THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED; YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION, INCLUDING HOW YOU CAN GET ACCESS TO THIS INFORMATION; AND HOW TO FILE A COMPLAINT CONCERNING A VIOLATION OF THE PRIVACY AND SECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTS CONCERNING YOUR INFORMATION.
PLEASE REVIEW THIS NOTICE CAREFULLY. YOU HAVE THE RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC FORM) AND TO DISCUSS IT WITH THE TRIBE’S PRIVACY OFFICER AT 907-335-7399 IF YOU HAVE ANY QUESTIONS.
The Kenaitze Indian Tribe (the Tribe) operates a fully integrated Medical, Dental, Wellness and Behavioral Health program and maintains a record of the health care that we provide. The Tribe respects your privacy, and the laws regarding confidentiality of health care we provide to you.
The Tribe makes a record of the care and services you receive, which is called “protected health information.” This information includes your symptoms, test results, diagnosis, treatment, health information from other health care providers, and billing and payment information related to those services. We will not disclose your information to others unless you authorize us to do so, or unless the law authorizes or requires us to do so.
This privacy notice will tell you about: the way that we may use and disclose health information about you; your privacy rights; special rules for patients of the Tribe’s substance use disorder (SUD) treatment programs; and the Tribe’s responsibilities in using and disclosing your health information.
This Notice applies to your records maintained by all of the Tribe’s health care programs, including the Dena’ina Wellness Center.
How the Tribe May Use or Disclose Your Health Information
Treatment: The Tribe can use and share your health information for treatment. The Tribe may share this information with other providers to help make decisions about what care is appropriate for you. For example, a doctor at the Tribe might ask if you have high blood pressure. This information lets the doctor avoid giving you medicine that could make your blood pressure worse. The Tribe may share this information with nurses, pharmacists, and other providers to avoid treatment that might make your blood pressure worse.
Payment: The Tribe can use and share your health information to bill and obtain payment for services we provide to you. The Tribe sends bills to Medicaid, other government programs, and private insurance. For example, insurance companies often need information about services you received in order to authorize payment. In addition, if someone else is responsible for your health care costs, we may disclose information to that person when we seek payment.
Health Care Operations: The Tribe can use and share your health information to improve our health care operations. Health care operations are certain administrative, financial, legal, and quality improvement activities necessary to run the Tribe’s health programs and make sure all patients receive quality care. For example, we may use health information about you to evaluate the performance of our staff or to evaluate the services provided.
Business Associate Agreements: The Tribe may disclose your health information to individuals and organizations that assist the Tribe with treatment, health care operations, payment, or compliance. The Tribe enters into agreements with these individuals or organizations under which they agree to maintain the confidentiality of any health information shared with them. For example, we may share your information with an organization that evaluates the quality of the Tribe’s health care.
Organized Health Care Arrangement: The Tribe might share your health information with other providers when the Tribe is part of an organized health care arrangement with them. The purpose of these arrangements is to make it easier to exchange information about patients when two providers are treating the same person.
Appointment Reminders: The Tribe may use and disclose your medical information to contact you as a reminder of an appointment. We may use or disclose health care information during the reminder call, but the information will be limited to what is necessary to remind you of the appointment.
Electronic Health Information Systems: The Tribe uses electronic health information systems, including an integrated multi-facility electronic health information system with a patient service communications network that permits providers involved in your care at other tribal health care facilities and the Indian Health Service to access health information accumulated about you at our facilities. Once information is entered into any of these electronic systems, it cannot be removed. Once a user is authorized to have access to your information contained in some of these systems, the user will continue to have such access until we determine otherwise. We may make your protected health information available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment and payment purposes. Participation in an electronic health information exchange also lets us see their information about you for our treatment and payment and health care operation purposes. You are permitted to request and review documentation regarding who has accessed your information through the electronic health information exchange.
