KAMIAH  HEALTH CENTER
P.O. BOX 1108
KAMIAH, ID 83536
(208) 935-0733 
1-888-891-2924 toll free

As a patient at Nimiipuu Health, you have the right to:

As a patient at Nimiipuu Health, you have the right to:

1.  Be treated with respect, consideration and dignity.

2. Privacy and dignity concerning your illness and treatment. Any discussion of your illness or treatments will be kept in confidence, and no one who is not involved in your care will be allowed to be present without your permission. Any medical students working in the clinic will be introduced as such, and you have the right to refuse their being present during your treatment or discussions with health care providers.

3. Know that all your records and medical information will be kept in confidence. Your records will only be read by those involved in your treatment, unless you give written permission for anyone else to see those records, except under court order.

4. All information concerning your diagnosis (to the degree known), treatment, and any known prognosis. This information will be provided to you in terms you know and understand. 

In the event that it is not medically advisable to give such information to you, this information will be made available to your legal representative.

5. Refuse any treatment offered to you as permitted by law. You will be informed of the risks you are taking by refusing treatment;

6. Give, not give, or take back your consent for medical personnel to do special procedures or treatment. In an emergency situation when your condition is immediately life threatening or it may result in permanent damage to you, the physician may not be able to give you a lot of information immediately, because this takes time that may be needed to be sure that you receive the care you need. As soon as the emergency is over, you may ask for any information you think is important.

7. To grant or refuse permission for you to be transferred to another facility for health care services not available at Nimiipuu Health. If there are other alternatives to a proposed transfer, you will be informed of those alternatives;

8. To change primary or specialty physician or dentist if other qualified providers are available;

9. Expect that public information provided by Nimiipuu Health about its services and capabilities to provide services available is not misleading or otherwise inaccurate;

10. Receive diagnosis, treatments, and referrals for needed treatments at this facility to the extent that there are resources available to provide them;

11. Expect that the referring physician and others involved in your health care will receive reports about your health care from those to whom you are referred for care;

12. Expect to be safe and secure while at the medical clinic;

13. Be informed by your physician if your condition is considered untreatable at this facility and offered the following options: 

• To be made as comfortable as possible and let the disease run its course;

• New (unproven) treatments. You have the right to know if your physician is considering using unproven treatments; you may refuse to allow the use of these treatments;

14. Present complaints (verbal or in writing) to the Executive Director or to any employee of Nimiipuu Health. Employees may assist you in completing a Patient Comment Form. All forms are then forwarded to the Executive Director. The Executive Director will acknowledge receipt of your complaint within five (5) working days and assign an investigator. Upon completion of the investigation, the Executive Director will provide a written response to your complaint.

If your complaint is not resolved to your satisfaction by the Executive Director, you have the right to present the complaint to the Nez Perce Tribal Health Board. Call Nimiipuu Health for time, date, and location of the next Health Board meeting. All requests to the Board for resolution of complaints must be accompanied by your written authorization for the Board to access any pertinent health records.

PATIENT RESPONSIBILITIES

As a patient at Nimiipuu Health you are expected to:

•Be responsible for your own behavior and to treat the staff with respect and courtesy;

•Make and keep appointments and cancel appointments or change appointment times as necessary;

 •Inform the staff of any changes in address or phone number;

 •Release all information related to past illnesses, treatments, and medications in order to assist the staff in providing the best possible health care;

 •Follow directions, treatment plans, and recommendations given by your health care providers;

 •Provide the clinic staff with information on private health insurance, Medicare, or Medicaid coverage you may have.

NIMIIPUU HEALTH
NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003

HIPPA
Health Insurance Portability and Accountability Act

PRIVACY RULE

This notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). It describes how we may use or disclose your protected health information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected health information.

ACKNOWLEDGMENT OF RECEIPT OF THIS NOTICE
You will be asked to provide a signed acknowledgment of receipt of this notice. Our intent is to make you aware of the possible uses and disclosures of your protected health information and your privacy rights. The delivery of your health care services will in no way be conditioned upon your signed acknowledgment. If you decline to provide a signed acknowledgment, we will continue to provide your treatment, and will use and disclose your protected health information for treatment, payment, and health care operations when necessary.

UNDERSTANDING YOUR HEALTH RECORD & INFORMATION
Each time you visit Nimiipuu Health for services, a record of your visit is made. If you are referred by Nimiipuu Health through Contract Health Services (CHS) Program, Nimiipuu Health also keeps a record of your CHS visit. Typically, this record contains your symptoms, examination, test results, diagnosis, treatment, and a plan for future care.

