Notice of privacy practices

Privacy promise

The Greene County Board of Developmental Disabilities understands that your personal information needs to be kept private. Protecting your personal information is important. We follow strict federal and state laws that require us to keep your personal information confidential.

How we use your personal information

When you receive services from the DD Board, we may use your personal information for such activities as providing you with services, billing for services, and conducting our normal board business.

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 the DD Board. For example, your service and support administrator keeps notes on all contacts made in coordinating and arranging for services. If you see a nurse working for the DD Board, the nurse will keep records of any care you receive. DD Board staff may share personal information while helping to develop your service plan.

If DD Board staff wants to share your personal information with anyone who is not employed by the DD Board, you must give them written permission first.

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. The DD Board 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 the DD Board. 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 the DD Board
Recommend to you service alternatives and other possible benefits
Tell you about other service providers who may be able to help you
Remind you of an appointment unless you tell the DD Board staff that you do not wish to be reminded
To allow the DD Board to review direct service contracts
Allow local, state, federal agencies to monitor your services
To investigate incidents affecting health and safety, to report these kinds of incidents and to take steps to protect your health and safety
To allow the DD Board 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 the DD Board 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:

Contact the DD Board at (937) 562-6500 or 245 Valley Road, Xenia, Ohio 45385

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:

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, 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

All other uses and disclosures, not described in this notice, require your signed authorization. You may revoke your authorization at any time with a written statement.

Your individual rights

You have the right to:

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.*
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. 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. Your request must state the period of time desired for the accounting, which must be within the 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 the DD Board for the appropriate form for your request.

Our Privacy Responsibilities

The DD Board 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 the DD Board facilities. You may also request a copy of any notice from the DD Board.

Our Organization

This notice describes the privacy practices of the Greene County Board of DD (the DD Board). This notice also describes the privacy practices of persons or entities which have signed a contract with the DD Board and which are acting as business associates, and have promised to follow the same rules of confidentiality.

The DD Board includes

Greene, Inc., Four Oaks Early Intervention, Homecroft, Inc., Community Services, the Administration as well as DD Board employees and volunteers at those facilities.

If you want to know about the privacy practices of service providers who are not employed by the DD Board and who are not business associates, you should contact them directly.

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 DD Board:
John LaRock, Superintendent
Greene County Board of DD
245 Valley Road
Xenia, Ohio 45385
(937) 562-6500

We will investigate all complaints and will not retaliate against you for filing a complaint. You also may file a written complaint with either:

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.
The office for 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 www.ocrmail@hhs.gov.