Caswell Center

Effective Date: April 14, 2003



Responsibilities of Caswell Center

Caswell Center is required by state and federal law to protect the privacy of our clients' health information.  This health information includes mental health and/or developmental disability services that are provided to our clients, payment for those health care services, or other health care operations provided on their behalf.   

Caswell is required by law to inform you of our legal duties and privacy practices with respect to our clients' health information through this Notice of Privacy Practices.  This Notice describes the ways we may share past, present and future health information, ensuring that we use and/or disclose this information only as we have described in this Notice.  We do, however, reserve the right to change our privacy practices and the terms of this Notice, and to make the new Notice provisions effective for all health information we maintain.  Any changes to this Notice will be posted in various areas around campus and on our web site at  Copies of any revised Notices will be available to you upon request.

If at any time, you have questions or concerns about the information in this Notice or about Caswell's privacy policies, procedures and practices, you may contact our Privacy Official at 252-208-3988.

Use and Disclosure of Health Information Without Your Authorization

Treatment: Caswell Center may use a client's health information, as needed, in order to provide, coordinate or manage their health care and related services.  This includes sharing health information with other health care providers within Caswell, including contract providers.  (Example:  A client's treatment/habilitation team, composed of staff such as doctors, nurses, and teachers, will need to review the client's treatment and discuss plans for their continued care and/or discharge.)

We will disclose a client's health information outside of Caswell for treatment purposes only with your consent or when otherwise allowed under state or federal law. (Example:  We may disclose a client's health information to other mental health facilities or professionals (e.g., Area Mental Health Programs, Developmental Disability Coordinators) in order to coordinate their care.) (Example:  We may share health information with a health care provider for emergency services. (e.g. staff with the local ambulance service))

Payment for Services:  The treatment provided to a client will be shared with Caswell's billing department so a bill can be prepared for services rendered.  We may also share health information with Caswell staff that review services provided to our clients to make certain they have received appropriate care and treatment.  We will not disclose a client's health information outside of this agency for billing purposes (e.g., bill an insurance company) without your consent except in certain situations when we need to determine if the client is eligible for benefits such as Medicaid, Medicare or Social Security.  (Example:  A Patient Relations Representative may contact the local Department of Social Services to determine if a client is currently eligible for Medicaid or if they would qualify for Medicaid.  Example:  Our billing department will collect insurance and other financial information from you at the time of admission.)

Health Care Operations: Caswell Center may use or disclose a client's health information in performing a variety of business activities that we call “health care operations”.  Some examples of how we may use or disclose health information for health care operations are:

·         Review the care that clients receive here and evaluating the performance of their treatment/habilitation team to ensure that the client has received quality care.

·         Review and evaluate the skills, qualifications and performance of health care providers who are taking care of our clients.

·         Provide training programs for agency staff, students and volunteers.

·         Cooperate with outside organizations that review and determine the quality of care that our clients receive.

·         Provide information to professional organizations that evaluate, certify or license health care providers, staff or facilities.

·         Allow Caswell's attorney to use a client's health information when representing Caswell in legal matters.

·         Resolve grievances within Caswell.

·         Provide information to an internal client advocate who is available to represent a client's interests upon their request.

Other Circumstances:  Caswell Center may disclose a client's health information for those circumstances that have been determined to be so important that your authorization may not be required.  Prior to disclosing this health information, we will evaluate each request to ensure that only necessary information will be disclosed.  Those circumstances include disclosures that are:

·         Required by law;

·         For public health activities. (Example, we may disclose health information to public health authorities if a client has a communicable disease and we have reason to believe, based upon information provided to us, that there is a public health risk such as evidence of the client's noncompliance with their treatment plan.  If a client suffers from a communicable disease such as tuberculosis or HIV/AIDS, information about the disease will be treated as confidential.  Other than circumstances described in other sections of this Notice, we will not release any information about a client's communicable disease except as required to protect public health or the spread of a disease, or at the request of the State or Local Health Director;

·         Regarding abuse, neglect or domestic violence;

·         For health oversight activities such as certification for Medicaid.

·         For law enforcement purposes unless otherwise prohibited by state or federal law;

·         For court proceedings such as adjudication of incompetence;

·         Related to death such as disclosure to a funeral director;

·         Related to donation of organs or tissue;

·         To avert a serious threat to the health or safety of a person or the public;

·         Related to specialized government activities such as national security;

·         To correctional institutions or other law enforcement officials when the client is in their custody; and

·         Related to medical research.

