Pioneer Home Health Care, Inc.
NOTICE OF PRIVACY RIGHTS
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.
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1. Below is a description, including at least one (1) example, of the types of uses and
disclosures that the above organization is permitted to make for each of the following
purposes: treatment, payment and health care operations.
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Disclosures to other health care providers, including, for example, to patients' attending
physicians. Submission of claims and supporting documentation including, for example,
to organizations responsible to pay for services provided by the organization.
Disclosures to conduct the operations of the organization, including, for example, sharing
information to supervisors of staff members who provide care to patients.
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2. Below is a description of each of the other purposes for which the organization is
permitted or required to use or disclose protected health information without
an individual's written consent or authorization.
To patients, incident to another permitted use or disclosure, by agreement, to the
Secretary of the U.S. Department of Health and Human Services, as required by law, for
public health activities, information about victims of abuse, neglect or domestic violence,
health oversight activities, for judicial and administrative proceedings, for law
enforcement proceedings, about decedents, for cadaveric organ, eye or tissue donation,
for research purposes, to avert a serious threat to health or safety, for specific government
functions, to business associates of the organization, to personal representatives, de-
identified information, to workforce members who are victims of crimes, to workers'
compensation programs, for involvement in the individual's care and for notification
purposes, with the individual present, for limited uses and disclosures when
the individual is not present and for disaster relief purposes.
3. Other uses and disclosures, such as disclosure of psychotherapy notes, use of protected
health information for marketing activities and the sale of protected health information,
will be made only with the individual's written authorization and the individual may revoke such authorization.
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4. The organization may contact the individual to schedule visits and for other coordination of care activities.
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5. The individual has the right to request further restrictions on certain uses and disclosures
of protected health information, but the organization is not required to agree to any
requested restriction(s), except disclosures must be restricted to health plans if the
disclosure is for the purpose of carrying out payment or health care operations and is not
otherwise required by law and the protected health information pertains solely to a health
care item or service for which the individual or person other than the health plan on
behalf of the individual has paid the organization in full.
6. The individual has the right to receive confidential communications of protected health
information, the right to inspect and copy protected health information, the right to
amend protected health information, the right to receive an accounting of disclosures of
protected health information and the right to obtain a paper copy of this Notice from the
organization upon request.
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7. The organization is required by law to maintain the privacy of protected health
information and to provide individuals with notice of its legal duties and privacy
practices with respect to protected health information and to notify affected individuals
following a breach of unsecured protected health information.
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8. The organization is required to abide by the terms of this Notice currently in effect.
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The organization reserves the right to change the terms of its Notice and to make the new
notice provisions effective for all protected health information that it maintains.
Individuals may obtain a revised copy of this Notice upon request.
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10. Individuals may complain to the organization and to the Secretary of the U.S. Department
of Health and Human Services if they believe their privacy rights have been violated.
Complaints should be directed to Norma Kryder, MSN, INP, Corporate Compliance, at
the organization at the following telephone number 760/872-4663. Individuals will not
be retaliated against for filing a complaint.
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11. For further information, individuals should contact Ruby Allen, RN, Administrator, at the
organization at the following telephone number: 760/872-4663.
12. This Notice is in effect as of September 23, 2013.
Pioneer Home Health Care, Inc.
CLIENT RESPONSIBILITIES AND PROVIDER RIGHTS
As a client, you or your representative have the responsibility to:
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Participate in your plan of care.
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Choose a willing, able, and available care partner when you are unable to manage your care independently
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Cooperate with your doctor, agency staff, and other caregivers.
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Remain under a doctor's care while receiving agency services.
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Provide the agency with a complete and accurate health history.
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Provide the agency with all requested insurance and financial records.
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Sign the required consents and releases for insurance billing.
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Accept the consequences for any refusal of treatment or decision to decline care, medical advice, or service.
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Provide a safe home environment in which your care can be given.
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Treat agency personnel with respect and consideration.
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Notify the agency when unable to keep appointments.
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This agency is an affirmative action/equal opportunity employer and does not discriminate on the basis
of race, color, national origin, religion, sex, handicap, or age.
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As a provider, we have the right to:
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Be free from threats of violence and actual violence.
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Provide services in patients' homes that are structurally sound.
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Be free from threatening behavior and/or physical injuries from animals.
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Be treated with dignity and respect by patients and their families at all times.
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Be free from unwanted remarks, either positive or negative, regarding their personal appearance.
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Be free from discrimination on the basis of race, religion, and ethnic origin by patients and their families.
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Work in patient's homes without being subjected to sexual remarks, advances, and/or harassment.
Pioneer Home Health Care, Inc.
CLIENT RIGHTS
To have one's property and person treated with respect. To be free of mistreatment, neglect or verbal, mental,
sexual and physical abuse, including injuries of unknown source neglect and misappropriation of patient property.
Have one's pain and symptoms controlled to the optimal level in a timely manner.
Be informed by a physician of your medical condition and be given an opportunity to participate
in designing a care plan for your needs and updating it as your condition changes.
Receive appropriate care without discrimination in accordance with physician orders.
