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Our Privacy Policy

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.

Use And Disclosure Of Health Information

Hospice Partners of Southern California may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. The Agency has established policies to guard against unnecessary disclosure of your health information.

The Following Is A Summary Of The Circumstances Under Which And Purposes For Which Your Health Information May Be Used And Disclosed:

To Provide Treatment:  The Hospice may use your health information to coordinate care within the Agency and with others involved in your care, such as your attending physician, members of the Hospice Partners interdisciplinary team and other health care professionals who have agreed to assist the Agency in coordinating care.  For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.  The Hospice also may disclose your health care information to individuals outside of the Hospice involved in your care including family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals.

To Obtain Payment:  The Hospice may include your health information in invoices to collect payment from third parties for the care you may receive from the Agency. For example, the Agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the Agency.  Hospice Partners also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for hospice care and the services that will be provided to you.

To Conduct Health Care Operations:  Hospice Partners may use and disclose health care information for its own operations in order to facilitate the function of the Hospice and as necessary to provide quality care to all of the Agency's patients.  Health care operations include such activities as:

• Quality assessment and improvement activities.
• Activities designed to improve health or reduce health care costs.
• Protocol development, case management and care coordination.
• Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
• Professional review and performance evaluation.
• Training programs including those in which students, trainees or practitioners in health care learn under supervision.
• Training of non-health care professionals.
• Accreditation, certification, licensing or credentialing activities.
• Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
• Business planning and development including cost management and planning related analyses and formulary development.
• Business management and general administrative activities of the Hospice.
• Fundraising for the benefit of the Hospice and certain marketing activities.

For example Hospice Partners may use your health information to evaluate its staff performance, combine your health information with other Agency patients in evaluating how to more effectively serve all Agency patients, disclose your health information to Hospice Partners staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

For Fundraising Activities:  Hospice Partners may use information about you including your name, address, phone number and the dates you received care at the Agency in order to contact you or your family to raise money for Hospice Partners.  The Agency may also release this information to a related Agency foundation.  If you do not want Hospice Partners to contact you or your family, notify the Administrator at 1-310-264-8413 and indicate that you do not wish to be contacted or you may return fundraising material indicating you wish to be removed from the mailing list.

For Appointment Reminders:  Hospice Partners may use and disclose your health information to contact you and/or your caregiver as a reminder that you have an appointment for a home visit.

Uses And Disclosures When An Authorization Is Not Required:

When Legally Required:  Hospice Partners will disclose your health information when it is required to do so by any Federal, State or local law.

When There Are Risks to Public Health:  Hospice Partners may disclose your health information for public activities and purposes in order to:

• Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
• To report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
• To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
• To an employer about an individual who is or was a member of the workforce as legally required to evaluate if the individual has a work related illness or injury.

To Report Abuse, Neglect Or Domestic Violence:  Hospice Partners is allowed to notify government authorities if the Hospice believes a patient is the victim of abuse, neglect or domestic violence.  The Agency will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

To Conduct Health Oversight Activities:  Hospice Partners may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.  The Agency, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.

In Connection With Judicial And Administrative Proceedings:  Hospice Partners may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when the Hospice makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

For Law Enforcement Purposes:  As permitted or required by State law, Hospice Partners may disclose your health information to a law enforcement official for law enforcement purposes as follows:

• As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or summons or similar process.
• For the purpose of identifying or locating a suspect, fugitive, material witness or missing person.
• Under certain limited circumstances, when you are the victim of a crime.
• To a law enforcement official if the Agency has a suspicion that your death was the result of criminal conduct including criminal conduct at the Agency.
• In an emergency in order to report a crime.

To Coroners and Medical Examiners:  Hospice Partners may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors:  Hospice Partners may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements.  If necessary to carry out their duties, the Agency may disclose your health information prior to, and in reasonable anticipation, of, your death.

For Organ, Eye, or Tissue Donation: Hospice Partners may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.

In the Event of A Serious Threat To Health Or Safety:  Hospice Partners may, consistent with applicable law and ethical standards of conduct, disclose your health information if the Agency, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

For Specified Government Functions:  In certain circumstances, the Federal regulations authorize the Agency to use or disclose your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.

For Worker's Compensation:  Hospice Partners may release your health information for worker's compensation or similar programs.

