This notice describes how personal information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Organization
This notice describes the privacy practices of the Marion County Board of Developmental Disabilities (MCBDD). This notice also describes the privacy practices of persons or entities which have signed a contract with MCBDD and which are acting as business associates, and have promised to follow the same rules of confidentiality.
MCBDD includes employees and volunteers at those facilities.
If you want to know about the privacy practices of service providers who are not employed by MCBDD and who are not business associates, you should contact them directly.
Privacy Promise
MCBDD understands that your personal information needs to be kept private. Protecting your personal information is important. We follow strict federal and state laws that requires us to keep your personal information confidential.
How We Use Your Personal Information
When you receive services from MCBDD, we may use your personal information for such activities as providing you with services, billing for services, and conducting our normal board business known as health care operations.
If you have chosen a personal representative and have agreed to let your personal representative obtain your personal information, we will provide the information to your personal representative. If you have a guardian we will provide the information to your guardian.
Examples of how we use your information include:
Treatment-We keep records of the care and services provided to you within MCBDD. For example, your service and support administrator (SSA) keeps notes on all contacts made in coordinating and arranging for services. If you see a nurse working for MCBDD, the nurse will keep records of any care you receive. MCBDD staff may share your personal information while helping to develop your service plan.
If MCBDD staff want to share your personal information with anyone who is not employed by MCBDD, you must give them written permission first. However, we may disclose your identity without your permission if necessary for your treatment or to obtain payment for services.
Some personal records, including confidential communications with a mental health professional and substance abuse records, may have additional restrictions for use and disclosure under state and federal law.
Payment-We keep records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment for your services from Medicaid, insurance or other sources. For example, we may disclose personal information about the services provided to you to confirm your eligibility for Medicaid and to obtain payment from Medicaid. MCDD may use your personal information to determine the amount and type of Medicaid services you need and send this information to the proper state department.
Health Care Operations- We use personal information to improve the quality of care, train staff, manage costs, conduct required business duties, and make plans to better serve you and other individuals enrolled in MCDD. For example, we may use your personal information to evaluate the quality of treatment and services provided by our service staff.
Other Services We Provide
We may also use your personal information to:
- Determine whether you are eligible
for services from MCBDD; - Recommend to you service
alternatives and other possible benefits; - Tell you about other service providers
who may be able to help you; - Allow MCBDD to review direct service
contracts; - Determine whether the waiting lists
are being kept in accordance with Ohio law; - Allow local, state, federal agencies
to monitor your services; - Investigate incidents affecting
health and safety, to report these kinds of incidents and to take steps to
protect your health and safety; - Allow MCBDD to prepare reports
required by the Ohio Department of Developmental Disabilities and the Ohio
Department of Job and Family Services; - Contact you for assistance in
passing levies, unless you notify MCBDD that you do not wish to be
contacted for these purposes; - Contact you for assistance for other
fund raising activities, unless you notify MCBDD that you do not wish to
be contacted for these purposes.
More Information
For more information about the practices and rights described in this notice:
- Visit our website at
marioncountydd.org. - Contact MCBDD at the phone number
and address on the back of this notice.
When You Must Provide Written Authorization
You sign a written authorization for all of the following:
- Any disclosure not listed as an
exception in this notice. - Most uses and disclosures of
psychotherapy notes, which are notes of private conversations between you
and your counselor or in a group counseling session. - All uses and disclosures for
marketing purposes. - Disclosures that constitute a sale
of your Personal Information.
Sharing Your Personal Information
There are limited situations when we are permitted or required to disclose personal information without your signed authorization. These situations are:
- We may disclose your identity, if
necessary, for your treatment or to obtain payment for services. - To protect victims of abuse,
neglect, or domestic violence. - To reduce or prevent a serious
threat to public health and safety; - For health oversight activities such
as investigations, audits, and inspections; - For lawsuits and similar
proceedings; - For public health purposes such as
reporting communicable diseases, work-related illnesses, or other diseases
and injuries permitted by law; reporting births and deaths, and reporting
reactions to drugs and problems with medical devices; - When required by law;
- When requested by law enforcement as
required by law or court order; - To coroners, medical examiners, and
funeral directors; - For organ and tissue donation;
- For workers’ compensation or other
similar programs if you are injured at work and are covered by workers’
compensation or other similar programs; - For specialized government functions
such as intelligence and national security; - For children attending school, proof
of immunization will be provided to your school district without the need
for a signed authorization, but the school must obtain your consent in
some form, including oral consent.
All other uses and disclosures, not described in this notice, required your signed authorization. You may revoke your authorization at any time with a written statement.
Our Privacy Responsibilities
MCBDD is required by law to:
- Maintain the privacy of your
personal information - Provide this notice that describes
the ways we may use and share your personal information - Follow the terms of the notice
currently in effect.
We reserve the right to make changes to this notice at any time and make the new privacy practices effective for all information we maintain. Current notices will be posted in MCBDD facilities and on our website at marioncountydd.org. You may also request a copy of any notice from MCBDD Privacy Officer.
Your Individual Rights
You have the right to:
- Receive notifications on breaches of
your unsecured protected health information. Your will receive such
notifications if any occur. - Request restrictions on how we use
and share your personal information. We will consider all requests for restrictions
carefully but are not required to agree to any restriction. - Require restrictions on certain
disclosures of protected health information to a health plan when you have
paid out of pocket in full for the health care item of service. * - Request that we use a specific
telephone number or address to communicate with you. - Inspect and copy your personal
information, including service, medical and billing records. You may
request your personal information in electronic format. Fees may apply.* - Request corrections or additions to
your personal information. You must give the reasons for wanting the
change.* - Request an accounting of certain
disclosures of your personal information made by us or by Business
Associates who are working for us. Your request must state the period of
time desired for the accounting. You may ask for an accounting of
disclosures made at least three years prior to your request, and in some
cases disclosures made for six years prior to your request. The first
accounting is free but a fee will apply if more than one request is made
in a 12-month period. * - Request a paper copy of this notice
even if you agree to receive it electronically.
Requests marked with a star (*) must be made in writing.
Contact MCBDD Privacy Officer for the appropriate form for your request.
Contact Us
If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision that we made about access to your personal information:
Contact the Marion County Board of Developmental Disabilities
Julie Cummins, SSA Director
2387 Harding Highway
Marion, Ohio 43302
(740)375-6138
We will investigate all complaints and will not retaliate against you for filing a complaint.
You also may file a written complaint with any of the following:
- The Secretary of the U.S. Department
of Health and Human Services at 200 Independence Avenue SW, Washington
D.C., 20201 or call 1/877/696/6775; or - The Office of Civil Rights, U.S.
Department of Health and Human Services at 200 Independence Avenue SW,
Room 509F, HHH Building, Washington D.C., 20201 or call OCR’s
hotline—voice at 1/800/368/1019, or e-mail at ocrmail@hhs.gov. - Attorney General for State of Ohio,
30 E. Broad Street, 17th Floor, Columbus, Ohio 43215 or by
e-mail at ohioattorneygeneral.gov/Contact