LUTHERAN CHILDREN AND FAMILY SERVICE
MEDICAL FOSTER CARE

NOTICE OF PRIVACY INFORMATION PRACTICES

Effective date: April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION FOR MEDICAL FOSTER CARE CHILDREN MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.

A. General description and purpose of notice.

LCFS Medical Foster Care is a health care provider that is subject to the Health Insurance Portability and Accountability Act of 1996, as amended (“HIPAA”). LCFS Medical Foster Care is required by HIPAA to provide you with a copy of our health care information privacy practices and that of:

1. Any health care professional authorized to enter information into the medical record created and/or maintained by us;

2. Any member of a volunteer group which may assist LCFS in delivering services; and

3. All of our employees, staff, and other personnel.

4. Liberty Lutheran Services and its affiliates who are covered entities under the
Health Insurance Portability and Accountability Act of 1996.

All of the individuals or entities identified above will follow the terms of this notice. These individuals or entities may share the health information of medical foster children with each other for purposes of treatment, payment, or health care operations, as further described in this notice.

B. Our agency’s policy regarding the health information of children receiving medical foster care services.

We are committed to preserving the privacy and confidentiality of health information created and/or maintained by our agency. Certain state and federal laws and regulations require us to implement policies and procedures to safeguard the privacy of health information.

This notice will provide you with information regarding our privacy practices and applies to all of the health information for medical foster children created and/or maintained by our agency, including any information that we receive from other health care providers. The notice describes the ways in which we may use or disclose health information and also describes your rights and our obligations regarding any such uses or disclosures. We will abide by the terms of this notice, including any future revisions that we may make to the notice as required or authorized by law.

We reserve the right to change this notice and to make the revised or changed notice effective for health information we already have as well as any information we receive in the future. We will post a copy of the current notice in our offices and make a good faith effort to provide you with a copy of the notice during the onset of our provision of services to the child and after any revisions are made to the notice. The first page of the notice contains the effective date and any dates of revision.

C. Uses or disclosures of health information for medical foster children.

We may use or disclose the child’s health information in one of following ways:

(1) For purposes of treatment, payment or health care operations
(2) Pursuant to your written authorization (for purposes other than treatment, payment or health care operations)
(3) Pursuant to your verbal agreement (to discuss the child’s health condition with family or friends who are involved in the child’s care);
(4) As permitted by law
(5) As required by law

The following describes each of the different ways that we may use or disclose health information. Where appropriate, we have included examples of the different types of uses or disclosures. While not every use or disclosure is listed, we have included all of the ways in which we may make such uses or disclosures.

1. Uses or disclosures made for purposes of treatment, payment or health care operations.

We may use or disclose health information for purposes of treatment, payment, or health care operations.

a. Treatment. We may use health information to provide health care treatment and services. We may disclose health information to doctors, nurses, nursing assistants, medication aides, technicians, medical and nursing students, rehabilitation therapy specialists, or other personnel who are involved in the child’s health care. For example, the child’s physician may order physical therapy services to improve your strength and walking abilities. Our social work staff will need to talk with the primary care physician to coordinate services and develop a plan of care. We also may disclose the child’s health information to people outside of our agency who may be involved in the child’s health care, such as family members, social services, or home health agencies.
i. Appointment reminders. We may use or disclose health information for purposes of contacting you to remind you of a health care appointment.
ii. Treatment alternatives, Health-related benefits and services. We may use or disclose the child’s health information for purposes of contacting you to inform you of treatment alternatives or health-related benefits and services that may be of interest to you.

b. Payment. We may use or disclose the child’s health information so that we may bill and collect payment from an insurance company or other third party payor for the health care services the child receives in the foster home. For example, we will need to give information to the Department of Public Welfare regarding services delivered so the Department of Public Welfare will pay for those services. We will tell the Department of Public Welfare about a needed treatment service in order to obtain prior approval for the services or to determine whether the Department of Public Welfare will cover the treatment.

c. Health care operations. We may use or disclose the child’s health information to perform certain functions within our agency. These uses or disclosures are necessary to operate our agency and to make sure that our clients receive quality care. For example, we may use the child’s health information to review our treatment and services and to evaluate the performance of our staff. We may combine health information about many of our clients to determine whether certain services are effective or whether additional services should be provided. We may disclose health information to physicians, nurses, nursing assistants, medication aides, rehabilitation therapy specialists, technicians, medical and nursing students, and other personnel for review and learning purposes. We also may combine health information with information from other health care providers to compare how we are doing and see where we can make improvements in the care and services offered to our clients. We may remove identifying information from this set of health information so that others may use the information to study health care and health care delivery without learning the specific identities of our clients.

