Notice of Privacy Practices

Treatment: We use and disclose your PHI to provide, coordinate or manage your health care and any related services. We may disclose PHI about you to doctors, nurses, technicians, interns or other allied health personnel who are involved in taking care of your medical needs. We may communicate PHI to another non-TrueCare health care provider for the purposes of coordinating your continuing care, and may make that PHI available electronically.

Payment: We may use and disclose your PHI to bill for services provided and to obtain payment from you, an insurance company, a third party, or a collection agency. This may include the disclosure of PHI to obtain prior authorization for treatment and procedures from your insurance plan or to inquire whether you are eligible for benefits (and for what range of benefits).

Health Care Operations: Uses and disclosures of PHI are necessary to operate our health care facilities and to make sure all of our patients receive quality care. We may use and disclose relevant PHI about you for our health care operations. Examples include quality assurance activities, telephone calls to follow up on your health status, medical staff credentialing, administrative activities including financial and business planning and development, customer service activities including patient satisfaction surveys, and formal investigation of complaints, among other similar activities.

Business Associates: TrueCare may use or disclose your PHI to an outside party that assists us in operating our health care facilities. They may perform various services such as, auditing, billing, legal services, management, or consulting services. These outside parties are called “Business Associates” and are required to keep any PHI received from us confidential in the same way we do. These parties may create or receive PHI on our behalf.

Situations That Require Your Authorization or Agreement

Communication with Individuals Involved in Your Care: TrueCare may share PHI with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort. If you are not able to tell us your preference, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. Additionally, we may disclose information about you to a personal representative. If a person has the authority by law to make health care decisions for you, we will generally treat that personal representative the same way we would treat you with respect to your health information.

Special Situations That Do Not Require Your Authorization

State and/or federal laws permit the following disclosures of your PHI without obtaining verbal or written permission.

Organ and Tissue Donation: We may release PHI to organizations that obtain, bank, or transplant organs or tissues.

Research: We may use and share your PHI for research. For example, comparing the health and recovery of all patients who received one medication to those who received another with the same condition. Before we use or disclose PHI for research, the project will ordinarily go through a special approval process. Even with special approval, we may permit researchers to look at PHI to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of the PHI.

Worker’s Compensation: We will release PHI about you for worker’s compensation or similar programs if you have a work-related injury.

Averting a Serious Threat to Health or Safety: We may use and disclose PHI about you, when necessary, to prevent a serious threat to your health or safety or the health and safety of another person or the public. These disclosures would be made only to those in authority to protect the health, safety, and welfare of our communities.

Health Oversight Activities: We may disclose PHI to health oversight agencies for activities authorized by law. These oversight activities include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Public Health Activities: We may disclose PHI about you for public health activities. These generally include the following:

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may disclose PHI about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.

Law Enforcement: We may disclose PHI if asked to do so by law enforcement officials for the following reasons:

National Security: We may disclose PHI to federal officials for intelligence and national security activities authorized by law. We also may disclose PHI to federal officials in order to protect the president, other officials or foreign heads of state, or to conduct investigations.

Coroners, Medical Examiners and Mortuaries: We may disclose PHI to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death of a person.

Military and Veterans: If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.

Legal Requirements: We disclose PHI about you without your permission when required to do so under federal, state or local law. We may also disclose PHI in response to a court order or administrative order, if you are involved in a lawsuit or similar proceeding. We may disclose PHI in response to a discovery request, subpoena, or other lawful process by another party involved in a dispute, but only in accordance with applicable law.

Health Information Exchanges and OCHA’s

Health Information Exchanges: We maintain your PHI in an electronic medical record system that allows TrueCare and their associates to access your PHI for specific reasons. We also participate in various electronic health information exchanges that facilitate access to PHI by other health care providers who provide you care. You can choose not to share your PHI through an electronic health information exchange by completing an opt-out form, which you can request from the TrueCare Privacy Officer at (760) 736-6700.

Organized Health Care Agreements (OCHA’s): TrueCare participates in organized health care arrangements including as a participant of OCHIN. A current list of OCHIN Member Health Centers is available at www.ochin.org. As a Business Associate of TrueCare, OCHIN supplies information technology and related services to TrueCare and other OCHIN Member Health Centers. OCHIN also engages in quality assessment and improvement activities on behalf of its Member Health Centers. For example, OCHIN coordinates clinical review activities on behalf of participating organizations to establish best practice standards and assess clinical benefits that may be derived from the use of electronic health record systems. OCHIN also helps TrueCare work collaboratively to improve the management of internal and external patient referrals. Your PHI may be shared by TrueCare with other OCHIN Member Health Centers when necessary for health care operations purposes of the organized health care arrangement.

