HIPAA Policy for Garcia Consulting and Lactation Services, PLLC
Purpose:
The purpose of this policy is to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations and ensure the confidentiality and security of protected health information (PHI) for all patients of Garcia Consulting and Lactation Services, PLLC.
Policy:
Garcia Consulting and Lactation Services, PLLC is committed to protecting the privacy of our patients' PHI. We will maintain the confidentiality and security of PHI, whether it is in written, oral, or electronic form. We will use and disclose PHI only for the purposes of treatment, payment, or healthcare operations, or as permitted or required by law.
Privacy Officer:
Garcia Consulting and Lactation Services, PLLC has designated a Privacy Officer who is responsible for developing and implementing policies and procedures to comply with HIPAA regulations. The Privacy Officer is also responsible for ensuring that all staff members receive HIPAA training and that all PHI is safeguarded.
Use and Disclosure of PHI:
Garcia Consulting and Lactation Services, PLLC will only use and disclose PHI for the following purposes:
Treatment: We may use and disclose PHI to provide treatment to our patients. This includes sharing PHI with other healthcare providers who are involved in the patient's care.
Payment: We may use and disclose PHI to obtain payment for services we provide to our patients. This includes sharing PHI with insurance companies or other third-party payers.
Healthcare Operations: We may use and disclose PHI for healthcare operations, such as quality improvement activities, conducting audits, and staff training.
Permitted or Required by Law: We may use and disclose PHI when required by law or authorized by the patient.
Patient Rights:
Patients of Garcia Consulting and Lactation Services, PLLC have the following rights:
Right to Access: Patients have the right to access their PHI and to request copies of their medical records.
Right to Request Restrictions: Patients have the right to request restrictions on the use and disclosure of their PHI.
Right to Request Amendment: Patients have the right to request amendments to their PHI.
Right to File a Complaint: Patients have the right to file a complaint if they believe their rights have been violated.
Security:
Garcia Consulting and Lactation Services, PLLC will ensure that all PHI is secure, whether it is in written, oral, or electronic form. We will implement appropriate administrative, physical, and technical safeguards to protect PHI from unauthorized access, use, or disclosure.
HIPAA Training:
All staff members of Garcia Consulting and Lactation Services, PLLC will receive HIPAA training as part of their orientation, and annual refresher training will be provided. Staff members who violate HIPAA policies and procedures may be subject to disciplinary action, up to and including termination.
Breach Notification:
If a breach of PHI occurs, Garcia Consulting and Lactation Services, PLLC will notify affected individuals as required by law.
Conclusion:
Garcia Consulting and Lactation Services, PLLC is committed to protecting the privacy and security of our patients' PHI. We will comply with HIPAA regulations and implement policies and procedures to safeguard PHI. If you have any questions or concerns about HIPAA or our privacy policies, please contact our Privacy Officer.
NOTICE OF PRIVACY PRACTICES
Effective Date of Notice: February 13, 2023
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.
If you have any questions about this Notice, please contact us at: Garcia Consulting and Lactation Services, PLLC at 269-358-8335.
WE WILL COMPLY WITH THIS NOTICE
This Notice describes the privacy practices of Garcia Consulting and Lactation Services, PLLC, Dr. Garcia, and any third parties that help us manage Protected Health Information. In general, we may use and disclose your health information to coordinate and oversee your medical treatment, pay your medical claims, and assist in health care operations as described in this Notice.
OUR COMMITMENT TO PROTECT YOUR HEALTH INFORMATION
We believe that information about you and your health, whether it be in verbal, written, or electronic format is personal and should be carefully safeguarded. We are committed to protecting your personal health information. We (or the third parties that assist us) maintain a record of all health care provided by or paid for by Garcia Consulting and Lactation Services, PLLC. This Notice applies to all of your health information that we maintain. Please be aware that health care providers or pharmacies not associated with us, such as other doctors, dentists, hospitals, or outside pharmacies, have their own policies regarding their use and disclosure of your health information created in their offices. You should consult their notice of privacy practices for information about how they may use and disclose your health information.
