NOTICE OF PRIVACY INFORMATION PRACTICES
Effective Date: April 19, 2005
NOTE: This Model Notice of Privacy Practices is for informational purposes only and should not be construed as legal advice.
THIS NOTICE DESCRIBES HOW HOME CARE-RELATED INFORMATION ABOUT OUR CLIENTS MAY BE USED AND DISCLOSED AND HOW OUR CLIENTS CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
A. PURPOSE OF THE NOTICE
Compassionate Community Care is committed to preserving the privacy and confidentiality of our clients’ home care-related information which is created and/or maintained at our office. State and federal laws and regulations require us to implement policies and procedures to safeguard the privacy of our clients’ home care-related information. This Notice will provide you with information regarding our privacy practices and applies to all of our clients’ home care-related information created and/or maintained at our company, including any information that we receive from other health care providers or facilities. The Notice describes the ways in which we may use or disclose our clients’ home care-related information and also describes our clients’ rights and our obligations concerning such uses or disclosures.
We will abide by the terms of this Notice, including any future revisions that we may make to the Notice as required or authorized by law. We reserve the right to change this Notice and to make the revised or changed Notice effective for home care-related information we already have about our clients as well as any information we receive in the future. We will post a copy of the current Notice, which will identify its effective date, in our office.
The privacy practices described in this Notice will be followed by:
- Any company personnel authorized to enter information into our clients’ home care files created and/or maintained at our company;
- All employees and other service providers who have access to our clients’ home care-related information at our office; and
- Any member of our clients’ family and related parties which is allowed while receiving services from our company.
The individuals identified above will share our clients’ home care-related information with each other for purposes of in-home assistance and payment and as further described in the Notice.
B. USES AND DISCLOSURES OF CLIENT FOR IN-HOME ASSISTANCE AND PAYMENT
1. In-Home Assistance and Payment. The following section describes different ways that we may use and disclose our clients’ health information for purposes of In-home assistance and payment. We explain each of these purposes below and include examples of the types of uses or disclosures that may be made for each purpose. We have not listed every type of use or disclosure, but the ways in which we use or disclose our clients’ information will fall under one of these purposes.
a. In-Home Assistance. We may use our clients’ home care-related information to provide our clients with in-home assistance. We may disclose our clients’ health information to social workers, doctors, nurses, nursing assistants, medication aides, rehabilitation therapy specialists, caregivers or other personnel who are involved in your health care.
For example, we may assist with range of motion exercises to improve our clients’ strength and walking abilities. We, including caregivers, will need to talk with the physical therapist so that we can coordinate services and provide an appropriate plan of care. We will share information with that health care provider in order to coordinate our clients’ care and services.
b. Payment. We may use or disclose our clients’ home care-related information so that we may bill and receive payment from our clients, an insurance company, or another third party for the home care services our clients receive from us. We also may disclose home care-related information about our clients to our clients’ health plan in order to obtain prior approval for the services we provide to our clients, or to determine that our clients’ health plan will pay for the services.
For example, we may need to give home care-related information to insurance carrier in order to receive payment.
C. USES AND DISCLOSURES OF HOME CARE-RELATED INFORMATION IN SPECIAL SITUATIONS
We may use or disclose our clients’ home care-related information in certain special situations as described below. For these situations, our clients have the right to limit these uses and disclosures as provided for in Section F of this Notice.
1. Family Members and Friends. We may disclose our clients’ health information to individuals, such as family members and friends, who are involved in our clients’ care or who help pay for our clients’ care. We may make such disclosures when: (a) we have our clients’ verbal agreement to do so; (b) we make such disclosures and our clients do not object; or (c) we can infer from the circumstances that our client would not object to such disclosures. For example, we will share information about our client with our client’s spouse or other family member after giving our client an opportunity to agree or object.
We also may disclose our client’s home-care related information to family members or friends in instances when our client is unable to agree or object to such disclosures, provided that we feel it is in his/her best interests to make such disclosures and the disclosures relate to that family member or friend’s involvement in our client’s care. For example, if our client’s medical condition prevents him/her from either agreeing or objecting to disclosures made to his/her family or friends, we may share information with the family member or friend that comes to visit our client at his/her home, but we will share only that information which relates to their involvement in our client’s care.
D. OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES OF HOME CARE-RELATED INFORMATION
There are certain instances in which we may be required or permitted by law to use or disclose our clients’ home care-related information without your permission. These instances are as follows:
1. As required by law. We may disclose our clients’ home care-related information when required by federal, state, or local law to do so.
2. Public Health Activities. We may disclose our clients’ home care-related information to public health authorities that are authorized by law to receive and collect health information for the purpose of preventing or controlling disease, injury or disability; to report births, deaths, suspected abuse or neglect, reactions to medications.
