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. 

Heluna Health is required to comply with both federal laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and California laws, such as the Confidentiality of Medical Information Act (CMIA), that provide additional protections for your health information.

If you have any questions, please contact The Heluna Health Privacy Officer at 562.205.2459 ext. 2459 phone number and/or privacy@helunahealth.org.  

WE ARE REQUIRED BY LAW TO

• Maintain the privacy and security of your protected health information;
• Provide you with this notice to inform you of our duties and privacy practices regarding your health information;
• Follow the terms of our notice that is currently in effect.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe different ways that we use and disclose medical and health information.  For each category of uses or disclosures we will explain what we mean and try to give some examples. 

Disclosure at Your Request

We will disclose your health information to individuals or entities you specifically authorize. Certain disclosures may require your written authorization.

Treatment

We may use and disclose health information about you to provide you with treatment or services.  We may use or disclose your health information about you to other health professionals who are involved in your medical care.

Payment

We may use and disclose your health information to bill and get payment from health plans or other entities.

Health Care Operations

We may use and disclose health Information for health care operation purposes.  For example, we use health information about you to manage treatment and services.

Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services

We may use and disclose health Information to contact you and to remind you that you have an appointment with us.  We also may use and disclose health information to tell you about treatment alternatives or health-related benefits and services.

Individuals Involved in Your Care or Payment for Your Care

When you consent, we may share health information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. 

Research

Under certain circumstances, we may use and disclose health information for research. 

Fundraising and Marketing

Health information may be used for fundraising communications, but you have the right to opt-out of receiving such communications.  Most uses and disclosures of health information for marketing purposes require your authorization.

SPECIAL SITUATIONS

As Required by Law

We will disclose health information when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety

We may use and disclose health information when necessary to prevent a serious threat to your health or safety or the health and safety of the public or another person. 

Workers’ Compensation

We may release health information for workers’ compensation or similar programs.  These programs provide benefits for work-related injuries or illness.

Public Health Risks

We may use or disclose your health information for public health activities.  These activities generally include disclosures to prevent disease, report suspected abuse or neglect, and report reactions to medications or products recalls.

Health Oversight Activities

We may use or disclose your health information to a health oversight agency for activities authorized by law.  These oversights include, for example, audits, investigations, inspections, and licensure. 

Lawsuits and Legal Actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Coroners, Medical Examiners and Funeral Directors

We may release health information to a coroner, medical examiner or funeral director when an individual dies.

Law Enforcement and Other Government Request

We may release health information for national security and presidential protective services, and law enforcement purposes or with a law enforcement official.

YOUR RIGHTS

You have the following rights regarding health information we have about you:

Right to Inspect and Copy

You have a right to inspect and copy health information. This includes medical and billing records. To inspect and copy this health information, you must make your request, in writing, to privacy@helunahealth.org or via regular mail at Heluna Health Privacy Office, 13300 Crossroads Parkway North, Suite 450, City of Industry, CA 91746.

Right to Request an  Amendment

If you feel your health information we have is incorrect or incomplete, you may ask us to amend the information. To request an amendment, you must make your request, in writing, to privacy@helunahealth.org or via regular mail at Heluna Health Privacy Office, 13300 Crossroads Parkway North, Suite 450, City of Industry, CA 91746.  We may deny your request if we determine the information is complete and accurate. 

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we made of health information for purposes other than treatment, payment and health care operations. To request an accounting of disclosures, you must make your request, in writing, to our office at Heluna Health Privacy Office, 13300 Crossroads Parkway North, Suite 450, City of Industry, CA 91746. 

Right to Request Restrictions

You have the right to request a restriction or limitation on the health information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing at Heluna Health Privacy Office, 13300 Crossroads Parkway North, Suite 450, City of Industry, CA 91746.  We are not required to agree to all such requests. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Request Confidential Communication

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communication, you must make your request, in writing, to our office. 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 this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice from our website, www.HelunaHealth.org. To obtain a paper copy of this notice please request it in writing.

Right to Electronic Records

You have the right to receive a copy of your electronic health records in electronic form.

Right to Breach Notification

You have the right to be notified if there is a Breach of privacy such that your health information is disclosed or used improperly or in an unsecured way. 

CHANGES TO THIS NOTICE

We reserve the right to change this notice and make the new notice apply to health information we already have as well as any information we receive in the future. We will post a copy of our current notice on our website. The notice will contain the effective date on the first page, in the top right-hand corner.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services Office for Civil Rights  online at  www.hhs.gov/hipaa/filing-a-complaint/index.html or calling 1-800-368-1019.

You also have the right to file a complaint with the California Department of Public Health (CDPH) Privacy Office if you believe your privacy rights under California law have been violated. The CDPH Privacy Office is responsible for ensuring compliance with state and federal privacy laws, including the California Information Practices Act (IPA) and the HIPAA Privacy Rule.

Contact Information for the CDPH Privacy Office:

• Email: Privacy@cdph.ca.gov
• Phone: (916) 440-7671
• Toll-Free: (877) 421-9634
• Fax: (916) 319-9821
• Mailing Address:
  California Department of Public Health
  Office of Legal Services, Privacy Office
  MS 0506
  P.O. Box 997377
  Sacramento, CA 95899-7377