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NOTICE OF PRIVACY PRACTICES  

Effective as of June 3rd, 2024 

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. 

This notice applies to the Community Public Health Teams (CPHT) 'South Central Heals' project, an  initiative of Esperanza Community Housing Corporation.

Esperanza Community Housing Corporation (“Esperanza”) is required by law to maintain the privacy of your  protected health information and to provide you with a copy of this notice which describes our legal duties and  privacy practices concerning your protected health information. Protected health information is generally health  information that may reveal your identity. A copy of our current notice is posted in our entrance area. You can  obtain an additional copy by accessing our website at https://www.esperanzacommunityhousing.org, calling  Esperanza at (213) 791-2086, or asking for a paper copy at the time of your appointment. 

Unless specifically noted in this notice, if you have any questions about this notice or would like further  information, please contact Esperanza in writing at 3655 S. Grand Ave, Suite 280, Los Angeles, CA 90007, by  phone at (213) 791-2086, or by e-mail to sch@esperanzacommunityhousing.org. 

I. WHO WILL FOLLOW THIS NOTICE? 

For the purposes of this notice, the term “Esperanza” includes various persons who provide your services. These  persons will share your protected health information as necessary to carry out services 

II. GENERAL INFORMATION 

How To Obtain A Copy Of Revised Notice. We may change or update our privacy practices from time to  time. If we do, we will revise this notice, but will not necessarily contact you regarding the revised practices.  The revised notice will apply to all of your health information. We will post any revised notice in Esperanza’s  entrance area. You will also be able to obtain a copy of the revised notice by accessing our website at  https://www.esperanzacommunityhousing.org, calling us at (213) 791-2086, or asking for one at the time of  your appointment. The effective date of the notice will be noted at the top of the first page. We are required by  law to abide by the terms of the notice that is currently in effect. 

How To File A Complaint. If you believe your privacy rights have been violated, you may file a complaint  with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, call  us at (213) 791-2086 or inform us when you visit us at 3655 S. Grand Ave, Suite 280, Los Angeles, CA 90007,  and request to talk to a CPHT Manager. You can also email us your complaint at  

sch@esperanzacommunityhousing.org. No one will retaliate or take action against you for filing a complaint. 

How Someone May Act On Your Behalf. You have the right to name a personal representative who may act  on your behalf to control the privacy of your health information. For instance, you may designate a surrogate to  make certain health services decisions on your behalf, including decisions related to your health information.  For information on how to name a personal representative, please call us at (213) 791-2086 or inform us during  an appointment. 

Special Protections for Mental Health, Substance Abuse or HIV Information. Special privacy protections  apply to mental health, substance abuse or AIDS/HIV related information. Some parts of this general Notice of  Privacy Practices may not apply to these types of information. If your records involve such information, they  will be handled, used and disclosed only as permitted by law.

III. WHAT HEALTH INFORMATION IS PROTECTED 

We are committed to protecting the privacy of protected health information we gather about you while providing  health-related services. Your protected health information is generally information related to your services at  Esperanza that include demographic information (such as your name or address); unique numbers that may  identify you (such as your Social Security number); and other types of information that may identify who you  are. Some examples of protected health information include: 

• Information indicating that you receive services at Esperanza; 

• Information about your health condition; 

• Information about health care products or services you have received or may receive; or • Information about your health care benefits under an insurance plan. 

IV. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION 

Requirement For Written Authorization. Esperanza can use or disclose your health information as part of its  services, or related activities, which are described in more detail below, where permitted by law. No specific  authorization from you is required for such uses or disclosures. However, except in the situations and exceptions  described in this notice, we will need to obtain your written authorization before using or disclosing your  protected health information for other purposes or for sharing it with others outside Esperanza. For example,  except as otherwise set forth under State and Federal law, we must obtain your written authorization for the use  or disclosure of your protected health information for marketing purposes, or for the sale of your protected  health information. 

You may also initiate the transfer of your records to another person by completing a written authorization form.  If you provide us with written authorization, you may revoke that written authorization at any time, except to the  extent that we have already relied upon it. To revoke a written authorization, please write to 3655 S. Grand Ave,  Suite 280, Attn. CPHT, Los Angeles, CA 90007. 