3. Home Care Oversight Activities. We may disclose our clients’ home care-related information to a health oversight agency that is authorized by law to conduct home care oversight activities, including audits, investigations, inspections, or licensure and certification surveys. These activities are necessary for the government to monitor the persons or organizations that provide home care to individuals and to ensure compliance with applicable state and federal laws and regulations.
4. Judicial or administrative proceedings. We may disclose our clients’ health information to courts or administrative agencies charged with the authority to hear and resolve lawsuits or disputes. We may disclose our clients’ home care-related information pursuant to a court order, a subpoena, a discovery request, or other lawful process issued by a judge or other person involved in the dispute, but only if efforts have been made to (i) notify our client of the request for disclosure or (ii) obtain an order protecting our client’s health information.
5. Worker’s Compensation. We may disclose our clients’ home care-related information to worker’s compensation programs when our clients’ health condition arises out of a work-related illness or injury.
6. Law Enforcement Official. We may disclose our clients’ home care-related information in response to a request received from a law enforcement official to report criminal activity or to respond to a subpoena, court order, warrant, summons, or similar process.
7. Coroners, Medical Examiners, or Funeral Directors. We may disclose our clients’ home care-related information to a coroner or medical examiner for the purpose of identifying a deceased individual or to determine the cause of death. We also may disclose our clients’ home care-related information to a funeral director for the purpose of carrying out his/her necessary activities.
8. To Avert a Serious Threat to Health or Safety. We may use or disclose our clients’ home care-related information when necessary to prevent a serious threat to the health or safety of our clients or other individuals.
9. Military and Veterans. If our client is a member of the armed forces, we may use or disclose our client’s home care-related information as required by military command authorities.
10. National Security and Intelligence Activities. We may use or disclose our clients’ home care-related information to authorized federal officials for purposes of intelligence, counterintelligence, and other national security activities, as authorized by law.
E. USES AND DISCLOSURES PURSUANT TO YOUR WRITTEN AUTHORIZATION
Except for the purposes identified above in Sections B through D, we will not use or disclose our clients’ home care-related information for any other purposes unless we have our clients’ specific written authorization. Our clients have the right to revoke a written authorization at any time as long as our clients do so in writing. If our clients revoke their authorization, we will no longer use or disclose our clients’ home care-related information for the purposes identified in the authorization, except to the extent that we have already taken some action in reliance upon our clients’ authorization.
F. YOUR RIGHTS REGARDING YOUR HOME CARE-RELATED INFORMATION
Our clients have the following rights regarding our clients’ home care-related information. Our clients may exercise each of these rights, in writing
1. Right to Inspect and Copy. Our clients have the right to inspect and copy home care-related information that may be used to make decisions about our clients’ care. We may deny our clients’ requests to inspect and copy our clients’ home care-related information in certain limited circumstances. If our clients are denied access to their home care-related information, they may request that the denial be reviewed.
2. Right to Amend. Our clients have the right to request an amendment of their home care-related information that is maintained by or for our company and is used to make home care-related decisions about our clients. We may deny our client’s request if it is not properly submitted or does not include a reason to support our client’s request. We may also deny our client’s request if the information sought to be amended: (a) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (b) is not part of the information that is kept by or for our company; (c) is not part of the information which our client is permitted to inspect and copy; or (d) is accurate and complete.
3. Right to an Accounting of Disclosures. Our clients have the right to request an accounting of the disclosures of their home care-related information made by us. This accounting will not include disclosures of home care-related information that we made for purposes of payment or home care operations or pursuant to a written authorization that our clients have signed.
4. Right to Request Restrictions. Our clients have the right to request a restriction or limitation on the home care-related information we use or disclose about our clients for in-home assistance and payment. Our clients also have the right to request a limit on the home care-related information we disclose about them to someone, such as a family member or friend, who is involved in their care or in the payment of their care.
For example, our client could ask that we not use or disclose information regarding their plan of care. We are not required to agree to our client’s request. If we do agree, that agreement must be in writing and signed by our client and us.
5. Right to Request Confidential Communications. Our clients have the right to request that we communicate with them about their health care in a certain way or at a certain location. For example, our clients can ask that we only contact them by mail.
6. Right to a Paper Copy of this Notice. Our clients have the right to receive a paper copy of this Notice. Our clients may ask us to give them a copy of this Notice at any time.
G. QUESTIONS OR COMPLAINTS
If you have any questions regarding this Notice or wish to receive additional information about our privacy practices, please contact our Privacy Officer at 1426 Fillmore Street, Suite 207 in San Francisco, California or call 415-921-5038. If you believe our client’s privacy rights have been violated, you may file a complaint with our agency.
To file a complaint with our agency, contact our Privacy Officer at 1426 Fillmore Street, Suite 207 in San Francisco, California or call 415-921-5038. All complaints must be submitted in writing. You will not be penalized for filing a complaint.