Mount Saint Vincent is a 501(c)3 corporation registered in the state of Colorado. Donations are tax-deductible. The information you provide will never be shared with other organizations. We value the privacy of our donors, so our database will never be sold to mailing list brokers.
Mount Saint Vincent is licensed by the Colorado Department of Human Services and accredited by The Council on Accreditation (COA). Our academic program is approved by the Colorado State Department of Education and accredited by the North Central Association. We are a member of the Colorado Association of Family and Children’s Agencies.
Mount Saint Vincent is a charter member of Mile High United Way.
At Mount Saint Vincent, our services are offered without discrimination by reason of sex, race, color, religion, sexual orientation, or national origin.
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW PERSONAL HEALTH INFORMATION ABOUT A CHILD MAY BE USED AND DISCLOSED AND HOW A PARENT OR GUARDIAN CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
WHO WILL FOLLOW THE PRIVACY PRACTICES IN THIS NOTICE
We provide health care to our clients together with physicians and other mental health care professionals. This Notice of Privacy Practices (“Notice”) describes how we will use and disclose personal health information. The privacy practices described in this Notice will be followed by:
Any member of our workforce authorized to access your personal health information.
Allied health professionals who participate in your health care.
I. Our commitment to safeguard your medical information
As a client or a parent/legally authorized representative of a client/child, you are the client’s “personal representative. Please read this notice with the understanding that we are discussing “you” to mean the patient.
We are committed to safeguarding the privacy of your protected health information (PHI). We are required by law to:
maintain the privacy of your protected health information;
provide you with this Notice about our privacy practices that explains how, when, and why we use and disclose your PHI;
abide by the terms of the current Notice;
make a good faith effort to obtain your written acknowledgement that you have received this Notice; and
notify you following a breach of your unsecured Protected Health Information.
II. How we may use and disclose medical and MENTAL HEALTH information
This Notice informs you about the ways in which we may use and disclose client personal health information. For each category of uses or disclosures, we explain what we mean and give some examples to help you better understand the meaning. If a use or disclosure is not included in one of these categories, we will seek your permission first.
Uses and Disclosures Without Your Permission
For Treatment. We may use and disclose client personal health information in providing the child with treatment and services. We may disclose personal health information to agency and non-agency personnel who may be involved in the child’s care, such as therapists, physicians, and nurses. For example, the agency nurse may report any change in the child’s physical condition to a physician. We also may disclose personal health information to individuals who will be involved in the child’s care after s/he leaves our facility or programs.
For Payment. We may use and disclose personal health information to bill and collect payment for the treatment and services provided. For billing and payment purposes, we may disclose personal health information to the child’s parent or guardian, a case worker, insurance or managed care company, Medicare, Medicaid or another third party payor, including state and county departments of human services, as well as school districts. For example, we may contact Medicare or a health plan to confirm coverage or to request prior approval for a proposed treatment or service.
For Health Care Operations. We may use and disclose personal health information for operations necessary for our facility to function and make sure our clients receive quality care. For example, we may use protected client information to evaluate our agency’s services, including the performance of our staff, to provide notices or reports, or to provide other needed services.
WE MAY USE AND DISCLOSE PERSONAL HEALTH INFORMATION ABOUT A CHILD FOR OTHER SPECIFIC PURPOSES SUCH AS THE FOLLOWING:
As Required By Law. We will disclose a child’s personal health information when required by law to do so.
Public Health Activities. We may disclose personal health information for public health activities. These activities may include, for example:
reporting to a public health or other government authority for preventing or controlling disease, injury or disability, or reporting child abuse or neglect;
reporting to the Federal Food and Drug Administration (FDA) concerning adverse events or problems with products for tracking products in certain circumstances, to enable product recalls or to comply with other FDA requirements;
to notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; or
for certain purposes involving workplace illnesses or injuries.
Reporting Victims of Abuse, Neglect or Domestic Violence. If we believe that a child has been a victim of abuse, neglect or domestic violence, we may use and disclose personal health information to notify a government authority as required or authorized by law.
Health Oversight Activities. We may disclose personal health information to a health oversight agency for oversight activities authorized by law. These may include: audits, investigations, inspections and licensure actions or other legal proceedings. These
activities are necessary for government oversight of the health care system, government payment or regulatory programs, and for compliance with other federal, state or local laws.
Judicial and Administrative Proceedings. We may disclose personal health information in response to a court or administrative order. We also may be required to disclose information in response to a subpoena, discovery request, or other lawful process. In those cases, an effort must be made to contact the child’s parent or guardian about the request or to obtain a court order or agreement protecting the information.
