You have certain rights regarding your information, described below. These rights apply to the information we keep. You must submit a written request to use any of these rights. You can send your written request to the Executive Director.
Right To Request Special Communications: You have the right to ask us to contact you about services in a certain way or at a certain place. We will follow all reasonable requests. Your request must tell us how you wish to be contacted.
Right to Inspect and Copy: With some exceptions, you have the right to read or get a copy of your record, and/or an accounting of disclosures, with some exceptions. We may turn down your request under certain circumstances.
Right to Request Changes: If you believe the information that we created is wrong or incomplete, you may ask us to change it. You must provide a reason why you want the change. We cannot take out or destroy any information already in your record. We also are not required to agree to make the change. If we do not agree to the change, you can write a letter about the changes. We will send you one back saying why we will not make the changes. You may then send another disagreeing with us. It will be attached to the information you wanted changed or corrected.
Right to Request Restrictions: You have the right to ask for a restriction or limitation on the medical information we use or share about you for payment, treatment, or agency operations, and the information we may share with your family, friends or others involved in your care. We are not required to agree to your request. If we agree, we will follow your request unless the information is needed to provide you with emergency treatment. You must tell us the type of restriction you want and to whom it applies.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. Copies of this notice will be available at the Anchorage & Juneau Four A’s office. In addition, it will be available on our website (www.alaskanaids.org).
All other uses and information will be done only with written permission.
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
Medical information may be used and shared so that we may provide you with care/ treatment/ support services and be paid for it, and so that we may run our business and follow state and federal legal rules. We must follow the terms of this notice.
Who Sees My Information
Case managers and other staff who are responsible for providing services to you may see and use your information to determine your plan of care or service(s) provided.
May I See My Information?
Under most circumstances you may see your file. There may be limitations on this right for legal reasons, or if your safety is at risk. If you think some of the information is wrong, you may ask in writing that correct or new information be added. You may ask that the corrected or new information be sent to others who have received your information from us.
Treatment We will use and share information to provide you treatment or support services, such as appointments with your doctor.
Payment We may use and share your medical information to be paid for the care services we provided you, or to arrange payment from another source.
Agency Operations We need to use and share your information to run our agency, which includes quality assurance activities, licensing, and training.
Business Associates We may share your information with anothercompany or organization, called a “business associate” that we hire to provide a service to us or on our behalf. We will only share your information if the business associate has agreed in writing to keep it private.
Appointment Reminders We may contact you to remind you ofan appointment or to change one. We may also let you know that it is time for a follow-up appointment.
Required by Law We must share information if federal, state or local law requires. Four A’s is a mandatory reporting agency. Confidentiality does not apply in the event of abuse, neglect, physical and sexual assault or threats of harm to self or others.
Legal Proceedings If a proper court or administrative authority orders us to do so, we may release your information. We will only share the information required by the order.
Public Health Safety We may share your information for public health reasons that include:
to prevent or control disease, injury or disability;
to report child abuse or neglect; or
to let you know that you may have been exposed to a disease or may be at risk for getting or spreading a disease or condition.
Signed Release of Information (ROI) Other than the uses and disclosures described above, Four A’s will share information only if we have or receive a signed ROI. We will only share the information requested. An ROI may be revoked by providing written notice to the Privacy Officer. We will only share information generated by the Four A’s.
The Four A's reserves the right to change this notice. We reserve the right to make any revised or changed notice effective for already supplied information (information we already have) as well as for future information. Changes will apply equally to information at Anchorage and Juneau offices. Any changes to these policies or this notice will be available on this site in addition at our offices in Anchorage an Juneau.
Questions Or Need To Report A Problem?
If you have any questions about this notice or about how your information is used or shared by us please contact us (907) 263-2050 in Anchorage, or (907) 586-6089 in Juneau. You may use our 800-478-2437 number in Alaska.
If you believe your privacy rights have been violated, you may file a complaint with us. You may also file a complaint with the Secretary of the Department of Health and Human Services.
To file a complaint with Four A's, please contact the Executive Director by phone, email or writing to the Anchorage office. (Information can found on our Contact page). Please give as much information as possible so that the complaint can be thoroughly investigated.
Your care will not be affected if you file a complaint. We care deeply for your privacy and the about quality of service we provide.