Adelphoi is supported by its business relationships with all types of vendors. We also encourage participation from small business owners including women-owned, disabled-owned and minority-owned businesses. Click here for a copy of our New Vendor Policy Information form.
E-mail completed forms to: firstname.lastname@example.org. Form submittal does not automatically qualify the registering company as an approved supplier of Adelphoi USA, Inc. or guarantee a bidding opportunity.
WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION. We will protect the privacy of the health information that we maintain that identifies you, whether it deals with the provision of health care to you or the payment for health care. We must provide you with this Notice about our privacy practices. It explains how, when and why we may use and disclose your health information. With some exceptions, we will avoid using or disclosing any more of your health information than is necessary to accomplish the purpose of the use or disclosure.
We are legally required to follow the privacy practices that are described in this Notice, which is currently in effect. However, we reserve the right to change the terms of this Notice and our privacy practices at any time. Any changes will apply to any of your health information that we already have. Before we make an important change to our policies, we will promptly change this Notice and post a new Notice in our programs and business office reception areas. You may also request, at any time, a copy of our Notice of Privacy Practices that is in effect at any given time, from program unit supervisor, the Ethics Committee or the Privacy Officer. You may view and obtain an electronic copy of this Notice on our web site at www.adelphoi.org.
We would like to take this opportunity to answer some common questions concerning our privacy practices:
QUESTION: HOW WILL THIS AGENCY USE AND DISCLOSE MY PROTECTED HEALTH INFORMATION (PHI)?
Answer: We use and disclose PHI for many different reasons. For some of these uses or disclosures, we need your specific authorization. Below, we describe the different categories of our uses and disclosures and give you some examples of each.
A. Uses and Disclosures Relating to Treatment, Payment or Health Care Operations. We may, by federal law, use and disclose your PHI for the following reasons:
Treatment: We may disclose your general PHI to other health care providers who are involved in your care, with the exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status (for which we may need your specific authorization). For example, we may disclose your medical history to a hospital if you need medical attention while at our facility. Reasons for such a disclosure may be to get them the medical history information they need to appropriately treat your condition, to coordinate your care or to schedule necessary testing.
To Obtain Payment for Treatment: We may use and disclose necessary PHI in order to bill and collect payment for the treatment that we have provided to you, with the exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status (for which we may need your specific authorization). For example, we may provide certain portions of PHI to the payor (which could include placement agency, health insurance company, MA, and/or MCO), in order to get paid for taking care of you. To do this, we will need to provide PHI to the billing company that handles our health insurance claims.
Health Care Operations: We may, at times, need to use and disclose PHI to run our agency. For example, we may use PHI to evaluate the quality of the treatment that our employee has provided to you. We may also need to provide some of your PHI to our accountants, attorneys and consultants in order to make sure that we’re complying with law.
PHI can be stored on our paper records, but also our electronic computer files, on servers and within our electronic health record. Releasing this information can also now be completed via an electronic format, if requested and appropriate. Electronic transmissions via the Internet are not necessarily secure from interception and so we cannot guarantee the security or confidentiality of such transmissions.
B. Certain Other Uses and Disclosures are Permitted by Federal Law. We may use and disclose PHI without your authorization for the following reasons:
When a Disclosure is Required by Federal, State or Local Law, in Judicial or Administrative Proceedings or by Law Enforcement – For example, we may disclose PHI if we are ordered by a court, or if a law requires that we report that sort of information to a government agency or law enforcement authorities.
Clients of Alcohol and Drug Treatment facility only – your records are protected under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 C.F.R., Chapter I, Part 2, and cannot be disclosed without your written consent unless otherwise permitted by the regulations. You may revoke this authorization at any time except to the extent that action has already been taken, and that in any event, the authorization expires. This information has been disclosed to you from records protected by federal confidentiality rules (42 C.F.R., Chapter I, Part 2). The federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 C.F.R., Chapter I, Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The federal rules restrict any use of the information to criminally investigate or prosecute any alcohol and drug abuse client.
Public Health Activities – As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Health Oversight Activities – For example, we will need to provide PHI if requested to do so by the County and/or the State when they oversee the program in which you receive care. We will also need to provide information to government agencies that have the right to inspect our offices and/or investigate healthcare practices. Similarly, we may also disclose a client’s health information for national security purposes, such as assisting in the investigation of suspected terrorists who may be a threat to our nation.
Research Purposes – In certain limited circumstances (for example, where approved by an appropriate Privacy Board or Institutional Review Board under federal law), we may be permitted to use or provide PHI for a research study.
