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.

MAIN USES AND DISCLOSURES

We typically use or share your health information in the following ways:

For Treatment

We can use your health information and share it with other professionals who are treating you.

Example: A nurse treating you for an injury asks another nurse about your overall health condition. 

To Run Our Organization

We can use and share your health information to run our agency, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

OTHER USES AND DISCLOSURES

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

To Help with Public Health and Safety Issues

We can share health information about you in situations affecting public health and safety such as:

• Preventing disease
• Helping with product recalls\
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

For Research Purposes

We can use or share your information for health research. Rev 12/1/24

To Comply with the Law

We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

To Respond to Organ and Tissue Donation Requests

We can share health information about you with organ procurement organizations.

To Work with a Medical Examiner or Funeral Director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address Workers’ Compensation, Law Enforcement, and Other Government Requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to Lawsuits and Legal Actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

‌USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

Further, we will not use or share your information for a purpose not described in this Notice of Privacy Practices unless you give us written permission to do so. If you give us written permission to use or share your information for such a purpose, you may change your mind at any time. Let us know in writing if you change your mind.

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Restrictions On Our Use and Disclosure of Certain Information

We may not use or share your information if the purpose is to use it to investigate or impose liability on a person for obtaining or providing lawful reproductive health care. For example, we may not share your medical record in response to a request from law enforcement if the purpose is to prosecute your health care provider for providing lawful reproductive health care to you.,kj7

If we receive certain requests, we must obtain a signed attestation from the requestor that your information will not be used for the prohibited purposes described above before we can share your information that is potentially related to reproductive health care. This includes requests for purposes of:

• Health oversight activities
• Judicial and administrative hearings
• Law enforcement purposes
• Disclosures to coroners and medical examiners

For example, if we receive a request from law enforcement for your medical record that contains information related to reproductive health care, we cannot share that information until the law enforcement official signs an attestation that the information will not be used to investigate or impose liability on a person for obtaining or providing lawful reproductive health care.

Redisclosure‌

When we share information about you with others, the recipient may share your information with others (redisclosure) and the information may no longer be protected by privacy laws.

YOUR CHOICES

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

YOUR RIGHTS

You have the right to:

Ask Us to Limit what We Use or Share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Request Confidential Communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Get an Electronic or Paper Copy of your Medical Record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 15 days of your request. We may charge a reasonable, cost-based fee.

Ask us to Correct (Amend) your Medical Record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Get a List of those with whom We’ve Shared Information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a Copy of this Privacy Notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

OUR DUTIES AND RESPONSIBILITIES

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

‌Redisclosure

When information about you is shared with others, it may be redisclosed by the recipient and no longer protected by the law.

CHANGES TO THE TERMS OF THIS NOTICE

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

COMPLAINTS

You can complain if you feel we have violated your rights by contacting our Privacy Officer at (214)689-2990 or (800) 442-4490. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W.,Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

FOR MORE INFORMATION

For further information, please contact our Privacy Officer at (214) 689-2990 or 1 (800) CALL VNA (225-5862).

This Notice is Effective 12/1/2024