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.

Use and Disclosure Of Health Information
United HomeCare Services, Inc. may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after the Agency has obtained your written consent. The Agency has established policies to guard against unnecessary disclosure of your health information.

I. Circumstances Under Which & Purposes For Which Your Health Information May Be Used And Disclosed.

• To Provide Treatment
• To Obtain Payment
• To Conduct Health Care Operations:
• Quality assessment and improvement activities.
• Activities designed to improve health or reduce health care costs.
• Protocol development, case management and care coordination.
• Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
• Professional review and performance evaluation.
• Training programs including those in which students, trainees or practitioners in health care learn under supervision.
• Training of non-health care professionals.
• Accreditation, certification, licensing or credentialing activities.
• Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
• Business planning and development including cost management and planning related analyses and formulary development.
• Business management and general administrative activities of the Agency.
• Fundraising for the benefit of the Agency and certain marketing activities.
• For Fundraising Activities
• For Appointment Reminders
• For Treatment Alternatives
  

II. Circumstances Under Which & Purposes For Which Your Health Information May Be Used And Disclosed Without First Receiving Your Written Consent.

• When Legally Required
• When There Are Risks to Public Health
• Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
• Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
• Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
• Notify an employer about an individual who is a member of the workforce as legally required.
• To Report Abuse, Neglect or Domestic Violence
• To Conduct Health Oversight Activities
• In Connection With Judicial And Administrative Proceedings
• For Law Enforcement Purposes
• As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or summons or similar process.
• For the purpose of identifying or locating a suspect, fugitive, material witness or missing person.
• Under certain limited circumstances, when you are the victim of a crime.
• To a law enforcement official if the Agency has a suspicion that your death was the result of criminal conduct including criminal conduct at the Agency.
• In an emergency in order to report a crime.
• To Coroners and Medical Examiners
• To Funeral Directors.
• For Organ, Eye or Tissue Donation
• For Research Purposes
• In the Event of A Serious Threat To Health Or Safety
• For Specified Government Functions
• For Worker's Compensation
  

Authorization To Use Or Disclose Health Information
Other than is stated above, the Agency will not disclose your health information other than with your written authorization. If you or your representative authorizes the Agency to use or disclose your health information, you may revoke that authorization in writing at any time.

You have the following rights regarding your health information, which the Agency maintains:

• Right to request restrictions.
• Right to receive confidential communications.
• Right to inspect and copy your health information.
• Right to amend health care information.
• Right to an accounting.
• Right to a paper copy of this notice.
  

Duties Of The Agency
The Agency is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The Agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If the Agency changes its Notice, the Agency will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative has the right to express complaints to the Agency and to the Secretary of DHHS if you or your representatives believe that your privacy rights have been violated. Any complaints to the Agency should be made in writing to the United HomeCare Services Compliance Officer. The Agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

Contact Person
The Agency has designated the United HomeCare Services privacy officer as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at 305-328-0891 to leave a voicemail.

Effective Date
This notice is effective April 14, 2003.