2. Uses or disclosures made pursuant to your written authorization.

We may use or disclose the child’s health information pursuant to your written authorization for purposes other than treatment, payment or health care operations and for purposes, which are not permitted or required law. You have the right to revoke a written authorization at any time as long as your revocation is provided to us in writing. If you revoke your written authorization, we will no longer use or disclose your health information for the purposes identified in the authorization. You understand that we are unable to retrieve any disclosures, which we may have made pursuant to your authorization prior to its revocation. Examples of uses or disclosures that may require your written authorization include the following:

a. A request to provide certain health information to a pharmaceutical company for purposes of marketing

b. A request to provide the child’s health information to an attorney for use in a civil litigation claim

c. A request to provide the child’s health information for purposes of including you on a mailing list

3. Uses or disclosures made pursuant to your verbal agreement.

We may use or disclose the child’s health information, pursuant to your verbal agreement, for purposes of releasing information to persons involved in the child’s care as described below.

Individuals involved in the child’s care. We may disclose health information to individuals, such as family and friends, who are involved in the child’s care or who help pay for that care. We also may disclose health information to a person or organization assisting in disaster relief efforts for the purpose of notifying family or friends involved in the child’s care about their condition, status and location.

4. Uses or disclosures permitted by law

Certain state and federal laws and regulations either require or permit us to make certain uses or disclosures of the child’s health information without your permission. These uses or disclosures are generally made to meet public health reporting obligations or to ensure the health and safety of the public at large. The uses or disclosures, which we may make pursuant to these laws and regulations, include the following:

a. Public health activities. We may use or disclose the child’s health information to public health authorities that are authorized by law to receive and collect health information for the purpose of preventing or controlling disease, injury or disability. We may use or disclose health information for the following purposes:

i. To report births and deaths
ii. To report suspected or actual abuse, neglect, or domestic violence involving a child or an adult
iii. To report adverse reactions to medications or problems with health care products
iv. To notify individuals of product recalls
v. To notify an individual who may have been exposed to a disease or may be at risk for spreading or contracting a disease or condition

b. Health oversight activities. We may use or disclose the child’s health information to a health oversight agency that is authorized by law to conduct health oversight activities. These oversight activities may include audits, investigations, inspections, or licensure and certification surveys. These activities are necessary for the government to monitor the persons or organizations that provide health care to individuals and to ensure compliance with applicable state and federal laws and regulations.

c. Judicial or administrative proceedings. We may use or disclose the child’s health information to courts or administrative agencies charged with the authority to hear and resolve lawsuits or disputes. We may disclose health information pursuant to a court order, a subpoena, a discovery request, or other lawful process issued by a judge or other person involved in the dispute, but only if efforts have been made to (i) notify you of the request for disclosure or (ii) obtain an order protecting the child’s health information.

d. Worker’s compensation. We may use or disclose the child’s health information to worker’s compensation programs when a health condition arises out of a work-related illness or injury.

e. Law Enforcement official. We may use or disclose the child’s health information in response to a request received from a law enforcement official for the following purposes:

i. In response to a court order, subpoena, warrant, summons or similar lawful process
ii. To identify or locate a suspect, fugitive, material witness, or missing person
iii. Regarding a victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
iv. To report a death that we believe may be the result of criminal conduct
v. To report criminal conduct at our agency
vi. In emergency situations, to report a crime—the location of the crime and possible victims; or the identity, description, or location of the individual who committed the crime

f. Coroners, medical examiners, or funeral directors. We may use or disclose the child’s health information to a coroner or medical examiner for the purpose of identifying a deceased individual or to determine the cause of death. We also may use or disclose health information to a funeral director for the purpose of carrying out his/her necessary activities.

