FAQ,Christian Haven, 888-956-3125

Christian Haven
12501 N. State Road 49
Wheatfield, IN 46392
(888) 956-3125
Fax (219) 956-4128
Email: proatis@christianhaven.org

Christian Haven Goals Statement

In a manner consistent with the Mission Statement, we will position ourselves to respond to the needs of children, youth and families quickly, effectively, and efficiently:

	To improve the emotional health and relational functioning of youth & families to achieve the successful, safe, reunification of the family and integration into the community.
	To improve the academic and vocational achievement of youth allowing for the successful reintegration back into the public school system or transition into the world of work.
	To challenge, teach, and encourage children, youth & families to develop the spiritual/moral foundation, and strength of character needed to address problems that may stand in the way of their becoming functional, self-supporting members of their community.
	To Serve as a service and training resource to the community, the Juvenile Justice System, public and private schools, universities, churches, and other agencies working with children, youth & families.

If you have questions or would like to arrange a visit,
please contact either
Patrick Oatis, Executive Director
Gary Adzia, Aerie Program Director,
Warren Stehling, Cornerstone Program
or Chris Kostbade, Ark/Odyssey Program

NOTICE OF PRIVACY PRACTICE
Effective Date: December 2003

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.

WHO WILL FOLLOW THIS NOTICE. This notice describes our practices and that of:

Ø Any health care professional authorized to enter information into your chart

Ø All departments and units of Christian Haven, Inc.

Ø Any member of a volunteer group we allow to help you at Christian Haven, Inc.

Ø All employees, staff and other personnel of Christian Haven, Inc.

Ø All these entities, sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share medical information with each other for treatment, payment or Christian Haven, Inc. operations purposes described in this notice.

OUR PLEDGE REGARDING MEDICAL INFORMATION.

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at Christian Haven, Inc. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Christian Haven, Inc. Other Providers may have different policies or notices regarding use and disclosure of your medical information.

This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

WE ARE REQUIRED BY LAW TO:

Maintain the privacy of your health information; Provide you with this notice of the legal duties and privacy practices with respect to information we collect and maintain about you; and Abide by the terms of this notice.

Personal Representatives. In most cases the rights and decisions of children receiving services from Christian Haven, Inc. will be exercised by an adult who is responsible for making decisions in your best interest. In those cases, that adult, known as you Personal Representative, will generally have the authority to make the decisions and determinations described in this Notice on your behalf.

HOW WE ARE REQUIRED BY LAW TO DISCLOSE MEDICAL INFORMATION ABOUT YOU.

Ø As Required By Law.

Ø To Avert a Serious Threat to Health or Safety.

Ø Public Health Risks.

Ø Health Oversight Activities.

Ø Lawsuits an Disputes

Ø Protective Services for the President and Others.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.

Ø For Treatment.

Ø For Payment.

Ø For Health Care Operations.

Ø Appointment Reminders.

Ø Treatment Alternatives.

Ø Health-Related Benefits and Services.

Ø Fundraising Activities.

Ø Facility Directory.

Ø Individuals Involved in Your Care or Payment for Your Care.

Ø Research.

SPECIAL SITUATIONS

Ø Organ and Tissue Donation.

Ø Military and Veterans.

Ø Coroners, Medical Examiners and Funeral Directors.

Ø National Security and Intelligence Activities.

Ø Inmates.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU:

	The right to request that we not use or disclose your health information in certain ways
	The right to request to receive communications in an alternative manner or location
	The right to access and obtain a copy of your health information
	The right to request an amendment to your health information
	The right to an accounting of disclosures of your health information.

To obtain a paper copy (a complete description of this privacy notice with explanations and examples) you may write, call or visit the administration building at Christian Haven, Inc. 12501 North State Road 49 Wheatfield, IN 46392; 219-956-3125.

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in each of our cottages, in the educational building, outreach building, and in our administration building.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health and Human Services. To file a complaint with Christian Haven, Inc. contact Jane C. Barrick, Privacy Officer, in writing at 12501 North State Road 49, Wheatfield, IN, 46392. All complaints must be submitted in writing.

You will not be penalized for filing a complaint.

We will not use or disclose the agency’s (residents or clients) private health information without authorization, except as described in this notice.

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Christian Haven 12501 North State Road 49 Wheatfield, IN 46392 (888) 956-3125 / Fax (219) 956-4128 Email: proatis@christianhaven.org	Web Site Development By: Dana Leek/Mirage Studio©2004 (877) 928-0300 www.miragestudio.com