As Required by Law: Some laws require or authorize the Tribe to report some kinds of health information to certain entities or individuals, in circumstances including:
- To notify authorities about the outbreak of a contagious disease;
- Injuries caused by guns, knives, and beatings, and other injuries commonly caused by violent crime;
- To government authorities conducting public health surveillance, public health investigations, and public health interventions;
- To the Food and Drug Administration (FDA) for the purposes of ensuring the quality, safety, or effectiveness of an FDA-regulated product or activity;
- To a health oversight agency for oversight activities authorized by law;
- To organ procurement organizations;
- To the police or other law enforcement officials for medical or criminal emergencies;
- Bad reactions to medicines or defective medical equipment;
- Notifying people of product recalls related to their health care;
- Notifying a person that they may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- To disaster relief agencies to assist in notification of your condition to family or others;
- When a judge orders the Tribe to produce information;
- For workers’ compensation claims;
- To the Alaska Vital Records Office to report births and deaths;
- To military command authorities if you are a member of the armed forces;
- To the federal government when they are investigating national security concerns;
- To the Secretary of the United States Department of Health and Human Services for purposes of determining compliance with our obligation to protect the privacy of your health information;
- To coroners, medical examiners, or funeral directors, when someone has died;
- To appropriate agencies to report abuse, neglect, or domestic violence;
- When disclosure is required by any other applicable law not specifically listed
Research: Under certain circumstances, the Tribe may use or disclose your health information for research purposes, subject to the rules imposed by federal regulations.
Interpreters: In order to provide you with proper care, we may use the services of an interpreter. This may require the use or disclosure of your personal health information to the interpreter.
Other Treatments and/or Health Products: The Tribe may use and disclose your health care information to tell you about or recommend possible treatment options or alternatives, or about health-related products or services that may be of interest to you.
Notification of Family and Others: Unless you object, we may release health information about you to a friend or family member who is involved in your health care. We may also give information to someone who helps pay for your care. If you would like to restrict the information provided to family or friends, please contact the number at the end of this notice. If you want a family member or friend to be able to access information about you or assist in arranging your health care, such as scheduling or checking on appointment times, please make sure that an authorization is on file for that person to access your records. This will be required for individuals to assist you in this manner.
Health and Safety: We may use and disclose your health information to prevent or reduce a serious threat to anyone’s health or safety.
Correctional Institutions: If you are in jail or prison, we may disclose your health care information to the Department of Corrections for your health and the health and safety of others.
Uses and Disclosures That Require Your Authorization: Other than the uses and disclosures described above, information will be used or disclosed only as allowed or required by law, or with your written authorization. If you tell us we can share your information, you have the right to change your mind at any time unless the disclosure is required by law, we have already relied on the authorization, or the law prohibits revocation. Information that is legally disclosed may not be subject to additional protections once it is received by the recipient.
Reproductive Health Care Information: The Tribe will not use or share your health information without your permission to allow anyone to conduct a criminal, civil, or administrative investigation into any person for the mere act of seeking, obtaining, providing, or facilitating lawful reproductive health care, or to impose criminal, civil, or administrative liability on any person for the same acts. For example, if you are under criminal investigation for legally terminating a pregnancy, we will not share any records of that procedure with the entity conducting the investigation without your written permission. If we receive a request for your records related to reproductive health care for any of the following purposes, we will require the requester to submit an attestation form stating that the purpose of the request is not prohibited: (1) health oversight activities; (2) judicial or administrative proceedings; (3) law enforcement purposes; and (4) disclosures to coroners and medical examiners. For example, if the Tribe receives a court order seeking your reproductive health records, we will require the entity that provided the court order to sign an attestation form before we release the covered records.
Special Rules for Substance Use Disorder
Patient Records
If you receive substance use disorder (SUD) treatment, diagnosis, or referral for treatment through the Tribe’s Behavioral Health Services program, any information that identifies you as a SUD patient may have additional protection under the federal confidentiality regulations at 42 C.F.R. Part 2 (“Part 2”). The Tribe will determine whether your information is protected by Part 2.
In general, the Tribe must obtain your written consent before disclosing any health information protected by Part 2 to people or organizations outside of the Tribe’s Behavioral Health Services program. However, Part 2 permits the Tribe to release your health information without your consent in certain limited circumstances, including the following:
- Pursuant to a court order;
- To medical personnel in a medical emergency when your consent cannot be obtained;
- For certain research, audit, or program evaluation purposes;
- For public health purposes, where there is no reasonable basis to believe that the information could be used to identify you as a SUD patient;
- To report a crime (or threat to commit a crime) against Behavioral Health Services personnel or that took place on Behavioral Health Services property;
- To report suspected child abuse or neglect to appropriate authorities;
- Pursuant to a written agreement between the Tribe and another organization that provides services to the Tribe, where the other organization has agreed to protect the privacy of your information.
In other situations, we will obtain your consent before disclosure. For example, we will obtain your consent before disclosing your SUD information for treatment, payment, or health care operations purposes. You may also revoke your written consent by providing a written statement to us. This revocation will not apply to any uses or disclosures that we have already made based on your prior consent.
