HIPAA Notice of Privacy Practices

HANDS Clinic of St. Lucie County (“HANDS,” “we,” “us,” or “our”) is committed to protecting the privacy of your health information. The law requires us to:

• Keep your protected health information (“PHI”) private
• Give you this Notice describing our legal duties and privacy practices regarding your PHI
• Follow the terms of the Notice currently in effect
• Notify you if there is a breach of your unsecured PHI

This Notice explains how we may use and share information about your healthcare and how you can access this information. PHI is information that may identify you and that relates to your past, present, or future physical or mental health, the healthcare you receive, or payment for that care.

The following categories describe ways we may use and disclose your PHI without needing your written authorization. Not every use or disclosure in a category will be listed, but every permitted use or disclosure will fall within one of the categories.

For Treatment. We may use and share your PHI to provide care to you and to coordinate care with other providers. For example, a HANDS physician may share your information with a specialist we refer you to.

For Payment. We may use and share your PHI to bill for our services and to obtain payment from you, an insurance company, or another payer when applicable. Because HANDS provides care at no cost, this is limited but may include processing prescription assistance applications, grant reporting, and similar activities.

For Healthcare Operations. We may use and share your PHI to run our clinic, improve quality of care, train staff and volunteers, evaluate provider performance, and conduct other administrative activities necessary to operate as a healthcare provider.

Required by Law. We will disclose your PHI when required to do so by federal, state, or local law.

Public Health Activities. We may disclose your PHI for public health activities, such as reporting communicable diseases, births and deaths, child abuse or neglect, reactions to medications, or product defects.

Health Oversight Activities. We may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure.

Victims of Abuse, Neglect, or Domestic Violence. We may disclose your PHI to a government authority authorized to receive reports of abuse, neglect, or domestic violence.

Judicial and Administrative Proceedings. We may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process.

Law Enforcement. We may disclose your PHI to law enforcement officials when required by law or in response to a valid legal request.

Coroners, Medical Examiners, and Funeral Directors. We may disclose PHI to these officials as necessary for them to carry out their duties.

Organ and Tissue Donation. If you are an organ donor, we may disclose your PHI to organizations that handle organ procurement, transplantation, or donation.

Research. We may use or disclose your PHI for research purposes when the research has been approved by an institutional review board and appropriate privacy protections are in place.

Serious Threat to Health or Safety. We may disclose your PHI to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of the public.

Military, Veterans, and National Security. If you are a member of the armed forces, we may disclose your PHI as required by military command authorities. We may also disclose PHI for national security and intelligence activities authorized by law.

Workers' Compensation. We may disclose your PHI as authorized by workers' compensation laws.

Other than the situations described above, we will not use or disclose your PHI without your written authorization. In particular, we will obtain your written authorization before:

• Using or disclosing your PHI for marketing purposes
• Selling your PHI
• Disclosing your psychotherapy notes (with limited exceptions allowed by law)

You may revoke your authorization at any time, in writing, except to the extent we have already acted in reliance on it.

You have the following rights with respect to your PHI:

Right to Inspect and Copy. You have the right to inspect and obtain a copy of your PHI in our records, with limited exceptions. We may charge a reasonable fee for the cost of copying and mailing.

Right to Request Amendment. If you believe information in your record is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances, but we will provide a written explanation if we do.

Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we have made of your PHI. The first accounting in any 12-month period is free; we may charge a reasonable fee for additional requests.

Right to Request Restrictions. You have the right to request that we limit how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, except in limited circumstances (such as when you have paid for a service in full and ask us not to share that information with a health plan).

Right to Request Confidential Communications. You have the right to ask us to communicate with you in a specific way or at a specific location — for example, by phone at work rather than at home. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically. To request a paper copy, contact us using the information below.

Right to Be Notified of a Breach. You have the right to be notified if there is a breach of your unsecured PHI.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be retaliated against for filing a complaint.

To exercise any of these rights, please submit your request in writing to our Privacy Officer using the contact information at the end of this Notice.

HANDS is required by law to:

• Maintain the privacy of your PHI
• Provide you with this Notice describing our legal duties and privacy practices
• Abide by the terms of the Notice currently in effect
• Notify you if a breach of your unsecured PHI occurs
• Accommodate reasonable requests for confidential communications

We reserve the right to change this Notice. Any change will apply to all PHI we maintain, including PHI created or received before the change. The current Notice will be posted in the clinic and on handsofslc.org. We will provide a copy of the current Notice on request.

We may revise this Notice at any time. The “Effective Date” at the top of this page reflects the most recent revision. The most current version will always be available at handsofslc.org and at the clinic.

When you first receive care at HANDS, we will ask you to acknowledge in writing that you have received a copy of this Notice. Your acknowledgment is a record that we provided the Notice — it is not consent for any specific use or disclosure.

If you have questions about this Notice, want to exercise any of your rights, or want to file a complaint, please contact our Privacy Officer:

Privacy Officer: HANDS Privacy Office
HANDS Clinic of St. Lucie County
3855 S. US 1, Suite B
Fort Pierce, FL 34982
Phone: 772-462-5646
Email: info@handsofslc.org