HIPAA Privacy

HIPAA Privacy Notice for Children and Their Families

Your Information. Your Rights. Our Responsibilities.

This Notice describes how health information about your child/children may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

You have the right to:

  • Get a copy of your child’s/children’s paper or electronic medical record
  • Correct your child’s/children’s paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share regarding your child/children
  • Get a list of those with whom we’ve shared your child’s/children’s information
  • Get a copy of this Privacy Notice
  • Choose someone to act for your child/children
  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share your child’s/children’s health information as we:

  • Communicate with family and friends about your child’s/children’s condition
  • Market our services and sell your information
  • Raise funds

Our Uses and Disclosures

We may use and share your child’s/children’s health information as we:

  • Provide health care services to your child/children
  • Operate our organization
  • Bill for the services provided to your child/children
  • Help with public health and safety issues
  • Conduct research activities
  • Comply with the laws and regulations
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions

Your Rights

When it comes to your child’s/children’s health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your child’s/children’s medical record

  • You can ask to see or get an electronic or paper copy of your child’s/children’s medical record and other health information we possess. Ask us how to do this.
  • We will provide a copy or a summary of your child’s/children’s health information, usually within 30 days of your request. We may charge a reasonable,         cost-based fee.

Ask us to correct your child’s/children’s medical record

  • You can ask us to correct health information about your child/children that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why ~ in writing ~ within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.

Ask us to limit what health information we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we     may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with        your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your child’s/children’s health information for six years prior to the date you ask, who we shared it with, and why we shared it.
  • We will include all the disclosures except for those pertaining to treatment, payment, and health care operations, and certain other disclosures (such as any    you asked us to make). We’ll provide one accounting a year for free but will          charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this Privacy Notice

  • You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically.
  • We will provide you with a paper copy of this Notice promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting    www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your child’s/children’s health information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your child’s/children’s care
  • Share your child’s/children’s health information in a disaster relief situation

We may share your child’s/children’s information if we believe it is in your child’s/children’s best interest. We may also share your child’s/children’s information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your child’s/children’s information unless you give us written permission:

  • Marketing purposes
  • Sale of your child’s/children’s information

In the case of fundraising:

  • We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

We typically use or share your child’s/children’s health information in the following ways:

To treat your child/children. Additionally, we can use your child’s/children’s health information and share it with other professionals who are treating your child/children. Example: A doctor treating your child/children for an injury asks another doctor about your child’s/children’s overall health condition.

To operate our organization

We can use and share your child’s/children’s health information to run our organization, improve your child’s/children’s care, and contact you when necessary. Example: We use health information about your child/children to manage their treatment and services.

To bill for your child’s/children’s services

We can use and share your child’s/children’s health information to bill and get payment from health plans or other entities. Example: We give information about your child/children to your health insurance plan so it will pay for their services.

How else can we use or share your child’s/children’s health information?

We are allowed or required to share your child’s/children’s information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share your child’s/children’s health information for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your child’s/children’s information for health research.

Comply with the law

We will share information about your child/children if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about your child/children:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about your child/children in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your child’s/children’s health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your child’s/children’s health information.
  • We must follow the duties and privacy practices described in this Notice and give you a copy of it.
  • We will not use or share your child’s/children’s health information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to the Terms of this Privacy Notice

We can change the terms of this Notice, and the changes will apply to all information we have about your child/children. The new Notice will be available upon request, on our web site, and we can mail a copy to you.

Effective Date of this Notice: June 9, 2014

Date Reviewed: July 1, 2018

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