TURNING POINT OF TAMPA, INC.
Notice of Privacy Practices

Privacy Statement

Turning Point of Tampa, Inc respects the privacy of its clients. Turning Point does not sell, rent, or loan any identifiable information regarding its clients or website visitors to any third party. Any information you give us is held with the utmost care and will not be used in ways for which you have not consented.

Confidentiality

Turning Point of Tampa, Inc is committed to making sure each client’s confidentiality is protected by our legal responsibility as mandated by state and federal law. Each staff member is dedicated to upholding these standards in all communications and records. Staff, clients, family members, and visitors all sign a confidentiality statement and agree to keep all knowledge or information of Turning Point of Tampa, Inc staff, clients, and family members confidential at all times. We go to great lengths to protect the anonymity of everyone who enters Turning Point of Tampa, Inc.

Website Privacy Statement. Assuring the security and confidentiality of Turning Point of Tampa’s website visitors is an important concern to us. We pledge to protect your privacy by NOT providing or releasing names, e-mail addresses, or postal addresses to any third party. (You should be aware, however, that certain state and federal laws may require that we report certain information from time to time). Turning Point of Tampa does NOT track or report on any individual’s activity on this site. Turning Point ensures you are sent the information you have requested and only what you have requested. We use data from this site to measure global, not individual, site activity. Turning Point of Tampa provides Internet security by hosting our site on a secure server. We do not sell services or items on the Internet and will never require you to enter any data for the same. Our web site visitors do not have to register to use this site and the only information that will obtained by Turning Point of Tampa is the information you choose to complete if you request information from our facility via the website. If you have addition questions or concerns about security on our web site, please contact Kirsten Forczek at 813-882-3003 or kforczek@tpoftampa.com.

Release of Personal Health Information
(Effective April 14, 2003)

Turning Point of Tampa, Inc has a legal duty to protect and safeguard your personal health information, which includes past and present information obtained during your treatment stay. We must provide you with this notice about our privacy practices, in that it will explain how and why we use and disclose your personal health information. Turning Point of Tampa, Inc is committed to protecting the confidentiality of information contained in your medical records, including your health and financial information, in accordance with applicable laws and regulations.

Turning Point of Tampa, Inc is required by law to maintain the privacy of your health information; we are required to abide by the terms of this notice currently in effect and reserve the right to change the terms of its notice and to make new notice provisions effective for all protected health information that it maintains.

How we will use and disclose your health information. (Some uses and disclosures will require a specific authorization.):

Treatment: Your health information will be released for the purpose of treatment at our facility, to include all members of your treatment team. Treatment team members include but are not limited to Turning Point of Tampa, Inc medical providers, therapists, nurses, dietician/nutritionist, case managers, medical records staff, intake personnel, and administrative/clinical personnel.

Limited access to your health information may include but is not limited to Turning Point of Tampa, Inc business office personnel (admissions, collections), receptionists, and administrative/clinical assistants.

Family members participating in the Family Program will have limited knowledge regarding your health information, as revealed by you, the client, in the program groups.

While you are in treatment, your health information is released to Dominion Diagnostics, which is an external laboratory facility that is utilized by Turning Point of Tampa, Inc for the purpose of lab studies. An authorization to release information is only signed by you, the client, if you choose to have Dominion Diagnostic bill your insurance carrier.

While in treatment, your health information is released to Walgreen’s’ Pharmacy and Eckerd’s Pharmacy, which are external pharmacies utilized by Turning Point of Tampa, Inc for the purpose of obtaining prescription medications.

While in treatment, your private health information may be released to Dr. Richard Keesal, an external physician who is utilized by Turning Point of Tampa, Inc. for the purpose of history and physicals and other medical concerns that may arise while the client is in treatment.

While in treatment, you may require a medical service that is not provided by Turning Point of Tampa, Inc; with your approval, your attending provider will recommend an external provider of care, and your health information will be released in order to provide care.