g. Research. We may use or disclose the child’s health information for research purposes under certain limited circumstances. Because all research projects are subject to a special approval process, we will not use or disclose health information for research purposes until the particular research project for which the child’s health information may be used or disclosed has been approved through this special approval process. However, we may use or disclose the child’s health information to individuals preparing to conduct the research project in order to assist them in identifying clients with specific health care needs who may qualify to participate in the research project. In most instances, we will ask for your specific permission to use or disclose health information if the researcher will have access to names, addresses or other identifying information.

h. To avert a serious threat to health or safety. We may use or disclose the child’s health information when necessary to prevent a serious threat to the health or safety of the child or other individuals. Any such use or disclosure would be made solely to the individual(s) or organization(s) that have the ability and/or authority to assist in preventing the threat.

i. National security and intelligence activities. We may use or disclose the child’s health information to authorized federal officials for purposes of intelligence, counterintelligence, and other national security activities, as authorized by law.

j. Inmates. If the child is an inmate of a correctional institution or under the custody of a law enforcement official, we may use or disclose health information to the correctional institution or to the law enforcement official as may be necessary (i) for the institution to provide health care; (ii) to protect the health or safety of the child or another person; or (iii) for the safety and security of the correctional institution.

5. Uses or disclosures required by law

We may use or disclose the child’s information where such uses or disclosures are required by federal, state or local law.

D. Your rights regarding health information

You have the following rights regarding the medical foster child’s health information, which we create and/or maintain:

1. Right to inspect and copy. You have the right to inspect and copy health information that may be used to make decisions about the child’s care. Generally, this includes medical and billing records, but does not include psychotherapy notes.

To inspect and copy the child’s health information, you must submit your request in writing to your social worker’s supervisor. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

We may deny your request to inspect and copy your health information in certain limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another professional selected by our agency will review your request and the denial. The person conducting the review will not be the person who initially denied your request. We will comply with the outcome of this review.

2. Right to request an amendment. If you feel that the health information we have about the child is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our agency.

To request an amendment, your request must be made in writing and submitted to your social worker’s supervisor. In addition, you must provide us with a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that

a. was not created by us, unless the person or entity that created the information is no longer available to make the amendment

b. is not part of the health information kept by or for our agency

c. is not part of the information which you would be permitted to inspect and copy

d. is accurate and complete

3. Right to an accounting of disclosures. You have the right to request an accounting of the disclosures, which we have made of the child’s health information. This accounting will not include disclosures of health information that we made for purposes of treatment, payment, or health care operations or pursuant to your authorization.

To request an accounting of disclosures, you must submit your request in writing to the Foster Care Program Director. Your request must state a time period, which may not be longer than six (6) years prior to the date of your request and may not include dates before April 14, 2003. Your request should indicate in what form you want to receive the accounting (for example, on paper or via electronic means). The first accounting that you request within a twelve (12)-month period will be free. For additional accountings, we may charge you for the costs of providing the accounting. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.

4. Right to request restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about the child for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about the child to someone, such as a family member or friend, who is involved in the child’s care or in the payment of the child’s care. For example, you could ask that we not use or disclose information regarding a particular treatment that the child received.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide emergency treatment to the child.

To request restrictions, you must make your request in writing to your social worker’s supervisor. In your request, you must tell us (a) what information you want to limit; (b) whether you want to limit our use, disclosure or both; and (c) to whom you want the limits to apply (for example, disclosures to a family member).

5. Right to request confidential communications. You have the right to request that we communicate with you about the child’s health care in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing to your social worker’s supervisor. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

6. Right to a paper copy of this notice. You will receive a paper copy of this notice at the onset of services provided by us to the medical foster child. You may ask us to give you a copy of this Notice at any time.

You may obtain a copy of this notice at our Web site: www.lcfsinpa.org
E. Complaints

If you believe privacy rights have been violated, you may file a complaint with our agency or with the secretary of the Department of Health and Human Services. To file a complaint with our agency, contact the Compliance Officer at 215-643-6335 ext. 137.

You will NOT be penalized for filing a complaint.