Privacy Practices

Michigan Center for Positive Living Supports

NOTICE OF PRIVACY PRACTICES

This Notice of Privacy Practices is applicable to all individuals receiving services from Michigan Center for Positive Living Supports and all Michigan Center for Positive Living Supports employees.

Michigan Center For Positive Living Supports is committed to keep the information gathered about you private.  Any information that identifies you and pertains to your past, present, or future physical or mental health or condition and/or related services and payment is called Protected Health Information (PHI).  We are required by law to give you this notice about our privacy practices.  We must abide by these practices but may change them at any time.  Written notification will be mailed to you regarding any changes, and it will cover all PHI information we keep.

PLEASE REVIEW THIS NOTICE CAREFULLY.  THIS NOTICE DESCRIBES:

  • THE TYPES OF MEDICAL INFORMATION OBTAINED
  • HOW MEDICAL INFORMATION ABOUT YOU IS USED AND DISCLOSED (SHARED)
  • HOW YOU CAN GET ACCESS TO THIS INFORMATION
  • YOUR RIGHTS CONCERNING THIS INFORMATION

 TYPES OF MEDICAL INFORMATION OBTAINED

Michigan Center for Positive Living Supports obtains information about you when you apply for or receive services.  We obtain personal information, such as your name, address, date of birth, social security number, and insurance information.  We also obtain and create medical and treatment information, reports on your progress, and other information necessary to carry out your treatment and receive payment for your services. 

HOW MEDICAL INFORMATION ABOUT YOU IS USED AND DISCLOSED (SHARED)

Michigan Center for Positive Living Supports is allowed to use and share medical information for treatment, payment, and health care operations.

  • Treatment:  We may use and share your medical information to provide, coordinate, or manage your care.  For example, we may share information with the Community Mental Health Services Provider (CMHSP), Prepaid Inpatient Health Plan (PIHP) and Michigan Department of Community Health (MDCH) responsible for your treatment. 
  • Payment:  We may use and share your information to obtain payment for your care services.  This may include information needed to make a determination of coverage for insurance benefits, reviewing medical services provided, or undertaking utilization review activities.
  • Health Care Operations:  We may use or share your protected health information in order to support our business activities.  This may include quality assessment, employee reviews, training, state and local reporting requirements, agency accreditations, etc. 

Michigan Center for Positive Living Supports is permitted or required by law to use and share medical information without your consent.  Examples include: 

  • Public health activities, such as communicable disease monitoring.  
  • Federal, state, or local agency responsible to review the activities of our agency.
  • An agency responsible by law to investigate abuse, neglect, or domestic violence.
  • Food and Drug Administration activities, such as product testing and monitoring.
  • Legal proceedings, such as subpoenas or other court orders.
  • Law enforcement purposes, such as investigation of criminal activities or in an attempt to prevent a serious threat to the health and safety of a person.
  • Coroners, medical examiners, or funeral directors to perform their duties as required by law, such as identification and death certificates.
  • Research.
  • Correctional facilities, so they may provide care.
  • To comply with other provisions of the law, such as military activity, national security, disaster relief, or the Secretary of the Department of Health and Human Services to investigate or determine Michigan Center For Positive Living Supports ’s compliance with these requirements.
  • Prosecuting attorney to participate in a proceeding governed by the MI Mental Health Code.
  • To a person who has the legal authority to act on your behalf after your death.

Michigan Center for Positive Living Supports may share information with your written permission.

With few exceptions, Michigan Center for Positive Living Supports will share information with your written permission to anyone you wish.  If you change your mind, you must inform Michigan Center for Positive Living Supports’ Privacy Officer in writing. We cannot take back information we have already shared. 

Michigan Center for Positive Living Supports, as required by Federal and State law, will not release information concerning substance abuse treatment, psychotherapy, or HIV/AIDS/ARC without your permission.

As a Michigan Center for Positive Living Supports employee, your signature on a benefit application gives permission to share information for the purpose of enrollment and receipt of entitled benefits (e.g., health insurance, life insurance, flexible benefit programs).   

HOW YOU CAN GET ACCESS TO THIS INFORMATION

  • You may look at and copy your records by submitting a written request to the Michigan Center For Positive Living Supports’  Privacy Officer at  (586) 263-8919.  Under federal law you may not inspect or copy psychotherapy notes, information gathered for use in court proceedings or administrative hearings, or when the law states you may not see it.

YOUR RIGHTS CONCERNING THIS INFORMATION

You have the right to:

  • Request a change, if you feel there is a mistake in your records created by Michigan Center for Positive Living Supports   You can do this by submitting your changes in writing to the Michigan Center for Positive Living Supports Privacy Officer.  
  • Ask that we communicate with you in a certain place or a certain way, such as sending mail to a Post Office Box, instead of your home address. 
  • Ask for restrictions on the use of your information by writing to the Michigan Center for Positive Living Supports Privacy Officer at (586) 263-8919.  We are not required to agree to your request.
  • Ask for a list of places we have shared your health information after April 14, 2003.  This list will not include the times we used your information for treatment, payment, health care operations, or information shared with your permission. 
  • Receive another copy of this notice at any time.  If you need a copy of this notice or require additional information on your privacy rights or the privacy practices of Michigan Center for Positive Living Supports, please contact our Privacy Officer at (586) 263-8919.   
  • File a complaint should you believe your privacy rights have been violated.  You may file a complaint in writing to Michigan Center for Positive Living Supports and/or the Federal Government.

Michigan Center For Positive Living Supports will not retaliate against you for filing a complaint

Michigan Center for Positive Living Supports      Attention: Privacy Officer

16200 Nineteen Mile Road
P.O. Box 380710
Clinton Township, Michigan 48038
PHONE (586) 263-8919; FAX (586) 263-8942; TTY/TTD (586) 286-5036

E-MAIL at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

A complaint form is available for your convenience.  You may get a copy by contacting the Michigan Center for Positive Living Supports Privacy Officer.

U.S. Department of Health and Human Services
Region V, Office for Civil Rights
233 North Michigan Avenue, Suite 240
Chicago, Illinois 60601
PHONE (312) 886-2359  FAX (312) 886-1807  TTY/TDD (312) 353-5693

E-MAIL at This e-mail address is being protected from spambots. You need JavaScript enabled to view it

This notice was published and becomes effective on August 14, 2009.