Workers’ Compensation – We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
Marketing/continuity of care – We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Fundraising – We may contact you as a part of a fundraising effort. You have the right to request not to receive subsequent fundraising materials by contacting Community Relations.
Communication with family – Unless you object, we, using our best judgment, may disclose to a family member, another relative, a close personal friend, or any other person that you identify health information relevant to that person’s involvement in your care or payment related to your care.
Disclosures to Notify a Family Member, Friend or Other Selected Person – When you first started in our program, we asked that you provide us with an emergency contact person or another available family member in case something should happen to you while you are in our program. Unless there is a court order specifying otherwise, we may disclose health information about you (your general condition, location, etc.) to your placing agency, legal guardian, payor, MA, MCO, and/or another available family member involved in your care, should you need to be admitted to the hospital, for example.
C. Exception to the Above In situations other than those categories of uses and disclosures mentioned above, or those disclosures permitted under federal law, we will ask for your written authorization before using or disclosing any of your protected health information. In addition, we need to ask for your specific written authorization to disclose information concerning your mental health, drug and alcohol abuse and/or treatment, or to disclose your HIV status.
If you choose to sign an authorization to disclose any of your health information, you can later revoke it to stop further uses and disclosures to the extent that we haven’t already taken action relying on the authorization, so long as it is revoked in writing, with the exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status (for which we may need your specific authorization).
QUESTION: WHAT RIGHTS DO I HAVE CONCERNING MY PROTECTED HEALTH INFORMATION?
A. The Right to Request Limits on Uses and Disclosures You have the right to ask us to limit how we use and disclose your health information. We will certainly consider your request, but you should know that we are not required to agree to it. If we do agree to your request, we will put the limits in writing and will abide by them, except in the case of an emergency. Please note that you are not permitted to limit the uses and disclosures that we are required or allowed by law to make, with the exception of information concerning mental health disorders and/or treatment, drug and alcohol abuse and/or treatment, and HIV status (for which we may need your specific authorization). If requested, we will comply with a request to restrict a disclosure to a health plan for purposed of payment or health care operations (not treatment) and the PHI pertains solely to an item or service for which the provider has been paid in full.
B. Right to ask for confidential communications You have the right to ask that we contact you at an alternate address or telephone number or by alternate means (for example, by mail instead of telephone). We must agree to your request so long as we can easily do so.
C. Right to ask to see and request a copy In most cases, you have the right to look at or get a copy of your health information that we have, but you must make the request in writing. A request form is available from your counselor or at the Records Department. We will respond to you within 30 days after receiving your written request. If we do not have the health information that you are requesting, but we know who does, we will tell you how to get it. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial. In certain circumstances, you may have a right to appeal the decision.
D. Obtain an accounting You have the right to get a list of certain types of disclosures that we have made of your health information. This list would not include uses or disclosures for treatment, payment or health care operations, disclosures to you or with your written authorization, or disclosures to your family for notification purposes or due to their involvement in your care. This list also would not include any disclosures made for national security purposes, disclosures to corrections or law enforcement authorities if you were in custody at the time, or disclosures made prior to April 14, 2003. You may not request an accounting for more than a six (6) year period.
To make such a request, we require that you do so in writing; a request form is available upon asking from your counselor or at the Records Department. We will respond to you within 60 days of receiving your request. The list that you may receive will include the date of the disclosure, the person or agency that received the information (with their address, if available), a brief description of the information disclosed, and a brief reason for the disclosure.
E. Right to ask for a correction If you believe health information we have is incorrect or incomplete, you have a right to ask that we make an appropriate change to your information as long as the information is kept by or for Adelphoi. You must make the request in writing, with the reason for your request, on a request form that is available at the reception desk, from your counselor or at the Records Department. We will respond within 60 days of receiving your request. If we approve your request, we will make the change to your health information, tell you when we have done so, and will tell others that need to know about the change. We may deny your request if the protected health information: (1) is correct and complete; (2) was not created by us; (3) is not allowed to be disclosed to you; or (4) is not part of our records.
QUESTION: HOW DO I COMPLAIN OR ASK QUESTIONS ABOUT THIS AGENCY’S PRIVACY PRACTICES?
Answer: If you have any questions about anything discussed in this Notice or about any of our privacy practices, or if you have any concerns or complaints, please contact the Ethics Committee at 724/804-7000. You also have the right to file a written complaint with the Secretary of the U.S. Department of Health and Human Services. We may not take any retaliatory action against you if you lodge any type of complaint.
Allegations of sexual abuse or sexual harassment involving potentially criminal behavior are referred for investigation to the local or state police.
Dependent upon the findings, Adelphoi will then file the report in the youth’s record, and, if necessary, take further action.
To report sexual abuse or harassment, click here.