Online Privacy Statement
Metropolitan Family Services is committed to the confidentiality and privacy of your personal information. We do not sell, distribute or otherwise disclose your personal information to third parties of any kind.
At Metropolitan Family Services, we are committed to protecting the privacy and the confidentiality of your records. This notice has been prepared in response to federal regulations that enforce the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The regulations contain legal requirements regarding how we must protect your health and service records.
This Notice describes how medical, mental health and social service information about you may be used and disclosed and how you can get access to this information. Please review it carefully. It will help you understand your rights as a recipient of services.
We maintain a policy of strict compliance with State and Federal confidentiality laws including the Illinois Domestic Violence Act, DCFS Title 89 Confidentiality Rules, HIPAA, and the Mental Health and Developmental Disabilities Act 740 ILCS 110. No protected health and service information will be released to or requested from other persons, organizations, agencies or other third parties without your informed written consent, except in response to a court order or as otherwise required by law, and/or to protect you and others from injury, abuse or neglect as provided below.
YOUR SERVICE INFORMATION RIGHTS
To Review and Copy Your Records - You have the right to review your records with sufficient notice for as long as we maintain your record. Your record includes medical, mental health and billing records, as well as any other records we use in providing services to you. You are entitled to a copy of your records and may be charged a fee for copying and mailing. You may request that your information be released to anyone of your choosing. You may request that information be sent to alternative addresses and in alternative formats.
To Obtain an Accounting of the Information Released From Your Record - You have the right to request a list of the disclosures of your protected information that we have made outside of Metropolitan Family Services. Your request must be made in writing to the Metropolitan Family Services Privacy Officer. The request must state the time period of the disclosures. You may request an accounting for disclosures made after April 14, 2003 and for a period of time not greater than six years.
To Request Amendments to Your Record - If you believe something in your record is incorrect or incomplete, you may request that it be amended. This request must be made in writing to the Metropolitan Family Services Privacy Officer. Your request must state exactly what information is incomplete or inaccurate and your reasoning that supports your request. We will provide you with a timely response. We are permitted to deny your request if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend information that:
- Was not created by Metropolitan Family Services, or if the person who created the information is no longer available to make the amendment
- Is not a part of the information maintained by or for Metropolitan Family Services
- We believe is accurate and complete
In cases where we deny a request, you may write a statement that you disagree with us. We will then add our response and your statement to the record. With your written permission, we will also make reasonable efforts to inform those people that have received the challenged information that an amendment has been made.
To Request Restrictions - You have the right to ask us to restrict or limit the information we use or disclose about you for delivery of services, payment or business operations. We are not required to agree to your request. If we do agree, we will comply with your request unless there is an emergency or we are otherwise required by law to disclose information.
To Request Confidential Communications - You have the right to request how we communicate with you to preserve your privacy. For example, you may request that we only call you at work or by mail at a special address or post office box instead of your home address. Your request must be in writing and must specify how or where we are to contact you. We will accommodate all reasonable requests.
HOW WE MAY USE YOUR INFORMATION
For Service Delivery - We will use your protected health and service information to provide, coordinate, or manage the services we will provide to you. The minimum amount of protected information necessary to accomplish treatment goals may be disclosed to supervisors, other treatment team members, consultants and administrators.
For Payment - Upon receipt of written consent, we may use and disclose you protected health and service information so that we can receive payment from you, your insurance company or other funding sources. The minimum amount of protected information will be disclosed to secure reimbursement for the services delivered to you. For example: we may disclose information that identifies you, your diagnosis and the services that you received.
For Business Operations - We may use your protected information to support our business activities and to improve the quality of our services. For example: we may use your records when evaluating the services you received. We may also disclose your protected information to health oversight and accrediting agencies and for activities authorized by law such as audits, investigations, inspections and licensure. Examples include the following:
- Governmental Entities - We are required to share protected information with State and Federal governmental entities to determine our compliance with federal and state laws related to health care. To coordinate care and avoid service complications, MFS programs receiving state or federal funding can share information about your diagnosis, medication and a description of services with other service providers associated with your care.
- Appointments and Communication - We may contact you at the phone number you provided with regard to appointments, treatment and/or other issues that relate to the services you are receiving.
- Training and Fundraising - Protected information that does not contain your personal identifiers may be disclosed for training and fundraising purposes.
- Business Associates - There are some services provided at Metropolitan Family Services through a third party "business associate". Examples include financial auditors, answering services, and psychiatrists. Whenever service delivery to you requires the use or disclosure of your protected information, Metropolitan Family Services will have a written contract that contains terms to protect the privacy of your service information.
