Purpose of this Notice

GCB respects the privacy of personal information and understands the importance of keeping this information confidential and secure. This Notice describes how we protect the confidentiality of the personal information we receive, how we may use and disclose it and how you can access this information. Please review it carefully.

Our Pledge to You

We understand that information we have about you is personal. We are committed to protecting that information. We create a record of the services you receive to provide quality care and to comply with legal requirements. This notice applies to all of the records that we maintain, whether created by our staff or by another agency or professional. We limit access to personal information to only those persons who need to know in order to provide treatment (such as sharing information about you with another professional who is part of your treatment team), obtain payment (such as sending billing information to your insurance company, Medicaid or Medicare) or to support operation functions (such as performing Quality Assurance reviews). We are required by law and our own code of ethics to keep personal information about you private, to provide you with this notice outlining our legal responsibilities and privacy procedures and to abide by the terms of this notice.

Disclosure of Personal Information

We may disclose any of the personal information we collect (as described above) as permitted by law. Other uses or disclosures of your information will be made only with your written authorization that you can revoke at any time to stop future disclosures (in accordance with our policy). Please be aware that we may receive and document information from other people about you without your authorization.

In the following situations, we may disclose information about you without your prior authorization (that may include HIV information and/or information about drug and alcohol treatment): when required by law (such as reporting suspected abuse/neglect), for public health activities (such as reporting vital statistics to the public health authority), for health oversight activities (such as audits), when relating to decedents (such as disclosing information to a coroner), for research purposes (such as providing outcomes information to the Ohio Department of Mental Health ), to avert threat to health or safety (such as sharing information with law enforcement) and for specific government functions (such as providing information to Medicaid).

Upon your request, we will provide a list of when and what disclosures of your personal information were made (after April 14th 2003) other than those noted in the categories above. Additionally, the list will not include disclosures for which we have your written authorization, that were made to you, or for national security purposes.

Your Rights regarding your Personal Information

• Unless your access is restricted for clear and documented treatment reasons, you can review your information upon written request.
• Our goal is to keep your information up-to-date and to correct inaccurate information. We have procedures by which you can request that personal information be corrected or updated (as long as the information was created by us.)
• We cannot limit disclosures that are required by law, but will consider any request to restrict uses of your information.
• In some cases, we may contact you for appointment reminders or for other health-related reasons. However, you can ask that we contact you via reasonable alternative methods.
• If you believe that any information that we have about you has been used or disclosed inappropriately you can contact:
  • our Privacy Officer, Amy Flesher, Privacy Officer, 1501 Madison Road, Cincinnati, OH 45206, (513) 354-7068, or
  • the Secretary of the US Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201 or call 1-877-696-6775

No retaliatory action will be made against you
for contacting the agents listed above.

Changes to this Notice

We may change our privacy policy from time to time. The effective date is listed just below the title. In accordance with the law, we will post any new notices in our facilities and on our Web site. You can receive a paper copy of the current Notice at any time at any of our locations.