Law Enforcement. We may disclose personal health information for certain law enforcement purposes, including:
as required by law to comply with reporting requirements;
to comply with a court order, warrant, subpoena, summons, investigative demand or similar legal process;
to identify or locate a suspect, fugitive, material witness, or missing person;
when information is requested about the victim of a crime if the individual agrees or under other limited circumstances;
to report information about a suspicious death;
to provide information about criminal conduct occurring at the facility;
to report information in emergency circumstances about a crime; or
where necessary to identify or apprehend an individual in relation to a violent crime or an escape from lawful custody.
To Avert a Serious Threat to Health or Safety. We may use and disclose personal health information when necessary to prevent a serious threat to a child’s health or safety or the health or safety of the public or another person. However, any disclosure would be made only to someone able to help prevent the threat.
Worker’s Compensation. We may use or disclose personal health information to comply with laws relating to workers’ compensation or similar programs.
Appointment Reminders/Notices/Reports. We may use or disclose personal health information to remind the child or his/her family/guardian about appointments, to provide required notices of meetings, or to provide reports.
Treatment Alternatives. We may use or disclose personal health information to provide information about treatment alternatives.
Health-Related Benefits and Services. We may use or disclose personal health information to inform about health-related benefits and services that may be of interest to you.
III. YOUR AUTHORIZATION IS REQUIRED FOR OTHER USES OF PERSONAL HEALTH INFORMATION
We will use and disclose personal health information (other than as described in this Notice or required by law) only with a written Authorization from the child’s parent or guardian. An Authorization to use or disclose personal health information may be revoked in writing at any time. If the Authorization is revoked, we will no longer use or disclose personal health information for the purposes covered by the Authorization, except where we have already
relied on the Authorization or as required by law.
IV. Rights regarding your medical information
Clients have the following rights regarding personal health information at Mount Saint Vincent:
The Right to Inspect and Obtain a Copy of Personal Health InformationYou have the right to see and receive a paper or electronic copy of medical information that may be used to make decisions about your care. (The law requires us to keep the original record.) To inspect and/or receive a copy of your personal health information, you must submit your request in writing to our Clinical Director. If you request a copy of the information, we may charge you a reasonable fee based on our costs.
The Right to Amend. If you believe that personal health information we have about you is incorrect or incomplete, you have the right to request that we correct the existing information or add missing information. To request an amendment, you must make the request in writing along with your reason for the request to the person listed in Section V below.
The Right to a List of Disclosures. You have the right to request a list of certain disclosures of your personal health information. To request this list or accounting of disclosures, you must submit a request in writing indicating a time period, which can be no longer than six years, to the person listed in Section V below. The first list you request within a 12-month period will be free. For additional lists during the same year, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
The Right to Request Restrictions on How We Use and Disclose Your Personal Health Information. A child’s parent or guardian may ask us not to use or disclose personal health information for a particular reason related to treatment, payment or operations. We will consider the request, but we are not legally obligated to agree to a requested restriction except in the following situation: if you have paid for services out-of-pocket in full, you may request that we not disclose information related solely to those services to your health plan. We are required to abide by such a request, except where we are required by law to make the disclosure. To request restrictions on the use or disclosure of PHI, you may do so at the time you register for services or by contacting the person listed in Section V below.
The Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Paper copies are available in our intake department. You may also obtain a copy of this Notice on our website at www.MSVome.org.
If you believe that a child’s privacy rights have been violated, you may file a written complaint with the person listed in Section V below. You also may send a written complaint to the Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue S.W., Room 515F, HHH Building, Washington, D.C. 20201 within 180 days of an alleged violation of your rights. You will not be penalized for filing a complaint about our privacy practices. You will not be required to waive this right as a condition of treatment.
VI. Person to contact for information about this Notice or to complain about our privacy practices
If you have any questions about this Notice or wish to make a complaint about our privacy practices, please contact at the Clinical Director, who is the agency’s Privacy Officer. Formal complaints must be in writing.
We reserve the right to change the terms of this Notice and our privacy policies at any time. We reserve the right to make the revised Notice effective for personal health information we already have about the client as well as any information we receive in the future. Before we make an important change to our policies, we will promptly change this Notice and post a new Notice on our website. The Notice will contain the effective date. You can also request a copy of this Notice from the contact person listed in Section V above at any time.
You will be asked to sign an acknowledgement of your receipt of this Notice of Privacy Practices. We are required by law to make a good faith effort to provide you with our Notice of Privacy Practices and obtain an acknowledgement from you that you received it. Care and treatment at our agency does not depend on signing the acknowledgement.