HIPAA Notice of Privacy Practice

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Opportunities Unlimited will follow this notice. If you have any questions about this notice, please contact the Privacy Officer at Opportunities Unlimited at (712) 277-8295.

OUR PLEDGE REGARDING HEALTH INFORMATION:

We understand that health information about you and your health care is personal. We are committed to protecting health information about you. This notice applies to all records created and maintained by all departments of Opportunities Unlimited. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information that we keep about you and describe certain obligations we have regarding the use and disclosure of your health information. We are required by law: 1) make sure that health information that identifies you is kept private; 2) give you this notice of our legal duties and privacy practices with respect to health information about you; and 3) follow the terms of the notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that we use and disclose health information. For each category of uses and disclosures we will explain what we mean. Not every use or disclosure in a category will be listed. However, information will fall within one of the categories.

A. Uses and Disclosures for Treatment, Payment & Operations

For Treatment: We may use health information about you to provide you with health care treatment services. We may disclose health information about you to doctors, nurses, technicians, health students, or other personnel who are involved in taking care of you. In the event that an entity separate from Opportunities Unlimited will be providing treatment, a separate release form will be provided which gives options to which personal health information will be released to that entity via Opportunities Unlimited.

For Payment: We may use and disclose health information about you so that the treatment and services you receive from us may be billed to and payment collected from you, an insurance company, or a third party. These actions may include:

• Making a determination of eligibility or coverage for health insurance;
  
• Reviewing your services to determine if they are medically necessary;
  
• Reviewing your services to determine if they were appropriately authorized or certified in advance of your care; or
  
• Reviewing your services for purposes of utilization review, to ensure the appropriateness of your care or to justify the charges for your care.

For Health Care Operations: We may use and disclose health information about you for operations of our health care practice. These uses and disclosure are necessary to run our organization and make sure that all of our clients receive quality care. These activities may include quality assessment and improvement, licensing, accreditation, and general administrative activities. We may combine health information of many of your clients to decide what additional services we should offer, what services are no longer needed, and whether certain treatments are effective.

We may also provide your health information to other health care providers or to your health plan to assist them in performing their operations. We will do so only if you have or have had a relationship with the other provider or health plan.

We may also use and disclose your health information to contact you and remind you of your appointment.

Finally, we may use and disclose your health information to inform you about possible treatment options or alternatives that may be of interest of you.

Health-Related Benefits and Services: We may use and disclose health information to tell you about health-related benefits or services that may be if interest to you. If you do not want us to provide you with information about health-related benefits or services, you must notify us in writing at Opportunities Unlimited, 3439 Glen Oaks Boulevard, Sioux City, IA 51104. Please state clearly that you do not want to receive materials about health-related benefits or services.

B. Uses and Disclosures That May Be Made Without Your Authorization, but for Which You Will Have an Opportunity to Object

Persons Involved in Your Care: We may provide health information about you to someone who helps pay for your care. We may use or disclose your health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition, or death. We may also use or disclose your health information to an entity assisting in disaster relief efforts and to coordinate uses and disclosures for this purpose to family or other individuals involved in your health care.

In limited circumstances, we may disclose health information about you to a friend or family member who is involved in your care. If you are physically present and have the capacity to make health care decisions, your health information may only be disclosed with your agreement to persons you designate to be involved in your care.

If you are in an emergency situation, we may disclose your health information to a spouse, family member, or friend so that such person may assist in your care. In this case, we will determine whether the disclosure is in your best interest and, if so, only disclose that which is directly relevant to participation in your care.

If you are not in an emergency situation, but are unable to make health care decisions we will disclose you health information to:

• A person designated to participate in your care in accordance with an advance directive;
  
• Your guardian or other fiduciary if one has been appointed by a court; or
  
• The state agency responsible for consenting to your care (if applicable).

C. Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object

Emergencies: We may use and disclose your health information in an emergency treatment situation.

Research: We may disclose your health information to researchers when their research has been approved by an Institutional review Board or a similar privacy board that has reviewed the research proposal and established protocols to protect the privacy of your health information.

As Required By Law: We will disclose health information about you when required to do so by federal, state, or local law.

To Avert A Serious Threat to Health or Safety: We may use and disclose health information about you when necessary to prevent a serious and imminent threat to your health or safety or to the health or safety of the public or another person. Under these circumstances, we will only disclose health information to someone who is able to help prevent or lessen the threat.

Public Health Activities: We may disclose health information about you for public health activities. These activities may include instances such as:

• Reporting to public health authorities for the purposes of preventing or controlling disease, injury, or disability;
  
• Reporting vital events such as birth or death;
  
• Conducting public health surveillance or investigations;
  
• Notifying the appropriate government authority if we believe a client has been the victim of abuse, neglect, or domestic violence;
  
• Reporting certain events to the Food & Drug Administration; or
  
• Notifying a person who may have been exposed to a communicable disease or may be at risk for contracting or spreading a communicable disease or condition - we only make this disclosure if you agree or when required or authorized by law.
  

Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example: audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights law.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative agency when a judge or administrative agency orders us to do so. We may also disclose health information about you in legal proceedings without your permission in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. We will not provide this information in response to a subpoena without your authorization if the request if for records of a federally-assisted substance abuse program.

Law Enforcement Activities: We may disclose health information to a law enforcement official for law enforcement purposes when:

• A court order, subpoena, warrant, summons or similar process requires us to do so;
  
• The information is needed to identify or locate a subject, fugitive, material witness or missing person;
  
• We report a death that we may believe may be the result of criminal conduct;
  
• We report criminal conduct occurring in the premises of our facility;
  
• We determine that the law enforcement purpose is to respond to a threat of an imminently dangerous activity by you or against your self or another person; or
  
• The disclosure is otherwise required by law.
  

We may also disclose health information about a client to a law enforcement official about a client who has been a victim of crime, without a court order or without being required to do so by law. However, we will do so only if the disclosure has been requested by a law enforcement official and the victim agrees to the disclosure, or in the case of the victim's incapacity, the following occurs:

• The law enforcement official represents to us that the victim is not the subject of the investigation and an immediate law enforcement activity to meet a serious danger to the victim or others depends upon the disclosure; and
  
• We determine the disclosure is in the victim's best interest.
  

Medical Examiners or Funeral Directors: We may provide health information about our clients to a medical examiner. Medical examiners are appointed by law to assist in identifying deceased persons and to determine the cause of death in certain circumstances. We may also disclose health information about our clients to funeral directors as necessary to carry out their duties.

Military & Veterans: If you are a member of the armed forces, we may disclose your health information as required by military command authorities. We may also disclose your health information for the purpose of determining your eligibility for benefits provided by the Department of Veterans Affairs.

National Security: We may disclose medical information about you to authorized federal officials.

Inmates: If you are under custody of a law enforcement official, we may disclose health information to aid in any necessary care or medications you may need.

Workers' Compensation: We may disclose health information about you to comply with the state's Workers' Compensation Laws.

Your Rights Regarding Health Information About You:

You have the following rights regarding health information we maintain about you.

Right to Inspect and Copy: You have the right to inspect and copy your personal health information that may be used to make decisions about your care. A request for this information may be made at any time and will be honored within a reasonable amount of time. We may deny your request to inspect or copy your health information in certain limited circumstances. If personal health information is stored in electronic form we will provide you a copy of this information in the form and format requested by you if it is readily producible, or, if not, in a readable electronic form and format as agreed to by us and you.

Right to Amend: You have the right to request an amendment to personal health information. If you feel that health information that we have about you is incorrect or incomplete, you may ask us to amend the information. In addition, you must provide a reason that supports your request for an amendment. 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 health information we maintain to make decisions on your care;
  
• Is not part of the information which you would be permitted to inspect or copy; or
  
• Is inaccurate or incomplete.
  

Any amendment we make to your health information will be disclosed to those with whom we disclose information previously specified in this document.

If we deny your request to amend, we will send you a written notice of the denial stating the basis for the denial and offering you the opportunity to provide a written statement disagreeing with the denial. If you do not wish to prepare a written statement of disagreement, you may ask that the requested amendment and our denial be attached to all future disclosures of the health information that is the subject of your request. If you choose to submit a written statement of disagreement, we have the right to prepare a written rebuttal to your statement of disagreement. In this case, we will attach the written request and the rebuttal to all future disclosures of the health information that this the subject of your request.

Right to an Accounting of Disclosures: You have the right to request a list accounting for any disclosures of your health information we have made, except for uses and disclosures for treatment, payment, and health care operations, as previously described. This will be made available upon request and honored within a reasonable amount of time.

Right to Request Privacy Protection: You have the right to request restriction or limitation on disclosure of your personal health information and we must agree to the requested restriction if the request concerns disclosures to a health plan and if (a) the disclosure is for payment or health care operations; and (b) the personal health information pertains solely to a health care item or service for which you or another person on your behalf has paid us in full. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care such as a family member or friend. We will comply with your request unless the information is needed to provide you emergency treatment. In your request, you must tell us what information you want to limit and to whom you want the limits to apply.

Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice at any time from the organization's administrative assistant. Copies will be available in each residential home and at the organization's main offices. An electronic copy will also be available online at the organization's website: www.opportunitiesunlimited.com.

CHANGES TO THIS NOTICE:

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. If substantial changes are made in our Notice of Privacy Practices, OU will mail a revised notice to all persons served. We will post a copy of the current notice at each residential home and at the organization's main offices.

COMPLAINTS:

If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the Department of Health and Human Services. To file a complaint with us, contact the Privacy Officer at Opportunities Unlimited. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

CHANGES TO DISCLOSURE:

Other uses and disclosures of health information covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission; we will no longer use or disclose health information about you for the reason covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provide you.

Acknowledgement of Receipt of this Notice:
We will request that you sign a separate form or notice acknowledging you have received a copy of this notice. If you choose, or are not able to sign, a staff member or guardian will sign their name, date. This acknowledgement will be filed with your records.