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.
Our commitment to your privacy
LaBase LLC, doing business as LaBase Living, is required by law to protect the privacy of health information we create or receive about you while providing supported community living and host home services. We are required to give you this notice about our privacy practices and to follow the terms of the notice currently in effect.
How we may use and disclose health information about you
We may use and disclose your health information without your written authorization for the following purposes:
- Treatment and care coordination — sharing information with the staff who support you, your case manager, your physicians and other treating providers, therapists, pharmacies, and, when appropriate, your guardian or legal representative, so your Individual Support Plan is carried out safely and consistently.
- Payment — submitting service documentation and claims to Iowa Medicaid, Iowa Medicaid managed care organizations, and other payers responsible for your services, and responding to their reviews and audits.
- Health care operations — quality assurance, incident review, staff training and supervision, compliance activities, and certification or quality reviews by the Iowa Medicaid Quality Improvement Organization and other oversight agencies.
- As required by law — disclosures required by federal or Iowa law, court orders, subpoenas, and lawful requests from health oversight agencies.
- Abuse or neglect reporting — our staff are mandatory reporters and must report suspected dependent adult or child abuse or neglect to the appropriate Iowa authorities.
- To avert a serious threat to health or safety — disclosures necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of another person, including disclosures to emergency responders.
Uses and disclosures that require your written authorization
Most uses and disclosures that are not described above require your written authorization. This includes most uses of psychotherapy notes, any use of your information for marketing purposes, the sale of your information, and sharing information with family members or others who are not part of your care team. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
Your rights regarding your health information
- Inspect and copy — you may ask to review and receive a copy of the health information we maintain about you. We may charge a reasonable, cost-based fee for copies.
- Request an amendment — if you believe information in your record is incorrect or incomplete, you may ask us to amend it. We will respond in writing and explain our decision.
- Accounting of disclosures — you may request a list of certain disclosures we have made of your health information.
- Request restrictions — you may ask us to limit how we use or disclose your information. We will consider every request, though we are not required to agree to all of them.
- Confidential communications — you may ask us to contact you at a specific phone number or address.
- A paper copy of this notice — you may request a paper copy at any time, even if you received this notice electronically.
- File a complaint — you may file a complaint with us or with the federal government without any retaliation, penalty, or effect on your services.
Our duties
We are required by law to maintain the privacy of your health information, to provide you with this notice of our legal duties and privacy practices, and to notify you if a breach occurs that may have compromised the privacy or security of your information.
We reserve the right to change this notice and to make the revised notice effective for health information we already have as well as information we receive in the future. Current copies are posted on this page and available at our office.
How to file a complaint
If you believe your privacy rights have been violated, contact our Privacy Officer at (319) 777-8705 or info@labaseliving.com, or write to us at 4515 N River Blvd NE, Cedar Rapids, IA 52411. We will not retaliate against you for filing a complaint.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at hhs.gov/ocr.
Office for Civil Rights
U.S. Department of Health and Human Services, Office for Civil Rights — hhs.gov/ocr
Contact our Privacy Officer
You may reach our Privacy Officer using the information below, or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/ocr.
LaBase Living (LaBase LLC)
4515 N River Blvd NE, Cedar Rapids, IA 52411
(319) 777-8705 · info@labaseliving.com
Template pending review by legal counsel.