Medical Privacy Policy

Visiting Nurse Association of Southwestern Indiana, Inc.
Notice of Privacy Practices
Effective April 14, 2003

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 will tell you how Visiting Nurse Association of Southwestern Indiana, Inc. (VNA) may use and disclose Protected Health Information (PHI) about you. PHI means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. This Notice tells you about your rights, VNA's duties with respect to your PHI, and explains how to complain to VNA if you believe we have violated your privacy rights. This Notice describes the practices of VNA and any other entity that participates in the provision of services for VNA and applies to the following delivery sites: patients' residence, wellness inpatient and outpatient facilities and community sites. VNA and its agents will follow what is said in this Notice.

1. HOW VNA MAY USE AND DISCLOSE YOUR PHI
VNA will use PHI only as necessary to carry out treatment, payment or health care operations. We may use and disclose your PHI without your written consent for the following purposes:

• FOR TREATMENT: VNA may use PHI to provide, coordinate or manage your health care and related services. We may disclose PHI to doctors, nurses, hospitals and other health facilities involved or consulting in your care. VNA may refer you to another health care provider and as part of the referral, share PHI with that provider. For example, you may need to receive services from a hospital. When you are transferred, we will provide your PHI to the hospital so they have the information they need to provide services for you.
• FOR PAYMENT: VNA may use and disclose PHI so we can be paid for the services we provide. For example, we may need to give your insurance company or government program information about your health care services to determine coverage or receive payment.
• FOR HEALTH CARE OPERATIONS: VNA may use and disclose PHI for health care operations. For example, we may use PHI to review the services we provide and the performance of our employees in caring for you. We may disclose PHI to train our staff, volunteers and students working in VNA. We also may use the information to study ways to more efficiently manage our organization.
• MARKETING COMMUNICATIONS: VNA may use and disclose PHI to communicate with you about a product or service to encourage you to purchase the product or service. All other use and disclosure of PHI for marketing communications will be done only with your written authorization.
• FUNDRAISING: VNA may use and disclose PHI to conduct fundraising. We may disclose PHI to one of VNA's business associates or a foundation related to us so that they may contact you to raise money for the benefit of VNA. We will only disclose demographic information, such as your name, address and the dates you received treatment or services from VNA. If you do not want us or our foundation to contact you for fundraising, you must notify the Director of Development and Human Resources at 610 E. Walnut Street, Evansville, IN 47713, in writing.
• VNA DIRECTORY: If you are a patient in the VNA Hospice Center, VNA may include your name, location in our facility, condition described in general terms and your religious affiliation in our directory while you are a patient in our facility. This information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may be given to members of the clergy. If you do not want to be included in VNA's facility directory, or you want to restrict the information we include in the directory, you must notify a member of VNA's supervisory staff of your objection.
• INDIVIDUALS INVOLVED IN YOUR CARE: VNA may disclose PHI to a family member or others who are involved in your care. We also may use or disclose PHI to notify, or assist in notifying, those persons of your location, general condition or death. If there is a family member, other relative or close personal friend that you do not want VNA to disclose your PHI to, please notify the Privacy Officer at 610 E. Walnut Street, Evansville, IN 47713 or tell your VNA caregiver.
• DISASTER RELIEF AND PUBLIC HEALTH ACTIVITIES: VNA may use or disclose PHI to a public or private entity authorized by law or by its charter to assist in disaster relief efforts or for public health activities and purposes. This includes reporting PHI to a public health authority that is authorized by law to collect or receive the information for purposes of preventing or controlling disease or one that is authorized to receive reports of child or adult abuse and neglect. It also includes reporting for purposes of activities related to the quality, safety or effectiveness of a United States Food and Drug administration regulated product or activity.
• REQUIRED BY LAW: VNA may use or disclose PHI when we are required to do so by law.
• VICTIMS OF ABUSE, NEGLECT OR DOMESTIC VIOLENCE: As required by law, VNA may disclose PHI concerning child abuse or abuse or neglect of endangered adults to governmental or law enforcement officials.
• HEALTH OVERSIGHT ACTIVITIES: VNA may disclose PHI to a health oversight agency for activities authorized by law, including audits, inspections or licensure activities.
• JUDICIAL AND ADMINISTRATIVE PROCEEDINGS: VNA may disclose PHI in the course of any judicial or administrative proceeding in response to (a) an order of the court or administrative tribunal; (b) subpoena; or (c) discovery request or other legal process, but only if efforts have been made to tell you about the request or to obtain a court order protecting the information to be disclosed.
• LAW ENFORCEMENT: VNA may disclose PHI for law enforcement purposes such as those required by law, responding to limited information requests for identification and location purposes and for reporting crimes.
• CORONERS, FUNERAL DIRECTORS AND ORGAN DONATION: VNA may disclose PHI to coroners, medical examiners and funeral directors relating to an individual's death. If you are an organ donor, we may disclose PHI to organizations that handle organ procurement and transplants.
• RESEARCH: VNA may use or disclose PHI for research. Before we do this, the research will have been approved through a process that evaluates the needs of the research with your needs for privacy. We may, however, disclose PHI to a person who is preparing to conduct research to permit them to prepare for the project, but no copies of your PHI will leave VNA during that person's review of the information.
• TO PREVENT HARM: VNA may provide PHI to law enforcement personnel or persons able to prevent or lessen harm in order to avoid a serious threat to the health or safety of a person or the public.
• MILITARY ACTIVITY AND NATIONAL SECURITY: VNA may use or disclose PHI of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military command authorities. We may disclose PHI about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
• INMATES; PERSONS IN CUSTODY: VNA may disclose PHI to a correctional institution or law enforcement official having custody of you. The disclosure will be made if it is necessary (a) to provide health care to you; (b) for the health and safety of others; or (c) the safety, security and good order of the correctional institution.
• WORKERS' COMPENSATION: VNA may disclose PHI to the extent necessary to comply with workers' compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.
• OTHER USES AND DISCLOSURES WE MAY MAKE WITHOUT YOUR WRITTEN AUTHORIZATION: VNA may use and disclose PHI to contact you for appointment reminders and/or treatment alternatives or health-related benefits that may be of interest to you.

