Privacy Notice for Human Services

Your Privacy is Our Priority

The City of Chesapeake understands your privacy is important. We are required by law to maintain the privacy of Protected Health Information (PHI) and to provide you with notice of your legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this notice. We will handle this information only as allowed by federal/state law and agency policy adhering to the most stringent law that protects your health information. If at any time you believe your privacy rights have been violated, you may verbally or in writing contact:

• Agency's Administrator, Supervisor, Resource Center Supervisor, and Case Manager
• State Advocate
• Secretary of Health and Human Services of the Federal government

Each time you receive services from us, the provider maintains a record of the visit. Typically, their documentation contains your assessment, service plan, progress notes, and plan for future treatment. These documents are kept in our office.

Your Federally-Denied Rights Under 45 CFR Parts 160 and 164, HIPPA, and the Commonwealth of Virginia's Code 35-115 and 35-115-90, Human Rights:

• You have the right to access or to request copies of your chart. You must request this in writing to your Resource Center Coordinator, Case Manager, Supervisor and or Administrator/Privacy Officer. If denied access, you will receive in a timely manner, written notice of the decision and reason, and a copy of this notice becomes a part of your chart.
• You have the right to request an amendment of your chart if you believe information in the record is inaccurate or incomplete. You must make this request in writing to your agency's Case Manager, Resource Center Coordinator, Supervisor, and or Administrator. We may deny the request for specific reasons, but you will be provided with written explanation of the denial.
• You have the right to receive an accounting of the agency's disclosures of your protected health information that were not for the purpose of treatment, payment, health care operations, or that were not otherwise authorized by you. You also have the right to be given the names of anyone, other than employees of the agency, who received information about you from the agency.
• You have the right to request from the Case Manager, Supervisor, or Administrator a restriction on the use or disclosure of your protected health information. This request will be given serious consideration by the Privacy Officer, Case Manager, Supervisor and or Administrator. You will be informed promptly whether we will be able to honor the requested restriction and still offer effective services and receive payment. Legally, we are not required to agree to any restrictions you request, but if we do agree, we are bound by that agreement except under certain emergency circumstances.