NOTICE OF PRIVACY PRACTICES

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.

Salud Family Health Centers provides health care services to our patients in partnership with physicians and other professionals and organizations. This Notice of Privacy Practices will be followed by Salud Family Health Centers, Associated Pharmacists Inc., and The Health District of Northern Larimer County Integrated Care Program. We will share medical information about you as necessary to carry out treatment, payment, and health care operations.

Salud Family Health Centers, Associated Pharmacists Inc., and The Health District of Northern Larimer County Integrated Care Program participate together in an organized health care arrangement to deliver health care to you at Salud Family Health Centers. We have all agreed to abide by the terms of this joint Notice regarding your health information.

I. Understanding Your Health Information

Each time you visit Salud Family Health Centers, a record of your visit is created. This record usually contains your name and other information that may identify you, your symptoms, examination and test results, diagnoses, treatment, plan for future health care, and financial information. This record is sometimes referred to as your "medical record" or "medical chart." This record allows:

Doctors, nurses, and other health professionals to plan your treatment;
• Salud Family Health Centers to obtain payment for services we provide to you, such as from insurance companies, Medicaid, or you; and
• Salud Family Health Centers to measure the quality of care provided to you.

As we have in the past, we are committed to keeping your health information confidential. We will not use or give to others your health information without your written permission, except as stated in this Notice.

II. How We Will Use and Give Out Your Health Information

a. Treatment, Payment, and Health Care Operations

We will use and give out your health information to provide you with health care treatments, to get paid for our services, and to help us operate our community health center. For example:

• We will give your health information to health care professionals not on our staff, such as other doctors and hospital staff, who help care for you;
• We may send a bill to your health insurance plan or to you; and
• Our community health center may use your medical record to review our performance and make sure you receive quality health care.

b. Other Uses and Disclosures Allowed or Required by Law

We may use or give out your health information for the following purposes under limited circumstances:

• AFTER OBTAINING PERMISSION FROM YOU: To people who are involved in your care or who help pay for your care, such as your family, your close personal friends, or any other person chosen by you, to notify them of your location, general health, and to assist you in your health care (such as to pick-up medicine or help with follow-up care);
• To government agencies that oversee our community health center (such as license and certification inspectors);
• To government agencies that have the right to receive and collect health information (such as to control disease outbreaks);
• When we are ordered by a court or judge;
• To workers' compensation programs when your health problem is from a work-related injury;
• When law enforcement requests information (such as to prevent danger or injury);
• To coroners and funeral directors to allow them to carry out their duties;
• To organ donor agencies (subject to applicable laws);
• For research studies that meet all privacy law requirements (such as research to stop a disease);
• To avoid a serious threat to the health or safety of others;
• To contact you about new treatments or medicines that may help you;
• To business associates of the community health center that help us perform required tasks, such as our accountants, computer consultants, and billing companies (only if the business associate agrees in writing to keep your health information confidential as required by law); and
• For any other purpose required or allowed by law.

c. Other Uses and Disclosures Requiring Your Written Permission

Except as stated above, we will use or give out your health information only after getting your written permission on an Authorization form. You may revoke your authorization at any time by notifying us in writing that you wish to do so.

d. Confidentiality of Alcohol and Drug Abuse Information

The confidentiality of alcohol and drug abuse information is protected by federal law and regulations. Generally, we may not say to a third party that a patient receives alcohol or drug abuse treatment, or disclose any information identifying a patient as an alcohol or drug abuser unless:

(1) the patient consents in writing;

(2) the disclosure is allowed by a court order; or

(3) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Violation of the federal law and regulations is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations. Federal law and regulations do not protect any information about a crime committed by a patient at our clinics, about a crime committed against any person who works for us, or about any threat to commit such a crime. Further, federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities. The federal laws may be found at 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3. The federal regulations may be found at 42 CFR Part 2.

III. Your Rights Regarding Your Health Information

Subject to certain legal limits, you have rights regarding the use and disclosure of your health information, including the rights to:

• Request limits on uses of your health information
• Receive confidential communications of your health information
• Inspect and copy your health information
• Request a change to your health information
• Receive a record of how we have used and given out your health information
• Obtain a copy of this Notice of Privacy Practices

IV. Questions, Concerns, and Changes to this Notice

If you have any questions or want to talk about any of the information in this Notice of Privacy Practices, please contact the business manager at the clinic of your visit, or the Privacy Officer with Associated Pharmacists Inc.

If you believe your privacy rights have been violated, you may file a complaint with Salud Family Health Centers, Associated Pharmacists Inc., The Health District of Northern Larimer County Integrated Care Program, or with the Secretary of the Department of Health and Human Services. To file a complaint with Salud Family Health Centers, contact the business manager at the clinic where you were seen. To file a complaint with Associated Pharmacists Inc., contact the Privacy Officer. To file a complaint with the Health District of Northern Larimer County Integrated Care Program, contact the Privacy Officer. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint.

We may change our Notice of Privacy Practices in the future. Such changes will apply to your health information that we created or received before the effective date of the change. We will notify you of any changes to our Notice of Privacy Practices by posting the changed notice at our community health center and on our web site.

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Salud is JCAHO accredited

Joint Commission on Accreditation of Healthcare Organizations  (JCAHO)