Contacting You

Caswell Center may use  a client's health information to contact you to:

·         Make you aware of changes in the client's medical condition  (Example: A nurse may call you at home to let you know that the client has been discharged from Acute Care or has been started on a new treatment.); or

·         Participate in raising funds for Operation Santa.  If you object to being contacted in this way for fund-raising efforts, you must notify our Privacy Official who is listed in this Notice.  (Example:  Volunteer Services may send information to your home announcing the Operation Santa needs.)

Disclosure of Health Information That Allows You an Opportunity to Object

There are certain circumstances where we may disclose a client's health information and you have an opportunity to object.  Such circumstances include:

·         The professional responsible for the client’s care may disclose their admission to or discharge from Caswell Center to their next of kin.

·         Disclosure to public or private agencies providing disaster relief.  (Example:  We may share a client's health information with the American Red Cross following a major disaster such as a flood.)

If you would like to object to our disclosure of the health information in either of the situations listed above, please contact Caswell's Privacy Official listed in this Notice for consideration of your objection.

Disclosure of Health Information That Requires Your Authorization

Caswell Center will not disclose a client's health information without your authorization except as allowed or required by state or federal law.  For all other disclosures, we will ask you to sign a written authorization that allows us to share or request the client's health information.  Before you sign an authorization, you will be fully informed of the exact information you are authorizing to be disclosed/requested and to/from whom the information will be disclosed/requested.

You may request that your authorization be cancelled by informing Caswell's Privacy Official that you do not want any additional health information exchanged with a particular person/agency.  You will be asked to sign and date the Authorization Revocation section of your original authorization; however, verbal authorization is acceptable. Your authorization will then be considered invalid at that point in time; however, any actions that were taken on the authorization prior to the time you cancelled your authorization are legal and binding.

Your Rights Regarding Client Health Information

You have the following rights regarding a client's health information as created and maintained by Caswell Center.

Right to receive a copy of this Notice 

You have the right to receive a copy of Caswell Center’s Notice of Privacy Practices.  During the client's first treatment encounter with Caswell, you will be given a copy of this Notice and asked to sign an acknowledgement that you have received it.  If you are not with the client at the time of admission then this Notice will be mailed to you and we will request that you return the signed acknowledgement to Caswell Center.  In the event of emergency services, you will be provided the Notice as soon as possible after emergency services have been provided.

In addition, copies of this Notice have been posted in several public areas throughout Caswell Center, as well as on Caswell's Internet web site at www.caswellcenter.orgYou have the right to request a paper copy of this Notice at any time from Family Services (252-208-3766) or our Privacy Official.

Right to request different ways to communicate with you

You have the right to request to be contacted at a different location or by a different method.  For example, you may request all written information from Caswell be sent to your work address rather than your home address.  We will agree with your request as long as it is reasonable to do so; however, your request must be made in writing and forwarded to our Privacy Official.

Right to request to see and copy a client's health information

All Caswell Center clients, whether they are a minor, incompetent adult or competent adult and their guardian (Personal Representative) have the right to request to see and receive a copy of the client's health information in medical, billing and other records that are used to make decisions about the client.  The request must be in writing and forwarded to our Privacy Official.  We must reply to your request within 30 days.  If your request is approved, we may charge a fee to cover the cost of the copy.

Instead of providing a full copy of the client's health information record, we may provide a summary or explanation of the health information, if you agree in advance to that format and to the cost of preparing such information.

The request may be denied by the client's physician or a professional designated by the Director of Caswell Center under certain circumstances.  If we do deny the request, we will explain our reason for doing so in writing and describe any rights you or the client may have to request a review of our denial.  In addition, you have the right to contact our Privacy Official to request that a copy of the client's health information be sent to a physician or psychologist of your choice.

The guardian (Personal Representative) has the same rights to request to see and copy a client's health information as the client does.

Right to request amendment of health information

You have the right to request changes in a client's health information in medical, billing and other records used to make decisions about them.  If you believe that we have information that is either inaccurate or incomplete, you may submit a request in writing to our Privacy Official and explain your reasons for the amendment.  We must respond to your request within 30 days of receiving your request.  If we accept your request to change the health information, we will add your amendment but will not destroy the original record.  In addition, we will make reasonable efforts to inform others of the changes, including persons you name who have received the health information and who need the changes.