This information, referred to as your health record or protected health information, serves as a;

• Plan for you care and treatment

• Communication source between health care professionals

• Tool with which we can check results and continually work to improve the care we provide

• Means by which Medicare, Medicaid, or private insurance payers can verify the services billed

• Tool for education of health care professionals

• Source of data for medical research, facility planning and marketing

• Legal document that describes that care you receive

Understanding what is in your health record and how the information is used helps you to:

•  Ensure its accuracy

• Better understand why others may review your health information

• Make an informed decision when authorizing disclosures

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
Although your health record is the physical property of Nimiipuu Health, the information belongs to you.

You may exercise the following rights by submitting a written request to the Privacy Officer. Depending on your request, you may also have rights under the Privacy Act of 1974. Your Nimiipuu Health Privacy Officer can guide you in pursuing these options. Please be aware that Nimiipuu Health might deny your request; however, you may seek a review of the denial.

Right to Inspect and Receive a Copy
You may inspect and obtain a copy of your protected health information that is contained in a "designated record set" for as long as we maintain the protected health information. A designated record set contains medical and billing records and any other records that Nimiipuu Health uses for making decisions about you.

If Nimiipuu Health believes that the restriction is not in the best interest of either party, or we cannot reasonably accommodate the request, Nimiipuu Health is not required to agree. If the restriction is mutually agreed upon, we will not use or disclose your protected health information in violation of that restriction, unless it is needed to provide emergency treatment. You may revoke a previously agreed upon restriction, at any time, in writing.

Right to Request Restrictions
You may ask us not use or disclose any part of your protected health information for treatment, payment, or health operations.  Your request must be made in writing to the Nimiipuu Health Privacy Officer.  In your request, you must tell us (1) what information you want restricted; (2) whether you want to restrict our use, disclose, or both; (3) to whom you want the restriction to apply, for example, disclosures to your spouse; and (4) an expiration date.

Right to Request a Correction/Amendment
If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your protected health information as long as we maintain this information.  While we will accept requests for amendment, we are not required to agree to the amendment.

Right to Request Confidential Communications
You may request that we communicate with you using alternative means or at an alternative location.  For example, you may request that we contact you at work, by telephone or by mail.  We will not ask you the reason for your request.  We will accommodate reasonable requests, when possible.

Right to an Accounting of Disclosures
You may request that we provide you with an accounting of the disclosures we have made of your protected health information.  This right applies to disclosures made for purposes other than treatment, payment, or health operation as described in this Notice of  Privacy Practices.  The disclosure must have been made after April 14, 2003, and no more than six years from the date of request.  This information is maintained for six years or the life of the record, whichever is longer.  The right to receive this information is subject to additional exceptions, restrictions, and limitations as described in this notice.

Right to Obtain a Copy of this Notice
You may obtain a copy of this notice upon request.

FEDERAL PRIVACY LAWS
The Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA).  There are several other privacy laws that also apply including the Freedom of Information Act, the Privacy Act and the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act.  These laws have not been superseded and have been taken into consideration in developing our policies and this notice of how we will use and disclose you protected health information.

OUR RESPONSIBILITIES TO YOU REGARDING PROTECTED HEALTH INFORMATION
"Protected health information" is individually identifiable health information. This information includes demographics, for example, age, address, and relates to your past, present, or future physical or mental health or condition or related health care services. We are required by law to:

•  Maintain the privacy of your protected health information.

• Inform you about this notice of our legal duties and privacy practices related tot he use and disclosure of your protected health information.

• Notify you if we are unable to agree to a requested restriction.

• Honor the terms of this notice and communicate any changes in the notice to you.

We reserve the right to change this notice and to make the new provisions effective for all protected health information we already have about you as well as any information we receive in the future. If we make any significant changes to this notice, we will provide you a copy of the revised notice within 60 days. We will post any revised Notice of Privacy Practices within our health care facilities and you may also request a copy to be mailed directly to you or ask for a copy at your next appointment.

We understand that health information about you is personal and we are committed to protecting your health information. We will not use or disclose your health information without your authorization, except as described in this notice and as permitted by the Privacy Act and the IHS Health and Medical Records; System Notice 09-17-0001.

CONFIDENTIALITY OF ALCOHOL/DRUG PATIENT RECORDS
The confidentiality of alcohol and drug abuse patient records maintained by Nimiipuu Health is protected by federal law and regulations. Generally, the program may not say to a person outside the program that a patient attends the program, or disclose any information identifying a patient as an alcohol or drug abuser unless one of the following conditions is met:

1. The patient consents in writing.
2. The disclosure is allowed by a court order.
3. The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research,   audit, or program evaluation.
4. The disclosure is made as mandated reporting of child abuse or neglect, including intent to commit such act.
5. The disclosure is made to report threats to commit, or commission of crimes, against program personnel or property.

HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION
The following are examples of permitted uses and disclosures of your protected health information.

Required Uses and Disclosures
By law, we must disclose your health information to you unless it has been determined by a competent medical authority that it would be harmful to you. We must also disclose health information to the Secretary of the Department of Health and Human Services (DHHS) for investigations or determinations of our compliance with laws on the protection of your health information.

Treatment
We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, if we refer you to another health care facility under the Contract Health Service (CHS) Program, we may disclose your protected health information, as necessary, to that health care provider for treatment decisions.

If you are transferred to another facility for further care and treatment, we may disclose protected health information to that facility to enable them to know the extent of treatment you have received and other information about your condition.

We may disclose your protected health information from time-to-time to another healthcare team member (for example, a specialist, pharmacist, or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment. This includes pharmacists who may be provided information on other drugs you have been prescribed to identify potential interactions.

In emergencies, we will use and disclose your protected health information to provide the treatment you require.

Payment
Your protected health information will be used, as needed, to obtain payment for your health care services. A bill may be sent to a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used. This information will support claims made in your behalf for payment of health care services in which reimbursement is based.

Health Care Operations
We may use or disclose, as needed, your protected health information to support the daily activities related to health care. These activities include, but are not limited to members of the medical staff, case management, risk management or quality improvement for assessments, reviews and investigations. This information will be used in an effort to continually improve the quality and effectiveness of health care and services we provide.

We will share your protected health information with third-party "business associates" who perform various activities (for example, transcription services) . The business associates will also be required to protect your health information.

Public Health
We may disclose your protected health information to a public health authority who is permitted by law to collect or receive the information. The disclosure may be necessary to do the following:

• Prevent or control disease, injury, or disability.

• Report births or deaths.

• Right to Request a Correction/Amendment

• Report a child abuse or neglect.

• Report reactions to medications or problems with products.

• Notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

• Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

Worker’s Compensation
We may disclose your protected health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.

Food and Drug Administration
We may disclose to the FDA, protected health information relative to adverse events with respect to food, supplements, medications and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Law Enforcement
We may disclose protected health information for law enforcement purposes as required by law or in response to a valid subpoena and or court order.

Communication
We may contact you with a reminder that you have an appointment for medical care at our facility or to advise you of a missed appointment. We may call you by name in the waiting room when your provider is ready to see you.

Non Violation of this Notice
Nimiipuu Health is not in violation of this Notice of or HIPAA Privacy Rule if any of its employees or its contractors (business associates) discloses protected health information under the following circumstances:

1. Disclosures by Whistle blowers:

If a Nimiipuu Health employee or contractor (business associate) in good faith believes that we have engaged in conduct that is unlawful or otherwise violates clinical and professional standards or that the care or services provided by Nimiipuu Health has the potential of endangering one or more patients or members of the workplace or the public and discloses such information to:

a. A Public Health Authority or Health Oversight Authority authorized by law to investigate or otherwise oversee the relevant conduct or conditions, or the suspected violation, or an appropriate health care accreditation organization for the purpose of reporting the allegation of failure to meet professional standards or misconduct by Nimiipuu Health, or

b. An attorney on behalf of the workforce member, or contractor (business associate) or hired by the workforce member or contractor (business associate) for the purpose of determining their legal options regarding the suspected violation.

2. Disclosures by Workforce Member Crime Victims:

Under certain circumstances, a Nimiipuu Health workforce member (either an employee or contractor) who is a victim of a crime on or off the facility premises may disclose information about the suspect to law enforcement official provided that:

a. The information disclosed is about the suspect who committed the criminal act.

b. The information disclosed is limited to identifying and locating the suspect.

Any other uses and disclosures will be made only with your written authorization, which you may later revoke in writing at any time. (Such revocation would not apply where the health information already has been disclosed or used or in circumstances where Nimiipuu Health has taken action in reliance on your authorization or the authorization was obtained as a condition of obtaining insurance coverage and the insurer has a legal right to contest a claim under the policy itself.)

For More Information or to Report a Problem
If you believe these privacy rights have been violated, you may file a written complaint with the following Nimiipuu Health Privacy Officers:

                                                                                Freda Montelongo
                                                                                P.O. Drawer 367
                                                                                Lapwai, ID  83540

                                                                                Loretta Penney
                                                                                P.O. Box 1108
                                                                                Kamiah, ID  83536

You may also file with the Office of Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below:

                                                                                Office of Civil Rights
                                                                                U.S. Department of Health and Human Services
                                                                                2201 Sixth Avenue, Suite 900
                                                                                Seattle, WA 98121-1831