WHO IS ELIGIBLE FOR LCBMRDD SERVICES?

A child younger than three years of age must present at least one developmental delay or established risk to be eligible for agency service. At-risk children include those who were born premature, those affected by drug exposure, or others who have diagnosed physical or mental conditions that may cause delays. A delay is when a child does not reach his or her developmental milestones at the expected times. Developmental delays can occur in one or many areas such as motor, language, social or thinking skills.

Children age three to six years must present at least two developmental delays or an established risk to be eligible.

Children ages 6 to 15 must exhibit a substantial functional limitation in at least three of the following areas of major life activity as appropriate for their age: self care; receptive and expressive language; learning; mobility; self direction; and capacity for independent living.

Individuals age 16 and older also must exhibit substantial functional limitations in at least three of the following areas of major life activity: the capacity for economic self-sufficiency; self care; receptive and expressive language; learning; mobility; self direction and capacity for independent living.

An individual must experience developmental disabilities or delays before age 22 to qualify for services.

Developmental disabilities must be assessed by a licensed psychologist and/or physician.

Functional limitations are evaluated through completion of the Ohio Eligibility Determination Instrument (OEDI, for those age 16 and older), and the Children's Eligibility Determination Instrument (COEDI, for those age 6 to 15).

Please direct eligibility questions to Intake Coordinator Lorrie Miller, (740) 349-1420, or (800 722-6096.

PRIVACY PRACTICES

Protecting your personal information is important to the Licking County Board of Mental Retardation and Developmental Disabilities (LCBMRDD). We follow strict state and federal laws that require us to keep your personal information confidential.

How the LCBMRDD uses your personal information
If you receive LCBMRDD services, we may use your personal information for activities such as providing you with services, billing for services and conducting normal business, including health care operations. If you have a legal guardian, we will provide information to your guardian. If you are an adult who has chosen a personal representative and have agreed to let that person obtain your personal information, we will provide the information to him or her.

LCBMRDD Privacy Practices Brochure

Services and Treatment
The LCBMRDD keeps records of the care and services we provide to you. Your service coordinator keeps notes on all contacts made in arranging services. If you see an LCBMRDD nurse or therapist, staff will keep records of care or services you receive. LCBMRDD staff may also share your personal information with other staff members when developing or updating your service plan (ISP or IFSP). If LCBMRDD staff members wish to share your personal information with anyone who is not employed by the agency, you must first give them written permission, called a "release of information." Some personal records, including confidential communications with mental health professionals and substance abuse records, may have additional restrictions for use and disclosure under state and federal laws.

Payment
The LCBMRDD keep records of payment information for the services provided to you. Your personal information may be used to obtain payment for your services from Medicaid, insurance or other sources. We also may disclose personal information about the services provided to you to confirm your eligibility for Medicaid, as well as determine the amount and type of Medicaid services you require.

Health Care Operations
The LCBMRDD uses personal information to make plans to better serve you and other enrolled individuals, improve its overall quality of care, train staff, manage costs and conduct required business duties. We may use your personal information, for example, to evaluate the quality of treatment and services provided by agency staff.

Other Services
The LCBMRDD also may use your personal information to:

  • Determine whether or not you are eligible for LCBMRDD services.

  • Recommend service alternatives and other possible benefits to you.

  • Tell you about other service providers that may be able to help you.

  • Allow it to review direct service contracts.

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

  • Investigate incidents affecting health and safety, report these incidents and take steps to protect your health and safety in the future.

  • Prepare reports required by the Ohio Department of Mental Retardation and Developmental Disabilities and the Ohio Department of Job and Family Services (the state Medicaid agency).

  • Contact you for assistance in passing levies, unless you notify the agency that you do not wish to be contacted for this purpose.

Disclosing Your Personal Information
There are limited circumstances when LCBMRDD is permitted or required by law to disclose personal information without your signed "release of information." These situations are:

  • To protect victims of abuse, neglect or domestic violence;

  • To prevent serious threats 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 reports of communicable diseases, work-related illnesses or other diseases and injuries permitted by law, reports of births and deaths and reports of reactions to drugs and problems with medical devices;

  • For requests by law enforcement required by law or court order;

  • To coroners, medical examiners and funeral directors;

  • For organ and tissue donation;

  • For workers compensation if you are injured at work and are covered by workers compensation or a similar program;

  • And for specialized government functions such as intelligence and national security.

All other uses and disclosures not previously described require a signed "release of information" form. You may revoke your authorization at any time with a written statement.

Your Individual Rights
You have the right to:

  • Request restrictions on how LCBMRDD uses and shares your personal information. We will consider all requests for restrictions carefully but is not required to agree to any restriction.

  • 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 provide a reason for requesting the change.

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

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

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

  • Request must be made in writing. If you need assistance making a request, please contact your service coordinator.

LCBMRDD Privacy Responsibilities
This describes the privacy practices of the LCBMRDD. We are required by law to maintain the privacy of your personal information, provide this notice that addresses the ways we may use and share that information and follow the terms of the notice currently in effect. Current notices are posted in each LCBMRDD building. You also may request a copy of this notice by calling LCBMRDD Administration, (740) 349-6588. The LCBMRDD reserves the right to make changes to this notice at any time and make the new privacy practices effective for all information it maintains. This brochure also describes the privacy practices of persons or entities that have signed a contract with the LCBMRDD, are acting as business associates and have promised to follow the same rules of confidentiality. If you are interested in the privacy practices of service providers not employed by the LCBMRDD and who are not business associates, please contact those providers directly.

If you would like additional information about your privacy rights, are concerned that your privacy rights have been violated or disagree with a decision that the LCBMRDD has made about access to your personal information,
please contact:

Lorrie Miller, Intake Coordinator
The Licking County Board of Mental Retardation and Developmental Disabilities
Service Coordination                                                                                                                         565 Industrial Parkway
Heath, OH 43056
(740) 349-1420
(800) 722-6096
lmiller@lcbmrdd.org

The LCBMRDD will thoroughly investigate all complaints and will not retaliate against any person who files a complaint. You also may file a complaint with:

The Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington D.C., 20201
(800) 368-1019

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