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Local Offices:

Tucson Area
4825 North Sabino Canyon Road
Tucson, AZ  85750
(520) 884-7954

Southeastern Arizona
954 West Highway 92
Bisbee, AZ  85603
(520) 432-5453

Phoenix and
Surrounding Areas
2415 West Huntington Drive,
Suite 103
Tempe, AZ  85282
(602) 431-9511

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office near you.

mail@cpes.com

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Notice of Privacy Practices

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.

Privacy Promise
CPES knows how important it is to keep your personal information confidential, and promises to follow strict federal and state laws that require us to keep your personal information private.

How We Will Use Your Personal Information
If you are being supported by CPES, we might use your personal information for such activities as providing you with services, billing for services and conducting our regular business known as health care operations.

If you have chosen a personal representative and have agreed to let your personal representative obtain your personal information, we will provide the information to your personal representative.  If you have a guardian, we will provide the information to your guardian.

Some examples of how we might use your information include:

• Treatment – We keep records of the care and services provided to within CPES.  For example, your Service Coordinator, Support Supervisor, Associate Director, or any other important staff keeps notes on all contacts made in coordinating and arranging for services.   If you see a nurse or therapist who works for CPES,  they  will keep records of any care you receive.  CPES staff may share your personal information while helping to develop your service plan.
  
  If CPES staff want to share your personal information with anyone who is not employed by CPES, you must give them your written permission first.
  
  Some personal records, including confidential communications with a mental health professional and substance abuse records may have additional restrictions for use  
   

• Payment – We keep records that include payment information and documentation of the services provided to you.  Your information may be used to obtain payment for your services from AHCCCS, insurance or other sources.  For example, we may disclose personal information about the services provided to you to confirm your eligibility for AHCCCS and to obtain payment from AHCCCS.  CPES may use your personal information to determine the amount and type of AHCCCS services you need and send this information to the proper state department.
   

• Health Care Operations – We use personal information to improve the quality of care, train staff, manage costs, conduct required business duties and make plans to better serve you and other individuals supported by CPES.  For example, we may use your personal information to evaluate the quality of treatment and services provided by our service staff.

Other Services We Provide
We may also use your personal information to: 

• Determine if you are eligible for CPES services
   

• Recommend service alternatives and other possible benefits
   

• Let you know about other service providers who may be able to help you
   

• Remind you of an appointment, unless you let CPES staff know that you don’t wish to be reminded
   

• Allow CPES to review direct service contracts
   

• Allow local, state and federal agencies to monitor your services
   

• Investigate any incidents affecting your health and safety, to report these kinds of incidents and to take steps to protect your health and safety
   

• Allow CPES to prepare reports required by the Division of Developmental Disabilities
   

• Contact you for assistance in passing levies, unless you notify CPES that you don’t wish to be contacted for these purposes

Sharing Your Personal Information
There are limited situations when we are permitted or required to disclose personal information without your signed authorization.  These situations are:

• To protect victims of abuse, neglect or domestic violence
   

• To reduce or prevent a serious threat to public health and safety
   

• For health oversight activities such as investigations, audits and inspections
   

• For lawsuits and similar proceedings
   

• For public health purposes, such as reporting communicable diseases, work-related illnesses or other diseases and injuries, as permitted by law; reporting births and deaths and reporting reactions to drugs and problems with medical devices
   

• When required by law
   

• When requested by law enforcement, as required by law or court order
   

• To coroners, medical examiners and funeral directors
   

• For organ and tissue donation
   

• For Worker’s Compensation or other similar programs, if you are injured at work and are covered by Worker’s Compensation or other similar programs
   

• For specialized government functions, such as intelligence and national security

All other uses and disclosures not described in this notice require your signed authorization.  You may revoke your authorization at any time with a written statement.

CPES’ Privacy Responsibilities
CPES is required by law to:

• Maintain the privacy of your personal information
   

• Provide this notice that describes the ways we may use and share your personal information
   

• Follow the terms of the notice currently in effect

We reserve the right to make changes to this notice at any time and make the new privacy practices for all information we maintain.  Current notices will be posted in all CPES facilities and on the CPES website.  You may also request a copy of any notice from the CPES Privacy Officer.

Your Individual Rights
You have the right to:

• Request restrictions on how we use and share your personal information.  CPES will consider all requests for restrictions carefully, but is not required to agree to any restriction.*
   

• Request that we use a specific telephone number or address to communicate with you
   

• Inspect and copy your personal information, including service, medical and       billing records.  Fees may apply.*
   

• Request corrections or additions to your personal information.  You must give the reasons for wanting the change.*
   

• Request an accounting of certain disclosures of your personal information made by us.  Your request must state the period of time desired for the accounting, which must be within the six years prior to your request.  The first accounting is free, but a fee will apply if more than one request is made in a 12 month period.*
   

• Request a paper copy of this notice even if you agree to receive it electronically

*Requests marked with a star (*) must be made in writing.  Contact the CPES Privacy Officer for the appropriate form for your request. 

Our Organization
This notice describes the privacy practices of CPES.  This notice also describes the privacy practices of individuals or entities which have signed a contract with CPES, which are acting as business associates and which have promised to follow the same rules of confidentiality. CPES includes all services and supports provided by CPES, as well as CPES employees and volunteers.

If you want to know more about the privacy practices of service providers who are not employed CPES, and who are not business associates, you should contact them directly.

Contact Us
If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision that we made about access to your personal information, you may contact:

CPES Privacy Officer
Mary Lynn Greenhow
4825 North Sabino Canyon Road, Tucson, AZ 85750
Phone:  (520) 884-7954
E-mail:  MLGreenhow@cpes.com

We will investigate all complaints and will not retaliate against you for filing a complaint.  You may also file a written complaint with either:

The Secretary of the US Department of Health and Human Services
200 Independence SW
Washington, DC 20201
Phone:  (877) 696-6775

The Office for Civil Rights, US Department of Health and Human Services
200 Independence Avenue SW, Room 509F, HHH Building
Washington, DC 20201
Phone:  (800) 368-1019
E-mail:   ocrmail@hhs.gov