Our Philosophy and Values
Happy and Smile is dedicated to providing supports for community living to promote independence, self-determination, community participation and family involvement to individuals with developmental and physical disabilities in their home and by their choice.
Independence—Happy and Smile staff members are trained to encourage and empower the people they serve to participate in their daily routines with as much personal independence as they desire—at work, at home, at school and in the community. Our services focus on providing the resources that will help each individual live where he or she wants to live with a positive quality of life.
Self Determination—Happy and Smile encourages each individual to participate as fully as possible in decision making about all aspects of their lives. We reinforce these four principles of self-determination: freedom, authority, support and responsibility. The focus of our support activities is to help people identify and pursue their own goals and dreams for their life. It is also understood that as each individual’s needs and goals change, the role and responsibilities of our staff will adjust to accommodate those changes.
Community Participation—Happy and Smile is committed to encouraging a truly valued lifestyle for each individual, making it possible for them to participate as active members of the community. This commitment includes the freedom to choose where to live, shop and travel, as well as the opportunity to develop meaningful and supportive relationships with people who are not paid to be with them. This may mean providing assistance in developing friendships with neighbors, people in local community groups, religious organizations, fun clubs, and other natural support networks.
Family Involvement— Happy and Smile encourages family members, legal representatives and guardians to become involved in the care we provide. Family members and guardians offer insights into the individual’s unique needs that help our caregivers provide key services to enhance each Individual’s lifestyle, activities and home. We welcome family input and feedback regarding who is selected to care for the individual. Supports for community living is one of the most important decisions a family makes and we want to ensure that our caregivers meet the criteria each family sets for their loved one.
Happy and Smile Notice of Privacy Practices for Protected Health Information.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions regarding this Notice of Privacy Practices, please contact:
OUR PROMISE TO YOU REGARDING YOUR PROTECTED HEALTH INFORMATION (PHI)
Happy and Smile is committed to protecting the privacy of all health information we create and maintain as a result of the care and services we provide to you. We are committed to comply with the requirements of the national, state, and organization framework for health information privacy protection by making available this Notice of Privacy Practices.
Your “protected health information” (PHI) includes information about your past, present or future health, health we provide and related health care services. PHI also includes all individually identifiable health information transmitted or maintained by Happy and Smile regardless of form (oral, written, electronic.)
Happy and Smile is required to abide by the terms of this Notice of Privacy Practices and will inform you about:
Happy and Smile uses and disclosures of Protected Health Information (PHI).
Your privacy rights with respect to your PHI.
Happy and Smile duties with respect to your PHI.
Your right to file a complaint with Happy and Smile and to the State or the U.S. Department of Health and Human Services; and
The office to contact for further information about Happy and Smile privacy practices.
RIGHTS OF THE INDIVIDUAL
The following is a statement of your rights with respect to your protected health information and a description of how you may exercise these rights.
Right to Request Restrictions on PHI Uses and Disclosures
You may request Happy and Smile to restrict uses and disclosures of your PHI to carry out treatment, payment or health care operations, or to restrict uses and disclosures to family members, relatives, friends or other persons identified by you who are involved in your care or payment for your care. However, Happy and Smile is not required to agree to such requested restriction.
You will be required to complete a form to request restrictions on uses and disclosures of your PHI. Such requests should be made to Happy and Smile
Right to Receive Confidential Communications
You have the right to receive confidential communications by alternative means or at alternative locations. You must request this in writing.
Right to Inspect and Copy PHI
You have a right to inspect and obtain a copy of your PHI contained in a “designated record set” for as long as HAS Home care maintains the PHI. PHI includes all identifiable health information transmitted or maintained by Happy and Smile regardless of form. This right does not apply to certain health information, including:
(1) information that is not held in the designated record set;
(2) psychotherapy notes;
(3) information compiled in reasonable anticipation of or for litigation; and
(4) other information not subject to the right to access information under HIPAA.
Designated Record Set includes the medical records and billing records about individuals maintained by a covered health care provider.
The requested information will be provided within thirty (30) days if the information is maintained on site or sixty (60) days if the information is maintained offsite. A thirty (30) day extension is allowed if HAS is unable to comply with the deadline provided that HAS provides a written statement for the reason for the delay.
You will be required to complete a form to request access to the PHI in your designated record set.
If access is denied, you will be provided with a written denial setting forth the basis for the denial, a description of how you may review those rights and a description of how you may complain to the Secretary of the U.S. Department of Health and Human Services.
Right to Amend PHI
You have the right to request HAS to amend your PHI or a record about you in a designated record set for as long as the PHI is maintained in the designated record set. HAS has sixty (60) days after the request is made to act on the request. A single thirty (30) day extension is allowed if HAS is unable to comply
with the deadline provided that HAS provides a written statement for the reason for the delay. If the request is denied in whole or part, Happy and Smile must provide you with a written denial that explains the basis for the denial. You may then submit a written statement disagreeing with the denial and have that statement included with any future disclosures of your PHI.
At your request, Happy and Smile will also provide you with an accounting of disclosures by Happy and Smile of your PHI during the six years prior to the date of your request. However, such accounting need not include PHI disclosures made: 1) to carry out treatment, payment or health care operations; 2) to individuals about their own PHI; 3) prior to the effective date of this notice; or 4) based on your written authorization.