We may deny your request if:

·         The information was not created by Caswell Center (unless you prove the creator of the information is no longer available to change the information);

·         The information is not part of the records used to make decisions about the client;

·         We believe the information is correct and complete; or

·         Your request for access to the information is denied.

If we deny your request to change the health information, we will explain to you in writing the reasons for denial and describe your rights to give us a written statement disagreeing with the denial.  If you provide a written statement, the statement will become a permanent part of the client's record.  Whenever disclosures are made of the information in question, your written statement will be disclosed as well.

Right to request a listing of disclosures we have made

You have a right to a written list of disclosures of the client's health information.  The list will be maintained for at least six years for any disclosures made after April 14, 2003.  This listing will include the date of the disclosure, the name (and address, if available) of the person or organization receiving the information, a brief description of the information disclosed and the purpose of the disclosure.

Caswell Center is not required to include the following on the list of disclosures:

·         Disclosure for client treatment;

·         Disclosure for billing and collection of payment for treatment;

·         Disclosures related to our health care operations;

·         Disclosures that you authorized;

·         Disclosures to law enforcement when the client is in their custody; or

·         Disclosures made to individuals involved in the client's care.

Your first request for a listing of disclosures will be provided to you free of charge.  However, if you request a listing of disclosures more than once in a 12 month period, you may be charged a reasonable fee.  We will inform you of the cost involved and you may choose to withdraw or modify your request at that time, before any costs are incurred.

Right to request restrictions on uses and disclosures of health information

You have the right to request that we limit our use and disclosure of the client's health information for treatment, payment and health care operations.  You also have the right to request a limit on the health information we disclose about the client to their next of kin or someone who is involved in your care.  (Example: you could ask that we not disclose information about a family history of heart disease.)  We will provide you with a form to document your request.

We will make every attempt to honor your request but are not required to agree to such request.  However, if we do agree, we must follow the agreed upon restriction (unless the information is necessary for emergency treatment or unless it is a disclosure to the U.S. Secretary of the Department of Health and Human Services).

You may cancel the restrictions at any time and we will ask that your request be in writing.  In addition, this agency may cancel a restriction at any time, as long as we notify you of the cancellation.


If you believe we have violated a client's privacy rights, or if you want to file a complaint regarding our privacy practices, you may contact our Privacy Official.  Contact information is as follows:

Caswell Center Privacy Official

2415 West Vernon Avenue

Kinston, NC   28504

Voice Phone:  (252) 208-3988

FAX:              (252) 208-4010

V/TDD:          (252) 208-4000


The North Carolina Department of Health and Human Services operates an information and referral service located in the Office of Citizen Services, known as CARE-LINE, which has been designated to receive and document complaints and concerns regarding our client's privacy.  Contact information is as follows:


2012 Mail Service Center

Raleigh, NC  27699-2012

Voice Phone (English and Spanish):

800-662-7030 (Toll Free)

(919) 733-4261 (Triangle Area and Out of State) 

FAX:    (919) 715-8174

TTY:    877-452-2514 (TTY Dedicated)

(919) 733-4851 (TTY Dedicated for local or out of state calls)


You may also send a written complaint to the United States Secretary of the Department of Health and Human Services.  Contact information is as follows:

Office for Civil Rights

U.S. Department of Health and Human Services

Atlanta Federal Center, Suite 3B70

61 Forsyth Street, S.W.

Atlanta, GA 30303-8909

Voice Phone: (404) 562-7886

FAX:             (404) 562-7881

TDD:            (404) 331-2867

If you file a complaint, we will not take any action against you or the client nor will we change the quality of health care services we provide to the client in any way. 

Legal References

Primary Federal and State laws and regulations that protect the privacy of your health information are listed below.

Confidentiality of Alcohol and Drug Abuse Patient Records – 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR Part 2 for Federal regulations.

Health Insurance Portability and Accountability Act (HIPAA), Administrative Simplification, Privacy of Individually Identifiable Health Information – 42 U.S.C. 1320d-1329d-8 and 42 U.S.C. 1320d-2(note) for Federal laws and 45 CFR Parts 160 and 164 for Federal regulations.

NC General Statutes – Chapter 122C, Article 3 (Client’s Rights and Advance Instruction), Part 1 (Client’s Rights).  Chapter 90 (Medicine and Allied Occupations), Article 1 (Practice of Medicine).

NC Administrative Code – 10 NCAC 18 D (Confidentiality Rules).