This notice describes how information about your child may be used and disclosed and how you can get access to this information. Please review it carefully.

Understanding Your Child's Health Record/Health Information

Each time your child visits Children's Mercy Hospitals and Clinics (CMH), a record of the visit is made. This record contains your child's symptoms, examination, test results, diagnoses, treatment and a plan for future care or treatment. This information is called your child's medical record. It is many things and provides many functions to different people:

• A plan of your child's care and treatment
• A way to communicate among the many health professionals caring for your child
• A legal document describing the care your child received
• A way you or an insurance company can verify that services were actually provided
• A tool to educate health professionals
• A source of data for medical research
• A source of information for public health officials charged with improving the health of the nation
• A source of data for facility planning and marketing
• A tool to help the hospital assess and continually work to improve the care it delivers

Understanding what is in your child's record, and how your child's health information is used, helps you to:

• Ensure its accuracy
• Better understand who, what, when, where, and why others may access your child's health information
• Make more informed decisions when giving permission to others to view the information

Your Child's Health Information Rights

Your child's health record is the physical property of Children's Mercy Hospital, but the information belongs to you or your child. You have the right to:

• Request limits of certain uses and disclosures of your child's information
• Obtain a paper copy of the Notice of Health Information Practices upon request
• Inspect and copy your child's health record
• Request amendments to your child's health record
• Request a record of disclosures of information from your child's health record
• Request your child's health information be communicated by other means or at other locations
• Revoke any authorization to use or disclose your child's health information except to the extent that action has already been taken with that information

Our Responsibilities

Children's Mercy Hospital is required to:

• Keep your child's health information private
• Provide you with a notice (this document) of the hospital's legal duties and privacy practices with respect to information it collects and maintains about your child
• Follow the terms of this notice
• Notify you if the hospital is unable to agree to a limit requested by you on the use or disclosure of your child's health information
• Try to meet reasonable requests you may have to communicate health information by other means or at other locations

The hospital reserves the right to change its practices and to be sure the new practices keep all health information safe. Should the hospital's health information practices change, it will post a revised notice on its web page (www.childrensmercy.org <>), throughout its facilities, and will have copies available for you to take with you. The hospital will apply any changes to all health information regardless of when created or received.

The hospital will not use or disclose your child's health information without your or your child's permission, except as described in this notice or allowed by law.

For More Information or to Report a Problem

If you have questions or would like additional information, you may contact the hospital's privacy officer at (816) 701-4573.

If you believe your child's privacy rights have been violated, you can file a complaint with the Secretary of the United States Department of Health and Human Services or contact the hospital's privacy officer at the number above. You will not be penalized for filing a complaint.

Examples of Disclosures for Treatment, Payment, and Health Operations

The hospital will use your child's health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your child's healthcare team will be recorded in your child's record and used to determine the course of treatment that should work best for your child. Your child's physician will document in your child's record their expectations of the members of your child's healthcare team. Members of your child's healthcare team will record the actions they took and their observations. In that way, your child's physician will know how your child is responding to treatment.

The hospital will also provide your child's physician or other healthcare provider involved in your child's care with copies of various reports that will help in treating your child once your child is discharged from this Hospital.

The hospital will use your child's health information for payment.

For example: A bill or other information may be sent to you or an insurance company in order for the hospital to obtain payment. The information on or with the bill may include information that identifies you or your child, as well as your or your child's diagnosis, procedures and supplies used.

The hospital will use your child's health information for regular healthcare business.

For example: Members of the medical staff, the risk manager, or members of the quality improvement team may use information in your child's health record to assess the care and results to compare it to others with the same condition or receiving the same care. This information will then be used to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Uses and Disclosures

Business associates: Additional disclosures of your child's health information may be made to outside parties known as business associates. There are some services provided to the hospital through contracts with these business associates. Examples include certain laboratory tests and a typing service that types medical reports. The hospital may disclose your child's health information to a business associate so that it can perform the job it has to do. To protect your child's health information, the hospital requires the business associate to protect your child's information at all times.

Hospital directory: Unless you tell the hospital that you object, the hospital will place your child's name, location in the hospital, general condition, and religious affiliation in a hospital directory and give that information to people who ask for your child by name, including members of the news media.

Family notification: The hospital may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your child's care of your child's location in the hospital and general condition.

Communication with family: Health professionals, using their best judgment, may disclose health information to a family member, other relative, close personal friend, or any other person you identify, about that person's role in your child's care or payment related to your child's care.

Research: The hospital may disclose information to researchers when an institutional review board (IRB) has approved their research. The IRB reviews research proposals and follows rules to ensure the privacy of your child's health information.

Coroners and funeral directors: The hospital may disclose information to coroners and funeral directors as directed by law to carry out their duties.

Organ procurement organizations: If your child is an organ donor, the hospital may disclose health information to organ procurement organizations or other organizations engaged in the procurement, banking, or transplantation of organs for the purpose of organ and tissue donation and transplant.

Marketing: We will ask your permission to contact you regarding information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fundraising: We will ask your permission to contact you as part of a fundraising or public relations effort.

Food and Drug Administration (FDA): The hospital may disclose to the FDA health information about adverse events caused by food, supplements, products and product defects, or information to help with product recalls, repairs, or replacement.

Workers' compensation: The hospital may disclose health information as directed by, and as necessary to comply with, laws relating to workers' compensation or other similar programs established by law.

Public health: As required by law, the hospital may disclose your child's health information to public health agencies or authorities charged with preventing or controlling disease, injury, or disability, or to report a suspected case of abuse or neglect.

Correctional institution: Should your child be an inmate of a correctional institution, the hospital may disclose to that institution or its agents health information necessary for your child's health and the health and safety of other individuals.

To avert a serious threat to health or safety: The hospital may use or disclose health information about you when necessary to prevent a serious threat to your child's health or safety or the health or safety of another person. Any disclosure would only be to someone able to prevent the threat.

Appointment reminders: The hospital may contact you to remind you of your child's appointments.

Law enforcement: The hospital may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Health oversight agencies: Federal law allows your child's health information to be released to an appropriate health oversight agency, or attorney, provided that a work force member or business associate of the hospital believes in good faith that the hospital engaged in unlawful conduct or has otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

The Department of Health and Human Services (DHHS): Under privacy standards, the hospital must disclose your child's health information to DHHS upon request so that DHHS may determine our compliance with those standards.

Lawsuits and disputes: If you or your child are involved in a lawsuit or dispute, the hospital may disclose health information about your child in response to a subpoena, court order, or administrative order. Information will be disclosed to someone else involved in the dispute only after efforts have been made to tell you about the request or to obtain an order protecting the information requested.

As required by law, the hospital will disclose health information about your child when required to do so by federal, state or local law.

Military and veterans: If you or your child are a member of the armed forces, the hospital may release health information about you or your child as required by military command authorities. The hospital may also release information about foreign military personnel to appropriate foreign military authorities.

Information rights are provided by 45 CFR 164.522-164.528 of the Health Insurance Portability & Accountability Act of 1996.

Effective Date: 14 April, 2003