Consortium Privacy Practices

The Consortium Program
Effective Date: 2/10/17
Joint Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This Consortium Program Joint Notice of Privacy Practices applies to the following health care and other providers (also known as “covered entities”):

• Bay Cove Human Services, Inc
• The Boston Health Care for the Homeless Program, Inc. (BHCHP);
• Boston Public Health Commission.
• Boston Rescue Mission, Inc.;
• Casa Esperanza, Inc.;
• The New England Center and Home for Veterans; and
• Victory Programs, Inc.

The providers listed above have all agreed to be part of the “Consortium Program” where they will coordinate their care and services as an Organized Health Care Arrangement to better provide primary health care, mental health services, substance use disorder services, social services, and other important services for the Massachusetts homeless population. As part of the Organized Health Care Arrangement, the providers listed above (called the “Consortium Members” here) have created this Consortium Program Joint Notice of Privacy Practices to describe the use and disclosure of limited amounts of your health information while you are receiving services from the Consortium Program.
In addition to the Consortium Members, the following organizations are not covered entities but provide services integral to the Consortium Program as “Consortium Associates”:

• Massachusetts Housing and Shelter Alliance, Inc.; and
• Saint Francis House, Inc.

This Joint Notice of Privacy Practices will be updated in accordance with this notice if the list of Consortium Members or Consortium Associates changes.
This notice applies to any staff member, consultant, volunteer, or student at the Consortium Members. Sharing of your health information by any staff member, consultant, volunteer, and/or student must be in accordance with all Federal and State laws and regulations, specifically including the Privacy Standards associated with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Each Consortium Member complies with HIPAA and Massachusetts General Laws Chapters 93H and 93I.

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Consortium Members work in close collaboration with each other, Consortium Associates, and with health care clinics at some area shelters, hospitals, other facilities, and agencies. Collaborative planning of health care occurs in an organized manner and some medical information is entered into a shared record. However, each Consortium Member that treats you will have its own separate treatment record for you.
For a full list of sites at which the Consortium Members provide care and a full list of Consortium Program collaborations, see page 8 of this document.
If you have any questions about this notice, please contact the Consortium Members using the contact information on page 7 below.
Each Consortium Member keeps a record for each patient of the health care and other services provided. They are required by law to keep your health information private and to notify you promptly if a breach occurs that may have compromised the privacy and security of your information. They are also required by law to notify patients of our legal duties and privacy practices used to keep your health information private. The Consortium Members are required to obey the Joint Notice of Privacy Practices and to give you a copy.

Typical Uses and Disclosures of Health Information

The Consortium Members may use and share your health information for treatment, payment, and health care operations without obtaining your specific permission (authorization).

• Treatment: The people involved in your care at the Consortium Members and Consortium Associates may use and share your health information to provide you with treatment or services. For example, a Consortium Member may use and share your health information for contacting you with a reminder that you have an appointment, getting you on a housing list prioritized for people with certain health diagnoses, and telling you about health related benefits or services that may be of interest to you.
• Payment: Consortium Members may use your health information to bill for their services and to collect for their services. For instance, your insurance, Medicare, MassHealth, or veteran-related benefits can request to see copies of your record to verify services you received. Another example is that Consortium Members may be required to share information with your payer to obtain prior approval for your treatment.
• Health Care Operations: Health care operations are the functions that all health care providers and payers perform to verify that the delivery of care to patients is being properly performed and that the provider/payer is functioning properly. One example of this is chart review to evaluate staff performance. Another example is chart review in the medical records department or by the Medical Records Committee to verify that all records are completed according to legal requirements.

Uses and Disclosures Without Your Authorization

In addition, the Consortium Members may use and share your health information for the following purposes without obtaining your specific authorization.

