Notice of Privacy Practices

El Aviso de Practicas de la Privacidad

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Please review it carefully.

This Notice of Privacy Practices describes how we may use and disclose your Protected Health Information to carry out your plan of care, get paid for our services, administer our Agency and for other purposes that are permitted or required by law.

This Notice also describes your rights with respect to your health information.

Visiting Nurse Service of Greater RI (VNSGRI) Responsibilities

VNSGRI is required by law to protect the privacy of your health information and will not use or disclose your health information without your written permission, except as described in this Notice. The Agency is required to abide by the terms of this Notice and as amended from time to time. The Agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. You or you appointed representative may obtain a copy of our Notice of Privacy Practices, including any revisions we have made, by contacting our Privacy Officer.

Throughout this Notice, we use the term “Protected Health Information” or PHI. PHI is information about you that may identify you and that relates to your past, present or future physical or mental health or condition, and related health care services.

You Have a Right to:

Request that we limit certain uses and disclosures of your information .

• You have the right to request that we limit how we use or disclose your PHI to carry out your plan of care, get paid for our services or administer our Agency. You also have the right to request a restriction on the PHI we disclose about you to someone who is involved in your care or payment for your care, such as a family member or friend. However, we are not required to agree to your request. The request for limitations or restrictions must be specific and in writing.

See and get a copy of your information .

• You have the right to look at and request a copy PHI about you contained in your medical and billing records for as long as the Agency maintains the information. A request to look at or obtain a copy of your PHI must be in writing. A fee may be charged for the costs of the copying, mailing, or other supplies that are necessary to grant your request. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time. We may deny your request in certain limited circumstances. If you are denied the right to see or copy your PHI, you may request that the denial be reviewed.

Correct or update your information .

• If you believe that PHI we have about you is incomplete or incorrect, you may request that we update (amend) the information. You may request an amendment for as long as we maintain your health information. A request to amend your health care record must be in writing, and include the reason(s) for your request. In certain cases, we may deny your request for amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with the decision and we may prepare a response to your statement, which we will provide to you.

Receive a list of the disclosures of your information .

• You have the right to receive a list (“accounting”) of the disclosures we have made of your PHI for most purposes other than treatment, payment, or health care operations. The accounting will not include disclosures we have made directly to you, disclosures to friends or family members involved in your care, and disclosures for notification purposes. The right to receive an accounting is subject to certain other limitations. To request an accounting, you must submit your request in writing. Your request must state the time period, but may not be longer than six years. The first accounting you request within any 12-month period will be provided free of charge; but a fee may be charged for the cost of providing each additional accounting you may request within the same 12-month period. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time.

Request communications of your information by alternative means or at alternative locations.

• For instance, you may request that we contact you about medical matters only in writing or at a different residence or post office box. To request confidential communication of your PHI, you must submit your request in writing. Your request must state how or when you would like to be contacted. We will accommodate all reasonable requests.

Withdraw your consent to use or disclose PHI except to the extent that action has already been taken .

• You may withdraw or “revoke” a consent by written statement at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the consent. We may refuse to continue to treat an individual that revokes his or her consent.

Obtain a paper copy of the Notice of Privacy Practices upon request .

• You may request a copy of the Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy of the Notice. To request a paper copy of the Notice, contact the Privacy Officer at the telephone number(s) listed below.

How VNSGRI Will Use and Disclose Your Protected Health Information

We will use your information for your care and treatment.

For example, information obtained by a nurse or other member of your care team will be recorded in your record and used to determine your plan of care. Your clinician will document in your record his or her expectations of the members of your care team. Members of your healthcare team will then record the actions they took and their observations.

We will use your information for payment.

For example, a bill may be sent to you, your insurance company or Medicare or Medicaid. The information on or accompanying the bill may include information that identifies you, as well as the treatment provided to you.

We will use your protected health information to operate our Agency.

For example,members of our quality improvement teammay use information in your health record to assess the care and outcomes in your case and others like it.

We may also use or disclose your PHI without your consent in the following circumstances:

When a disclosure is required by federal, state or local law, judicial or administrative proceedings or law enforcement :

• For example, we may disclose your PHI for law enforcement purposes as required by law or in response to a valid subpoena. If you are involved in a lawsuit or a dispute, we may disclose your PHI 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 by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Communication with family or friends involved in your care or payment for your care :

• Our nurses or other clinicians, using their professional judgment, may disclose to a family member, close personal friend or any other person you identify as your caregiver, PHI related to that person’s involvement in your care or payment related to your care, unless you object.

Food and Drug Administration (FDA) :

• We may disclose to the FDA PHI relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Worker’s compensation :

• We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

Public health and health oversight activities :

• As required by law, we may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability. We may also provide information to coroners, medical examiners, and funeral directors as necessary for these persons to carry out their duties. We may disclose your PHI to an oversight agency for activities authorized by law, including audits and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Specific government functions :

• For example, if you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also disclose your PHI to authorized federal officials for national security purposes, such as protecting government officials and performing intelligence activities or investigations.

Organ or tissue procurement organizations :

• Consistent with applicable law, we may disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Business associates :

• There are some services provided by the Agency through contracts with business associates such as billing companies. When these services are contracted for, we may disclose your PHI to our business associates so that they can perform the job we have asked them to do. We require our business associates to appropriately safeguard your information.

Personal communications :

• We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fundraising :

• We may contact you as part of a fundraising effort for our Agency.

Notification :

• We may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or person responsible for your care, your location and general condition.

Correctional institution :

• If you are or become an inmate of a correctional institution, we may disclose to the institution or its agents PHI necessary for your health and safety, and that of other individuals.

To avert a serious threat to health or safety :

• We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or that of the public or another person.

Victims of abuse, neglect, or domestic violence :

• We may disclose PHI about you to a social service or protective services agency, if we reasonably believe you are a victim of abuse, neglect, or domestic violence. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and we believe it is necessary to prevent serious harm to you or someone else; or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.

Before using or disclosing your PHI for any other purposes, we will obtain your written authorization. You may withdraw or “revoke” this authorization in writing at any time. After we receive your written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization.

To Report a Problem

If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer of VNSGRI. The Privacy Officer may be contacted by address and/or telephone numbers listed elsewhere in this Notice. You may also file your complaint in writing with Secretary of Health and Human Services, 200 Independence Ave. , Washington , D.C. , 20201 . There will be no retaliation for filing a complaint. You are encouraged to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

This Notice is Effective as of April 14, 2003.