Effective Date: July 28, 2005

We respect patient confidentiality and only release medical 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.

Privacy Contact. If you have any questions about this policy or your rights, contact your case manager or the Quality Improvement/Utilization Review/Program Evaluation Manager (Privacy Officer) at (618)833-4456.

The Fellowship House staff does not release information about you to anyone without your written consent.  The treatment you receive here is confidential.

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

Treatment. We may ask you to allow us to disclose medical 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. 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 or for billing purposes.

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.

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

Coroners, Funeral Directors, and Organ Donation. We may disclose medical information to a coroner or medical examiner and funeral directors for the purposes of carrying out their duties. When organs are donated sufficient information is provided to the program as necessary to facilitate the organ or tissue donation.

Governmental Requirements. We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations inspections and licensure. There also might be a need to share information with the Food and Drug Administration related to adverse events or product defects. We are also required to share information if requested with the Department of Health and Human Services to determine our compliance with federal laws related to health care.

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 when we believe an immediate danger may occur to someone.

Changes in Policy. The Fellowship House reserves the right to change its privacy practices based on the needs of The Fellowship House and changes in state and federal law.