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.
If
you have questions about this notice, you may contact the Livingstone Community
Health Clinic (LCHC) in either of the following ways:
·
You
can call 714-248-9500
·
You
can e-mail admin@08a8be9517.nxcli.io
You
can also view additional information about Notices of Privacy Practices at the
following website: http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Our
Pledge Regarding Protected Health Information
·
We
understand that information about you and your health is personal. We are
committed to protecting the privacy of your protected health information.
·
We
create a record of the care and services you receive at LCHC, and we may
receive similar records from others.
·
We
use these records to provide you with quality care and to comply with legal
requirements.
·
This
Notice tells you about the ways we may use and disclose information about you.
It also describes your rights, and the obligations we have regarding the use
and disclosure of your information.
We
are required by law to do the following:
·
Make
sure that information that identifies you is kept private.
·
Give
you this Notice of our legal duties and privacy practices with respect to
information about you.
·
Follow
the terms of the Notice we currently have in effect.
A. Who Will Follow This Notice
· This Notice describes LCHC’ practices and the practices of all of the following entities:
– Any health care professional authorized to enter information into your
electronic health
record.
– All employees, contractors, volunteers, staff, and other LCHC personnel.
·
There may also be other state and federal laws
that LCHC and other health care providers will follow that provide additional
protections related to:
– Communicable Disease
– Mental Health
– Substance or Alcohol Abuse
– Other Health Conditions
B.
How LCHC May Use or Disclose
Your Protected Information
Following
are the different ways we may lawfully use or disclose your protected health information.
The examples provided in each section do not represent all the ways your
protected health information may be used. They are only intended to generally
describe situations when uses or disclosures may happen.
1.
For Treatment
Our
use:
·
We
may use your protected health information to provide you with comprehensive
medical, dental, and mental health services.
For example:
– We may disclose protected health information about you to LCHC doctors,
nurses, technicians, case workers, and other LCHC employees who are involvedin
providing the care you need.
– We may also share your protected health information with a provider or entity
outside of LCHC in order to provide or coordinate services for you such as
ordering outside lab work or an x-ray.
2. For
Payment
Our use:
·
We
may use and disclose your protected health information to obtain payment for
the services we provide.
– We give your health insurance plan the information it requires before it will
pay us.
·
We
may also contact a health insurance plan or a third-party payor about a
treatment or service you are going to receive in the future. We would do this
so we can obtain priorapproval or to determine what your insurance plan may
cover.
3.
For Health Care Operations
Our use:
·
We
may use and disclose your protected health information to operate this clinic.
These types of uses and disclosures are necessary to run LCHC and ensure that
all our patients and clients receive quality care.
For example:
– We may use medical information to review our treatment and services and to
evaluate the staff caring for you.
– We may also combine information about many clinic patients together to make
operational decisions, for example, to determine what additional services the
clinic shouldoffer, or if a certain treatment is effective.
– We may also disclose information to our staff for learning and review
purposes.
– We may also compare the information we have with other clinics or
organizations to compare how we are doing and to make improvements in the
services and care we offer.
– We may remove information that identifies you from these sets of medical
information so that others may use it without learning who the specific patient
is.
Use by a third party:
·
We
may also share your protected health information with a third-party “business
associate” who is assisting us with clinic operations.
For example:
– We might share protected health information with a billing service performing
administrative services.
– We might share protected health information with an information technology
firm assisting us with our electronic medical record maintenance. We have a
written contract with each of these business associates which requires them to
protect the confidentiality of your protected health information.
4.
For Health-related Benefits and Alternative Services
Our
use:
·
We
may use and disclose protected health information to tell you about
health-related services, benefits, or programs that might benefit you.
·
We
may also disclose protected health information to tell you about or recommend
possible treatment options or alternatives.
5.
To Individuals Involved in Your Care
Our
use:
·
We
may release your protected health information to a friend or family member who
is involved in your care or who helps pay for your care.