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• As Required by Law or Legal Authorities: The Consortium Members may use or disclose your health information, including your condition and the fact that you are being treated, for those uses or disclosures required by federal, state or local law. For example, a Consortium Member may disclose your information to the federal Department of Health and Human Services if it is investigating the Consortium Member’s compliance with privacy laws.
• Public Health and Safety Issues: The Consortium Members can share your health information for certain situations such as preventing disease, helping with product recalls, reporting adverse reactions to medications, or reporting suspected abuse, neglect, or domestic violence to the appropriate agencies.
• Certain Government Requests: The Consortium Members can share health information for certain government purposes, such as for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, or for special government functions such as military, national security, and presidential protective services.
• Medical Emergencies: If a situation arises where a Consortium Member believes there is a serious and imminent threat to a person’s health or life and which requires immediate intervention, they may share health information to lessen the threat.
• Lawsuits and Legal Requests: A Consortium Member can share health information in response to a subpoena, court order, or administrative order.
• Medical Examiners and Funeral Directors: A Consortium Member can share health information with a coroner, medical examiner, or funeral director.
• Research: Under certain circumstances, we may share health information about you for research purposes; however, we will do this only through a special review process. If a researcher will have access to your name, address, or other information that reveals who you are, we will ask for your authorization or get approval from an Internal Review Board.
  Permitted Release of Health Information Unless You Decline
  For the following uses and disclosures, a Consortium Member will attempt to give you an opportunity to agree to or prohibit/restrict the use or disclosure; in general, they will comply with your preferences. If a Consortium Member does not know your preferences, however, such as in an emergency situation where you are unconscious, they may go ahead and share the information if they believe it is in your best interest.
• Disaster Relief: A Consortium Member may share your health information with legally authorized public or private disaster relief organizations.
• Individuals Involved in Your Care or Payment for Your Care: A Consortium Member may share your medical information, including your condition and the fact that you are being treated, to friends or family members who are involved in your care or payment for your care.

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Other Sharing of Medical Information

Sharing of your health information for any other reason, such as for marketing purposes, sale of information, and most sharing of psychotherapy notes, will be done only with your written permission (authorization). If you provide written authorization for a Consortium Member to share your medical information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, the Consortium Member will no longer share your health information for that purpose; however, the Consortium Member cannot take back any information they have shared in reliance on your authorization.
Please note that by signing the initial authorization to participate in the Consortium Program, in addition to authorizing the Consortium Members and Consortium Associates to use and share your health information amongst themselves, you are also authorizing the City of Boston, Department of Neighborhood Development to use and disclose such information on its own for limited purposes. More specifically, the City is providing the Consortium Program with network functionality to support collaboration and coordination activities by hosting your information on its servers. Through this arrangement, the City will also be permitted to use and disclose your information to maintain its database of individuals who are potentially eligible to receive housing assistance. Furthermore, to participate in the Consortium Program, you will need to sign the authorization for the City’s corresponding Homeless Management Information System (HMIS) network, to which the consortium network is linked.

Substance Abuse Information

If you receive alcohol and/or drug prevention and treatment services, your medical records that identify you as receiving those services are protected not only by HIPAA, but also by the federal Substance Abuse and Mental Health Services Administration confidentiality law. This law provides additional safeguards to protect the privacy of these records and requires your written consent except for certain disclosures, such as to medical personnel in a medical emergency, to report suspected abuse or neglect or a crime on the premises, for certain audit purposes, or pursuant to a court order.

Your Rights Regarding Your Medical Information

Each Consortium Member operates independently from the others with respect to its responsibilities for your health information, which are described below. Therefore, to exercise your rights for an individual Consortium Member, you must provide a written request to that specific Consortium Member using the contact information on page 10 below. Any requests or complaints to one Consortium Member will not be deemed to be filed with any of the other Consortium Members.

• Right to Inspect and Copy: You have the right to inspect and receive a copy of your medical record and other health information that may be used to make decisions about your care, usually within 30 days of your request. If you request a copy of the information, the Consortium Member may charge a fee for the costs of copying, mailing, and supplies used.

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The Consortium Member may deny your request to inspect and copy in certain limited circumstances. In some of these circumstances, you can have another licensed health care professional chosen by the Consortium Member review the initial denial and possibly overturn it. The person conducting the review will not be the person who denied your request.
If the Consortium Member denies your request to access a copy of your psychotherapy records, you may request that the Consortium Member release a copy of your psychotherapy records to another psychotherapist of your choice or your attorney.