In the event that while in treatment you need to be either voluntarily transferred (for safety and further stabilization) or involuntarily transferred (due to danger to self, danger to others, refusing to remain on one-to-one evaluation, or if the need for a higher level of care is required), then an immediate response agency will be contacted. Emergency Crisis Management will be notified to complete an assessment. If they are not available, 911 will be contacted to transfer you to the appropriate facility.

Medical Emergencies: We may use or disclose your protected health information in a medical emergency situation to medical personnel only. Our staff will try to provide you a copy of this notice as soon as reasonably practicable after the resolution of the emergency.

Your health information will be released to referring professionals, therapists, medical providers, and extended care facilities for the purpose of continuity of care after discharge when you have given proper authorization.

Criminal Activity on Program Premises/Against Program Personnel: We may disclose your protected health information to law enforcement officials if you have committed a crime on program premises or against program personnel.

Court Order: We may disclose your protected health information if the court issues an appropriate order and follows required procedures.

Payment: Your health information will be disclosed for the purpose of payment from your insurance carrier or third party for reimbursement purposes when proper authorization has been given. While in treatment and after you discharge, your health information will be released to process your insurance, to conduct third party reviews, and for other financial arrangements, as authorized by you, the patient. In the event that your bill for services rendered by Turning Point of Tampa, Inc has not been resolved in a timely manner, the information in your financial record will be copied and sent to an external collection agency and/or attorney for collection services.

Healthcare Operations: Your health information will be used and disclosed for the purpose of healthcare operations to include administrative functions such as evaluation of performance by your providers or evaluation of quality of services provided to you during your treatment stay. Your health information may be released for audit purposes to include (but not limited to) the Joint Commission on Accreditation of Healthcare Organizations, Florida Department of Health Services for licensure, Yost Accounting for financial audits, and insurance auditors employed by your insurance carrier for comparing the claim to the medical record. Outcome studies are completed by Turning Point of Tampa, Inc for the purpose of improving our patient care.

Internal Use: Your first name and last initial will be posted on the white boards located in group rooms, admissions office, and clinical team staffing room, 4A office, as well as posted on your therapist’s office door designating your session date and time. Your first name and last initial may also be posted on group allocation board, nurse sign-in sheet, activity sign-up sheets, meeting sign-up sheets, med boxes and log book, village log book, and other locations pertinent to ensure client security, safety, and access to services.

Your medical record, which is located in a secure location, will have your full name for the purpose of ensuring that client care is provided to the correct client.

Your picture will be taken upon admission and stored digitally within Turning Point of Tampa’s client database for the purpose of client identification. Your photograph will also be printed on your medical record demographic face sheet, as well as on any utilization review notices used internally to document contact with your case coordinator at your insurance company.

Your first and last name, along with your medical record number, program, house number, admission date, referral source and therapist is contained on the daily census, which is distributed to the treatment team and administrative staff daily.

Your medical record will be kept on site in a secure location for up to seven years post-discharge. Once your record has reached the seven-year limit, it is destroyed (process of shredding).

A financial file will be created upon admission to Turning Point of Tampa, Inc; this file will contain all documents signed during the admissions process relating to payment for services, as well as the claim form that is processed after your discharge. Some of these documents will have limited personal health information, so they will be safeguarded and secured just like your medical record. These files are kept on site for seven years and then destroyed (process of shredding).

Substance Abuse Health Information: The release of medical information concerning substance abuse may be subject to and released in compliance with the requirements of Federal Law and regulations.

HIV Information: All medical information regarding substance abuse is kept strictly confidential and released only in conformance with the requirements of federal and state laws. Disclosure of any medical information referencing HIV status may only be made with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.

Public Health: As required by state law, public health agencies will be contacted and your health information will be disclosed for the following reasons:
• Child abuse or neglect
• An attempted suicide or a self-injury
• Death of a client
• Prevent or control diseases, injury, or disability
• Adverse reactions to medications
• Adverse events or defects
• Exposure to a communicable disease or risk of spreading a disease or infection
• Avert a serious threat to the health or safety of a person or the public

Litigation: Your personal health information cannot be released to any entities involved in a litigation suit without authorization from you. If you are involved in litigation after you have discharged from Turning Point of Tampa, Inc, your personal health information will be released to Turning Point of Tampa, Inc's corporate attorneys to oversee the litigation process. Otherwise, your personal health information may be released in accordance with applicable state or federal law. Subpoenas served upon Turning Point of Tampa, Inc will be followed according to federal and state law.

