This Notice of Privacy Practices will be followed by all KTCH staff and health care professionals who treat you in one of the above office sites.
 
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.

KTCH is committed to providing you with quality, culturally competent, primary health care regardless of financial or other barriers to care. We value our relationship with you, a relationship built on trust. We protect your privacy and confidentiality by creating and implementing policies and procedures that limit access to your personal health information.

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information is your health or medical record and it is an essential part of the health care we provide for you.

Your health record serves as a:

• Basis for planning your care and treatment
• Means of communication among the health professionals who contribute to your care
• Document describing the care you received
• Means by which you or a third party payer can verify that services billed were actually provided
• Tool in educating health professionals
• Source of data for medical research
• Source of information for public health officials charged with improving the health of the nation
• Source of data for facility planning and marketing
• Tool with which we can access and continually use to improve the care
  we render

Your health record contains personal health information, the confidentiality of which is protected under both state and federal law. Understanding how we will use and disclose your health information helps you to:

• Ensure your record's accuracy
• Better understand who, what, when, where, and why your health care providers and others may access your health information
• Make more informed decisions when you authorize disclosure of your health information to others

Although your health record is the physical property of KTCH, the information belongs to you. You have the right to:

• Receive this notice describing the uses and disclosures we expect to make of your health information
• Request additional restrictions on uses and disclosures of your health information, however, KTCH is not required to agree to any such request.
• Request that we send you confidential communications of protected health information by alternative means or to alternative locations. This request must be in writing.
• Inspect and obtain a copy of your health record. Contact the Medical Records Department for instructions on how to do this.
• Request that your health record be amended. A request for amending your health information must be in writing using the specific form and directed to the Director of Clinical Services at KTCH. A request for amendment letter must state a reason for the requested change.
• Obtain an accounting of disclosures of your health information made after April 13, 2003, for purposes other than treatment, payment, and health care operations. A request for an accounting of disclosures must be in writing and directed to the Privacy Officer.
• Obtain a paper copy of the Notice upon request even if you have received the Notice electronically KTCH is required by the Federal Privacy Rules to:

• Maintain the privacy of your health information.
• Provide you with this notice about our privacy practices with respect to your health information.
• Follow the information practices that are described in this notice.

KTCH reserves the right to change our health information practices and the terms of this notice, and to make the new provisions effective for all protected health information we maintain, including health information created or received prior to the effective date of any such revised notice. If our health information practices change, we will post our revised notice in visible areas throughout our facilities and on our website. We will not use or disclose your health information except as described in this notice.

We will use your health information for treatment. For example, information obtained by a nurse will be recorded in your medical record and used to determine the course of treatment that should work best for you. Also, the nurse will write observations in your record so the physician will know how you are responding to treatment.

We may send relevant portions of your medical record to specialists to whom you are being referred for care, to physicians whom your providers here may want to consult on a care issue, or to hospitals.

We may use and disclose health information about you to remind you that you have an appointment with us for treatment or that it is time for you to schedule an appointment with us.

We may provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.

We will use your health information for payment. For example, a bill may be sent to you or your insurance company or health plan. The information on or accompanying the bill may include information that identifies you and may contain your diagnosis, procedures performed and supplies used.

We will use your health information for regular healthcare operations. Examples of health care operations include:

• Quality improvement: for example, members of the medical staff, managers, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information is then used to continually improve the quality and effectiveness of the health care services we provide.
• Utilization review: a process by which patients' needs are matched with the appropriate type and level of care, i.e., hospital, nursing home, outpatient, etc. It involves communication between insurance companies that pay for the care and the professionals that provide the care.
• Medical education and training.
• Peer review: a process whereby healthcare professionals (physicians, nurses and others) review their work to improve the delivery of care.
• Providing identifying information for clergy .

We provide some services with business associates, who are independent professionals that use patient health information provided by us in order to perform these services. Examples of business associates are our Transcription and Microfilming professional services, which are contracted. We may disclose your health information to them so they can perform the job we have asked them to do. Other examples of business associates include accrediting agencies and patient satisfaction survey companies. To protect your health information, we require the business associate to appropriately safeguard your information.

The Federal Privacy Rules require us to disclose your personal health information in two instances: to you at your request and to the Secretary of Health and Human Services when requested as part of an investigation or compliance review.

In addition, we are required to use and disclose your health information without your authorization for certain purposes:

• When required by state or federal law.
• To state and federal public health authorities, including state medical officers, the Food and Drug Administration, and other agencies charged with preventing or controlling disease.
• To government authorities, including protective service agencies, authorized to receive reports of abuse and neglect.
• To government health oversight agencies, such as the state and federal Departments of Health and Human Services, Medicare/Medicaid Peer Review Organizations, state Boards of Medicine, Nursing, and Pharmacy, and other licensing authorities.
• When required by court order in a judicial or administrative proceeding.
• To law enforcement officials for certain law enforcement purposes, including the reporting of certain types of wounds or injuries and any crimes against a person under 16 years of age.
• To coroners, medical examiners, or funeral directors for purposes of identifying a deceased person or carrying out their duties as required by law.
• For purposes of organ or tissue donation and transplantation, consistent with applicable law.
• For research approved by an Investigational Review Board or Privacy Board that has reviewed the research proposal.
• To established protocols to ensure the privacy of your health information.
• When required to avert a serious threat to health or safety.
• When requested for certain specialized government functions authorized by law, including military and similar situations, e.g., national security.

We expect to make other uses and disclosures of your protected health information only on the basis of written authorization forms signed by you. You have the right to revoke any such authorization at any time, except to the extent we have already relied on it in making an authorized use or disclosure.

If you have any questions or complaints about this notice or our privacy practices, please contact:Katy Trail Community Health
Privacy Officer
Or
Director of Clinical Services
821 Westwood Drive
Sedalia, MO 65301
660-826-4774

If you believe your privacy rights have been violated, you may send a written complaint to the KTCH Privacy Officer or Director of Clinical Services at the above address, or to the following:

DSS Privacy Officer
Division of Legal Services
PO Box 1527
Jefferson City, MO 65102-1527
Phone:  573-751-3229
Fax:  573-526-1484Secretary of the Department of Health and Human Services (DHHS)
200 Independence Ave, SWWashington, DC 20201