340:2-8-4. Client rights to access personal health information (PHI)
(a) Oklahoma Department of Human Services (DHS) clients, per Section 164.524 of Title 45 of the Code of Federal Regulations (45 C.F.R. § 164.524), have the right to:
(1) access, inspect, and obtain a copy of their own PHI in DHS files or records consistent with federal and state law, except for:
(A) psychotherapy notes that are not specifically released by the originator of the notes; and
(B) information compiled for use in civil, criminal, or administrative proceedings;
(2) rebut a denial of access to their PHI by requesting a review in writing to the DHS privacy officer. When a client requests a review, the DHS privacy officer promptly acts on his or her request and arranges for the review;
(3) receive an accounting of disclosures DHS made of their PHI for up to six years prior to the requesting date by completing Form 13HI004E, Request for Accounting of Disclosures. This does not include disclosures made for the purposes of treatment, payment, or health care operations activities or of PHI previously authorized by the client for use or disclosure. After receiving Form 13HI004E, DHS staff completes and sends Form 13HI005E, Accounting of Disclosures, to the client within 60-calendar days of receiving the request; and • 1
(4) submit complaints if they believe or suspect that DHS improperly used or disclosed their PHI. When a client or his or her personal representative submits a complaint, per Oklahoma Administrative Code 340:2-8-9, DHS staff gives the client the DHS privacy officer's name and phone number. The privacy officer: • 2
(A) reviews the complaint;
(B) makes a decision regarding the complaint;
(C) documents the decision; and
(D) informs the client of the decision in writing.
(b) Clients may ask DHS to take specific actions regarding the use or disclosure of their PHI, per 45 C.F.R. § 164.522, and DHS may approve or deny the request. Specifically, clients have the right to request that DHS:
(1) restrict uses and disclosures of their PHI for treatment, payment, and operations; • 3
(2) provide information by alternative means, such as email, fax, mail, or phone, or at alternative locations by completing Form 13HI006E, Request for Alternative Means of Communication. DHS terminates the agreement to communicate by alternative means, when: • 4
(A) the client agrees to or requests termination; or
(B) DHS is unable to contact the client by the method requested or at the designated location; and
(A) When DHS grants the amendment, DHS staff: • 6
(i) makes the appropriate amendment to the client's PHI;
(ii) provides timely notice to the client that the amendment was accepted; and
(iii) seeks the client's agreement to notify other relevant persons or agencies with whom DHS has cause to share the amended information.
(B) DHS denies the client's request for amendment, when the information:
(i) did not originate from DHS, unless the client provides a reasonable basis to believe that the originator of such information is no longer available to act on the requested amendment; or
(ii) is accurate and complete.
(C) When DHS staff denies the amendment, a written denial is sent to the client explaining the reason for the denial within 60-calendar days of the request for an amendment. The denial explains the client's right to submit a written statement disagreeing with the denial and how to file the statement. When the client files a statement disagreeing with the denial, DHS staff has the right to complete a written rebuttal to the client's statement and sends a copy of the rebuttal to the client. • 7
(c) Clients have the right to receive Form 13HI001E, Privacy Notice. • 8
1. Copies of Form 13HI004E, Request for Accounting of Disclosures, and Form 13HI005E, Accounting of Disclosures, are imaged or filed in the client's case record for at least six years.
2. The privacy officer images or files copies of the decision and all pertinent documentation in the case record.
3. Oklahoma Department of Human Services (DHS) staff documents the client's request and the reasons for granting or denying the request in the client's case record. DHS staff forwards the request to the privacy officer who decides whether to accept or deny the request.
4. DHS staff images or files Form 13HI006E, Request for Alternate Means of Communication, in the client's case record. The information is kept for six years.
5. DHS staff images or files Form 13HI007E, Request for Amendment of Protected Health Information, in the client's case record.
6. When the amendment is granted, DHS staff documents the amendment in the client's case record.
7. When the client files a statement disagreeing with the denial, DHS staff images or files the written statement in the client's case record. When DHS staff completes a written rebuttal, he or she images or files the rebuttal in the client's case record.
8. (a) DHS posts a copy of Form 13HI001E, Privacy Notice, for public viewing at each worksite and on the DHS website. A copy is given to clients upon request.
(b) DHS staff providing clients with direct health care treatment or services, give Form 13HI001E to each client no later than the date of first-service delivery after April 14, 2003, and obtain the client's written acknowledgement of receipt of the notice, except in emergency treatment situations, by having the client sign Form 13HI002E, Privacy Notice Acknowledgment.
(c) DHS staff images or files the signed Form 13HI002E in the client's case record. When DHS staff makes a good faith effort to have the client sign Form 13HI002E, but he or she refuses, DHS staff documents the circumstances on Form 13HI002E and images or files it in his or her case record.