It is the policy of Huckleberry House, Inc. that all members of our workforce will preserve the integrity and confidentiality of information about our clients while ensuring that we have sufficient information to provide the highest quality care. Huckleberry House will collect, use and disclose protected health information only in conformance with state and federal law and current client authorizations, as appropriate. Huckleberry House will not disclose protected health information unless the client (or his or her parent/guardian or his or her authorized representative) has properly permitted, consented to, or authorized the release, or the release is otherwise permitted by state or federal law. All members of Huckleberry House’s workforce must adhere to this policy. Violation of this policy is grounds for disciplinary action, up to and including termination of employment, termination of association or affiliation with Huckleberry House, and criminal, civil, or professional sanctions in accordance with Huckleberry House’s policies and procedures.
A copy of the Authorization Form and the Notice of Disclosure and Notice of Prohibition on Redisclosure form will be placed in the client’s record by records room staff.
The Privacy Officer will provide the reception office staff with an authorization to release information form for clients to complete when the client wants information maintained by Huckleberry House released. The blank authorization form may be mailed, e-mailed or faxed to the client at the client’s request. If the client currently has an open case, the Authorization To Release Confidential Information form can be accessed through the direct service staff and forwarded directly to the Program Supervisor for processing.
Reception office staff will ensure that the authorization form is completely and accurately filled out, dated, and signed by the client (or his or her parent/guardian or his or her authorized representative).
If necessary, reception office staff may request documentation from the client (or his or her parent/guardian or his or her authorized representative) to confirm the identity of the person authorized to consent. Any questions regarding identification, authenticity, capacity, signature or client representation should be referred to the Privacy Officer for prompt resolution.
Once the authorization form is completed, it will be forwarded by the reception office staff to the appropriate Program Supervisor for processing in accordance with its contents. Any questions regarding compliance with the client’s directives as contained on the authorization form should be referred to the Privacy Officer for resolution. The Privacy Officer may consult with the Client’s Rights Officer in order to promptly resolve any issues presented by the client’s directives on the authorization form.
After review by the Program Supervisor, the client information that is requested to be released on the form shall be promptly procured and duplicated by records room staff. Once prepared, the Notice of Disclosure and Notice of Prohibition on Redisclosure form shall be attached to the client information and returned to the Program Supervisor for final review. After final review, the documents shall be placed in a sealed envelope for mail, courier or personal delivery to the recipient identified by the client. In the alternative, information can be faxed to the recipient at the client’s request. The Notice of Privacy Practices will notify the client that the privacy of this alternative delivery method cannot be assured by members of Huckleberry House’s workforce. Prior to sending information via fax, records room staff will take reasonable steps to ensure that the fax number submitted by the client belongs to the recipient identified by the client.