Alaskan AIDS Assistance Association Notice of Privacy Practices

This Notice of Privacy Practices is effective November 3, 2016.

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

The Four A’s is not directly subject to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). However, we understand and recognize the need to adhere to the strictest level of confidentiality to maintain trust and the highest level of service. We have an ethical and legal commitment to our clients and the community to keep your information confidential. If you have any questions about this Notice please contact our Executive Director at (907) 263-2050 or by mail at Four A’s, 1057 West Fireweed, Suite 102, Anchorage, AK 99503. You may also contact the DHHS Office of Civil Rights at 200 Independence Avenue S. W., Room 509F, HHH Building, Washington D. C. 20201.

A. What This Notice Covers

  1. The policy and practices in this notice cover the processing of protected health information for clients of The Four A’s
  2. Protected Health Information (PHI) is any information we maintain about a client that:
    • a. allows identification of an individual directly or indirectly and is related to the past, present or future healthcare of that individual; or
    • b. can be linked with other available information to identify a specific client. When this notice refers to personal information, it means PHI.
  3. We adopted this policy because of standards for Homeless Management Information Systems issued by the Department of Housing and Urban Development. We intend our policy and practices to be consistent with those standards. See 69 Federal Register 45888 (July 30, 2004).
  4. This notice tells our clients, our staff, and others how we process personal information. We follow the policy and practices described in this notice. We also:
    • Keep your protected health information private;
    • Provide notice of our legal duties and privacy practices with respect to protected health information; • Notify affected individuals following a breach of unsecured protected health information;
    • Give you this Notice of Privacy Practices; and
    • Follow the terms of the Notice of Privacy Practices currently in effect.
  5. We may amend this notice and change our policy or practices at any time. Amendments may affect personal information that we obtained before the effective date of the amendment.
  6. We give a written copy of this privacy notice to any individual who receives services from The Four A’s. We maintain a copy of this policy on our website at (www.alaskanaids.org).

B. How and Why We Collect Personal Information

  1. We collect personal information only when appropriate to provide services, or for another specific purpose of our organization, or when required by law. We may collect information for these purposes:
    • a. to provide or coordinate services to clients
    • b. to locate other programs that may be able to assist clients
    • c. for functions related to payment or reimbursement from others for services that we provide
    • d. to operate our organization, including administrative functions such as legal, audits, personnel, oversight, and management functions
    • e. to comply with government reporting obligations
    • f. when required by law
  2. We only use lawful and fair means to collect personal information.
  3. We normally collect personal information with the knowledge or consent of our clients. If you seek our assistance and provide us with personal information, we assume that you consent to the collection of information as described in this notice.
  4. We may also get information about you from:
    • a. Individuals who are with you
    • b. Other private organizations that provide services (ANHC, ANMC, etc.)
    • c. Government agencies
    • d. Telephone directories and other published sources
  5. We post a sign at our intake desk or other location explaining the reasons we ask for personal information. The sign says:
     
    We collect personal information directly from you for reasons that are discussed in our privacy statement. We may be required to collect some personal information by law or by organizations that give us money to operate this program. Other personal information that we collect is important to run our programs, to improve services and to better understand the need of individuals. We only collect information that we consider to be appropriate.