National Security & Intelligence Activities: We may be required to release your medical information to authorized federal officials for intelligence, counterintelligence, and other national security activities as authorized or required by law.

Business Associates: We may disclose protected health information to a business associate and may allow a business associate to create, receive, or use protected health information on its behalf pursuant to a written contract or other written arrangements. A business associate performs a function on behalf of the treatment center. For example, vendors to perform billing services, accountants to perform audits, and agencies to provide accreditation.

Research: Turning Point of Tampa, Inc may use and disclose your health information for research purposes. All research projects will require a signed authorization by you, the client, if health information will be used or disclosed.

Coroners, Medical Examiners, and Funeral Directors: We may release medical information to a coroner or medical examiner for the purpose of identifying a deceased person or to find out the cause of deal, or for other legal duties. We may release medical information about treatment center clients to funeral directors so they may carry out their duties.

Patient Rights: Written Authorizations: All other uses and disclosures (i.e., verbal, written, Internet, and fax) of personal health information will be made only with the written authorization made by you, the client. Turning Point of Tampa, Inc will only accept the original signed authorization; no photocopies will be accepted. Any information that Turning Point of Tampa, Inc obtained from another healthcare facility will not be released.

Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. You must submit your request for confidential communication in writing. Your request must specify how and where we should contact you. We will try to accommodate all reasonable requests.

Other Uses of Medical Information: Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will only be made with your written permission and after you have had an opportunity to agree or object. You may revoke that permission in writing at any time.

Revocation of Authorization: You have the right to revoke this authorization at any time; however, the revocation will not apply to your personal health information that was disclosed before the revocation. If you choose to revoke authorization while in treatment, you need to notify your primary therapist. If you choose to revoke authorization after you have discharged, you will need to contact the Medical Records Department.

Request for Restriction of Use & Disclosure: You have the right to request restrictions concerning certain uses and disclosures of your protected health information as it relates to treatment, payment, and healthcare operations. However, Turning Point of Tampa, Inc is not required to agree to this request. Turning Point of Tampa, Inc will document the decision to accept or deny your request.

Request to Access: You have the right, which may be restricted in certain circumstances, to inspect and copy medical information that may be used to make decisions about your care. To receive a copy of your health information, you need to contact the Medical Records Department. A nominal fee will be assessed for labor, supplies, and postage costs.

Request to Amend: You have the right to request an amendment to your health information. It is your right to append a statement or counter-opinion. It is not, however, your right to obliterate or totally remove documentation from your record. In addition, Turning Point of Tampa is not required to agree with this request. Amendments that are made and accepted will be transmitted to those who need to know. All of these requests will be handled through the Privacy Officer at Turning Point of Tampa, Inc.

Request for Accounting of Disclosures: You have the right to receive an accounting of any disclosures of your health information. All of these requests will be handled through the Privacy Officer at Turning Point of Tampa, Inc. A nominal fee may be assessed for labor, supplies, and postage costs.

Copy of Privacy Notice: You have a right to request a copy of this notice from us. Any questions should be directed to our Privacy Officer.

Complaints: If you believe that your privacy has been violated, you have the option of submitting your written complaint to the Privacy Officer at Turning Point of Tampa, Inc. We will not retaliate against you for filing a complaint. The Privacy Officer at Turning Point of Tampa, Inc is Kirsten Forczek and can be contacted at 6227 Sheldon Road, Tampa, Florida 33615, or by calling 813-882-3003. If Turning Point of Tampa, Inc cannot resolve your concern, you have the right to file a written complaint to the United States Secretary of the Department of Health and Human Services at Office for Civil Rights 61 Forsyth Street, SW – Suite 3B70, Atlanta, Georgia 30323, (404) 562-7886.