Notice of Privacy Practices

Our duties

• We are required by law to keep your child’s protected health information (PHI) private, to give you this notice of our legal duties and privacy practices, and to follow the notice currently in effect.
• We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
• 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 by letting us know in writing.

How we use and share your information

We typically use or share your information in the following ways, without your written authorization:

• Treatment. To provide care and coordinate it with other providers. Example: sharing your child’s history with a specialist, hospital or lab involved in their care.
• Payment. To bill and get paid by health plans or others. Example: giving your insurance company information about a visit so it pays the claim.
• Health care operations. To run our practice, improve care and train staff. Example: reviewing records to check the quality of our care.
• Appointment reminders and health information. To remind you of visits and tell you about treatment options or health services that may interest you.
• Family and others involved in care. With a parent, guardian or other person you identify as involved in your child’s care or payment, unless you object. In an emergency or if you cannot respond, we may share information if we believe it is in your child’s best interest.

Other uses and disclosures allowed or required by law

We may share your information without your authorization when the law allows or requires it, including:

• Public health and safety. Reporting diseases, immunizations to the California Immunization Registry (CAIR), adverse reactions to medicines, and suspected child abuse or neglect; preventing a serious threat to someone’s health or safety.
• Research. Only as permitted by law, for example with approval of an institutional review board and protections for your information.
• As required by law. When state or federal law requires it, including to the U.S. Department of Health and Human Services to show we comply with privacy law.
• Health oversight. For audits, investigations, inspections and licensing by agencies such as the Medical Board of California.
• Legal proceedings. In response to a court or administrative order, or to a subpoena when the law allows.
• Law enforcement. For limited law-enforcement purposes allowed by law.
• Coroners, medical examiners, funeral directors and organ donation. As allowed by law.
• Government functions. For military, national security and protective services, as the law allows.
• Workers’ compensation. For workers’ compensation claims, as the law allows.

Uses that need your written permission

• We will never sell your information or use it for marketing without your written authorization.
• Uses of psychotherapy notes, and most uses for fundraising, need your written authorization.
• Featuring your child in photos, videos, reviews or social media posts needs your written authorization (our Photo & Video Authorization form).
• California law requires your specific written permission before we release certain sensitive records, such as mental health records, HIV test results, substance-use treatment records and genetic test results.
• Any other use or disclosure not described in this notice needs your written authorization, which you may cancel in writing at any time (except for what we already did relying on it).

Minors and parents

• As a parent or legal guardian, you usually act for your child and may exercise the rights in this notice on their behalf.
• Under California law, minors may consent on their own to certain services (for example some mental health, reproductive and sexual health care). For those services, the minor controls the related records, and we may not share them with a parent without the minor’s permission, except as the law allows.

Your rights

• Get a copy of your child’s record. You can ask to see or get an electronic or paper copy of your child’s medical record and other health information. We will provide it, usually within 30 days, and may charge a reasonable, cost-based fee.
• Ask us to correct the record. If you think information is incorrect or incomplete, you can ask us in writing to correct it. We may say “no”, but we will tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way (for example a different phone number or mailing 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 information for treatment, payment or operations. We are not required to agree, except that if you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer, and we will say “yes” unless the law requires us to share it.
• Get a list of those we have shared with. You can ask for a list (accounting) of the times we shared your information in the six years before your request, who we shared it with and why, except for treatment, payment, operations and certain other disclosures. One list a year is free.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. A legal guardian or someone with medical power of attorney can exercise your rights. We will confirm they have this authority before we act.
• File a complaint. If you believe your privacy rights have been violated, you can complain to us (see “Contact us”) or to the U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.

Changes to this notice

• We can change the terms of this notice, and the changes will apply to all information we have about your child. The new notice will be available on request, in our office and on our website.

Contact us

• To use any of these rights, ask a question or make a complaint, contact: Dr. Lydia Elias, Privacy Officer, Lighthouse Pediatrics, 23441 Madison Street, Suite 301, Torrance, CA 90505 · (310) 953-0020 · office@lighthousepeds.com.
• This notice applies to Lighthouse Pediatrics, its physicians, physician assistants and staff.