• Right to Amend: If you feel that the medical information a Consortium Member has about you is inaccurate or incomplete, you have the right to request the Consortium Member to amend your record for as long as the information is kept by (or for) the member.
  The Consortium Member can deny your request for amendment in certain circumstances. If the member denies your request, it will tell you why in writing within 60 days.
• Right to an Accounting of Disclosures: You have the right to request an accounting of disclosures, which is a list of the times a Consortium Member shared your health information with others, except for those times they shared your information for treatment, payment, and health care operations, and certain other disclosures (for example, where you asked the Consortium Member to share the information on your behalf). The list will include information on when the Consortium Member shared your information with a third party, who they shared it with, and why.
  The accounting of disclosures list will go back a maximum of six years from the date of your request. The first list you request within a 12-month period will be free. For additional requests within that 12-month period, the Consortium Member may charge you a reasonable, cost-based fee for the costs of providing the list.
• Right to Request Restrictions: You have the right to request a restriction on the medical information a Consortium Member shares about you for treatment, payment, or health care operations.
  In general, the Consortium Member is not required to agree to your request, especially if the restriction would affect your care. However, the Consortium Member is required to agree to your request in the situation where you have paid for the health care item or service out-of-pocket in full, and the restricted disclosure would be to a health insurer for the purpose of carrying out payment or health care operations and is not otherwise required by law.
• Right to Request Confidential Communications: You have the right to request that a Consortium Member communicate with you about health information in a certain way or at a certain location. For example, you can ask that the member only contact you at work or by mail. The Consortium Member will accommodate all reasonable requests.
• Right to Have Someone Else Act for You: If you have given someone medical power of attorney or they are your legal guardian, that person may exercise all of your rights described in this notice and make

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choices about your health information. The Consortium Members will make sure the person has this authority and can act for you before they take any action.

• Right to a Paper Copy of This Notice: You have the right to obtain a paper copy of this notice at any time upon request. You may also obtain a copy of this notice at the Consortium Member’s website or by other electronic means, i.e. E-Mail. Even if you have chosen to obtain this notice electronically, you are still entitled to a paper copy of this notice.
• Right to Complain: If you feel that your privacy rights have been violated, you may file a complaint with that Consortium Member by filing a grievance in accordance with the Consortium Member’s Grievance Procedure.
  You may also notify the Office for Civil Rights at the Health and Human Services by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.You cannot be penalized for filing a complaint.

Notice Changes

The Consortium Members reserve the right to revise or change this notice as changes in the law allow. They reserve the right to make the revised or changed notice effective for both the health information the Consortium Members already have about you or any information they receive in the future. The new notice will be available upon request, in the members’ facilities, and on their websites.

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Consortium Member Contact Info:
The Boston Health Care for the Homeless Program, Inc.:
BHCHP
780 Albany Street
Boston, MA 02118
Attn: Compliance Officer

Bay Cove Human Services, Inc.:
Bay Cove Human Services, Inc.
66 Canal Street
Boston, MA 02114
Attn: Privacy Officer

Boston Rescue Mission, Inc.:
Boston Rescue Mission
39 Kingston Street
Boston, MA 02111
Attn: Privacy Officer

Casa Esperanza, Inc.:
Casa Esperanza
245 Eustis Street
P.O. Box 191540
Roxbury, MA 02119
Attn: Privacy Officer

The New England Center and Home for Veterans:
The New England Center and Home for Veterans
17 Court Street
Boston, MA 02108
Attn: Privacy Officer

Victory Programs, Inc.:
Victory Programs
965 Massachusetts Avenue
Boston, MA 02118
Attn: Privacy Officer

Boston Public Health Commission:
Boston Public Health Commission
1010 Massachusetts Avenue, #2
Boston, MA 02118
Attn: Privacy Officer

Consortium Associates:
 Massachusetts Housing and Shelter Alliance
 Saint Francis House, Inc.

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Consortium Sites and Collaborations
 Bay Cove Human Services, Inc. including, without limitation, Bay Cove Treatment Center (Methadone Treatment), Boston Night Center, Andrew House Detox, Center for Change (Adult Day Health), New Hope Transitional Support Services, and the Cardinal Medeiros Center.
 Boston Health Care for the Homeless Program/McInnis Health Group including, without limitation, its sites, programs and services without limitation, 780 Albany Street (Admin. Offices), Anchor Inn, Asian Task Force Against Domestic Violence, Barbara McInnis House, Beacon Townhouse Inn #2,Beth Israel Hospital, Boston Medical Center, Boston Family Shelter, Boston Living Center, Brigham & Women’s Hospital, Brookview House, Cambridge Health Alliance/Cambridge Health Care for the Homeless, Cardinal Medeiros Center, Carolina Hills Shelter, Casa Nueva Vida, Church of Advent, Crittenton Women’s Union, Crossroads, Dove, Entre Familia, Families in Transition, Father Bill’s Place, Finex House, Friends of the Homeless of the South Shore, Hildebrand Family Shelter I & II, Hopefound, including Stay-In Beds and Transitional Living Program, Housing Families, BMC Clinic/Jean Yawkey Place Clinic, Kingston House, Kit Clark, Latinas y Ninas, Lindemann Mental Health Center, Margaret’s House, Massachusetts General Hospital, Massachusetts Mental Health Center, Millennium House #1 & 2, Nazareth Residence, Temporary Home for Women and Children (“New Chardon Street Shelter”), Pilgrim Shelter, Pine Street Inn (and its programs and services, including, without limitation, Pine Street Inn at Shattuck Hospital), Project Hope, Queen of Peace Shelter, Renewal House, Revision House, Rosie’s Place, Safe Harbor, SOAR, Sojourner House, Supportive Place for Observation and Treatment (or “SPOT”), St. Ambrose, St. Anthony Shrine, St. Mary’s Center for Women and Children (and its programs or services, including, without limitation, Bridge Home, Margaret’s House), St. Patrick Women’s Shelter, Stacy Kirkpatrick House, Tufts Medical Center, Transition House, Outreach (including, without limitation, scattered site apartments, motels [temporary placements}, mobile vans, schools and day care facilities [including Horizons for Homeless Children, Above and Beyond, and others]), Transitions, and Women’s Lunch Place.
 Boston Public Health Commission including, without limitation, Woods Mullen Shelter, 112 Southampton Shelter, PAATHS, Transitions, Wyman Program, and 1010 Massachusetts Avenue
 Boston Rescue Mission/Kingston House
 Casa Esperanza
 New England Center and Home for Veterans
 St. Francis House
Victory Programs including without limitation, Women’s Hope, Living and Recovery Community, LARC, Victory House; New Victories, Shepherd House, New Joelyn’s Home, Boston Living Center, and Victory Housing on Warren Street

