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Ho`okele Care at Home – NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW PERSONAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this notice, please contact our office at  (808) 457-1655

OUR PLEDGE REGARDING YOUR HEALTH INFORMATION

We understand that health information about you and your healthcare is personal. We are committed to protecting health information about you. We will create a record of the care and services you receive from us. We do so to provide you with quality care and to comply with any legal or regulatory requirements.

This Notice applies to all of the records generated or received by Ho`okele Care at Home, whether we documented the health information, or another service provider forwarded it to us. This Notice will tell you the ways in which we may use or disclose health information about you. This Notice also describes your rights to the health information we keep about you, and describe certain obligations we have regarding the use and disclosure of your health information. Our pledge regarding your health information is supported by Federal law. Pursuant to the standards for privacy and security in the Health Insurance Portability and Accountability Act (“HIPAA”), we will: o Make sure that health information that identifies you is kept private, in the manner described in this Notice of Privacy Practices; o Make available this Notice of our legal duties and privacy practices with respect to health information about you; and o Follow the terms of our Notice of Privacy Practices that is currently in effect.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The following categories describe different ways that we may use or disclose health information about you. Unless otherwise noted each of these uses and disclosures may be made without your permission. For each category of use or disclosure, we will explain what we mean and give some examples. Not every use or disclosure in a category will be listed. However, unless we ask for a separate authorization, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment. We may use health information about you to provide you with home care services. We may disclose health information about you to doctors, nurses, technicians, health students, volunteers or other personnel who are involved in taking care of you. For example, a doctor treating you may need to know information about your blood pressure, weight, blood sugars (glucose) or other information we have that may affect your treatment by your medical providers, or we may have information from your other providers that a doctor may request to facilitate treatment of you. We may provide that information to a physician or provider treating you.

For Payment: We may use and disclose health information about you so that the treatment and services you receive from us may be billed to and payment collected from you, any insurance company or third party payor. For example, we may need to give your health insurance plan information to coordinate health plan benefits you may have, to assist in payment to you or us of any benefits you may be due.

For Healthcare Operations: We may use and disclose health information about you for operation of our Home Care program. These uses and disclosures are necessary to run our program and make sure that all of our Clients receive quality services. For example, we may use health information to review our services, to obtain legal advice and to evaluate the performance of our staff in caring for you. We may also combine health information about many Clients to decide what additional services we should offer, what services are not needed, whether certain new services are effective, or to compare how we are doing with others and to see where we can make improvements. We may remove information that identifies you from this set of health information so others may use it to study home care delivery without learning who our specific Clients are.

Schedule Reminders: We may use and disclose health information to contact you as a reminder regarding our scheduling. Please let us know if you wish us to use a specific telephone number to contact you for this purpose.

Research. There may be situations where we want to use and disclose health information about you for research purposes. For example, a research project may involve comparing the efficacy of certain home care services over other services. For any research project that uses your health information, we will either obtain an authorization from you or ask an Institutional Review or Privacy Board to waive the requirement to obtain authorization. A waiver of authorization will be based upon assurances from a review board that the researchers will adequately protect your health information.

As Required By Law. We will disclose health information about you when permitted or required to do so by federal, state, or local law.

To Avert a Serious Threat to Health or Safety . We may use and disclose health information about you when we believe it necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone we reasonably believe can help prevent the threat.

Military and Veterans. If you are a member of the armed forces or are separated/discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.

Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Public Health Risks. We may disclose health information about you for public health activities. These activities generally include the following: o To prevent or control disease, injury or disability; o To report births and deaths; o To report child abuse or neglect; o To report reactions to medications or problems with products;

To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;  To notify the appropriate government authority if we believe a Client has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to an order issued by a court or administrative tribunal. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only after efforts have been made to tell you about the request and you have time to obtain an order protecting the information requested.

Law Enforcement. We may release health information if asked to do so by a law enforcement official: o In response to a court order, subpoena, warrant, summons or similar process; o To identify or locate a suspect, fugitive, material witness, or missing person; o If you are the victim of a crime and we are unable to obtain your consent; o About a death we believe may be the result of criminal conduct; o In an instance of criminal conduct at our facility; and o In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.

Such releases of information will be made only after efforts have been made to tell you about the request and you have time to obtain an order protecting the information requested.

Coroners, Health Examiners and Funeral Directors. We may release health information to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary to carry out their duties. Business Associates. There may be some services provided in our organization through contracts with business associates. If so, when these services are contracted, we may disclose your health information to business associates so that they can perform such services. However, any business associates will be required to appropriately safeguard your information to the extent required by HIPAA.

Family and Friends. We may disclose your health information to a member of your family or to someone else that is involved in your medical care or payment for care. This may include telling such a person about the status of your health or any payment issues. In the event of a disaster, we may provide information about you to a disaster relief organization so they can notify your family of your condition and location. We will not disclose your information to family or friends if you object; please put any objection in writing and date and sign it so we will have a clear instruction regarding your wishes in this regard.

Service Alternatives. We may contact you about other health-related benefits and services that may be of interest to you.

Other Uses. Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission, unless otherwise permitted by Law. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain the records of the care that we provided to you.

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU

You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy: You have certain rights to inspect and copy health information that may be used to make decisions about your services. Usually, this includes health and billing records. To inspect and copy such health information, you must submit your request in writing on a form provided by us at the address below. To request a form or seek assistance you may call our office at 808-457-1655. If you request a copy of your health information, we may charge a fee for the costs of locating, copying, mailing or other supplies and services associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may in certain instances request that the denial be reviewed. A licensed healthcare professional chosen by us will review your request and the denial. The person conducting the review will not be the person who denied your initial request. We will comply with the outcome of the review.

Right to Amend. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we keep the information. To request an amendment, your request must be made in writing on a form provided by us and submitted to us at the address below.

We may deny your request for an amendment if it is not the form provided by us and does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  • Is not part of the health information kept by or for our services;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • Is accurate and complete.

Any amendment we make to your health information will be disclosed to those with whom we disclose information as previously specified.

Right to an Accounting of Disclosures. You have the right to request a list (accounting) of any disclosures of your health information we have made, except for uses and disclosures for treatment, payment, and health care operations, as previously described.

To request this list of disclosures, you must submit your request on a form that we will provide to you. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. The first list of disclosures you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We will mail you a list of disclosures in paper form within 30 days of your request, or notify you if we are unable to supply the list within that time period and by what date we can supply the list; but this date should not exceed a total of 60 days from the date you made the request.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care. While we will try to accommodate your request for restrictions, we are not required to do so if it is not feasible for us to ensure our compliance with law or we believe it will negatively impact the services we may provide you. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or its disclosure is required by law. To request a restriction, you must make your request on a form that we will provide you. In your request, you must tell us what information you want to limit and to whom you want the limits to apply.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain manner or at a certain location. For example, you can ask that we only contact you at work or at a certain phone number or mail address. During our intake process, we will ask you how you wish to receive communications about your health care or for any other instructions on notifying you about your health information. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this Notice at any time upon request, even if you have previously agreed to receive an electronic copy of the Notice.