THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND RELEASED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

USE AND RELEASE OF HEALTH INFORMATION

VNA may use your health information for purposes of providing you Treatment, obtaining Payment for your care and conducting health care Operations. VNA has established policies to guard against unnecessary release of your health information. 

THE FOLLOWING IS A LIST OF PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND RELEASED:

To Provide Treatment.  VNA may use your health information to coordinate care within the VNA and with others involved in your care, such as your attending physician and other health care professionals.  For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.  VNA also may release your health care information to individuals outside of the Agency involved in your care including family members, pharmacists, suppliers of medical equipment or other health care professionals for the purpose of providing treatment.

To Obtain Payment.  VNA may include your health information on invoices to collect payment from third parties for the care you received from VNA.  For example, VNA may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or VNA.  VNA also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you.

To Conduct Health Care Operations.  VNA may use and release health information for its own operations and as necessary to provide quality care to all of the VNA patients/clients.  Health care operations may include activities such as: 

1.   Quality assessment and improvement activities. 

2.  Training programs including those in which students, trainees or practitioners in health care learn under supervision.

 3.   Accreditation, certification, licensing or credentialing activities.

For Agency Directories:  Except when an objection is expressed, the VNA mayuse you name to maintain a directory of patients/clients of the VNA

For Others involved in Care:  Except when an objection is expressed, VNA may disclose to a family member, personal representative, or any other person identified by the patient, the protected health information that is directly relevant to such person’s involvement with the care.

For Appointment Reminders.  VNA may use and release your health information in order to contact you as a reminder that you have an appointmen for a home visit or have missed an appointment.

For Treatment Alternatives.  VNA may use and release your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. 

For Fundraising Activities. VNA occasionally conducts fundraising activities & may use information about you including your name, address, phone number and the dates you received care in such activities. If you do not want VNA to contact you, notify Nona Odum at P O Box 768 Kennett, Mo  63857 and indicate that you do not wish to be contacted. 

 For Disaster Relief Pruposes:  VNA may disclose protected health information to a public or private entity authorized by law or by charter to assist in disaster relief efforts.

THE FOLLOWING IS A LIST OF PURPOSES FOR WHICH YOUR HEALTH

             INFORMATION MAY BE USED AND RELEASED.

When Legally Required.  VNA will release your health information when it is required to do so by any Federal, State or local law.

When There Are Risks to Public Health.  VNA may release your health information for public activities and purposes in order to:

-     Prevent or control disease, injury or disability, report disease, injury, or death.  

-     Report adverse events, or product defects. 

-     Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.

To Report Abuse, Neglect Or Domestic Violence.  VNA is allowed to notify government authorities if the Agency believes a patient is the victim of abuse, neglect or domestic violence.

To Conduct Health Oversight Activities.  VNA may release your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. VNA, however, may not release your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.

 In Connection With Judicial And Administrative Proceedings.  VNA may release your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when VNA obtains an order protecting your health information. 

For Law Enforcement Purposes.  As permitted or required by State law, VNA may release your health information to a law enforcement official for certain law enforcement purposes such as:

-     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. 

-     Under certain limited circumstances, when you are the victim of a crime or report 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.

To Coroners And Medical Examiners.  VNA may release your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors.  VNA may release your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements.  If necessary to carry out their duties, VNA may disclose your health information prior to and in reasonable anticipation of your death.

For Organ, Eye Or Tissue Donation.  VNA may use or release your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.

In the Event of A Serious Threat To Health Or Safety.  VNA may, consistent with applicable law and ethical standards of conduct, release your health information if VNA, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

For Specified Government Functions.  In certain circumstances, the Federal regulations authorize VNA to use or release your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.

For Worker's Compensation.  VNA may release your health information for worker's compensation or similar programs.

AUTHORIZATION TO USE OR RELEASE HEALTH INFORMATION

Other than is stated above, VNA will not release your health information without your written authorization. If you or your representative authorizes VNA to use or release your health information, you may revoke that authorization in writing at any time.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights regarding your health information that VNA maintains:

-          Right to request restrictions.  You or your legal representatives may request limits on certain uses and releases of your health information.  You have the right to request a limit on VNA’s release of your health information to someone who is involved in your care, the payment of your care, or health care operations.  However, VNA is not required to agree to your request.  If you wish to make a request for restrictions, please contact Nona Odum P O Box 768 Kennett, MO  63857

-     Right to receive confidential communications.  You or your legal representatives have the right to request that VNA communicate with you in a certain way.  For example, you may ask that VNA only conduct communications pertaining to your health information with you privately with no other family members present.  If you wish to receive confidential communications, please contact Nona Odum at P O Box 768 Kennett, Mo  63857 VNA will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

-     Right to inspect and copy your health information.  You or your legal representatives have the right to request, to inspect, and copy your health information, including billing records.  A request to inspect and copy records containing your health information may be made to Nona Odum P O Box 768 Kennett, MO 63857.  If you request a copy of your health information, VNA may charge a reasonable fee for copying and assembling costs associated with your request.

-     Right to amend health care information.  You or your legal representatives have the right to request that VNA amend your records, if you believe that your health information is incorrect or incomplete.  That request may be made as long as the information is maintained by VNA.  A request for an amendment of records must be made in writing to Executive Administrative Assistant, Nona Odum P O Box 768 Kennett, Mo  63857 .  VNA may deny the request if it is not in writing or does not include a reason for the amendment.  The request also may be denied if your health information records were not created by VNA, if the records you are requesting are not part of VNA‘s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of VNA, the records containing your health information are accurate and complete.

-     Right to an accounting.  You or your legal representatives have the right to request a list of releases of your health information made by VNA for any reason other than for treatment, payment or health operations.  The request for an accounting must be made in writing to Nona Odum Executive Administrative Assistant P O Box 768 Kennett, Mo  63857.  The request should specify the time period for the accounting starting on or after April 14, 2003.  Accounting requests may not be made for periods of time in excess of six (6) years.  VNA would provide the first accounting you request during any 12-month period without charge.  Subsequent accounting requests may be subject to a reasonable cost-based fee.

-          Right to a paper copy of this notice.  You or your legal representatives have a right to an additional paper copy of this Notice at any time even if you or your representatives have received this Notice previously.  To obtain an additional paper copy, please contact  Nona Odum Executive Administrative Assistant P O Box 768 Kennett, Mo  63857

-          Right to Express Complaints

You or your personal representatives have the right to express complaints to VNA and to the Secretary of DHHS if you or your representatives believe that your privacy rights have been violated. Any complaints to VNA should be made in writing to Nona Odum P O Box 768 Kennett, Mo  63857.  VNA 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. 

DUTIES OF THE AGENCY

VNA is required by law to maintain the privacy of your health information and to provide to you and your legal representatives this Notice of its duties and privacy practices. VNA is required to abide by the terms of this Notice. VNA 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. (See effective date below)

CONTACT PERSON

VNA has designated Nona Odum as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards.  You may contact this person at P O Box 768 Kennett, MO  63857

EFFECTIVE DATE

This Notice is effective April 14, 2003.

IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
Nona Odum at VNA P O Box 768 Kennett, Mo  63857 or (573) 888-5892 Ext. 147