Sitios y colaboradores del Consorcio

• Bay Cove Human Services, Inc. incluyendo, sin limitación, Bay Cove Treatment Center (Tratamiento con metadona), Boston Night Center, Andrew House Detox, Center for Change (Centro de día para adultos), New Hope Transitional Support Services y el Cardinal Medeiros Center.
• Boston Health Care for the Homeless Program/McInnis Health Group incluyendo, sin limitación, sus sitios, programas y servicios entre otros, 780 Albany Street (Oficinas administrativas), Anchor Inn, Asian Task Force Against Domestic Violence, Barbara McInnis House, Beacon Townhouse Inn #2,Beth Israel Hospital, Boston Medical Center, Boston Family Shelter, Boston Living Center, Brigham & Women’s Hospital, Brookview House, Cambridge Health Alliance/Cambridge Health Care for the Homeless, Cardinal Medeiros Center, Carolina Hills Shelter, Casa Nueva Vida, Church of Advent, Crittenton Women’s Union, Crossroads, Dove, Entre Familia, Families in Transition, Father Bill’s Place, Finex House, Friends of the Homeless of the South Shore, Hildebrand Family Shelter I & II, Hopefound, incluyendo Stay-In Beds y Transitional Living Program, Housing Families, BMC Clinic/Jean Yawkey Place Clinic, Kingston House, Kit Clark, Latinas y Ninas, Lindemann Mental Health Center, Margaret’s House, Massachusetts General Hospital, Massachusetts Mental Health Center, Millennium House #1 & 2, Nazareth Residence, Temporary Home for Women and Children (“New Chardon Street Shelter”), Pilgrim Shelter, Pine Street Inn (y sus programas y servicios, incluyendo, sin limitación, Pine Street Inn en Shattuck Hospital), Project Hope, Queen of Peace Shelter, Renewal House, Revision House, Rosie’s Place, Safe Harbor, SOAR, Sojourner House, Supportive Place for Observation and Treatment (o “SPOT”), St. Ambrose, St. Anthony Shrine, St. Mary’s Center for Women and Children (y sus programas o servicios, incluyendo, sin limitación, Bridge Home, Margaret’s House), St. Patrick Women’s Shelter, Stacy Kirkpatrick House, Tufts Medical Center, Transition House, Outreach (incluyendo, sin limitación, apartamentos aislados, moteles [ubicaciones temporarias], camionetas, escuelas y guarderías [incluyendo Horizons for Homeless Children, Above and Beyond y otros]), Transitions y Women’s Lunch Place.

• Boston Public Health Commission incluyendo, sin limitación, Woods Mullen Shelter, 112 Southampton Shelter, PAATHS, Transitions, Wyman Program y 1010 Massachusetts Avenue
• Boston Rescue Mission/Kingston House
• Casa Esperanza
• New England Center and Home for Veterans
• St. Francis House
• Victory Programs incluyendo, sin limitación, Women’s Hope, Living and Recovery Community, LARC, Victory House; New Victories, Shepherd House, New Joelyn’s Home, Boston Living Center y Victory Housing on Warren Street.