Potential for Redisclosure

There is the potential for PHI disclosed pursuant to applicable law to be subject to redisclosure and no longer protected by federal or state privacy laws.

Special Categories of Treatment Information

In most cases, federal or state law requires your written authorization for disclosure of information related to substance use treatment, Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) test results, and mental or behavioral health treatment.

We may not use or disclose your PHI, to the extent it relates to reproductive health care, for any of the following activities (collectively, “Prohibited Activities”): (1) to conduct a criminal, civil, or administrative investigation about the mere act of seeking, obtaining, providing or facilitating reproductive health care; (2) to impose criminal, civil, or administrative liability for the mere act of seeking, obtaining, providing, or facilitating reproductive health care; or (3) to identify any person for any purpose relating to (1) or (2). This prohibition applies when TrueCare has received a request for PHI and reasonably determined that one or more of the following conditions exist: (a) the reproductive health care is lawful under the law of the state in which such health care is provided under the circumstances in which it is provided; (b) the reproductive health care is protected, required, or authorized by federal law, including the U.S. Constitution, under the circumstances in which such health care is provided, regardless of the state in which it is provided; and (c) the presumption below applies. The reproductive health care provided by another person is presumed lawful for the purposes of this section unless TrueCare has: (i) actual knowledge that the reproductive health care was not lawful under the circumstances in which it was provided; and (ii) factual information supplied by the person requesting the use or disclosure of PHI that demonstrates a substantial factual basis that the reproductive health care was not lawful under the specific circumstances it was provided. For example, TrueCare will not provide your PHI to assist in an investigation about reproductive health care provided by a particular physician without actual knowledge that the care was unlawful or the provision of documentation to overcome the presumption that the care was lawful.

Other Uses and Disclosures of PHI

If there are reasons we need to use your PHI not described in the sections above, or not otherwise permitted by applicable law, we will obtain your written permission. This permission is described as an “authorization.” If you authorize us to use or disclose PHI about you, you may revoke that authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose PHI about you for the reasons stated in your written authorization. Please understand that we are unable to take back any disclosures already made with your permission.

Personal Rights Regarding Your PHI

You have the rights described below regarding your PHI. Please contact our Health Information Department for information or instructions on exercising any of the following rights at (760) 736-6717.

Right to Inspect, Copy, or Receive Electronically: You have the right to inspect, copy, or request electronic PHI that may have been used to make decisions about your care, subject to certain exceptions. Usually this includes medical and billing records, but may not include certain PHI based on certain requirements or exceptions under applicable law (for example: mental health information or psychotherapy notes). There may be a nominal fee for processing these requests. Whether you want to review, receive a copy or electronic health record information, you must make the request in writing. You may also request access to our patient portal to assist with access to your PHI. We may also deny access to certain PHI on the portal. If we do deny access, we will give the reason, in writing. We will also explain how you may appeal the decision.

You also have the right to inspect and receive a copy of your PHI that may be used to make decisions about your health by completing an Authorization for Use or Disclosure form.

Right to Request a Correction or Amendment: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the PHI. Requests for amending your PHI should be made to the Health Information Department at (760) 736-6717. You have a right to request a correction or other amendment for as long as the PHI is kept by TrueCare and provided that the PHI is not otherwise correct or complete.

Right to Request an Accounting of Disclosures: You have the right to request a list of certain disclosures of your PHI made by TrueCare within six years of the date of your request. To request an accounting of disclosures, you must make your request to the should be made to the Health Information Department at (760) 736-6717.

Request to Change Communication Preference: You have the right to request that TrueCare communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make your request to the Health Information Department at (760) 736-6717, specifying the requested method of contact, or the location where you wish to be contacted. TrueCare will accommodate reasonable requests. You do not need to give a reason for your request.

Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose to someone involved in your care or the payment for your care, like a family member or friend.

To request a restriction, you must make your request in writing to the Health Information Department at (760) 736-6717. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of PHI to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “out-of-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Notice of Breaches: You have the right to be notified in the event that TrueCare or one of our Business Associates discovers a breach involving your PHI.

Copy of this Notice: You are entitled to receive a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. To obtain a copy of this Notice, contact the TrueCare Privacy Officer at (760) 736-6700.