Uses and Disclosures of Protected Information:

Horizons uses health information to maintain health and safety, to plan services, to implement those plans, and to seek reimbursement for health services. Horizons may also use health information to tell you about service alternatives or other health-related benefits and services. For example:

• Your individual Implementation Plan (IIP) is written, based in part, on your health information.
The IIP identifies you, is written about you, and states the type of care you need to remain safe and healthy.
• We may use information from your records to obtain payment for the services you receive.
• Horizons may share your information with your support coordinator, school, or other service providers.
• Horizons may share your information with a company that reviews service provider records to check on the quality of care that you receive.

Horizons may also use and disclose your health information as permitted by law, potentially including disclosures:

• To government agencies that determine eligibility or authorize services
• To government or private agencies that reimburse Horizons for your services
• For public health, such as disaster relief; disease control;or to report abuse, neglect, exploitation, or domestic violence
• For health oversight, such as inspections, investigations, and audits
• To avert a serious threat to health or safety of a person or the public
• To law enforcement; or in response to a court order, subpoena, or other legal process
• To a law enforcement officer or a correctional institution that has you in custody
• To the Federal Government for national security, protective services, military, or veterans activities
• To conduct research to benefit community rehabilitation services
• For worker's compensation or other similar programs
• To coroners, medical examiners, and funeral directors; and for organ donations
• To your family or other person who are involved in your medical care. (You have the right to object to disclosing this information if you are a legally competent adult.)
• As otherwise required by law

Other uses or disclosures of protected health information require your written authorization. If you give us your authorization, you may cancel it by notifying our Privacy Officer at the address listed below. If you cannot give your authorization due to an emergency, Horizons may release health information if it is in your best interest.

You have the following rights with respect to your protected health information:

• To see or obtain a copy of your health information that is maintained by Horizons. We may not be able to provide health information that includes psychotherapy notes, is part of a legal case, or is otherwise excluded from disclosure by law. We may charge a copying fee. Horizons has 30 days to provide access after receipt of your written request.
• To request that Horizons amend health information it maintains that is wrong or incomplete. Horizons will act within 60 days of your written request.
• To request a list of where Horizons has sent your health information since April 14, 2003. After April 14th, 2009, the list will include only disclosures made in the previous six years. The list may not include disclosures authorized by you; disclosures for treatment, payment, and health care operations; or other disclosures permitted by law. Horizons will provide the request within 60 days of your request. One accounting per year is free; thereafter a reasonable fee will be imposed.
• To request that Horizons respect your confidentiality when communicating with you. For example, if you want to receive appointment notifications at alternative phone numbers, please notify us.
• To request Horizons restrict the use and disclosure of certain information in your record that otherwise would be allowed for treatment, payment, or health care operations. However, we do not have to agree to these restrictions.
• To request another copy of this notice.
• To revoke your own written authorization of use or disclosure of health information.

We May Contact You:

• Horizons may contact you to provide appointment reminders or to provide information about treatment alternatives or other health related benefits and services that may be of interest to you.
• Horizons may contact you with information about treatment alternatives or other health-related benefits or services that may be of interest to you.
• Horizons may contact you to raise funds for Horizons. If you do not want Horizons to contact you for fundraising, provide the Privacy Official your name and state that you do not want to be contacted for the purpose of raising funds.

Privacy Official:

• Dr. Julie McNabb, Chief Operations Officer, (850) 863-1530, ext. 224