Note: If you have given someone power of attorney, or if someone is your legal
guardian, that person can exercise your rights, and make choices about your
protected health information. We will make sure the person has the authority,
and can act for you, before we take any action.
·
In
addition, in the event of a disaster, we may disclose information about you to
an entity assisting in a disaster relief effort.
Note: California law requires that only basic information such as your name,
city of residence, age, sex, and general condition be provided in response to a
disaster welfareinquiry.
6.
As Required by Law
Use
by another entity:
We will disclose your protected health information when required to do so by federal,
state, or local law.
For example:
– In some circumstances the law
may require your physician to report instances of abuse violence, or neglect.
7.
To Avert a Serious Threat to Health or Safety
Use
by another entity:
·
We
may use or disclose your protected 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. Any disclosure, however, would only be to someone
able to help, prevent, or lessen the threat.
8.
For Research Purposes
Use
by another entity:
LCHC
may participate in research projects conducted by various entities.
·
All
research projects are reviewed and approved through a special review process to
protect patient safety, welfare, and confidentiality.
·
Your
protected health information may be important to research efforts and the
development of new knowledge. We may use and disclose protected health
information for this purpose.
·
Research
studies may be performed using information about your treatment without
requiring informed consent.
For example:
– A research study may involve comparing the health of patients
Special
Situations
9.
Public Health Activities
Use
by another entity:
We may disclose information about you to various public health entities for
public health purposes.
These
purposes generally include the following:
a. Preventing or controlling diseases (such as cancer and tuberculosis),
injury, or disability
b. Reporting vital events such as births and deaths
c. Public health surveillance, investigations, interventions, or at the
direction of a public health authority
d. Providing it to an official of a foreign government agency acting in
collaboration with a public health authority
e. Reporting child abuse or neglect
f. Reporting adverse events or reactions related to foods, drugs, or products
g. Notifying people of recalls, repairs, or replacements of products they may
be using
h. Notifying a person who may have been exposed to a disease or who may be at
risk of contracting or spreading a disease or condition
i. Notifying the appropriate government authority if we believe a patient has
been the victim of abuse, neglect, or domestic violence, and make this
disclosure as required or authorized by law.
10.
Health Oversight Activities
Use
by another entity:
·
We
may disclose protected health information to governmental, licensing, auditing,
and accrediting agencies for activities authorized by federal and California
law.
11.
Lawsuits and Other Legal Actions
Use
by another entity:
·
We
may disclose information about you in response to a court or administrative
order, or in response to a subpoena, discovery request, warrant, summons, or
other lawful proceeding.
12.
Law Enforcement
Use
by another entity:
·
We
may disclose your protected health information to law enforcement officials
upon their request, for any of the following reasons:
– In response to a court order, subpoena, warrant, investigative demand, or
other similar process
– To help identify or locate a suspect, fugitive, material witness, or missing
person; about the victim of a crime if, under certain limited circumstances, we
are unable to obtain thevictim’s agreement
– About a death we believe may be the result of criminal conduct; about
criminal conduct occurring on our premises
– In emergency circumstances to report a crime, the location of the crime or
victims, or the identity, description, or location of the person who committed
the crime
13.
Coroners, Medical Examiners, and Funeral Directors
Use by another entity:
·
We
may, and are often required by law, to disclose your protected health
information to coroners, medical examiners, and/or funeral directors. This is
done to assist these professionals with their investigation of death or to help
them carry out their professional duties.
14.
Organ and Tissue Donation
Use
by another entity:
·
We
may disclose your protected health information to organizations involved in
obtaining, storing, or transplanting organs and tissues.
·
You
may request, in writing, a restriction on how much information we share when
responding to requests about the appropriateness of obtaining, storing, or
transplanting organs and tissue
For example:
– Since HIV is usually a reason not to do these activities, you may ask us in
writing to simply say it is not medically appropriate, without providing more
information about the reasons why it is not appropriate.
15.