SUD records, or testimony about the content of such records, will never be used or disclosed in any civil, administrative, criminal, or legislative proceedings against you unless you have consented, or where the use or disclosure is required by a valid court order. SUD records will only be used or disclosed based on a court order after notice and an opportunity to be heard is provided to you or the Tribe as required by law. A court order authorizing use or disclosure of SUD records must be accompanied by a subpoena or other legal mandate compelling disclosure before the records can be used or disclosed.
You may provide the Tribe with a single written consent form allowing us to use and disclose your SUD records for all future treatment, payment, or health care operations purposes. Records disclosed based on such consent form to another health care provider, health plan, or to a business associate of the Tribe may be further disclosed by the recipient without your additional consent, as long as the additional disclosures are in line with general federal protections for health information. However, such records still cannot be shared by the recipient in civil, criminal, administrative, or legislative proceedings against you without your written consent or pursuant to a valid court order, as described above.
Your Health Information Rights
You have many rights concerning your health care information held by the Tribe:
- Notice: You have the right to receive a paper or electronic copy of this Notice.
- Right to Get a Copy of Your Health Records: You have the right to request to see or get an electronic or paper copy of your health We will provide you with a copy or summary of your health information, usually within 30 days of the request. You might be asked to pay a small amount for copying or postage costs. If the Tribe refuses to give you certain records, you can appeal this decision to the Privacy Officer.
- Right to Request Restricted Use: You have a right to ask the Tribe to limit certain uses and disclosures of your health information. If you want to limit use and disclosure you must submit a written request. The Tribe is not required to grant the request, except under special circumstances, such as a restriction on information provided to a third-party payer for services paid by you out of For SUD records, you may also request restrictions on disclosures made with your prior consent for purposes of treatment, payment, and health care operations.
- Right to Request Changes to Your Medical Record: You have the right to ask us to correct health information about you that you believe is incomplete or incorrect. Such requests must be in writing and directed to the Tribe’s Privacy The Tribe may deny your request, but we will tell you why we denied the request in writing within 60 days of your request.
- Right to Know About Disclosures of Your Information: You have a right to request a list (an “accounting”) of certain disclosures of your health information made by the Tribe or its business associates for up to six years following the disclosure. This list will not include disclosures to third-party payers, or disclosures for treatment or health care operations purposes. Other exceptions to the accounting requirement include, but are not limited to, disclosures made subject to your right of access, to individuals involved in your care, for national security purposes, and for the health and safety of inmates or detainees. You may request an accounting at any time. The Tribe is only required by law to provide one accounting without charge during any 12-month period. We will notify you of the cost involved if you request this information more than once in a 12-month period.
- Right to Request Confidential Communications: You may request that the Tribe communicate with or contact you by a particular means (mail, fax, etc.) or at a particular location. These requests must be made in writing and we have a form available for this type of request.
- Right to Not Receive Fundraising Communications: You have the right to elect not to receive any fundraising communications from the Tribe.
Our Responsibilities
We are required by law to:
- Keep your health information private and secure;
- Give you this Notice of our legal duties and privacy practices with respect to your health information;
- Notify you of your specific rights regarding your SUD records that are protected by 42 C.F.R. Part 2;
- Let you know promptly if a breach occurs that compromises the privacy or security of your health information; and
- Follow the terms of the Notice of Privacy Practices currently in effect.
The Tribe has the right to change our practices regarding the health information that we maintain, and to make those practices effective for records that it already maintains. If we make such changes, we will update this Notice. You may obtain the most recent copy of this Notice by calling and requesting a copy, visiting any of our tribal health programs and asking for a copy, or by visiting our website: https://www.kenaitze.org/denaina-wellness-center/privacy-practices/.
Questions, Comments, and Complaints: If you have questions, want more information, or want to file a written complaint because you believe your privacy rights have been violated, you may contact:
Privacy Officer
Kenaitze Indian Tribe
508 Upland Street
Kenai, AK, 99611
(907) 335-7399
Compliance@kenaitze.org
You can also file a written complaint with the U.S. Department of Health and Human Services’ Office of Civil Rights at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf or by sending a written complaint to:
Centralized Case Management Operations
U.S. Department of Health & Human Services
200 Independence Avenue S.W.
Room 509F, HHH Building
Washington, D.C. 20201
The Tribe will not retaliate or discriminate against you or anyone else due to reports you’ve made to us or the federal government regarding your privacy rights.