This Notice informs you about the ways we may use and disclose your health information. This Notice also describes your privacy rights, along with the obligations that we have regarding the use and disclosure of your health information. Federal medical privacy law requires us to:
make sure your health information is kept private;
give you this Notice of our privacy practices with respect to your health information; and
follow the terms of this Notice.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We do not sell your personal health information or disclose it to companies that wish to sell you their products. We must have your written permission (called an "authorization") to use and disclose your health information, except for the uses and disclosures described below. We do not sell your health information to anyone or disclose your health information to other companies who may want to sell their products to you (e.g. catalog or telemarking firms). Additionally, Michigan law may require that we obtain your specific prior authorization to use and disclose certain health information, such as behavioral health, substance abuse and HIV/AIDS information.
You and Your Personal Representative. We may disclose your health information to you or your personal representative (an individual who has the legal right to act on your behalf).
Others Involved In Your Care. We may share your health information with family members or friends who are directly involved in your medical care, or the payment of your medical care, when you are present and have given us verbal or written permission. We will not discuss your health information with your family or friends if you are not present unless you have given us your permission or we believe it is in your best interest. Our health professionals will exercise their professional judgment in determining when friends and family members may receive health information (e.g., a family member picking up a prescription from the pharmacy for a sick individual).
Treatment. We may use your health information or disclose it to third parties to aid with your medical treatment. We may disclose health information about you to doctors, nurses, pharmacists, technicians, medical students, or other persons who are involved in taking care of you. For example, we may use your health information to set up an appointment for you; test or examine you; prescribe medication or treatment; refer you to another doctor or clinic for specialized care or services; or get copies of your health information from another professional that you may have been before us.
Payment. We may use your health information or disclose it to third parties in order to obtain payment for the services that we provide to you. For example, we may discuss your health information with your insurer to determine whether our health plan will cover the treatment.
Health Care Operations. We will use and disclose your health information for general administrative and managerial functions, and activities such as quality assessment and improvement, providing educational training programs for medical, nursing, dental, and other health and non-health care professions, accreditation, certification, and licensing. Examples of how we use or disclose your health information for health care operations are: financial or billing audits; internal quality assurance; personnel decisions; participation in managed care plans; training of students, including imaging of treatment sessions; defense of legal matters; business planning; and outside storage of our records.
Appointment Reminders And Health Related Benefits And Services. We may use and disclose your health information to remind you about prescription refills and appointments for medical care in our offices.
By supplying your phone number, email address, and any other personal contact information, you authorize the Garcia Consulting and Lactation Services, PLLC to employ a third- party automated outreach and messaging system to use your personal information, the name of your care provider, the time and place of your scheduled appointment(s), and other limited information, for the purpose of notifying you of a pending appointment, missed appointment, or any other reasonable healthcare related communication. You also authorize your healthcare provider to disclose to third parties, who may intercept these messages, limited protected healthcare information regarding healthcare events, unpaid balances, missed appointments, and to leave a reminder message on your voice mail or answering system if you are unavailable at the number you provided.
Research. We may use or disclose your health information to third parties for research purposes when an Institutional Review Board has determined that such disclosure is appropriate without your permission.
Marketing. We may also engage in face-to-face communication with you about alternative treatment options available to you, or communicate with you about the health related services available to you through our clinic. Before we can use your health information for other marketing purposes or receive payment for sending marketing communications, we must first obtain your written authorization.
As Required By Law. We will disclose your health information to third parties when required to do so by federal, state or local law. For example, we may share your health information when required to do so by state workers' compensation law, the Department of Health and Human Services, or state regulatory officials.
To Avert A Serious Threat To Health Or Safety. We may use and disclose your health information to third parties when it is necessary to prevent a serious threat to your health and safety or to the health and safety of the public or another person. Any disclosure, however, would only be to someone able to assist in preventing the potential harm.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose your health information in response to a court or administrative order. We may also disclose your health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only after we make efforts to inform you of the request or to obtain an order protecting the requested information. If you are a party to a lawsuit in a Michigan court case, a court order or your authorization must be provided to release your health records (in addition to a subpoena).
