Notice of Privacy Practices
Effective Date: April 14, 2003
Updated March 30, 2012
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
Who We Are:
- This Notice describes the privacy practices of CommuniCare Health Centers and the privacy practices of: all of our doctors, nurses, and other health care professionals authorized to enter information about you into your medical chart.
- all of our departments, including, our medical records and billing departments.
- all of our health center sites: Davis Community Clinic, Peterson Clinic, Salud Clinic, Esparto Dental Clinic, John H. Jones Community Clinic - Woodland, John H. Jones Community Clinic – West Sacramento.
- all of our employees, staff, volunteers and other personnel who work for us or on our behalf.
How We May Use and Disclose Your Health Information:
Treatment: Your medical information is routinely shared among health care professionals involved in your care to coordinate or manage treatment, both within and outside CommuniCare clinics. For example, we may consult with a specialist about your care or provide lab results to the hospital.
Payment: We may use and disclose health information about you to bill and collect payment from you, your insurance company, including Medi-Cal and Medicare, or other third party that may be available to reimburse us for some or all of your health care. For example, we may need to share information about your office visit with your health plan in order for your health plan to pay us or reimburse you for the visit.
Health Care Operations: We may use and disclose health information about you for our day-to-day operations, and may disclose information about you to other health care providers involved in your care or to your health plan for use in their day-to-day operations. These uses and disclosures are necessary to run CommuniCare Health Centers and to make sure that all of our patients receive quality care, and to assist other providers and health plans in doing so as well. For example, we may use health information to review the services that we provide and to evaluate the performance of our staff in caring for you.
Individuals Involved in Your Care or Payment for Your Care: We may release health information about you to a friend or family member who is involved in your health care or the person who helps pay for your care.
Medical Research: Under certain circumstances, we may use and disclose health information about you for research purposes. However, all research projects are subject to a special approval process. We will never give permission for the researcher to use your name unless you have given us prior consent.
As Required By Law: We will disclose health information about you when 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 necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Public Health Activities: We may disclose health information about you for public health activities. These activities generally include the following: to prevent or control disease, injury or disability, to report births and deaths, to report child abuse or neglect, to report reactions to medications or problems with products, to notify people of recalls of 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 patient has been the victim of abuse, neglect or domestic violence.
Health Oversight Activities: We may disclose health information about you 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.
Lawsuits and Disputes: We may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or other lawful process that is not accompanied by a court or administrative order, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement: We may release health information about you if asked to do so by a law enforcement official.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the corrections institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care, (2) to protect your health and safety or the health and safety of others, or (3) for the safety and security of the correctional institution.
Right to Inspect and Copy: You have the right to inspect and request a copy of your protected health information. There may be a charge for this service.
Right to Amend: You have the right to request to have your protected health information amended, unless the information was created elsewhere, is unavailable, is not part of the information which you are permitted to inspect or copy, or is determined to be already accurate and complete. Your request must be in writing.
Right to Receive an Accounting of Disclosures: You have the right to request an accounting of certain disclosures of your health information that we have made. Your request must be in writing.
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. We are not required to agree to your request for restrictions if it is not feasible for us to comply with your request or if we believe that it will negatively impact our ability to care for you. Your request must be in writing to our privacy contact person.
Right to Receive Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you at work or by mail to a specified address.
Changes to this Notice:
We reserve the right to change this notice and to make the changed notice effective for all of the health information that we maintain about you, whether it is information that we previously received about you or information we may receive about you in the future. We will post a copy of our current notice in our facility with the effective date listed. We will also give you a copy of our current notice upon request.
Complaints and Privacy Person/Office:
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing or faxing us a written description of your complaint or by telling us about your complaint in person or over the telephone to:
Corporate Compliance Officer/HIPAA Privacy Officer
CommuniCare Health Centers Administrative Office
P.O. Box 1260
Davis, CA 95617
Please describe what happened and give us the dates and names of anyone involved. Please also let us know how to contact you so that we can respond to your complaint. You will not be penalized for filing a complaint.
Other Uses and Disclosures of Your Protected Health Information:
Other uses and disclosures of personal health information not covered by this notice or applicable law will be made only with your written authorization. If you give us your written authorization to use or disclose your personal health information, you may revoke your authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your personal health information for the reasons covered by your written authorization. You understand that we are unable to take back any uses and disclosures that we have already made with your authorization, and that we are required to retain our records of the care that we have provided to you.