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As required by the privacy regulations created by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Our Commitment to Your Privacy

Growing Healthy Together is dedicated to maintaining the privacy of your or your child’s individually identifiable health information (IIHI). In conducting our business, we create records regarding you or your child and the treatment and services we provide. We are required by law to maintain the confidentiality of health information that identifies you or your child. We also are required by law to provide you with this notice of our legal duties and the privacy practices we maintain concerning your or your child’s IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

We realize that these laws are complicated, but we must provide you with the following important information:

The terms of this notice apply to all records containing your or your child’s IIHI created or retained by our practice. We reserve the right to revise or amend this Notice of Privacy Practices. Any revision or amendment will be effective for all your records that our practice has created or maintained in the past and for any of your records that we may create or maintain. Our practice will post a copy of our current Notice in our offices in a visible location, and you may request a copy of our most current notice at any time.

IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:

Site Manager, Growing Healthy Together at 562-473-4441.

 

We May Use and Disclose Your or Your Child’s Individually Identifiable Health Information (IIHI)

The following categories describe the different ways in which we may use and disclose your IIHI:

Treatment: Our practice may use your or your child’s IIHI for treatment. For example, we may disclose your IIHI as follows:

Payment: Our practice may use and disclose your IIHI to bill and collect payment for the services and items provided by us for you or your child. For example, we may disclose your IIHI as follows:

Health Care Operations: Our practice may use and disclose your IIHI to operate our business. Examples of how we may use and disclose your or your child’s information for our operations include, but are not limited to, the following:

Use and Disclosure of Your or Your Child’s IIHI in Certain Special Circumstances

The following categories describe unique scenarios in which we may use or disclose your identifiable health information to the extent such use or disclosure is required by law:

Public Health Risks: Our practice may disclose your or your child’s IIHI to public health authorities that are authorized by law to collect information for:

Health Oversight Activities: Our practice may disclose your IIHI to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure, and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

Lawsuits and Similar Proceedings: Our practice may use and disclose your IIHI in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. We also may disclose your or your child’s IIHI in response to a discovery request, subpoena, or other lawful processes by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

Law Enforcement: We may release IIHI if required by law to do so. For example:

Deceased Patients: Our practice may release IIHI to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we also may release information for funeral directors to perform their jobs.

Research: Our practice may use and disclose your IIHI for research purposes in certain limited circumstances. We will obtain your written authorization to use your child’s IIHI for research purposes except when an Internal Review Board or Privacy Board has determined that the waiver of your consent satisfies the following: (i) the use or disclosure involves no more than a minimal risk to your or your child’s privacy based on the following: (A) an adequate plan to protect the identifiers from improper use and disclosure;

(B) an adequate plan to destroy the identifiers at the earliest opportunity consistent with the research (unless there is a health or research justification for retaining the identifiers or such retention is otherwise required by law); and (C) adequate written assurances that the Protected Health Information (PHI) will not be re-used or disclosed to any other person or entity (except as required by law) for authorized oversight of the research study, or for other research for which the use or disclosure would otherwise be permitted; (ii) the research could not practicably be conducted without the waiver; and (iii) the research could not practicably be conducted without access to and use of the PHI.

Serious Threats to Health or Safety: Our practice may use and disclose your IIHI when necessary to reduce or prevent a serious threat to your or your child’s health and safety or the health and safety of another individual or the public. Under these circumstances, we will only disclose to a person or organization to help prevent the threat.

Workers’ Compensation: Our practice may release your or your child’s IIHI for workers’ compensation and similar programs.

Compliance: We must disclose your or your child’s IIHI to the Secretary of the Department of Health & Human Services or their designee upon request to investigate our compliance with HIPAA or to you upon request.

Your Rights Regarding Your or Your Child’s IIHI

You have the following rights regarding the IIHI that we maintain about you:

Confidential Communications: You have the right to request that our practice communicate with you about your health and related issues in a particular manner or at a specific location. For instance, you may ask us not to contact your work. To request confidential communication, you must write to the Site Manager, specifying the requested method or the location you wish us to contact. We will accommodate reasonable requests. You do not need to give a reason for your request.

Requesting Restrictions: You have the right to request that we limit the use and disclosure of your IIHI for treatment, payment, and healthcare operations. Additionally, you have the right to request that we restrict our disclosure of your or your child’s IIHI to only specific individuals involved in your or your child’s care, such as family members or friends. You must make your request in writing to the Site Manager. Under federal law, we must agree to your request and comply with your requested restrictions if:

Inspection and Copies: You have the right to inspect and obtain a copy of the IIHI that may be used to make decisions about you or your child, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request to the Site Manager in writing to inspect and obtain a copy of your child’s IIHI. Our practice may charge a fee for copying, mailing, labor, and supplies associated with your request. Our practice may deny your request to inspect and copy in certain limited circumstances; however, you may request a review of our denial. Another licensed healthcare professional chosen by us will conduct reviews.

Amendment: You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to the Site Manager. You must provide us with a reason that supports your request for amendment. Our practice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IIHI kept by or for the practice; (c) not part of the IIHI which you would be permitted to inspect and copy; or (d) not created by our practice, unless the individual or entity that created the information is not available to amend the information.

Accounting of Disclosures: All our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain non-routine disclosures our practice has made of your or your child’s IIHI for non-treatment, non-payment, or non-operation purposes. Use of your IIHI as part of the routine patient care in our practice is not required to be documented. For example, the doctor may share information with the nurse, or the billing department may use your child’s information to file your insurance claim. We also will not provide an accounting of disclosures made to you about your child or incident to a use or disclosure we are permitted to make as described above or according to an authorization. To obtain an accounting of disclosures, you must submit your request in writing to the Site Manager. All requests for an “accounting of disclosures” must state a period, which may not be longer than six (6) years from the date of disclosure. The first list you request within 12 months is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

Right to a Paper Copy of This Notice: You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy at any time. To obtain a paper copy of this notice, contact the Site Manager or visit our website at www.ghtkids.com.

Right to File a Complaint: If you believe your privacy rights have been violated, you may file a complaint with our practice or the Department of Health and Human Services Secretary. To file a complaint, contact us at Growing Healthy Together, 3835 E 7th. St, Long Beach, CA 90804, Attn: Site Manager. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Right to Provide an Authorization for Other Uses and Disclosures: Our practice will obtain your written authorization for uses and disclosures not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your or your child’s IIHI may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your IIHI for the reasons described in the authorization. We are required to retain records of your care.

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