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This page describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Our Duty to Safeguard Your Protected Health Information Individually identifiable information about your past, present, or future health or condition, the provision of health care to you, or payment for health care is considered "Protected Health Information" (PHI). We are required to extend certain protections to your PHI, and to give you this Notice about our privacy practices that explains how, when and why we may use or disclose your PHI. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the intended purpose of the use or disclosure. You may request a copy of this notice at any time. How We May Use and Disclose Your Protected Health Information We use and disclose PHI for a variety of reasons. We have a limited
right to use and/or disclose your PHI for purposes of treatment,
payment and for our health care operations. For uses beyond that,
we must have your written authorization unless the law permits or
requires us to make the use or disclosure without your authorization.
If we disclose your PHI to an outside entity in order for that entity
to perform a function on our behalf, we must have in place an agreement
from that outside entity that it will extend the same degree of
privacy protection to your information that we must apply to your
PHI. However, if the law provides that we are permitted to make
some uses/disclosures without your consent or authorization. The
following describes and offers examples of our potential use/disclosures
of your PHI. Uses and Disclosures of PHI Requiring Authorization For uses and disclosures beyond treatment, payment and operations purposes we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described below. Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken an action in reliance upon your authorization. Uses and Disclosures of PHI from Mental Health Records Not Requiring Consent or Authorization The law provides that we may use/disclose your PHI from mental health records without consent or authorization in the following circumstances: When required by law: We may disclose PHI when a law requires that we report information about suspected abuse, neglect or domestic violence, or relating to suspected criminal activity, or in response to a court order. We must also disclose PHI to authorities that monitor compliance with these privacy requirements. For public health activities: We may disclose PHI when we are required to collect information about disease or injury, or to report vital statistics to the public health authority. For health oversight activities: We may disclose PHI to protection and advocacy agencies, and other agencies responsible for monitoring the health care system for such purposes as reporting or investigating unusual incidents, and monitoring of insurance programs. Relating to descendants: We may disclose PHI related to a death
to coroners and medical examiners. For research purposes: In certain circumstances, and under supervision of a privacy board, we may disclose PHI to research staff and their designees in order to assist in mental health research. To comply with laws relating to worker' compensation or similar program: We may disclose your PHI to your employer for Workers' Compensation or other program that provides benefits for work-related illness or injury. Uses and Disclosures of PHI from Alcohol and Other Drug Records Not Requiring Consent or Authorization The law provides that we may use/disclose your PHI from alcohol and other drug records without consent or authorization in the following circumstances: When required by law: We may disclose PHI when a law requires that we report information about suspected child abuse and neglect, or when a crime has been committed on the premises or against personnel, or in response to a court order. Relating to descendants: We may disclose PHI relating to an individual's death if state or federal law requires the information for collection of vital statistics or inquiry into cause of death. For research, audit or evaluation purposes: In certain circumstances, we may disclose PHI for research, audit or evaluation purposes. To avert threat to health or safety: In order to avoid a serious threat to health or safety, we may disclose PHI to law enforcement when a threat is made to commit a crime on LCFS premises or against LCFS personnel. Your Rights Regarding Your Protected Health Information You have the following rights relating to your protected health information: To request restrictions on uses/disclosures: You have the right to ask that we limit how we use or disclose your PHI. We will consider your request, but are not legally bound to agree to the restriction. To the extent that we do agree to any restrictions on our use/disclosure of your PHI, we will put the agreement in writing and abide by it except in emergency situations. We cannot agree to limit uses/disclosures that are required by law. To choose how we contact you: You have the right to ask that we send you information at an alternative address or by an alternative means. We must agree to your request as long as it is reasonable easy for us to do so. To inspect and request a copy of your PHI: Unless your access to your records is restricted for clear and documented treatment reasons, you have a right to see your protected health information upon your written request. We will respond to your request within 30 days. If we deny your access, we will give you written reasons for the denial and explain any right to have the denial reviewed. If you want copies of your PHI, a charge for copying may be imposed, depending on your circumstances. You have a right to choose what portions of your information you want copied and to have prior information on the cost of copying. To request amendment of you PHI: If you believe that there is a mistake or missing information in our record of your PHI, you may request, in writing, that we correct or add to the record. We will respond within 60 days of receiving your request. We may deny the request if we determine that the PHI is: (1) correct and complete; (2) not created by us and/or not part of our records, or; (3) not permitted to be disclosed. Any denial will state the reasons for denial and explain your rights to have the request and denial, along with any statement in response that you provide, appended to your PHI. If we approve the request for amendment, we will change the PHI and so inform you, and tell others that need to know about the change in the PHI. To find out what disclosures have been made: You have a right to
get a list of when, to whom, for what purpose, and what content
of your PHI has been released other than instances of disclosure:
for treatment, payment, and operations; to you, your family, or
the facility directory; or pursuant to your written authorization.
The list also will not include any disclosures made for national
security purposes, to law enforcement officials or correctional
facilities, or disclosures made before April 2003. You Have the Right to Receive this Notice You have a right to receive a paper copy of the Notice. How to Complain About Our Privacy Practices If you think we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed below. You also may file a written complaint with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington D.C. 20201 or call 1-877-696-6775. We will take no retaliatory action against you if you make such complaints. Contact Person for Information or to Submit a Complaint If you have questions about this Notice or any complaints about our privacy practices, please contact our Compliance Officer at: Lutheran Child and Family Services |