2. USE AND DISCLOSURE OF PHI REQUIRING YOUR WRITTEN CONSENT
In any other situation not described above, we will ask for your written authorization before using or disclosing your PHI.

3. YOUR RIGHTS WITH RESPECT TO PHI ABOUT YOU

• *RIGHT TO REQUEST RESTRICTIONS: You have the right to ask that VNA limit how we use and disclose your PHI. We will consider your request, but are not legally required to accept it. If we accept your request, we will abide by it except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make.
• RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS: You have the right to request and must do so in writing that VNA communicate your PHI to you in a certain way or at a certain location. For example, you can ask that we only contact you by mail or telephone. We will not require you to tell us why you are asking for the confidential communication. VNA will accommodate your request if we can easily provide it in the form you request. However, we may require you to provide us with an alternate address or other method to contact you in order to facilitate payment.
• RIGHT TO INSPECT AND COPY: In most cases, you have the right to inspect and copy your PHI, but your request must be in writing. Your request should state specifically what medical information you want to inspect or copy. If you request a copy of the information, VNA may charge a fee for the costs of copying and mailing. Upon receipt of your written request, VNA will respond within thirty (30) calendar days. If we grant your request, in whole or in part, we will inform you of our acceptance of your request. VNA may deny your request if the PHI is (a) compiled in anticipation of, or use in, a civil, criminal or administrative action or proceeding or; (b) related to the Clinical Laboratory Improvements Amendments of 1988 (CLIA). If we do deny your request, we will tell you, in writing, the reason for the denial and explain your right to have the denial reviewed.
• RIGHT TO CORRECT OR UPDATE YOUR PHI: If you believe there is a need to correct or update your PHI, you have the right to request that VNA amend the existing information. You must provide the request and your reason for the request in writing. Your amendment statement may not exceed one (1) page. VNA will respond within 60 days of receiving your request. We may deny your request in writing if the PHI is (a) correct and complete, (b) not created by us, (c) not allowed to be disclosed, or (d) not part of our records. VNA's written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file a disagreement, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If VNA approves your request, we will amend to your PHI, inform you of the approved request and inform others that need to know about your amended PHI.
• RIGHT TO ACCOUNTING OF DISCLOSURES: You have the right to receive an accounting of disclosures of medical information about you. The accounting may be for up to six (6) years prior to the date on which you request the accounting but not before April 14, 2003. Certain types of disclosures are not included in such an accounting: (a) Disclosures to carry out treatment, payment and health care operations; (b) Disclosures of your medical information made to you; (c) Disclosures that are incident to another use or disclosure; (d) Disclosures that you have authorized; (e) Disclosures for the VNA Hospice Center facility directory or to persons involved in your care; (f) Disclosures for disaster relief purposes; (g) Disclosures for national security or intelligence purposes; (h) Disclosures to correctional institutions or law enforcement officials having custody of you; (i) Disclosures that are part of a limited data set for purposes of research, public health, or health care operations (a limited data set is where things that would directly identify you have been removed).
  
  Under certain circumstances your right to an accounting of disclosures to a law enforcement official or a health oversight agency may be suspended. Should you request an accounting during the period of time your right is suspended, the accounting would not include the disclosure or disclosures to a law enforcement official or to a health oversight agency. Usually, we will act on your request within 60 calendar days after we receive your request. Within that time, we will either provide the accounting of disclosures to you or give you a written statement of when we will provide the accounting and why the delay is necessary. VNA will provide the accounting to you at no charge. If you make more than one request in the same year, we will charge you for each additional request.
• RIGHT TO COPY OF THIS NOTICE: You have the right to obtain a paper copy of VNA's Notice of Privacy Practices. You may obtain a paper copy even though you agreed to receive the notice electronically. You may request a copy of the Notice of Privacy Practices at any time. You may obtain a copy of VNA's Notice of Privacy Practices over the internet at our web site, www.vnahc.org. To obtain a paper copy of this notice, contact the Privacy Officer at 610 E. Walnut Street, Evansville, IN 47713.

4. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PHI
VNA is legally required to protect the privacy of your health information. We also must provide individuals with this notice of our legal duties and privacy practices with respect to PHI. VNA is required to abide by the terms of the Notice of Privacy Practices in effect at the time. We also reserve the right to change the Notice of Privacy Practices and to make the new notice's provisions effective for all PHI that we maintain, including that created or received by us prior to the effective date of the new notice. A copy of VNA's current Notice of Privacy Practices will be posted in each VNA office as well as on our website, www.vnahc.org. You can also obtain a copy of the current notice by contacting VNA.

5. PERSON TO CONTACT FOR PHI INFORMATION OR COMPLAINTS
All complaints should be submitted in writing and you will not be retaliated against for filing a complaint. You may complain to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated by us. (OFFICE FOR CIVIL RIGHTS, US DEPARTMENT OF HEALTH AND HUMAN SERVICES, 200 INDEPENDENCE AVENUE SW, WASHINGTON, DC 20201)

To file a complaint with VNA or for questions or more information about this notice, contact the Privacy Officer at 610 E. WALNUT STREET, EVANSVILLE, IN 47713, 1-800-326-4862.