C. How We Use and Disclose Personal Information

  1. We use or disclose personal information for activities described in this part of the notice. We may or may not make any of these uses or disclosures with your information. We assume that you consent to the use or disclosure of your personal information for the purposes described here and for other uses and disclosures that we determine to be compatible with these uses or disclosures:
    • a. to provide or coordinate services to individuals
    • b. for functions related to payment or reimbursement for services
    • c. to carry out administrative functions such as legal, audits, personnel, oversight, and management functions
    • d. to create de-identified (anonymous) information that can be used for research and statistical purposes without identifying clients
    • e. when required by law to the extent that use or disclosure complies with and is limited to the requirements of the law
    • f. to avert a serious threat to health or safety if
      • 1) we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public, and
      • 2) the use or disclosure is made to a person reasonably able to prevent or lessen the threat, including the target of the threat
    • g. to report about an individual we reasonably believe to be a victim of abuse, neglect or domestic violence to a governmental authority (including a social service or protective services agency) authorized by law to receive reports of abuse, neglect or domestic violence
      • 1) under any of these circumstances:
        • a) where the disclosure is required by law and the disclosure complies with and is limited to the requirements of the law
        • b) if the individual agrees to the disclosure, or
        • c) to the extent that the disclosure is expressly authorized by statute or regulation, and
          • i. we believe the disclosure is necessary to prevent serious harm to the individual or other potential victims, or
          • ii. if the individual is unable to agree because of incapacity, a law enforcement or other public official authorized to receive the report represents that the PHI for which disclosure is sought is not intended to be used against the individual and that an immediate enforcement activity that depends upon the disclosure would be materially and adversely affected by waiting until the individual is able to agree to the disclosure.
      • and
      • 2) when we make a permitted disclosure about a victim of abuse, neglect or domestic violence, we will promptly inform the individual who is the victim that a disclosure has been or will be made, except if:
        • a) we, in the exercise of professional judgment, believe informing the individual would place the individual at risk of serious harm, or
        • b) we would be informing a personal representative (such as a family member or friend), and we reasonably believe the personal representative is responsible for the abuse, neglect or other injury, and that informing the personal representative would not be in the best interests of the individual as we determine in the exercise of professional judgment.
    • h. for academic research purposes
      • 1) conducted by an individual or institution that has a formal relationship with the Four A’s if the research is conducted either:
        • a) by an individual employed by or affiliated with the organization for use in a research project conducted under a written research agreement approved in writing by a designated Four A’s administrator (other than the individual conducting the research), or
        • b) by an institution for use in a research project conducted under a written research agreement approved in writing by a designated Four A’s administrator.
      • and
      • 2) any written research agreement:
        • a) must establish rules and limitations for the processing and security of PHI in the course of the research
        • b) must provide for the return or proper disposal of all PHI at the conclusion of the research
        • c) must restrict additional use or disclosure of PHI, except where required by law
        • d) must require that the recipient of data formally agree to comply with all terms and conditions of the agreement, and
        • e) is not a substitute for approval (if appropriate) of a research project by an Institutional Review Board, Privacy Board or other applicable human subjects protection institutions.
    • i. to a law enforcement official for a law enforcement purpose (if consistent with applicable law and standards of ethical conduct) under any of these circumstances:
      • 1) in response to a lawful court order, court-ordered warrant, subpoena or summons issued by a judicial officer, or a grand jury subpoena
    • and
      • 2) to comply with government reporting obligations for homeless management information systems and for oversight of compliance with homeless management information system requirements.
  2. Before we make any use or disclosure of your personal information that is not described here, we will obtain a written authorization from you permitting us to do so.

D. Your Rights With Regard to Personal Information

You have the following rights regarding personal information we maintain about you:

  • Right to Inspect and Copy You may come to our offices and inspect and copy most of the medical information about you that we maintain. We will normally provide you with access to, or copies of, this information within 30 days of your request. We may also charge you a reasonable fee for you to copy any medical information that you have the right to access. If your records are held in electronic format, you may also obtain an electronic copy if it is reasonably available. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials.
  • Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must provide a supporting reason, be made in writing, and be submitted to the Privacy Officer. If we agree to amend the information, we will generally amend your information within 60 days of your request and will notify you when we have amended the information. We may deny your request for an amendment if does not meet the requirements listed above. In addition, we may deny your request if you ask us to amend information that: is not kept by or for The Four A’s; was not created by us, unless the person or entity that created the information is no longer available to make the amendment; is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.
  • Right to an Accounting of Disclosures. You have the right to request a list of disclosures, where such disclosure was made for any purpose other than treatment, payment or health care operations. We are not required to give you an accounting of information we have shared with our business associates or for which you have given us a written authorization. To request an accounting of disclosures, you must submit your request in writing to the Privacy Officer. Your request must state a time period, which may not be longer than six years or before April 14, 2003. Your request should indicate in what form you want the list (i.e. paper or electronic). The first list you request within a 12-month period will be free, and you may be charged for the cost of any additional lists. We will notify you of the cost and you may choose to withdraw or modify your request before any costs are incurred.
  • Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a transport or treatment we provided. We are not required to agree to your request unless the disclosure is to a health plan for purposes of carrying out payment or health care operations (not treatment purposes) and the information pertains solely to an item or service paid for fully out of pocket. To request restrictions, you must make your request in writing to the Privacy Officer. In your request, you must describe: (1) what information you want to limit; (2) whether you want to limit use, disclosure or both; and (3) to whom the limits shall apply, for example, your spouse.
  • Right to Request Confidential Communications. You can request that we communicate confidentially with you about medical matters. 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 the Privacy Officer. We will accommodate reasonable requests. Your request must specify how you wish to be contacted.
  • Right to a Paper Copy of This Notice. You may request a paper copy at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy.
  • Right to Revoke Authorization/Permissions. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you. Your substance abuse records received by a person or entity pursuant to your written authorization may not be re-disclosed without your written consent.

F. Complaints and Accountability

  1. We accept and consider questions or complaints about our privacy and security policies and practices. Complaints should be in writing and addressed to the Executive Director/Privacy Officer of the Four A’s. Complaints may also be directed to the DHSS Office of Civil Rights at the address listed above. You will not be retaliated against or penalized for filing a complaint.
  2. All members of our staff (including employees, volunteers, affiliates, contractors and associates) are required to comply with this privacy notice. Each staff member must receive and acknowledge receipt of a copy of this privacy notice.

G. Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for PHI information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office. The notice will contain the effective date on top of the first page. You will be offered a copy of the current notice when you visit our officers for services.