Military, National Security, and Intelligence Activities
Use
by another entity:
·
We
may disclose your protected health information to authorized federal officials
for intelligence, counterintelligence, and other national security activities
authorized by law.
·
We
may also release protected health information about you to federal officials so
they may provide protection to the President, other authorized persons, or foreign
heads of states. If the law so requires.
16.
Inmates
Use
by another entity:
·
If
you are an inmate of a correctional institution, or under the custody of law
enforcement officials, we may release your protected health information to the
correctional institution or to a law enforcement official.
·
This
release would be necessary for any of the following reasons:
a. For the institution to provide you with health care.
b. To protect your health and safety or the safety of others.
c. For the safety and security of the correctional institution.
17.
Worker’s Compensation
Use
by another entity:
·
We
may disclose your protected health information as necessary to comply with
Worker’s Compensation laws.
·
These
programs provide benefits for work-related injuries or illnesses.
For example:
– If your care is covered by
Worker’s Compensation, we will make periodic reports to your employer about
your condition.
– We are also required to report
cases of occupational injury or occupational illness to the employer or Worker’s
Compensation insurer.
18.
Outreach and Fundraising Activities
Our
use:
·
We
will not use or disclose your protected health information in any of our outreach
orfundraising activities.
·
However,
we may use combined demographic data about many people for such activities.
For example:
– We might create a brochure to
hand out at events that lists the number of LCHC patients and provides basic
demographic information about our patients in general.
– We may also send out fundraising information to individuals who have made
donations in the past or who may make donations in the future, and to past
patients.
If you want to exclude your personal information from being used in this way,
notify LCHC at the telephone number or e-mail address listed at the top of this
Notice.
19.
Psychotherapy Notes
Use
by another entity:
·
We
will not use or disclose your psychotherapy notes without your express written
consent, except in limited circumstances related to payment, treatment, and
other health careoperations, as allowable by law. We Never Sell Your
Information.
20.
Marketing and Sales
Our
use:
We
will never use your information for marketing purposes without first obtaining
your express written consent.
C. Your
Rights Regarding Your Protected Health Information
1. Your
Right to Inspect and Copy
·
With
certain exceptions, you have the right to inspect and copy your protected
health information.
·
To
access your protected health information, you must submit a request, in
writing, to:
LCHC
12362 Beach Blvd., Suite
10
Stanton, CA 90680
·
If
you request a copy of this information we will provide it to you within 15
days, and we may charge you a reasonable fee. If there are any circumstances
which prevent us from fulfilling your request within 15 days, we will notify
you of the delay.
·
We
may deny your request under limited circumstances. If we deny your request to
access your records, you have the right to appeal our decision. If we deny your
request to access your psychotherapy notes, you have the right to have them
transferred to another health professional.
·
If
your written request clearly, conspicuously, and specifically asks us to send
an electronic copy of your medical record to you or another person or entity,
and we do not deny the request, we will send a copy of the electronic record as
you requested and will charge you no more than what it costs us to respond to
your request.
2. Your Right to Amend or
Supplement
·
If
you feel the information that we have about you is incorrect or incomplete, you
may ask us to amend the information or add an addendum.
·
You have the right to seek an amendment or
addendum for as long as the information is kept by LCHC.
·
To
request an amendment or addendum, a request must be made, in writing, and
submitted to:
LCHC
12362 Beach Blvd., Suite
10
Stanton, CA 90680
·
In
addition, you must provide a reason that supports your request.
·
An
addendum may not be more than 250 words per alleged incomplete or incorrect
item in your record.
·
We
may deny your request for an amendment or an addendum regarding your protected
health information or record for any of the following reasons:
– The request is not in writing.
– The health information was not created by LCHC, is not part of the designated
record set.
– The health information is already accurate and complete.
– The health information is not information you are permitted to review (as
outlined in §164.524 of the Health Insurance Portability and Accountability
Act).
·
If
we deny your request we will explain why, in writing, within sixty (60) days.
