Privacy Policies

Notice of Privacy Practices

5.501b - 101.171b    HIPAA Compliance

This notice describes how medical and related information regarding you may be used and disclosed and how you can get access to this information.

Please review it carefully.

       We are required by law to maintain the privacy of your health care information and to provide you with a notice or our privacy practices.  We are required to abide by the terms of the notice that is currently in effect.  We reserve the right to change our privacy practices at any time.  If our privacy practices change, we will post a revised notice on our website and at each of our offices.  We will also provide you with a paper copy of a revised notice at your request.

 Our use of your health care information

 We may use your information for treatment, payment, and health care operations.  For example:

• For treatment purposes: We may use your information to coordinate your care within SMART Child and Family Services (SMART), and with your permission, to coordinate your care and referrals to another health care or related services provider.

• For payment purposes: We may submit portions of your information to  Mainecare, your insurance carrier, or other third-party payer.

• For health care operations purposes: We may use your information in the course of quality assurance, evaluation, training, or audit activities.

     We may disclose information without your authorization as permitted or required by applicable law, including for any of the following purposes: to comply with public health statutes and rules; to make any required reports of abuse or neglect; to take steps to protect you or others if your clinician/psychiatrist determines that you pose an imminent risk of serious harm to yourself or another or an emergency situation exists regarding your health or safety; to comply with health oversight activities by government agencies; to comply with a court order; government subpoena, or other lawful process; for law enforcement purposes; in the event of your death, to a medical examiner or funeral director as necessary; to avert a serious threat to health or safety; to government agencies, as required for national security or other specialized government functions; for workers’ compensation purposes; or to family or a direct care provider if ordered by the Commissioner of Behavioral and Developmental Services or his/her designee in compliance with applicable rules.

        We may use your information to contact you for appointment reminders or to provide information about treatment alternatives or other health services.  We may also use it to contact you for fundraising purposes.  Except as described above, we will not use or disclose your information, except with your written permission.

 YOUR RIGHTS

       You have the right to request restrictions on the use and disclosure of your information.  However, we are not required to agree to a requested restriction, and it is our policy not to agree to such restrictions unless we determine, in our sole discretion, that a compelling reason exists to do so.  You have the right to receive communications from us in a confidential manner.  If you would like us to use another address or telephone number to contact you, you must request so in writing.

       You have the right to see and receive a copy of the information in your record unless your clinician/psychiatrist determines that doing so would create imminent danger to your physical or mental well being.  If your clinician/psychiatrist has a reasonable concern that reviewing your record would have a possible harmful effect on you, a supervisor may review your record with you.  If you request a copy of your record, there may be a charge for the actual cost of copying.

       You have the right to decide to allow the release of your record to other treatment providers or others.  If you wish to do so, you must complete a written release of information form.  There may be a charge for the actual cost of copying.

       You have a right to receive an accounting of our disclosures of your health care information.  To receive such an accounting please contact the Chief Privacy Officer (CPO) identified below.

      You have the right to amend your health care information if you believe the information there is incorrect or that important information is missing.  If you wish to do so, please submit the proposed amendment in writing to the Chief Privacy Officer identified below.

      You have the right to a paper copy of this Notice of Privacy practices upon request.

       You have the right to complain to us and to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated.  To file a complaint with us, please contact the Chief Privacy Officer as set forth in this notice.  Nobody is permitted to retaliate against you for filing a complaint. 

       SMART will retain your records for at least six years after you have completed your care with us.  Following the required time of detention, your records will be confidentially destroyed.

       For further information about our privacy policies, please contact

Amy L. Thomas, Executive Director

SMART Child and Family Services

86 Tandberg Trail

P.O. Box 1360

Windham, ME  04062

(207) 893-0386