HIPAA Notice of Privacy Practices
Effective Date: September 23, 2013

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. IT ALSO DESCRIBES YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION. WE ARE REQUIRED BY LAW TO MAINTAIN THE PRIVACY OF YOUR HEALTH INFORMATION, GIVE YOU THIS NOTICE OF OUR LEGAL DUTIES AND PRIVACY PRACTICES REGARDING YOUR HEALTH INFORMATION, NOTIFY YOU FOLLOWING A BREACH OF YOUR UNSECURED HEALTH INFORMATION, AND FOLLOW THE TERMS OF OUR CURRENT NOTICE. THE PRIVACY PRACTICES DESCRIBED IN THIS NOTICE WILL BE FOLLOWED BY ALL HEALTH CARE PROFESSIONALS, EMPLOYEES, STUDENTS, AND VOLUNTEERS OF KIN CARE, INC. A COPY OF THIS NOTICE, IS ALSO LISTED ON OUR WEBSITE AT www.kinCareinc.com

PLEASE REVIEW IT CAREFULLY AND THEN SIGN THE AUTHORIZATION FOR RELEASE OF INFORMATION FORM.

If you have any questions about this notice, please contact Joan Brogdon, CEO at (773) 975-7777.

INTRODUCTION

We understand information about you and your health care is personal and are committed to protecting private and health information about you. Effective April 14, 2003 a new law, known as HIPPA (Health Insurance Portability and Accountability Act), became effective which governs that information. Additional protections were added with the HITECH (Health Information Technology for Economic and Clinical Health) Act which became effective September 23, 2013. This notice is intended to address the requirements of these laws.

We create a record of the care and services you receive from us and need this record to provide you with quality care and services and to comply with certain legal requirements. This notice applies to all of your records of care generated by Kin Care, Inc. and will tell you about the ways in which we may use and disclose health information about you.

We may change the terms of our HIPPA notice, at any time. The new notice will be effective for all health information we maintain at that time. We will provide you with any revised Notice of Privacy Practices if you request a revised copy be sent to you in the mail or if you ask for one when you are in the office.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe ways we use and disclose health and personal information. Each category of uses or disclosures is explained though not every use or disclosure in a category will be listed. All of the ways we are permitted to use and disclose information, however, will fall within one of the categories. Information will be transmitted by phone, mail, e-mail, fax, or in-person. We do not participate in a Health Exchange at this time. .

For Services and Care. We may use health information about you to provide you with services or treatment/care. We may disclose health or personal information about you to doctors, nurses, pharmacies, technicians, aides, Kin Care staff, day program staff, or other personnel who are involved in taking care of or, providing services to you. They may work at our offices, at a doctor's office or hospital, another health care provider, or another service location where we may refer you for consultation, services or other treatment purposes.

For Payment, Scheduling or Other Services. Occasionally, we may need to disclose information to obtain payment for services. For instance, Medicaid, Medicare or health plans may need information from us about you in order to authorize payment. Your protected health information will be used, as needed, to comply with their requests. Information provided may include your diagnoses, services provided, or recommended care. We may also use or disclose your protected health information, as necessary, to contact you to remind you of appointments or services which may be of interest to you. You may request that we provide such reminders in a certain way or at a certain place. We will try to honor all reasonable requests.

We may also share your medical information with third party "business associates" that perform activities ranging from billing and the filling of prescriptions to consultants and professional service providers to the agency. Whenever an arrangement between our office and a business associate involves the use or potential disclosure of your health information, we will have a written contract with them. All of these parties are required to protect the privacy and security of your Health Information.

For Administrative and Marketing Activities. We may use and disclose health information about you to support the business activities of our agency. These activities are necessary to assure we manage our services effectively and efficiently. For example, we may use health information to review our services, to evaluate the performance of our staff in serving you, when training staff or, with people who accredit us or provide internal/external reviews of our operations to assure quality. We may also use your information to send you a newsletter about our services,

Other Uses and Disclosures of Protected Health Information Based upon your Written Consent or Authorization with an Opportunity to Object. Certain other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then we may, using professional judgement, determine whether the disclosure is in your best interest. In this case, only the protected health and service information that is relevant to your health care will be disclosed. You may revoke this authorization, at any time, in writing.