3. Your
Right to an Accounting of Disclosures
·
You
have a right to receive an “accounting of disclosures.”
·
The
accounting is a list of the disclosures of your protected health information we
have made in the last six (6) years that were for purposes other than treatment,
payment, or health care operations, and certain other purposes.
·
To request an accounting of disclosures, you
must submit your request, in writing to:
LCHC
12362 Beach Blvd., Suite
10
Stanton, CA 90680
·
Your
request should also indicate in what form you want the list (for example, on
paper or
electronically).
·
The
first request within a 12-month period will be free. For additional lists we
may charge you for the costs of providing the list. We will notify you of the
cost and you may choose to
withdraw or modify your request.
4. Your
Right to Request Restrictions
·
You
have the right to request a restriction or limitation on the protected health
information we use or disclose about you for treatment, payment, or health care
operations.
·
You
also have the right to request a limit on the protected health information we
disclose about you to someone who is involved in your care or the payment for
your care, like a family member or friend.
For example:
– You could ask that we not use or disclose information about a specific
medication you are taking.
·
To
request restrictions, you must make your request in writing to:
LCHC
12362 Beach Blvd., Suite
10
Stanton, CA 90680
In your request, you must tell
us:
a. what information you want to limit;
b. whether you want to limit our use, disclosure, or both; and
c. to whom you want these limits to apply, for example, disclosures to your
spouse.
·
In
general, we are not required to agree with your request.
·
If
we do agree, we will comply with your request unless the information is needed
to provide you emergency treatment, or we are compelled to disclose the
information under the law.
·
However,
if you tell us not to disclose health information to your commercial health
insurance plan, and you pay for the services out-of-pocket and in full at the
time of service, we are required by law to comply with your request.
5. Your
Right to Request Confidential Communications
·
You
have the right to request that you receive your protected health information in
a specific way or at a specific location.
For example:
– You may ask that we send information to your work address.
·
We
will comply with all reasonable requests submitted in writing to:
LCHC
12362 Beach Blvd., Suite
10
Stanton, CA 90680
·
The
request must specify how or where you wish to receive these communications. We
must comply with your request if you inform us that not doing so will put you
in danger.
6. Your
Right to a Paper Copy of this Notice
·
You
can receive a paper copy of this Notice even if you have previously received
this Notice electronically.
·
If
you would like to have a more detailed explanation of these rights, or if you
would like to exercise one or more of these rights, contact LCHC at the
telephone number or e-mail address listed at the top of this Notice.
D. Breach
Notification
·
If,
despite LCHC’ efforts to keep your protected health information confidential, a
breach of unsecured protected health information occurs, we will notify you as
required by law.
·
In
some instances, our business associate may provide the notification.
·
The
law also requires us to report any breach of protected health information to
both state and federal authorities.
E. Changes
to This Notice of Privacy Practices
·
We
reserve the right to change LCHC’ privacy practices and this Notice at any time.
·
Until
a change is made, we are required by law to comply with this Notice.
·
After
a change is made, the revised Notice of Privacy Practices will apply to all
protected health information that we maintain, regardless of when it was
created or received.
·
We
will keep a copy of the current notice posted in our reception areas and will
offer you a copy at your next appointment after changes have been made. We will
also post the current notice on our website.
G.
Complaints
·
Complaints
regarding our Notice of Privacy Practices, or how LCHC handles your protected
health information, should be directed to LCHC at the telephonenumber or e-mail
address listed at the top of this Notice.
·
You
will not be penalized or retaliated against for filing a complaint.
If you are not satisfied with how LCHC handles a complaint, you
may take any of the following steps:
– You may submit a formal written complaint to the Office of
Civil Rights at:
Centralized Case Management Operations
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
– Or you may email your complaint to: OCRComplaint@hhs.gov
– To file a complaint online, visit https://ocrportal.hhs.gov/ocr/cp/wizard_cp.jsf
For
more information on filing a complaint with the Office of Civil Rights, visit:
https://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html