Public Policy Matters. We may use or disclose your health information in certain limited instances for matters involving the public welfare, such as:
for public health risks (e.g., prevention or control of disease, reporting births and deaths, reporting abuse and neglect) or for research purposes when there are sufficient privacy protections in place.
to a health oversight agency for activities authorized by law (e.g., audits, investigations, inspections, and licensure necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws)
to law enforcement officials (in response to a court order, subpoena, warrant, summons or similar process or to report certain kinds of crimes) and to national security officials under certain limited circumstances
to a funeral director, coroner, or medical examiner to permit them to carry out their duties 3
to facilitate organ donation and specified research purposes, so long as certain safety measures are in place to protect your privacy
Employers and Plan Sponsors. In order for you to be enrolled in a health plan, we may share limited information with your employer or other organizations that help pay for your health coverage. However, if your employer or another organization that helps pay for your health coverage asks for specific health information, we will not share your health information unless they first obtain your written authorization.
Business Associates. We hire third parties to provide us with various services that are necessary for our health plan to function. Before we share your health information with these companies, we will have a written contract with them in which they promise to protect the privacy of your health information.
Fundraising. We may use and disclose your health information for fundraising communications; however, you have the right to opt out of receiving future fundraising communications.
Other Uses and Disclosures of PHI. We have no plans to use or disclose your health information for purposes other than those provided for above or as otherwise permitted or required by law. If you provide us an authorization to use or disclose your health information to third parties, you may revoke the authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization. Please remember that we are unable to take back any disclosures we have already made with your authorization.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have several rights regarding your health information and we will respect your right to exercise them. If you wish to exercise your rights, you must submit a written request to Garcia Consulting and Lactation Services, PLLC in person.
Right To Inspect And Copy. You have the right to inspect and copy your health information that we maintain. Usually this includes your medical and billing records. If you request a copy of the information, we may charge a fee for our costs of providing the copy. We may deny your request to inspect and copy in very limited circumstances. If we deny your request to access your health information, we will explain why the request was denied and whether you have the right to a further review of the denial.
Right To Request Amendments. If you feel that your health information is incorrect or incomplete, you may ask us to correct the information. You must include with your request an explanation of how and why your health information needs to be corrected. We may deny your request for correction in certain limited circumstances. If we agree to your request for correction, we will take reasonable steps to inform others of the correction.
Right To Request An Accounting Of Disclosures. You have the right to request an accounting of disclosures. This is a list of certain disclosures of your health information that we have made to third parties. This is limited to disclosures during the last three years. If you request this accounting more than once in any 12 month period, we may charge you for the cost of responding to these additional requests. Your request should tell us how you want the list (e.g., on paper, via e-mail, or on a disk).
Right To Request Additional Restrictions. You have the right to request a restriction on how we use or disclose your health information to third parties for your medical treatment, payment of your medical claims, or management of our health care operations. You also have the right to request a limitation on how we disclose your health information to those involved in your care or the payment for your care, such as a family member or friend. For instance, you can request that we not disclose information to your spouse or children concerning a sensitive surgical procedure or a disease you have suffered. Please note that under federal law, we are generally not required to agree to your request. However, if you pay the full cost of your treatment without any contribution from a health plan, your health care provider will agree upon your request not to share your treatment with your health plan for payment or health care operations purposes.
Right To Request Confidential Communications. We communicate to you information about your health care treatment and payment. If you feel that our communicating with you may endanger you, you may request that we communicate with you using a reasonable alternative means or location. For example, you can ask that we contact you only at work, by e-mail, or by mail at a specified address (such as a P.O. box, rather than your home mailing address). We will accommodate all reasonable requests.
Right To A Paper Copy Of This Notice. You have the right to receive a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. You may obtain a copy of this Notice on our website, www.garcialactation.com or by writing to us at the e-mail address listed above.
Right to Receive Notification of a Breach of Your Health Information. You will receive timely notification if there is a breach of your unsecured health information.
CHANGES TO THIS NOTICE
We have the right to change the terms of this Notice. We also have the right to make these changes apply to health information we already have about you, as well as any we receive or create in the future. We will post a copy of the most current Notice on our website, www.garcialactation.com and have a copy available for you to request and take with you. Please look at the top right-hand comer of the Notice to determine the Notice's effective date.
QUESTIONS OR COMPLAINTS
If you have questions about your privacy rights described in this Notice, or if you believe that we may have violated your privacy rights, please contact us at: 269-358-8335 or info@garcialactation.com. You may also file a written complaint with us, as well as with the Department of Health and Human Services. We support your right to protect your health information. We will not penalize you or retaliate against you for filing a complaint.