We may use and disclose your protected health information upon your Written Consent or Authorization with an Opportunity to Object to:

Others Involved in Your Healthcare. Unless you object, we may disclose to a member of your family, a relative, a close friend or other persons you identify, your protected health information that directly relates to that person's involvement in your health care and services. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition, or care needs.

Emergencies. We may use or disclose your protected health information in an emergency situation. If this happens and consent is required but consent has not been obtained for emergencies, we shall try to obtain your consent as soon as reasonably practical after the delivery of treatment.

Communication Barriers. We may use and disclose your protected health information if we attempt to obtain consent from you but are unable to do so due to substantial communication barriers and we determine, using professional judgement, that you intend to consent to use or disclose under the circumstances.

Other Permitted and Required Uses and Disclosures That May Be Made Without Consent, Authorization or Opportunity to Object. We may use or disclose your protected health information without your consent or authorization in the following situations:

Required By Law. We may use or disclose your protected health information to the extent required by law. The use or disclosure will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.

Public Health. We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to obtain the information.

Communicable Diseases. We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight. We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure.

Abuse or Neglect. We may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration. We may disclose your protected health information to a person or company as required by the Food and Drug Administration.

Legal Proceedings. We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal.

Law Enforcement. We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include: (1) in response to a court order, subpoena, warrant, summons or otherwise required by law, (2) to identify or locate a suspect, fugitive, material witness or missing person, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises, and (6) medical emergency (not on the agency's premises) and it is likely that a crime has occurred.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your medical information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose medical information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Coroners, Health Examiners and Funeral Directors. We may release health information to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about clients to funeral directors, as necessary, to carry out their duties.

Organ and Tissue Donation: if you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Research: We may disclose your medical information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your medical information has approved their research.

Workers' Compensation. Your protected health information may be disclosed by us as authorized to comply with workers' compensation laws and other similar legally-established programs.

Required Uses and Disclosures. Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

YOUR RIGHTS

Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.

You have the right to inspect and copy your protected health information. You may inspect and obtain a copy of protected health information about you that is contained in your records for as long as we maintain the protected health information. Please contact Kin Care, Inc. at 773-975-7777 if you have questions about access to your record. You do not have the right to counseling notes and related files.

After you have made a written request to Kin Care, Inc., we will have 30 days to satisfy your request. If we deny your request to inspect or copy your medical information, we will provide you with a written explanation of the denial.

You have the right to request a restriction of your protected health information. You may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.

The agency is not required to agree to your request. If we believe it is in your best interest to permit use and disclosure of your medical information, your medical information will not be restricted. If we do agree to the requested restriction, we may not use or disclose your health information in violation of that restriction unless it is needed to provide emergency treatment. Your written request must be specific as to what information you want to limit and to whom you want the limits be apply. You may note the your request on your release of information or under separate cover by sending it to Kin Care, Inc.

You have the right to request to receive confidential communications from us at a location other than your primary address. We will try to accommodate reasonable requests. Please make this request in writing to Kin Care, Inc.

You may have the right to have Kin Care, Inc. amend your protected health information. If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. To request an amendment, your request must be made in writing, submitted to Joan Brogdon, CEO, and must provide a reason that supports your request for an amendment. If we deny your request for amendment, you may file a statement of disagreement with us. Please contact Kin Care, Inc. to determine if you have questions about amending your medical record.

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described in this Notice of Privacy Practices. It also excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. This right is effective April 14, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations.

You have the Right to Notice of a Breach of Certain Medical Information. We are required to notify you by first class mail or e-mail (if you have told us you prefer to receive information by e-mail), of a breach of your Health Information. A breach is any unauthorized acquisition, access, use or disclosure of certain categories of Health Information that compromises the security or privacy of you Health Information.

Other uses of health information. Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you give us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
You have the right to obtain a paper copy of this notice from us. Your signature on the Authorization for Release of Information indicates you have read this notice in it's entirety.

COMPLAINTS
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying Kin Care, Inc. of your complaint. We will not retaliate against you for filing a complaint.