Notice of Privacy Practices

I. Uses and Disclosures of Your Health Care Information Without Written Authorization

We may use or disclose your protected health information without your written authorization for the following purposes:

Treatment and Health Care Operations

We may use or disclose your protected health information for your treatment or for health care operations. For example:

• Treatment - We may need to seek consultation regarding your condition from other health care providers associated with Open Arms Pregnancy Clinic. We may also use your information to direct you to certain alternative treatments, therapies, health care providers or settings of care.
• Health Care Operations – We may use and disclose protected health information for OAPC’s own internal administration, planning and various activities to improve the quality of care we deliver to you. In addition, in the event that OAPC merges with another organization, your health information/record will become the property of the new owner.

Emergencies

We may disclose health information to notify or assist in notifying a family member or another person responsible for your care in the event of an emergency.

Disclosure to Relatives, Close Friends and Other Caregivers Physically Present with You

We may disclose your protected health information to a family member, a close personal friend or any other person who is physically present with you at the time we provide you with services, and we can reasonably infer that you do not object to the disclosure.

As Required by Law

We may use and disclose your protected health information when required to do so by any applicable law.

Public Health

We may disclose your health information to public health authorities for the purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure.

Health Oversight Activities

We may disclose your protected health information to an agency responsible for ensuring compliance with government health care program rules, such as Medicaid.

Judicial and Administrative Proceedings

We may disclose your health information in the course of any administrative or judicial proceeding.

Law Enforcement

We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena, and other law enforcement purposes.

Victims of Abuse, Neglect or Domestic Violence

We may use and disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect or domestic violence or the possible victim of other crimes. We may share your information if necessary to prevent serious threat to your health or safety or the health or safety of others.

Research and Organ Donation

We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board and to organizations involved in procuring, banking, or transplanting organs and tissues.

Fundraising

We may contact you for fundraising efforts but you may request to be excluded from future contacts.

Deceased Persons

We may disclose your health information to coroners or medical examiners.

Public Safety

It may be necessary to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or to the general public.

Specialized Government Agencies

We may disclose your health information for Workers’ compensation claims, military, national security, and government benefits purposes and to correctional institutions.

II. Uses and Disclosures of Your Health Care Information with Written Authorization

Marketing 

We must obtain your written authorization to use or disclose your protected health information for marketing communications (other than face-to-face encounters and to give you a promotional gift of nominal value).

Sale of Protected Health Information

We will not sell your protected health information without your written authorization.

Psychotherapy Notes

We will not use or disclose your psychotherapy notes without your written authorization except for your treatment, payment for your care or to defend ourselves in a legal action or other proceeding brought by you.

Highly Confidential Health Information

Federal and California law requires special privacy protections for certain highly confidential health information about you, including alcohol and drug abuse treatment program records, HIV/AIDS status and genetic information. We will obtain your authorization before disclosing any of your highly confidential health information.

All other uses and disclosures of your protected health information not described in this notice will be made only with your written authorization. 

III. Your Health Information Rights

• You have the right to request restrictions on certain uses and disclosures of your health information. Please be advised, however, that OAPC is not required to agree to the restriction that you requested unless the request is required by law.
  
• You have the right to have your health information received or communicated through an alternative method or sent to an alternative location other than the usual method of communication or delivery, upon your request.
  
• You have the right to inspect and copy your health information.
• You have a right to request that the OAPC amends your protected health information. Please be advised, however, that OAPC is not required to agree to amend your protected health information. If your request to amend your health information has been denied, you will be provided with an explanation of our denial reason(s) and information about how you can disagree with the denial.
  
• You have a right to receive an accounting of disclosures of your protected health information made by the OAPC.
• You have a right to an electronic or paper copy of this Notice of Privacy Practices at any time upon request.

Changes to this Notice of Privacy Practices

OAPC reserves the right to amend this Notice of Privacy Practices at any time in the future, and will make the new provisions effective for all information that it maintains. The most current Notice will be available upon request in our office and on our internet site at www.openarmspregnancy.com.

If you have questions about any part of this notice or if you want more information about your privacy rights, please call this office at (818) 626-9404 and ask for the Privacy Officer or the Executive Director. You may also request an appointment for a conference in person or via telephone within 7 working days.

Complaints

Complaints about your Privacy Rights or about how OAPC has handled your health information should be directed to the Privacy Officer. All complaints must be submitted in writing. 

If you are not satisfied with the manner in which this office handles your complaint, you may submit a formal complaint to: 

DHHS, Office of Civil Rights

200 Independence Avenue, S.W.

Room 509F HHH Building

Washington, DC 20201

Or call: 1 (800) 368-1019

Or visit: https://www.hhs.gov/hipaa/filing-a-complaint/index.html 

This notice is effective as of, January 1, 2016. 

I have read the Notice of Privacy Practices and understand my rights contained in the notice.

By way of my signature, I provide Open Arms Pregnancy Clinic with my authorization and consent to use and disclose my protected health information as described in the Notice of Privacy Practices.