Breastfeeding Medicine Consent Form
I give my consent for Dr. Garcia to work with me and my baby during this consultation for our breastfeeding problems/concerns. This consent is for in-person visits, as well as telephone conversations.
I understand that a thorough breastfeeding medicine consultation may involve:
Touching my breasts and/or nipples for the purposes of assessment
Inserting gloved fingers into my baby’s mouth to assess suck and tongue-tie
Observation of a breastfeeding session and suggestions to enhance latch and/or position.
Demonstration and use of equipment or supplies that may be recommended.
Demonstration of techniques designed to improve breastfeeding.
I understand that Dr. Garcia will ask questions; perform a physical exam, which includes the musculoskeletal system, in order to detect any abnormalities such as tenderness, asymmetry, restricted range of motion and abnormal changes in the muscles, joints, bones, connective tissue, etc.
I understand that if Dr. Garcia finds any musculoskeletal abnormalities, she can use gentle OMM (Osteopathic Manipulative Medicine) techniques to reduce or resolve these dysfunctions.
I understand that these techniques range from a very light touch to more increased pressure.
I understand a partial or follow-up visit is sometimes necessary. I understand that breastfeeding supplies and/or breast pumps may be recommended as effective management of specific situations.
I understand that I am responsible for informing Dr. Garcia of changes I feel are necessary in the care path at the time of the visit or during the course of follow-up communications. I understand it is my responsibility to call Dr. Garcia with progress reports, questions, or concerns.
I give my consent for Dr. Garcia to use clinical information and any photographs obtained during our sessions for conferring with other health care providers and education of mothers about lactation. I won’t be identified in any way, but aspects of my situation may be described and discussed.
I understand that Garcia Consulting and Lactation Services’ financial policy I signed also applies to Breastfeeding Medicine Services. I also understand that Garcia Consulting and Lactation Services does not give refunds for services rendered.
I understand that for this Breastfeeding Medicine consultation and all follow-ups, Dr. Garcia will protect the privacy of my personal health information as required by Federal Medical Privacy laws.
I have received a copy of Garcia Consulting and Lactation Services’ Notice of Privacy Practices.
Mother’s Name: ________________________________________ Date: __________________
Mother’s Signature: _____________________________________________________________
Policy for Code of Conduct and Ethical Standards for the Breastfeeding Clinic:
Respect and Dignity: We are committed to treating all patients, staff, and visitors with respect, dignity, and sensitivity. We will not discriminate based on race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other personal characteristic.
Confidentiality: We will maintain confidentiality and protect the privacy of our patients and their families. We will not share any information about patients or their families without their consent, except when required by law.
Professionalism: We will maintain a professional and courteous attitude towards our patients and their families, as well as other staff members. We will always strive to provide the highest level of care and support to our patients.
Informed Consent: We will obtain informed consent from our patients and their families before providing any treatment or services. We will explain the risks and benefits of each treatment option, as well as any potential side effects or complications.
Evidence-Based Practice: We will provide evidence-based practice in the care of our patients, based on the most up-to-date research and clinical guidelines. We will also strive to continuously improve our knowledge and skills through ongoing education and training.
Conflict of Interest: We will disclose any potential conflicts of interest that may arise in our interactions with patients, their families, or other healthcare providers. We will avoid any situation that may compromise our professional integrity or the quality of care provided to our patients.
Workplace Harassment: We will not tolerate any form of harassment or discrimination in the workplace, including but not limited to sexual harassment, verbal or physical abuse, or any other behavior that creates a hostile or intimidating environment. Any such behavior will be immediately reported to management and dealt with according to the policies and procedures of the clinic.
Compliance with Laws and Regulations: We will comply with all relevant laws and regulations governing the practice of healthcare, including but not limited to laws related to patient privacy and confidentiality, informed consent, and professional licensing.
Continuous Improvement: We will continuously evaluate and improve our policies, procedures, and practices to ensure the highest quality of care and support for our patients and their families.
By following these policies and ethical standards, we will uphold the values of our breastfeeding clinic and provide the highest level of care and support to our patients and their families.