FULL NONDISCRIMINATION STATEMENT

All publications and handouts mentioning USDA Child Nutrition Programs must contain the following full nondiscrimination statement.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits.  Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800)877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form.  To request a copy of the complaint form, call (866)632-9992.  Submit your completed form or letter to USDA by:

Mail: U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410

NOTICE OF PRIVACY PRACTICES

United Methodist Youth Home, Inc.

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW YOUR PERSONAL MEDICAL INFORMATION MAY BE USED

AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

OUR OBLIGATIONS:

We are required by law to:

  • Maintain the privacy of protected health information
  • Give you this notice of our legal duties and privacy practices with respect to protected health information
  • Notify affected individuals following a breach of unsecured protected health information

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:

The following describes the ways we may use and disclose health information that identifies you (“Health Information”). Except for the purposes described below, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to the person listed on the last page.

For Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.

For Payment. We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment and services you received. For example, we may give your health plan information about you so that they will pay for your treatment.

For Health Care Operations. We may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and to operate and manage our office. For example, we may use and disclose information to make sure the behavioral health care you receive is of the highest quality. We also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operation activities.

Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services. We may use and disclose Health Information to contact you to remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care. When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a .close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.

SPECIAL SITUATIONS:

Research. Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may he included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.

Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform our billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.

Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes, or tissues to facilitate organ, eye, or tissue donation and transplantation.

Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.

Worker’s Compensation. We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries and illnesses.

Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.

Coroner, Medical Examiners, and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.

National Security and Intelligence Activities. We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.

WHEN REQUIRED BY FEDERAL, STATE, OR LOCAL LAW WE WILL DISCLOSE YOUR HEALTH INFORMATION AS FOLLOWS:

To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.

Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain the person’s agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Protective Services for the President and Others. We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.

USES AND DISCLOSURES THAT REQUIRE USTO GIVE YOUAN OPPORTUNITY TO OBJECT AND OPT

Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.

Disaster Relief. We may disclose your Protected Health Information to disaster relief organizations that seek your Protected Health Information to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.

YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES

The following uses and disclosures of your Protected Health Information will be made only with your written authorization:

  1. Uses and disclosures of Protected Health Information for marketing purposes; and
  2. Disclosures that constitute a sale of your Protected Health Information

Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our HR Coordinator/Compliance Officer and we will no longer disclose Protected Health Information under the authorization. But disclosure that we made in reliance on your authorization before you revoked it will not be affected by the revocation.

YOUR RIGHTS:

You have the following rights regarding your Health Information:

Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to the HR Coordinator/ Compliance Officer (contact information is at the end of the Privacy Notice). We have up to 30 days to make your Protected Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state of federal needs- based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review.

Right to an Electronic Copy of Electronic Medical Records. If your Protected Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. We will make every effort to provide access to your Protected Health Information in the form or format you request, if it is readily producible in such form or format. If the Protected Health Information is not readily producible in the form or format you request your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.

Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured Protected Health Information.

Right to Amend. If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to the HR Coordinator/ Compliance Officer.

Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to the HR Coordinator/ Compliance Officer.

Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. We are not required to grant your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment. To request a restriction, you must make your request, in writing, to the HR Coordinator/Compliance Officer.

Out-of-Pocket-Payments. If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.

Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communications, you must make your request, in writing, to the HR Coordinator/Compliance Officer. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice, at our website, www.umyh.com. To obtain a paper copy of this notice, please contact the person listed below.

COMPLAINTS

If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact the person listed below. You also may send a written complaint to the U.S. Department of Health and Human Services- Office of Civil Rights. The person listed below can provide you with the appropriate address upon request or you may visit www.hhs.gov/ocr for further information. You will not be penalized or retaliated against for filing a complaint with the Office of Civil Rights or with us.

CHANGES TO THIS NOTICE

We reserve the right to change this policy at any time. In the event that we make a significant change in our policies, we will provide you with a revised copy of this notice. We will also post a copy of our current notice at our office. The notice will contain the effective date on the first page, in the top right-hand corner. You can also request a copy of our notice at any time. For more information about our privacy practices, contact the person listed below.

DESIGNATED CONTACT

HR Coordinator/Compliance Officer

2521 N. Burkhardt Rd.

Evansville, IN 47715

812-479-7535

Wellness Policy on Physical Activity and Nutrition

United Methodist Youth Home, Inc.

Wellness Policy on Physical Activity and Nutrition

Philosophy:  The United Methodist Youth Home, Inc. supports the health and well-being of all residents and students by promoting nutrition and physical activity.

Statement of Purpose:  In accordance with federal law, it is the policy of UMYH to provide residents and students access to healthy foods and beverages; provide opportunities for developmentally appropriate physical activity; and require that all meals served by UMYH meet or exceed the federal nutritional guidelines issued by the U.S. Department of Agriculture.  A coordinated Wellness Committee will be formed and maintained to oversee these activities.

UMYH’s Wellness Policy will be made available to youth and their families by means of the student/resident handbook and UMYH’s website.

  • Wellness Committee

UMYH will encourage students, parents/guardians, staff, health professionals, and other interested community members in developing, implementing, monitoring, and reviewing agency-wide nutrition and physical activity policies.  A Wellness Committee will be formed and maintained at the agency to oversee the development, implementation, and evaluation of the wellness policy.