Refuse care or treatment after the consequences of refusal have been fully presented.
Choose a healthcare provider, including choosing an attending physician.
Have medical information and clinical records treated in a confidential manner.
Be advised on Agency policies and procedures regarding the disclosure of clinical records.
Receive information in advance, both verbally and in writing, about the financial benefits and
services covered under one's insurance, as well as individual financial responsibility.
Receive information about the scope of services that the Agency will provide and specific
limitations on those services. Receive all services outlined in the plan of care.
Be advised in advance of the discipline of staff who will provide care and the proposed frequency of visits.
Be informed about Advanced Directives for Health Care.
Be able to identify visiting personnel through proper identification.
Be fully informed in advance of one's responsibility.
Be informed of expected outcomes of care and of any barriers in outcome achievement.
Be informed about the nature and purpose of any technical procedure that will be performed,
including information about both the potential benefits and burdens to you, as well as who will perform the procedure.
Voice grievances, recommend changes in policy and services without discrimination or reprisal
regarding treatment or care that is (or fails to be) furnished and the lack of respect of property by
anyone who is furnishing care or service on behalf of the Agency by directly contacting the
Administrator of Pioneer Home Health Care, Ruby Allen, RN, 760-872-4663. Your call will be
documented, reviewed and resolved by the Administrator.
Receive, in writing, the contact information of entities who should be informed of unresolved
grievances with the Agency.
End of Life Option Act
PURPOSE
To define the agency’s position related to the California End of Life Option Act effective
June 9, 2016
PHILOSOPHY
This agency’s hospice team brings exceptional care into the home with innovation and compassion to enhance the quality of life of those we serve. We recognize the unique physical, social, emotional and spiritual needs of each patient. Ultimately, we have a respect for the dignity of human life from its beginning to its natural end. We are committed to providing skilled quality care to persons with a life-threatening illness, and their families and loved ones who care for them.
Pioneer Home Health Care, Inc. and its Hospice of the Owens Valley program acknowledge that there may be hospice patients who will wish to avail themselves of their legal right under California’s “End of Life Option Act” (Act) to pursue a request from their attending physician for a prescribed drug for the purpose of ending their own life. This agency recognizes that this is a matter between the patient and his or her physician; consequently, Pioneer Home Health Care, Inc. and the Hospice of the Owens Valley program will not actively participate in this physician-assisted Act.
POLICY
Every hospice patient will receive the Agency’s written position paper on the End of Life Option Act at the initial visit. Patients who inquire about the option will be provided with 3rd party information/literature and directed to contact their attending physician. The agency will continue to provide standard hospice services to our patients regardless of their stated interest or intent in pursuing this option.
Neither staff nor patient care volunteers will provide, deliver, administer, or assist with medication intended for this physician-assisted Act. Neither will staff or patient care volunteers be present with the patient at the time of consumption of the physician prescribed drug, nor on the site/location of wherever the physician prescribed drug is being consumed, but staff may continue to address symptom management needs, per routine hospice visits, thereafter.
Staff and patient care volunteers who are morally or ethically opposed to the Act will have the option of transferring care responsibilities to others, if their patient states an intent to pursue the physician-assisted Act.
PROCEDURE
As is customary, our hospice staff will explore and evaluate patients’ statements related to suicide if they arise during routine visits.
If patients or family members make an inquiry about the End of Life Option Act and the aid-in-dying drug, the Agency will respond to inquiries or requests for information and refer them to their attending physician. The Agency will not act as an agent in initiating this Act.
Staff or volunteers who are aware that a patient is considering requesting the aid-in dying drugs, will notify the administrator, the hospice program coordinator and the social worker. Patients who verbalize this intent will be told that this information will be shared with the hospice team, and they will be strongly encouraged to discuss it with their family if they have not already done so.
Staff and volunteers working with a patient/family who has verbalized an interest in physician-ordered aid-in-dying drugs will document all discussions and interventions with patient, family, other team members, and any other person who may be involved with the patient. This documentation will become part of the patient’s permanent medical record.
An interdisciplinary team conference will be convened, and it will include all of the available staff and volunteers working with the patient/family and the attending physician. At the conference, the nature of the request will be examined to determine if the patient has any unmet needs. Staff having contact with such patients will consult with and be supported by the social worker, hospice program coordinator and/or the administrator on an ongoing basis.
If the patient chooses to pursue physician-ordered aid-in-dying drugs, the patient/family will be informed of the role of the Agency regarding participation in the law; that is, this is a discussion between the patient and physician. The Agency will continue to serve the patient and family; we will offer our customary hospice services that seek to meet not only the physical needs of the patient/family, but the emotional, social and spiritual needs as well. The Agency will not be actively involved in the Act itself.
If a patient asks his/her physician for a prescription for medication to end his/her life, the patient and family will continue to receive ongoing support. As is customary, bereavement support will be available to all families.
The Ethics Committee will meet as needed to review cases involving the End of Life Option and to review our Policy and Procedure. The Committee will also meet at the request of the staff and volunteers to discuss concerns about any individual case or to review our Policy and Procedure.