• Effective Date: 02/07/2025

Last Updated: 02/07/2025

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.

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record

• Correct your paper or electronic medical record

• Request confidential communication

• Ask us to limit the information we share

• Get a list of those with whom we’ve shared your information

• Get a copy of this privacy notice

• Choose someone to act for you

• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way we use and share information, including:

• Sharing information with family and friends involved in your care

• Provide medically tailored meals, cooking education and nutrition assessment services

• Marketing our services (only with your written permission)

• Using information for fundraising efforts

Our Uses and Disclosures

We may use and share your information as we:

• Provide you with services

• Operate our organization

• Bill for our services

• Comply with the law

• Respond to lawsuits and legal actions

• Work with public health and safety officials

• Conduct research

• Address workers’ compensation, law enforcement, and other government requests

Your Rights in Detail

Get an electronic or paper copy of your medical record You can request to see or obtain a copy of your medical record. We will provide it within 30 days of your request and may charge a reasonable fee.

Ask us to correct your medical record You can ask us to correct incorrect or incomplete health information. We may decline your request, but we will explain why in writing within 60 days.

Request confidential communications You may request that we contact you in a specific way (e.g., home or office phone) or send mail to a different address. We will accommodate reasonable requests.

Ask us to limit what we use or share You can ask us not to use or share certain health information for providing the service, payment, or operational purposes. While we will consider your request, we may need to decline if it impacts your care.

If you pay out-of pocket in full for our services, you can request that we do not share that information with your health insurer for payment or operational purposes. We will honor this request unless a law requires us to disclose the information.

Get a list of those with whom we’ve shared your information You have the right to request a record (accounting report) of the times we’ve shared your health information over the past ten years, who we shared it with along with the reason for sharing. This record will exclude disclosures related to the service provided, payment, health care operations, and certain other exceptions, such as those you requested.

We provide one free report per year. If you request additional reports within 12 months, a reasonable, cost-based fee may apply.

Get a copy of this privacy notice You may request a paper copy of this notice at any time.

Choose someone to act for you If you have given someone medical power of attorney or have a legal guardian, they can make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated You may file a complaint with us or with the U.S. Department of Health and Human Services if you believe your rights have been violated. We will not retaliate against you for filing a complaint.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C.  20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us.  Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care.

• Share information in a disaster relief situation.

We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In the following cases we never share your information unless you give us written permission:

• Marketing purposes.

• Sale of your information.

• Most sharing of psychotherapy notes.

How We Typically Use and Share Your Information

Providing you with services We use your health information to coordinate and provide our services.

Operating our organization We can use and share your health information to operate our operations, improve your care, and contact you when necessary.

Billing for services We use and share your health information to bill and receive payment for services provided from health plans or other entities.  

To work with our business associates We engage with vendors to perform some services on our behalf. For example, we may have a contract with a billing service. These vendors are called our business associates. When we contract for these services, we may disclose your PHI to our business associates so that they can perform the job we have asked them to do. To protect your information, we require all business associates to appropriately safeguard your information and comply with HIPAA. 

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.  We have to meet many conditions in the law before we can share your information for these purposes.  For more information see:  www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Do research We can use or share your information for health research.

De-identification HIPAA expressly allows using health information to create de-identified information. The privacy principles described above do not apply to de-identified information. Health information is considered de-identified if (i) it does not identify an individual and (ii) there is no reasonable basis to believe it can be used to identify an individual. HIPAA does not restrict the use or disclosure of de-identified information. It is the practice of the Company to use and/or disclose de-identified information where doing so is consistent with the role of an academic medical center engaged in biomedical research and education. How do we use de-identified information? We use de-identified information to support our patient care, biomedical research and education activities, some of which are conducted in collaboration with other academic institutions, foundations, organizations, government agencies, and commercial entities here in the U.S. and internationally. The de-identified information is also used to help us improve treatment options, reduce costs of care, improve administration of our health care operations, and advance public health initiatives.

Comply with the law We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Address workers’ compensation, law enforcement, and other government requests We can use or share health information about you:

• For workers’ compensation claims

• For law enforcement purposes or with a law enforcement official

• With health oversight agencies for activities authorized by law

• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Help with public health and safety issues We can share health information about you for certain situations such as:

• Preventing disease

• Helping with product recalls

• Reporting adverse reactions to medications

• Reporting suspected abuse, neglect, or domestic violence

• Preventing or reducing a serious threat to anyone’s health or safety

Respond to organ and tissue donation requests We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in this notice and give you a copy of it.

• 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.  Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

If you have any questions about this Notice, if you wish to contact us about your privacy rights or obtaining a copy of your records, or you wish to file a complaint, you can contact our Head of Privacy:

• David Avalos

• Tell: (415) 612-3293

• Email: healthy@myfoodom.com

In the event that state law provides greater protection than the HIPAA protections listed in this Notice, we will follow the requirements of state law.