For Reporting Child and Elder Abuse - Staff with reasonable cause to believe that a child may be subjected to abuse or neglect are required by law to report this to the Illinois Department of Children and Family Services. Staff with reasonable cause to believe that an older person, who is incapable of seeking assistance because of some dysfunction, has been subjected to abuse or neglect are required by law to report this to the Illinois Department on Aging or one of its elder abuse provider agencies.
For Reporting Risk of Harm to Clients and Others - Staff with reasonable cause to believe that a risk exists of serious, immediate, physical or emotional injury or death may inform law enforcement agencies and persons who may be affected by threatened action. Staff may also take steps to facilitate or secure the client’s hospitalization, if warranted. Criminal activity on our premises may require the sharing of information with law enforcement agencies.
For Continuous Quality Improvement - Continuous Quality Improvement (CQI) or "Peer Review" is another valuable process that Metropolitan Family Services uses to improve services. CQI activities may include the review of client records. Some of the findings may be published for use within and outside of Metropolitan Family Services but your name and other information that would identify you will not be used in any publications and reports.
For Research - We may use and disclose your protected information to researchers provided the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
CLIENT COMPLAINT AND GRIEVANCE
Your rights of grievance are protected in accordance with the Illinois Medical Patient Rights Act 410 ILCS 50. There will be no retaliation if you file a complaint.
Confidentiality and Privacy Complaints - If you want to file a privacy or confidentiality complaint with Metropolitan Family Services or have any questions regarding your privacy rights or the information in this notice, please contact the Metropolitan Family Services Privacy Officer by mail or phone:
Metropolitan Family Services
Attn: Privacy Officer
1 North Dearborn, Suite 1000
Chicago, IL 60602
If you believe that Metropolitan Family Services has violated your privacy rights, you may file a complaint with the Office of Civil Rights, U.S. Department of Health and Human Services at the following address:
Office for Civil Rights
U.S. Department of Health and Human Services
233 North Michigan Avenue, Suite 240
Chicago, IL 60601
312-886-2359 or TDD at 312-353-5693
Metropolitan Family Services Client Grievance Procedures - Metropolitan Family Services provides internal procedures to address client complaints. We encourage you to express any concern about the services you receive to your service provider as soon as they arise. You can expect to have a satisfactory response from the provider of your service following a complaint and if not satisfied, a Supervisor is available to address your concerns. If you are still not satisfied after supervisory contact, you can expect the involvement of the following individuals willing to address your concern. Listed in rising authority they include Manager, Executive Director, Chief Operating Officer and President who has final decision authority. You can expect a written response from Metropolitan Family Services regarding your grievance. Metropolitan Family Services maintains grievance records for qualitative review.
Fundamental Client Rights - Metropolitan Family Services will not discriminate against a service recipient or applicant for services because of race, disability, color, creed, religion, sex, age, national origin, ancestry, citizenship, veteran status, sexual orientation or other related factors and legally protected characteristics.
- Clients have the right to be free from abuse, neglect and exploitation.
- Clients will have mental health services provided in the least restrictive setting.
- Clients have the right not to be denied, suspended or terminated from services or have services reduced by exercising any rights.
- Clients have the right to contact the public payer or insurer of payment regarding a grievance or complaint. An agency staff will assist clients to access appropriate resources and to facilitate contact.
- Clients have the right to accommodation for their disabilities as required by the American With Disabilities Act, section 504 of the Rehabilitation Act and the Human Rights Act [775 ILCS 5]
Access to Advocacy and Rights Organizations - In order to safeguard your rights as a recipient of mental health and other services, staff is available to offer you assistance in contacting any of the following agencies regarding your concern about rights:
Equip for Equality
20 North Michigan Avenue, Suite 300
Chicago, IL 60602
Guardianship and Advocacy Commission
160 N La Salle StreetSuite S500
Chicago Illinois 60601
312-793-5900 IllinoisChicago, Illinois 60607
Department of Human Services
401 South Clinton Street
Illinois Department of Children and Family Services
100 West Randolph St, 6th Floor
Chicago, Illinois 60601
Illinois Office of Inspector General (For Clients Funded By Medicaid Only)160 N. LaSalle
Chicago, IL. 60601
1-800-368-1463200 Independence Avenue, S.W.
The U.S. Department of Health and Human Services
Washington, D.C. 20201
Toll Free: 1-877-696-6775
Last Revised 8/15/2012