FAMILY SERVICE OF GLENCOE
We maintain a policy of strict compliance with both state and federal confidentiality laws. No confidential health or service information will be released to or obtained from other persons, organizations, agencies or other third parties without your informed written consent, unless in response to a court order or otherwise required by law.
How Family Service of Glencoe May Use Your Information
Pursuant to Illinois and federal law, Family Service of Glencoe is permitted to use and disclose your health information without your consent under the following circumstances:
For Service Delivery. We will use your health and service information to provide, coordinate, or manage the services we will provide to you. The minimum amount of information necessary to accomplish goals of service may be disclosed to supervisors, other treatment team members, consultants, and administrators. We will use and disclose information to recommend possible alternative services that may be of benefit to you.
For Payment. We may use and release your health and service information to receive payment from you, your insurance company or other funding source. Family Service of Glencoe will only disclose the minimum amount of protected information necessary to obtain reimbursement for the services delivered to you.
For Business Operations. We may use your health information to conduct a quality assessment of our programs and to improve our services. We may also use your health information for case management or service coordination. Information that does not contain your name may also be used for training purposes.
For Reporting Child Abuse or Elder Abuse. Service providers with reasonable cause to believe that a child may have been subject to abuse or neglect are required by law to report their observations to the Illinois Department of Children and Family Services. Elder abuse reports are made to the Illinois Department on Aging.
For Reporting Risk of Harm to Self and Others. Service providers with reasonable cause to believe that a risk exists of serious, immediate, physical or emotional injury or death may inform law enforcement agencies and other individuals who may be affected by the threatened action.
For Research. We may use and release your health information to researchers, in limited circumstances, provided that the research proposal has been approved by an institutional review board and protocols have been established to ensure the privacy of your information and with your consent.
As Required By Law. We may release your health information without your authorization pursuant to a court order or as otherwise required by law.
Your Service Information Rights
You have the following rights under Illinois and federal law:
Right to Copy and Inspect Your Record. With limited exceptions, you have the right to inspect and ask for a photocopy of the records Family Service of Glencoe has generated about you.
Right to Restriction of Record. You may ask us not to use or disclose part of the record. This request to restrict must be made in writing and submitted to Family Service of Glencoe. Family Service of Glencoe is not required to agree to the request if we feel that it is in your best interest to permit disclosure of the information.
Right to Confidential Communications. You have the right to request how we communicate with you to preserve your privacy. You may, for example, request that we only call you at work or by a private email, instead of a work email. Your request must be made in writing to Family Service of Glencoe. Family Service of Glencoe will accommodate any reasonable requests.
Right to Amend Record. You may request that we amend your records by adding or deleting certain information that is incomplete or inaccurate. This request must explain why you want the record amended, and it must be made in writing to Family Service of Glencoe. Family Service of Glencoe may deny your request if the record was not created by Family Service of Glencoe, if the person who created the information is no longer available to make the amendment, or for certain other reasons. You may then respond with a statement of disagreement which will be added to your records. If we grant the request, we will also make a reasonable effort to, with your written authorization, inform others that the amendment has been made.
Right to Copy of Privacy Notice. You are entitled to obtain a paper copy of this notice upon request, even if you have agreed to receive this notice electronically.
NOTE: Family Service of Glencoe reserves the right to change this notice based on changes in policy and applicable law.
Family Service of Glencoe
675 Village Court