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Notice of privacy practices

Notificación sobre las prácticas de privacidad

Your Information. Your Rights.
Our Responsibilities.

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

Your Rights

When it comes to your health information, you have certain rights.

This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. You may also download a printable copy here.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us at:
    Corporate Compliance
    Eric Maristela, Corporate Compliance & Privacy Officer
    1115 S. Sunset Ave., West Covina, CA 91790
    626.814.2572
    rmaristela@emanatehealth.org
  • You can file a complaint with the U.S. Department of Health and
    Human Services Office for Civil Rights by sending a letter to
    200 Independence Ave., S.W., Washington, D.C. 20201, calling
    1.877.696.6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
  • We will not retaliate against you for filing a complaint.

Questions or concerns about your hospital stay or experience

For questions or concerns about your hospital stay and experience, please contact the Patient Relations Department at 626.858.8519 or patientrelations@emanatehealth.org.
www.emanatehealth.org/patients-visitors/patient-relations/

Your Choices

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes

In the case of fundraising:

  • We may contact you for fundraising efforts, but you can tell us not to contact you again. To opt out of receiving fundraising information you may contact us at:
    Emanate Health Foundation
    1041 W. Badillo St., Suite 106
    Covina, CA 91722
    626.814.2421
    foundation@emanatehealth.org

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways. Not every use or disclosure will be listed. All of the ways we are permitted to use and disclose information will fall within one of the following categories. Other uses and disclosures not described in this Notice will be made only if we have your written authorization.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

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

Example: We give information about you to your health insurance plan so it will pay for your services.

Appointment reminders

We may contact you to remind you that you have an appointment at Emanate Health.

Business associates

We can share information with contracted services. A business associate is required to appropriately safeguard your information.

Example: We utilize a vendor to provide physical and electronic copies of health records.

Health information exchanges

We participate in an electronic Health Information Exchange (HIE) network with other physicians, hospitals and health care providers in our community. The use of the network is limited and open only to other participants.

For more information see: lanesla.org/faqs/

How Else Can We Use or Share Your Health Information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. Some information, such as drug and alcohol information, HIV information, genetic information and mental health information is entitled to special restrictions for use and disclosure. We have to meet many conditions in the law before we can share your information for these purposes.

For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Help with public health and safety issues

We can share health information about you for certain situations
such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
  • Reporting vital events such as births and deaths
  • Notifying persons of recalls, repairs or replacements of products they may be using

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to 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.

Special categories

Some health information may be subject to restrictions such as mental health conditions, HIV tests or substance use disorders. We have precautions in place to protect this information. Many times this information requires special permission from you.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

This Notice of Privacy Practices Applies to the Following Site Locations

Emanate Health

Emanate Health consists of Emanate Health Medical Centers, Emanate Health medical groups,
clinics and physician offices, employee health areas, administrative and operational units.

  • Emanate Health Inter-Community Hospital
  • Emanate Health Queen of the Valley Hospital
  • Emanate Health Foothill Presbyterian Hospital
  • Emanate Health Home Care
  • Emanate Health Medical Care Foundation
    (clinics and physician offices)
  • Emanate Health Foundation
  • Emanate Health Imaging

Notice of Nondiscrimination

Emanate Health provides free aids and services to people with disabilities to communicate effectively with us. Click here for more information about our nondiscrimination policy. The following language assistance services are available for you to use:

English
ATTENTION: Language assistance services, free of charge, are available to you. Call 1.855.301.5522 (TTY: 711).

Español (Spanish)
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1.855.301.5522 (TTY: 711).

繁體中文 (Chinese)
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1.855.301.5522 (TTY: 711).

Tiếng Việt (Vietnamese)
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1.855.301.5522 (TTY: 711).

Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1.855.301.5522 (TTY: 711).

Korean
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1.855.301.5522 (TTY: 711). 번으로 전화해 주십시오.

Հայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 1.855.301.5522 (TTY: 711).

Farsi (Persian)
وجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد.
با 1-855-301-5522 (TTY: 711).

Русский (Russian)
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1.855.301.5522 (TTY: 711).

日本語 (Japanese)
注意事項：日本語を話される場合、無料の言語支援をご利用いただけます1-855-301-5522 (TTY: 711) まで、お電話にてご連絡ください

اتصل برقم (Arabic)
العربية ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. (.
.(TTY: 711) رقم هاتف الصم والبكم1-855-301-5522

ਪੰਜਾਬੀ (Punjabi)
ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 1.855.301.5522 (TTY: 711).

ខ្មែរ (Cambodian)
ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ 1.855.301.5522 (TTY: 711).។

Hmong Hmoob
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1.855.301.5522 (TTY: 711).

हिंदी (Hindi)

Thai
ภาษาไทย เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1.855.301.5522 (TTY: 711).