical information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.  return to list

Law Enforcement
We may not release your medical information to a law enforcement official except in response to a valid court order, subpoena, warrant, summons, or similar lawful process that complies with state law and JFCS policies and procedures.  return to list

As Required By Law
We may disclose your medical information when required to do so by federal, state, or local law. Such use or disclosure will be limited to the relevant requirements of the law.  return to list

Your Rights Regarding Your Medical Information

• Right to Access
• Right to Amend
• Right to an Accounting of Disclosures
• Right to Request Restrictions
• Right to Request Confidential Communications
• Right to Paper Copy of this Notice
• Changes to this Notice
• Complaints
• Other Uses and Disclosures

Right to Access
You have the right to inspect and copy medical 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 copy medical information that may be used to make decisions about you, you must submit your request in writing to your primary care worker at JFCS. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. return to list

Right to Amend
If you feel that your medical information is incorrect or incomplete, you may ask us to amend that information. You have the right to request an amendment for as long as your medical information is kept by JFCS. To request an amendment, your request must be made in writing and submitted to your primary care worker at JFCS. You must provide a reason that supports your request. return to list

We may deny your request if you ask us to amend information that:

• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• Is not part of the medical information kept by or for JFCS;
• Is not part of the medical information which you would be permitted to inspect or copy; or
• Is accurate and complete.

Right to an Accounting of Disclosures
You have the right to request an accounting of disclosures of your medical information. This is a list of disclosures we made of your medical information to others outside of JFCS. The accounting does not include information disclosed as a part of treatment, payment, or health care operations. The accounting does not include disclosures that were authorized by you in writing. To request this accounting, you must submit your request in writing to your primary care worker at JFCS. Your request must state a period of time for the accounting that may not be longer than six years and may not include dates before April 14, 2003. return to list

Right to Request Restrictions
You have the right to request a restriction on the medical information we use or disclose about you. 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 you emergency treatment. To request a restriction, you must make your request in writing to your primary worker at JFCS. In your request, you must tell us what information you want to restrict, and to whom you want the restriction to apply. return to list

Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location if you believe that you could be endangered. For example, you can ask that we only contact you at a certain telephone number or address. To request confidential communication, you must make your request in writing to your primary worker at JFCS. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. return to list

Right to Paper Copy of this Notice
You have the right to a paper copy of this privacy notice. You can access a copy of this privacy notice at any time by requesting it from your primary worker at JFCS. return to list

Changes to this Notice
JFCS reserves the right to change this notice and the right to make the revised notice effective for your medical information that JFCS already has about you, as well as any information we will receive following the revision. JFCS will post a copy of the current notice at its main office and on its website. The agency will post the notice at all of its service sites. The notice will contain the effective date at the bottom of each page. JFCS will make you aware of any revisions by posting the revised notice in all the above locations. return to list

Complaints
If you believe your privacy rights have been violated, you may submit your complaint in writing to the JFCS President/CEO at JFCS, 4301 E. 5th Street, Tucson, AZ 85711. For questions, you may contact the President/CEO at 520-795-0300. If we cannot resolve your concern, you also have the right to file a written complaint with the United States Secretary of the Department of Health and Human Services. The quality of your care will not be jeopardized nor will you be penalized for filing a complaint. return to list

Other Uses & Disclosures
Other uses and disclosures of your medical information not covered by this notice will be made only with your written authorization. If you provide us with written authorization to use or disclose your medical information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, JFCS will no longer use or disclose your medial information for the reasons covered by the authorization. JFCS is unable to take back any disclosures already made based on your previous authorization. return to list

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