In Iowa:
1523 S. Fairmount Street
P.O. Box 3278
Davenport, IA 52808-3278
Phone: 563-322-2667
Fax: 563-322-3671
E-mail:

cads@cads-ia.com

In Illinois:
4230 11th Street
Rock Island, IL 61201
Phone: 309-788-4571

Privacy Statement

Information regarding your health care, including payment for health care, is protected by two federal laws: the health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. § 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2. Under these laws, the Center for Alcohol & Drug Services (The CENTER) may not say to a person outside of the CENTER that you attend the program, nor may the CENTER disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law.

The CENTER must obtain your written consent before it can disclose information about you for payment purposes. For example, the CENTER must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before the CENTER can share information for treatment purposes or for health care operations. However, federal law permits the CENTER to disclose information without your written permission in the following circumstances:

  1. Pursuant to an agreement with a qualified service organization/business associate
  2. For research, audits or evaluations
  3. To report a crime committed on the CENTER premises or against CENTER personnel
  4. To medical personnel in a medical emergency
  5. To appropriate authorities to report suspected child abuse or neglect
  6. As allowed by a court order

For example, the CENTER can disclose information without your consent to obtain legal or financial services, or to another medial facility to provide health care to you, as long as there is a qualified service organization/business associate agreement in place.

Before the CENTER can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.

Your Rights

Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. The CENTER is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency.

You have the right to request that we communicate with you by alternative means or at an alternative location. The CENTER will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by the CENTER, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances. If you want copies of your health information a charge for coping may be imposed.

Under HIPAA, you also have the right, with some exceptions to amend health care information maintained in the CENTER records, and to request and receive an accounting of disclosures of your health related information made by the CENTER without your consent during the six years prior to your request. You also have the right to receive a paper copy of this notice.

CENTER Duties

The Center for Alcohol & Drug Services (The CENTER) is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. The CENTER is required by law to abide by the terms of this notice. The CENTER reserves the right to change the terms of this notice and to make new provisions effective for all protected health information it maintains. The new notice will be effective for all protected health information that the CENTER maintains at that time. You may obtain a copy of any revised Notice of Privacy Practices by asking for one at the time of your next appointment, by calling the office and requesting that one be sent to you by mail, or by downloading a PDF of the Policy from this website.

Complaints & Reporting Violations

If you believe that your privacy rights have been violated under HIPAA, you may file a complaint with the Center for Alcohol & Drug Services, Inc. (The CENTER) and the Secretary of the United States Department of Health & Human Services.

Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.

Acknowledgement

You are entitled to a copy of this notice. Acknowledgement of this notice requires a signature on the Orientation Sign-Off Sheet.

PDF of Privacy Practices

 

 

Copyright 2005