Notice of Privacy Practices

Your Information. Your Rights. Our Responsibility.

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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record.

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record.

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say "no" to your request, but we will tell you why in writing within 60 days.

Request confidential communication.

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say "yes" to all reasonable requests.

Ask us to limit what we use or share.

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless the law requires us to share that information.

Get a list of those with whom we've shared your information.

  • You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice.

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you.

  • If you have given someone health care power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated.

  • You can complain if you feel we have violated your rights by contacting us using the information on page 4 of the PDF format, or at the bottom of this page.
  • You can file a complaint with the U.S. Department of Health and Human Services Office of Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In this case, we never share your information unless you give us written permission.

  • Sharing of psychotherapy notes

Our Uses and Disclosure

How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treat you.

  • We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization.

  • We can use and share your health information to run our organization, improve your care, and contact you when necessary. Example: We use health information about you to maintain our Medicaid certification.

Bill for your services.

  • We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to Medicaid so it will pay for your services.

How else can we use or share your health information? We are allowed or required to share your information in other ways - usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

  • Help with public health and safety issues. We can share health information about you for certain situations such as:
    • Preventing diseases
    • Helping with product recalls
    • Reporting adverse reactions to medications
    • Reporting suspected abuse, neglect, or domestic violence
    • Preventing or reducing a serious threat to anyone's health or safety
  • Do research. We can use or share your information for health research.
  • Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
  • Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
  • Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
  • Address workers' compensation, law enforcement, and other government requests. We can use or share health information about you:
    • For your workers' compensation claims.
    • For law enforcement purposes or with a law enforcement official to avoid a serious threat to health or safety.
    • With health oversight agencies for activities authorized by law.
    • For special government functions such as military, national security, and presidential protection services
  • Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing.
  • If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office and on our website at dodd.ohio.gov.

Your Comments or Complaints

How to comment or complain about our privacy practices.

If you would like to comment on our privacy practices, if you think we may have violated your privacy rights, or if you disagree with a decision we made about access to your health information, you may file a complaint with the HIPAA privacy officer at any of the following locations:

Ohio Department of Developmental Disabilities
30 East Broad Street, 12th Floor, Columbus, Ohio 43215
Telephone: 614-466-5216 Fax: 614-752-8551

Cambridge Developmental Center
66737 Toland Dr., Cambridge, OH 43725-8987
Telephone: 740-439-1371 Fax: 740- 439-4382

Columbus Developmental Center
1601 W Broad Street, Columbus, OH 43222-1807
Telephone: 614-272-0509 Fax: 614-272-1054

Gallipolis Developmental Center
2500 Ohio Avenue, Gallipolis, Ohio 45631
Telephone 740-446-1642 Fax 740-446-1341

Montgomery Developmental Center
7650 Timbercrest Drive, Huber Heights, OH 45424
Telephone: 937-233-8108 Fax: 937-233-9020

Mount Vernon Developmental Center
1250 Vernonview Drive, Mount Vernon, OH 43050
Telephone: 740-393-6200 Fax: 740-393-6415

Northwest Ohio Developmental Center
1101 South Detroit Avenue, Toledo, OH 43614
Telephone: 419-385-0231, Fax: 419-382-0719

Southwest Ohio Developmental Center
4399 East Bauman Lane, Batavia, OH 45103
Telephone: 513-732-9200 Fax: 513-732-9222

Tiffin Developmental Center
600 North River Road, Tiffin, OH 44883
Telephone: 419-447-1450 Fax: 419-447-5829

Warrensville Developmental Center
4325 Green Road, Highland Hills, OH 44128
Telephone: 216-464-7400 Fax: 216-464-1436

Youngstown Developmental Center
4891 East County Line Road, Mineral Ridge, OH 44440
Telephone: 330-544-2231 Fax: 330-544-3519