I. SAFEGUARDING YOUR PROTECTED HEALTH INFORMATION (PHI)

·        We have a legal obligation to protect the privacy of your health information. Your PHI includes information that can be used to identify you that we have created or received about your health or condition and related health care services. We may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure, with some exceptions. We must provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. We are legally required to abide by the privacy practices that are described here.

II. USING AND DISCLOSING YOUR PROTECTED HEALTH INFORMATION (PHI)

·        For treatment. We may use and disclose your PHI to provide or coordinate your care. This includes disclosures to physicians or other health care facilities or personnel (e.g., a specialist, your primary care provider, etc.) who provide you with health care services or are involved in your care. For example, your PHI may be forwarded to your primary care physician for continuity of care purposes, or provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.

·         When the law requires a disclosure. For example, we are required to make disclosures about victims of abuse, neglect or domestic violence; when dealing with gunshot and other wounds; or when ordered in a judicial or administrative proceeding.

·        Your PHI will never be used for fundraising or marketing.

III. YOUR RIGHTS REGARDING YOUR PHI

A. The Right to Request Limits on Uses and Disclosures of Your PHI

·        You have the right to request that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. You may not limit the uses and disclosures that we are legally required or allowed to make.

B. The Right to Choose How We Send PHI to You

·        You have the right to ask that we send information to you to an alternate address (e.g., sending information to your work address rather than your home address) or by alternate means (e.g., fax rather than regular mail). We must agree to your request as long as we can easily provide it in the format you requested.

C. The Right to Inspect and Copy Your PHI

·        In most cases, you have the right to look at or obtain copies (at a nominal fee) of your PHI for as long as we maintain the PHI. You may not inspect or copy notes or PHI compiled in anticipation of a legal proceeding or that is subject to any law that prohibits its access.

·        All requests must be made in writing. We will respond to you within 60 days after receiving your written request. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial.

E. The Right to Correct or Amend Your PHI

·        If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we correct or add to the existing information. You must provide the request and your reason for the request in writing. We will respond within 60 days of receiving your request. If we approve your request, we will make the change to your PHI, tell you that we have done it and tell others that need to know about the change to your PHI.

·        We may deny your request in writing if the PHI is (1) correct and complete, (2) not created by us, (3) not allowed to be disclosed or (4) not part of our records. Our written denial will state the reasons for the denial. You have the right to ask that your request and our denial be attached to all future disclosures of your PHI.

IV. HOW TO RAISE CONCERNS ABOUT OUR PRIVACY PRACTICES

·        If you think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may send a written complaint to the secretary of the Department of Health and Human Services. We will take no retaliatory action against you if you file a complaint about our privacy practices.