  • In accordance with state and federal law, UMYH will form and maintain a Wellness Committee that includes at least the following:  
  • Parents/Guardians
  • Residents/Students
  • Staff
  • Executive Director
  • Director of Programming
  • Wellness Coordinator
  • Any interested members of the general public
  • Representatives of Interested Community Organizations
  • The Wellness Committee shall meet at least quarterly to review nutrition and physical activity policies and to develop an action plan for the coming year.  The Wellness Committee will also discuss implementation activities and address any barriers and challenges.
  • The Wellness Policy will be updated at least every 3 years.
  • The Wellness Policy shall be made available to youth and their families by means of the student/resident handbook and UMYH’s website.
  • Nutrition Education and Nutrition Promotion

Nutrition topics shall be integrated within programming and taught to every resident and Day Treatment student.

  • Nutrition education will also be incorporated into the Independent Living Curriculum.  This will include teaching the youth how to read and use food labels, choosing healthy options, and portion control.
  • Foods of minimal nutritional value, including brands and illustrations, shall not be advertised or marketed in the educational setting.
  • Standards for USDA Child Nutrition Programs and Meals

UMYH will provide and promote the National School Lunch and Breakfast Programs to ensure that all residents and Day Treatment students have access to healthy foods to support healthier choices.

  • Meal Content
  • Meals served through the National School Lunch and Breakfast Programs will:
  • Be appealing and appetizing to youth
  • Meet, at a minimum, the nutrition requirements established by the USDA for federally funded programs
  • Offer fruits and vegetables
  • All cooked food will be baked or steamed.  Proper procurement procedures and preparation methods will be used to decrease excess fat, calorie, and sodium levels in food.
  • Special dietary needs of youth will be considered when planning meals.
  1. School Meal Participation
  • To the extent possible, we will provide the USDA School Breakfast and Lunch Program to all residents and Day Treatment students.
  • Breakfast, lunch, and dinner will be provided to youth at consistently scheduled times each day.
  1. Mealtimes and Scheduling
  • Adequate time will be provided to youth to eat lunch (at least 20 minutes after being served) and breakfast (at least 10 minutes after being served).
  • Meals will be served in clean and pleasant settings.
  • Youth will have convenient access to hand-washing or sanitizing stations.
  • Drinking water will be readily available at all mealtimes.
  1. Professional Development
  • Professional development and training will be provided at least annually to staff on proper food handling techniques and healthy cooking practices.
  • Nutrition Standards for Competitive and Other Foods and Beverages
  • United Methodist Youth Home does not have any vending machines available for the youth.
  1. BAvailability

Youth will have free, portable drinking water for consumption available in their program.

  1. Celebrations
  • Celebrations will focus on activities (giving free time, extra recess, music and reading time) rather than on food.
  • Celebrations that include food will be limited.  Food items must meet the guidelines set forth in this document.
  1. Food as Punishment
  • Staff will not withhold food or drink at mealtimes as punishment.  
  • Physical Activity and Physical Education
  • UMYH supports the health and well-being of students by promoting physical activity through various recreational activities and other physical activity breaks.  Additionally, UMYH supports physical activity among youth by providing them with at least 30 of the recommended 60 minutes of physical activity per day.
  • Staff will not use physical activity (running laps, pushups, etc.) or withhold opportunities for physical activity as punishment.
  • Other Activities that Promote Student Wellness

The board supports the health and well-being of our students and staff by creating and promoting policy and environmental supports to provide physical activity and healthy eating opportunities.

  • Evaluation

UMYH is committed to enforcing the policies and guidelines included in this document.  Through implementation of the Wellness Policy, UMYH will create an environment that supports opportunities for physical activity and healthy eating behaviors.  To ensure continuing progress, UMYH will evaluate implementation efforts and their impact on youth and staff.

Nutrition Education Goals

  • Every year, all students and residents shall receive nutrition education that is age-appropriate and aligned with the curriculum standards and benchmarks established by the State of Indiana.  
  • Nutrition education posters and other nutrition education information will be displayed in the cafeteria.
  • The staff shall be encouraged to model healthy eating as a valuable part of daily life.

Physical Education Goals

  • Students and residents are given opportunities for physical activity during the school day through physical education classes, daily recreation periods for Day Treatment students, and other scheduled recreational programming during the day.  During inclement weather, students and residents will utilize the recreation building for physical activity.
  • Recreational programming will provide a variety of activities with an emphasis on developing healthy habits for a lifetime of regular physical activity.
  • Recreational programming shall teach cooperation, fair play, and responsible participation.
  • Recreational programming shall take into account gender and cultural differences.

Goals to Encourage Healthy Eating

  • UMYH will offer breakfast and lunch to all residents and students, prepared and served in a clean, safe environment, by well-prepared staff who understands food safety.  
  • Menus will meet the nutrition standards established by the U.S. Department of Agriculture and will feature a variety of healthy choices that are tasty, attractive, of excellent quality, and are served at the proper temperature.
  • UMYH will ensure that students, residents, and staff with documented nutrition-related health problems are provided with appropriate meals, and, if necessary, are referred to appropriate services for medical treatment.

Other School Based Activities

  • UMYH shall provide attractive, clean environments in which the students eat.  
  • Students and residents are discouraged from sharing their foods or beverages with one another during meal times, given concerns about allergies and other restrictions on some student’s diets.
  • At any function, healthy food choice options should be available to students and residents.