Authorization To Use Or Disclose Health Information

Other than is stated above, Hospice Partners will not disclose your health information without your written authorization.  If you or your representative authorizes the Agency to use or disclose your health information, you may revoke that authorization in writing at any time.  Any information already used or disclosed prior to the authorization revocation is not subject to that revocation. For example, the authorization form would be required when the uses/disclosures are made to a patient's employer for disability, fitness for duty or drug testing purposes.

Your Rights With Respect To Your Health Information

You have the following rights regarding your health information that Hospice Partners maintains:

• Right to request restrictions:  You may request restrictions on certain uses and disclosures of your health information.  You have the right to request a limit on the Agency's disclosure of your health information to someone who is involved in your care or the payment of your care.  However, the Agency is not required to agree to your request.  If you wish to make a request for restrictions, please contact the Administrator at 1-310-264-8413.
• Right to receive confidential communications:  You have the right to request that the Agency communicate with you in a certain way.  For example, you may ask that the Hospice only conduct communications pertaining to your health information with you privately with no other family members present.  If you wish to receive confidential communications, please contact the Director of Patient Care Services at 1-310-264-8413.  The Agency will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.
• Right to inspect and copy your protected health information:  You have the right to request and obtain access to your Protected Health Information, to the extent required by and consistent with the HIPAA Privacy Rules. We reserve the right to deny access to Protected Health Information that is not otherwise required to be given under the HIPAA Privacy Rules or other applicable laws. You have the right to inspect and copy your health information, including billing records.  A request to inspect and copy records containing your health information may be made in writing to the Administrator at 1919 Santa Monica Blvd., Suite 200, Santa Monica, CA  90404.  If you request a copy of your health information, Hospice Partners may charge a reasonable fee for copying and assembling costs associated with your request.
• Right to amend health care information:  You or your representative has the right to request that the Agency amend your records, if you believe that your health information records are incorrect or incomplete.  That request may be made as long as the information is maintained by the Hospice.  A request for an amendment of records must be made in writing to the Director of Patient Care Services, 1919 Santa Monica Blvd., Suite 200, Santa Monica, CA  90404.  The Hospice may deny the request if it is not in writing or does not include a reason for the amendment.  The request also may be denied if your health information records were not created by the Hospice, if the records you are requesting are not part of the Hospice's records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of the Hospice, the records containing your health information ae accurate and complete.
• Right to an accounting:  You or your representative have the right to request an accounting of disclosures of your health information made by Hospice Partners for certain reasons, including reasons related to public purposes authorized by law and certain research. The request for an accounting must be made in writing to the Administrator, 1919 Santa Monica Blvd., Suite 200, Santa Monica, CA.  The request should specify the time period for the accounting starting on or after August 1, 2007.  Accounting requests may not be made for periods of time in excess of six (6) years.  The Agency would provide the first accounting you request during any 12-month period without charge.  Subsequent accounting requests may be subject to a reasonable cost-based fee.
• Right to a paper copy of this notice:  You or your representative have a right to a separate paper copy of this Notice at any time even if you or your representative have received this Notice previously.  To obtain a separate paper copy, please contact the Office Manager at 1-310-264-8413. The current version of the Agency's Notice of Privacy Practices is also available at our website, www.hospicepartners.org

Duties Of The Hospice

Hospice Partners is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices.  The Agency is required to abide by terms of this Notice which may be 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.  If Hospice Partners changes its Notice of Privacy Practices, the Agency will provide a copy of the revised Notice to you or your appointed representative at the next date of service and post it on the Agency's website.  You or your personal representative have the right to express complaints to Hospice Partners of Southern California and to the Secretary of Health and Human Services if you or your representative believe that your privacy rights have been violated.  Any complaints to the Agency should be made in writing to the Administrator, 1919 Santa Monica Blvd, Suite 200, Santa Monica, CA   90404 regarding the privacy of your information.  You will not be retaliated against in any way for filing a complaint.

Contact Person

Hospice Partners of Southern California has designated the Health Information/Office Manager as its Privacy Officer and contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at 1919 Santa Monica Blvd, Suite 200, Santa Monica, CA   90404, 1-310-264-8413.

EFFECTIVE DATE

This Notice is effective April 14, 2003.

If You Have Any Questions Regarding This Notice, Please Contact:
 Administrator
 Hospice Partners of Southern California
 1919 Santa Monica Blvd., Suite 200
 Santa Monica, CA   90404
 1-310-264-8413