Client Care Pri­va­cy Policy

Ken­neth Young Cen­ter Notice of pri­va­cy practices:

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

We respect client con­fi­den­tial­i­ty and only release con­fi­den­tial infor­ma­tion about you in accor­dance with the Illi­nois and fed­er­al law. This notice describes our poli­cies relat­ed to the use of the records of your care gen­er­at­ed by this agency. 

Use and Dis­clo­sure of Pro­tect­ed Health Information

In order to effec­tive­ly pro­vide you care, there are times when we will need to share your con­fi­den­tial infor­ma­tion with oth­ers beyond our agency. This includes for:

Treat­ment. We may use or dis­close treat­ment infor­ma­tion about you to pro­vide, coor­di­nate, or man­age your care or any relat­ed ser­vices, includ­ing shar­ing infor­ma­tion with oth­ers out­side our agency that we are con­sult­ing with or refer­ring you to. 

Pay­ment. With your writ­ten con­sent, infor­ma­tion will be used to obtain pay­ment for the treat­ment and ser­vices pro­vid­ed. This will include con­tact­ing your health insur­ance com­pa­ny for pri­or approval of planned treat­ment and for billing purposes.

Health­care oper­a­tions. We may use infor­ma­tion about you to coor­di­nate our busi­ness activ­i­ties. This may include set­ting up your appoint­ments, review­ing your care, and train­ing staff.

Infor­ma­tion Dis­closed With­out Your Consent

Under illi­nois and fed­er­al law, Infor­ma­tion about you may be dis­closed with­out your con­sent in the fol­low­ing circumstances:

Emer­gen­cies. Suf­fi­cient infor­ma­tion may be shared to address the imme­di­ate emer­gency you are facing.

Fol­low up appointments/​care. We will be con­tact­ing you to remind you of future appoint­ments or infor­ma­tion about treat­ment alter­na­tives or oth­er health-relat­ed ben­e­fits and ser­vices that may be of inter­est to you. We will leave appoint­ment infor­ma­tion on your answer­ing machine unless you tell us not to.

As required by law. This would include sit­u­a­tions where we have a sub­poe­na, court order, or are man­dat­ed to pro­vide pub­lic health infor­ma­tion, such as com­mu­ni­ca­ble dis­eases or sus­pect­ed abuse and neglect such as child abuse, elder abuse, or insti­tu­tion­al abuse. 

Coro­ners. We are required to dis­close infor­ma­tion about the cir­cum­stances of your death to a coro­ner who is inves­ti­gat­ing it.

Gov­ern­ment require­ments. We may dis­close infor­ma­tion to a health over­sight agency for activ­i­ties autho­rized by law, such as audits, inves­ti­ga­tions, inspec­tions and licen­sure. We are also required to share infor­ma­tion, if request­ed with the u.s. Depart­ment of health and human ser­vices to deter­mine our com­pli­ance with fed­er­al laws relat­ed to health care and with illi­nois state agen­cies that fund our services..

Crim­i­nal activ­i­ty or dan­ger to oth­ers. If a crime is com­mit­ted on our premis­es or against our per­son­nel we may share infor­ma­tion with law enforce­ment to appre­hend the crim­i­nal. We also have the right to involve law enforce­ment when we believe an imme­di­ate dan­ger may occur to someone.

Client Rights

You have the fol­low­ing rights under Illi­nois and fed­er­al law:

Copy of record. You are enti­tled to inspect the client record our agency has gen­er­at­ed about you. We may charge you a rea­son­able fee for copy­ing and mail­ing your record.

Release of records. You may con­sent in writ­ing to release of your records to oth­ers, for any pur­pose you choose. This could include your attor­ney, employ­er, or oth­ers who you wish to have knowl­edge of your care. You may revoke this con­sent at any time, but only to the extent no action has been tak­en in reliance on your pri­or authorization. 

Restric­tion of record. You may ask us not to use or dis­close part of the clin­i­cal infor­ma­tion. This request must be in writ­ing. The ken­neth young cen­ter is not required to agree to your request if we believe it is in your best inter­est to per­mit use and dis­clo­sure of the infor­ma­tion. The request should be giv­en to the pri­va­cy con­tact.

Con­tact­ing you. You may request that we send infor­ma­tion to anoth­er address or by alter­na­tive means. We will hon­or such a request as long as it is rea­son­able and we are assured it is cor­rect. We have a right to ver­i­fy that the pay­ment infor­ma­tion you are using is correct. 

Amend­ing record. If you believe that some­thing in your record is incor­rect or incom­plete, you may request we amend it. To do this con­tact the pri­va­cy con­tact and ask for the request to amend health infor­ma­tion form. In cer­tain cas­es, we may deny your request. If we deny your request for an amend­ment you have a right to file a state­ment if you dis­agree with us. We will then file our response and your state­ment and our response will be added to your record.

Account­ing for dis­clo­sures. You may request an account­ing of any dis­clo­sure we have made relat­ed to your con­fi­den­tial infor­ma­tion, except for infor­ma­tion we used for treat­ment, pay­ment, or health care oper­a­tions pur­pos­es or that we shared with you or your fam­i­ly, or infor­ma­tion you gave us spe­cif­ic con­sent to release. It also excludes infor­ma­tion we were required to release. To receive infor­ma­tion regard­ing dis­clo­sures made for a spe­cif­ic time peri­od no longer than six years and after april 14, 2003, please sub­mit your request in writ­ing to our pri­va­cy con­tact. We will noti­fy you of the cost involved in prepar­ing this list. 

Ques­tions and com­plaints. If you have any ques­tions, wish an addi­tion­al copy of this pol­i­cy or have any com­plaints you may con­tact our pri­va­cy con­tact in writ­ing at our office for fur­ther infor­ma­tion. You also may com­plain to the U.S. Depart­ment of Health and Human Ser­vices if you believe our agency has vio­lat­ed your pri­va­cy rights. We will not retal­i­ate against you for fil­ing a complaint. 

Changes in pol­i­cy. Ken­neth Young Cen­ter reserves the right to change its pri­va­cy pol­i­cy based on the needs of the agency and changes in state and fed­er­al law.

Pri­va­cy Contact

Health Infor­ma­tion Tech­ni­cian at (847) 524‑8807 ext.126