Sunrise Opportunities Privacy Statement

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SUNRISE OPPORTUNITIES

NOTICE OF PRIVACY PRACTICES

Summary Of Privacy Practices

This paper tells you how we can use information about you and what we can tell others. It also tells you how you can see your information. Sunrise Opportunities doesn't share the health information about people who receive services from us.

This means Sunrise Opportunities doesn't share:

We don't share information about you from the past. We don't share information about things that are happening today. We also won't share information about your plans for the future.

If you sign a consent form, we can give information about you to others. For example, we may share information with:

You don't have to sign the consent form. If you don't sign the consent form, it may be hard to get services to you.

You may ask to have some of your health information not shared with other people. Sunrise Opportunities doesn't have to agree with you about not sharing this information, but if we do agree, then we won't share the information.

Also, there may be some special times when we have to use information about you even if you haven't give us permission to do so. For example,

You can look at your health information and you might be able to change it if you don't think it's correct. We will tell you to whom we gave information about you. We will also keep a record of anyone who has received your health information.

If you want more information about your Privacy Rights or our Privacy Practices, or if you think we haven't followed the rules, you may contact Sunrise Opportunities Privacy Officer at 1-800-255-3124. We will not retaliate against you if you file a complaint of any kind.

Notice Of Privacy Practices

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

Please review it carefully.

In compliance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Sunrise Opportunities safeguards the protected health information of people who receive services from us.

Protected health information includes descriptive information that can be used to identify a person and that relates to the physical or mental health or condition, the health care provided to the person, or payment for the health care. The protected health information includes information from the past, present, or future. The right to privacy continues after death.

You have the right to expect that only those individuals, organizations and/or agencies that have a need to know will be granted permission to use your protected health information, unless otherwise allowed by law or by your written authorization.

This notice will explain your rights more completely. These rights are the same as rights under 34B MRSA § 5605 et seq., Rights of Recipients of Mental Health Services, or Rights of Recipients of Mental Health Services who are Children in Need of Treatment. If Maine State Law is stricter, then we have to follow the strictest law.

1. Who we are

This notice describes the privacy practices of Sunrise Opportunities for all consumers in all our programs.

2. Our Privacy Obligations

We are required by law to keep your protected health information private, to tell you about these rules and to follow the rules.

3. Disclosing and Using Your Information with your consent

When you begin receiving services from us, we will ask that you (or your legally authorized representative) sign a consent form, which will permit us to release information about you in order to provide services to you, in order to be paid by your insurance company or MaineCare for the services provided to you, and to conduct our regular business activities.

Your consent will permit us to share information with other parties who provide services to you. We will specifically ask your permission to share information related to psychiatric treatment, substance abuse or substance abuse treatment, and information pertaining to HIV testing and treatment. We will share information with

We will also share information to resolve any complaints or grievances that you may have.

You may request to have the use or disclosure of your protected health information restricted. Sunrise Opportunities does not have to agree to the restriction you request. If we do agree, we must make a record of the restrictions and we must honor them.

If you wish to have information provided to other parties, you will be asked to sign an authorization. The authorization will allow us to provide information to others. We cannot provide information that was given to us by someone else. You may revoke this authorization at any time by providing a written dated notice.

4. Using Your Protected Health Information for Other Purposes

Generally, we may use your protected health information for other reasons only when we have a specific authorization signed by you or your legally authorized representative. We will use your protected health information when necessary to contact you about appointments and to provide you with information we think you may be interested in. You may provide us with another address or method to contact you and we will honor that request. There are some times when we may be unable to obtain your consent or an authorization and we will still need to use your protected health information. We will use only what is absolutely necessary to accomplish the purpose. Examples of when we might use protected health information about you without consent or authorization include:

There are also times when we are required to provide information about you. For example,

5. Reviewing your Protected Health Information

You have the right to inspect and obtain a copy of protected health information maintained in Sunrise Opportunities files. You will be expected to make an appointment for this and you may be charged fees for copying. You may also request that your records be sent to a mental health professional for their review. If you choose to do this, you may be charged fees for copying. Some protected health information in our files, particularly if it was provided to Sunrise Opportunities by others, may not be reviewed or copied.

6. Amending your Protected Health Information

You have the right to amend your protected health information in Sunrise Opportunities files for as long as that protected health information is maintained in our files. You may not amend material that was not created by Sunrise Opportunities. You may add written material to your record to clarify information if you believe the information is false, inaccurate or incomplete. You may amend your records once annually at no cost. If you amend your records more frequently, you may be charged fees.

7. Disclosures

You have the right to request an accounting of all disclosures of your protected health information that Sunrise Opportunities may make if the disclosure was for something other than treatment, payment or Sunrise Opportunities' business needs. You have the right to request an accounting of any disclosures you authorized.

Information and Complaints

If you want more information about your Privacy Rights or our Privacy Practices, or are concerned that we have not followed our rules, you may contact the Sunrise Opportunities Privacy Officer at 1-800-255-3124. You may also file a written complaint with the Director, Office for Civil Rights. Upon request, we will provide you with the address. We will not retaliate against you if you file a complaint of any kind.

Duration of this notice

This notice goes into effect on April 14, 2003. We may change the terms of this notice at any time. If we do so, you may obtain any new notice from us by writing: Sunrise Opportunities, P O box 88, Machias, Maine 04654

Revised 03/31/2008. All other versions obsolete.