NOTICE OF HOME CARE PRIVACY PRACTICES
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.
USE AND DISCLOSURE OF HEALTH INFORMATION
C4E may use your health information for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after C4E has obtained your written consent. C4E has established policies to guard against unnecessary disclosure of your health information by employees or outside parties.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES WHERE YOUR HEALTH INFORMATION MAY BE USED/ DISCLOSED WITH YOUR CONSENT.
To Provide Treatment:
C4E may use your health information to coordinate care within C4E and with your physician, therapists, case managers, pharmacists, medical equipment suppliers, family, POAs and others who are legally appropriate to receive your health information.
To Obtain Payment:
C4E may disclose your health information to insurance companies as needed to obtain prior approval and to collect payment for the care you receive from C4E.
To Conduct Health Care Operations:
C4E may use and disclose health information for its own operations in order to facilitate the function of C4E, and as necessary to provide quality care to all of C4E ‘s clients.
For Appointment Reminders:
C4E may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit.
For Treatment Alternatives:
C4E may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT
When Legally Required.
C4E will disclose your health information when it is required to do so by any Federal, State or local law and law enforcement officials.
When There Are Risks to Public Health
C4E may disclose your health information for public activities and purposes in order to:
Prevent or control disease, injury or disability and to report adverse events; to notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
Notify an employer about an individual who is a member of the workforce as legally required.
To Report Abuse, Neglect or Domestic Violence.
C4E is allowed to notify government authorities if C4E believes a client is the victim of abuse, neglect or domestic violence.
To Conduct Health Oversight Activities.
C4E may disclose your health information to a health oversight C4E for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.
In Connection with Judicial and Administrative Proceedings.
C4E may disclose your health information in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful processes.
To Coroners and Medical Examiners.
C4E may disclose your health information to coroners, medical examiners and funeral directors of determining your cause of death and for making funeral arrangements.
For Organ, Eye or Tissue Donation.
For Research Purposes.
For Worker's Compensation.
C4E may release your health information for worker's compensation or similar programs.
For Specified Government Functions.
In certain circumstances, the Federal regulations authorize C4E to use or disclose your health information to facilitate specified government function.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than is stated above, C4E will not disclose your health information without your written authorization. You may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that C4E maintains:
Right to request restrictions.
You may request restrictions on certain uses and disclosures of your health information.
Right to receive confidential communications.
You have the right to refuses any persons other than yourself to have access to your health information.
Right to inspect and copy your health information.
You have the right to inspect and copy your health information.
Right to amend health care information.
You or your representatives have the right to request that C4E amend your records if you believe that your health information is incorrect or incomplete. C4E may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by C4E.
Right to an accounting.
You or your representative have the right to request an accounting of disclosures of your health information made by C4E for any reason other than for treatment, payment or health operations. The request should specify the time period for the accounting starting on or after April 14, 2003. Six (6) years is the maximum period of time for the request.
Right to a paper copy of this notice.
You/your representative have a right to a separate paper copy of this Notice at any time. To obtain a separate paper copy, please contact Care4Everyone at 651-300-2073. The client or a client’s representative may also obtain a copy of the current version of C4E’s Notice of Privacy Practices at its website www.care4everyone.org.
DUTIES OF C4E:
C4E is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. C4E is required to abide by the terms of this Notice. You have the right to express complaints to C4E and to the Secretary of DHHS if you believe that your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint.
For all issues regarding client privacy and your rights under the Federal privacy standards, you may contact Care4Everyone, 749 Milton Street North, Saint Paul, 55104 or by phone (651) 300-2073 if you have any questions or concerns about this privacy notice or your rights.