If the accounting cannot be provided within sixty (60) days, an additional thirty (30) days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided. If you request more than one accounting within a twelve (12) month period, HAS will charge a reasonable, cost-based fee for each subsequent accounting.
A Note About Personal Representatives
You may exercise your rights through a personal representative. Your personal representative will be required to produce evidence of his/her authority to act on your behalf before that person will be given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms:
(1) a power of attorney for health care purposes notarized by a notary republic;
(2) a court order of appointment of the person as the conservator or guardian of the individual; or
(3) an individual who is the parent of a minor child.
HAS retains discretion to deny access to your PHI to a personal representative to provide protection to those vulnerable people who depend on others to
exercise their rights under these rules and who may be subject to abuse or neglect. This also applies to personal representatives of minors.
HAPPY AND SMILE’S DUTIES
HAPPY AND SMILE is required by law to maintain privacy of PHI and to provide individuals (consumers or guardians) with notice of its legal duties and privacy practices. Happy and Smile is required to comply with the terms of this notice. However, Happy and Smile reserves the right to change its privacy practices and to apply the changes to any PHI received or maintained by prior HAPPY to that date. If a privacy practice is changed, a revised version will be available upon request and will be posted in a clear and prominent location. If Happy and Smile makes a material change to the uses and disclosures, your rights, Happy and Smile ’s Legal duties, or other privacy practices in this notice, we will review and distribute the notice within sixty (60) days.
Minimum Necessary Standard
When using or disclosing PHI or when requesting PHI from another covered entity, HAPPY will make reasonable efforts to limit the disclosure and use of protected health information. HAPPY will use or disclose the minimum amount of PHI necessary to accomplish the intended purpose of the use. However, the minimum necessary standard will not apply in the following situations; (1) disclosures to or requests by a health care provider for treatment; (2) uses or disclosures made to the individual or guardian.
YOUR RIGHT TO FILE A COMPLAINT WITH THE PLAN OR THE SECRETARY OF THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
If you believe that your privacy rights have been violated you may complain to Happy and Smile, You may file a complaint with the Secretary of the U.S. Department of Health and Human Services. Happy and Smile will not retaliate against you for filing a complaint.
WHOM TO CONTACT FOR MORE INFORMATION
If you have any questions regarding this notice or the subjects addressed in it, you may contact Happy and Smile
CONCLUSION
PHI use and disclosure by Happy and Smile is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. This notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this notice and the regulations.
NOTICE OF PHI USES AND DISCLOSURES
Happy and Smile may use and disclose your protected health information as necessary for your treatment, payment for services provided and health care operations, without your permission as described in the following section. Other sections of this notice describe uses and disclosures that require your authorization and the rights you have to restrict our use and disclosure of your medical information.
Uses and disclosures to carry out treatment, payment and health care operations.
Happy and Smile may use PHI to carry out treatment, payment and health care operations.
Treatment is the provision, coordination or management of health care related services. This includes your physician and other health care professionals who have agreed to assist Happy and Smile in coordinating care. For example, your physician will need information about your symptoms in order to prescribe treatment or appropriate medications. We may also disclose your health care information to individuals outside of Happy and Smile who are involved in your care such as family members, laboratory personnel, pharmacists, suppliers of medical equipment, or other health care professionals.
Payment includes but is not limited to health information for the payment activities of other health care providers or payers. For example, a bill may be sent to you or a third-party payer, including Medicare or Medicaid. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.
Health care operations include but are not limited to quality assessment and improvement, reviewing competence or qualifications of health care professionals, case management, conducting or arranging for medical review, business planning and development, business management and general administrative activities.
Uses and disclosures that require you to be given an opportunity to agree or object prior to the use or disclosure.
Unless you object, we may disclose to a member of your family, other relatives, or a close friend or any other person you identify (who is not your legal guardian), your protected health information if it relates to that person’s involvement in your health care. If you are unable to agree or object to the use or disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
Uses and disclosures that do not require your authorization or opportunity to object.
We may use or disclose your protected health information in the following situations without your authorization:
When required by federal, state, or local law.
To support public health activities by reporting to the Department of Health as required or authorized by state law. These reports may include, but are not limited to, the reporting of exposure to a communicable disease or risk of spreading a disease or condition.
To cooperate with law enforcement officials for certain law enforcement purposes as directed by a court order, warrant, criminal subpoena, or other lawful process.
To report abuse or neglect.
To support health oversight activities such as administrative or criminal investigations, inspections, licensure or disciplinary actions and other activities necessary for appropriate oversight of government benefit programs or functions including, but not limited to, complaints against providers and investigations of Medicare or Medicaid fraud.
When required to be given to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as required by law.
For company research, financial audit, program planning, evaluation, education or other routine uses.
When consistent with applicable law and standards if Happy and Smile reasonably believes the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat.
Disclosure for judicial or administrative proceedings.
State and Federal Laws may be more stringent than HIPAA and may prohibit certain uses and disclosures identified above.
Uses and disclosures that require your authorization.
In all other situations, your written authorization will be obtained before Happy and Smile will use or disclose your PHI to third parties. Third parties include everyone except the client, the guardian, Happy and Smile’s staff or others outside of our organization that are charged with the client’s care while providing services.