Exceptions To Written Authorization Requirement. There are some situations when we do not need your  written authorization before using your health information or disclosing it to others. For example, we are  required to disclose your protected health information to the Secretary of Health and Human Services as  necessary for it to determine if Esperanza is compliant with HIPAA. Other exceptions that permit us to disclose  your protected health information without your authorization are: 

1. Provision of services and Healthcare Operations. We may use your information or share it with others in  order that they may treat your condition or provide you with services, and to complete Esperanza’s business  operations with regard to this project. We may also disclose your information for the service provision or  treatment activities of a service or health care provider who participates in your treatment. In some cases, we  may disclose your protected health information for the business operations of another provider that participated  in your service provision. Below are examples of how your information may be used and disclosed for these  purposes. 

Services. We may share your health information with staff from Esperanza who are involved in providing  services to you, and they may in turn use that information to provide services to you. Staff at Esperanza may  share your health information with another staff member inside Esperanza, or with a staff member of another  facility to determine how to provide services, treat you, or to refer you to health care or other services. 

Health Care Operations. We may use your health information or share it with others that may not be directly  involved in your care and treatment in order to conduct Esperanza’ business operations. For example, we may  use your health information to evaluate the performance of our staff in providing services to you. We may also  combine information about many Esperanza participants to decide what additional services we should offer. We may also disclose information to staff for educational and training purposes. Finally, we may share your health  information for the business operations of other health care providers if the information is related to a  relationship the provider has with you. 

Business Associates. We may disclose your health information to contractors, agents and other business  associates who need the information in order to assist us in providing services to you and with carrying out our  business operations and administrative activities. We will only share your information with business associates  who have agreed to keep your information private and confidential. 

Appointment Reminders, Treatment Alternatives, Benefits And Services. In the course of providing  services to you, we may use your health information to contact you with a reminder that you have an  appointment at Esperanza or with one of Esperanza’s partners. Communications such as newsletters or  announcements, support group activity or educational services provided by Esperanza may be sent to you. We  may also use your health information in order to recommend possible service alternatives or health-related  benefits and services that may be of interest to you. You may opt out of receiving certain communications by  contacting us. 

2. Persons Involved in Your Care 

Family, Friends And Other Persons Involved In Your Services or Care. We may share your health  information with a family member, relative, close personal friend, or other person identified by you, who is  involved in your services or care, but only that portion of your health information relevant to that person’s  involvement with your care. We may also notify a family member, personal representative or another person  responsible for your services or care about your location and condition here at Esperanza. If you are present, or  otherwise available, we will give you the opportunity to object to such uses and disclosures of your health  information.  

3. Public Need. 

We may use your health information, and share it with others, in order to comply with State or Federal laws,  licensure, accreditation or regulatory requirements, or to meet important public needs described below.  

Uses And Disclosures Required By Law. We may use or disclose your health information if we are required  by law to do so. We also will notify you of these uses and disclosures if notice is required by law. 

Public Health Activities. We may disclose your health information to authorized public health officials (or a  foreign government agency collaborating with such officials) so they may carry out their public health activities.  For example, we may share your health information with government officials that are responsible for controlling disease, injury or disability, such as the Department of Health or the United States Center for Disease Control, or for other permitted public health purposes. 

Victims Of Abuse, Neglect Or Domestic Violence. We may disclose your health information to a public health  authority that is authorized to receive reports of abuse, neglect or domestic violence. We may make an effort to  obtain your permission before releasing this information, but in some cases we may be required or authorized to  act without your permission. 

Oversight, Licensing, Accreditation And Regulatory Activities. We will only do the following if required by  law. We may disclose your health information to oversight agencies authorized to conduct audits, investigations,  and inspections of our facility. These government agencies monitor the operation of service providers, and  compliance with government regulatory programs and civil rights laws.  

Lawsuits And Disputes. We may disclose your health information if we are ordered to do so by a court or an  administrative hearing officer that is handling a lawsuit or other dispute or provided with a valid subpoena.

Law Enforcement. Only for the following purposes may we disclose your identity and your other protected  health information to law enforcement officials: A) To comply with court orders or as required by law; or B) If  you have been the victim of a crime and we determine that: (1) we have been unable to obtain your agreement  because of an emergency or your incapacity; (2) law enforcement officials need this information immediately to  carry out their law enforcement duties; and (3) in our professional judgment disclosure to these officers is in  your best interest; or C) If necessary, to report a crime that occurred on our property. 

To Avert A Serious And Imminent Threat To Health Or Safety. We may use or disclose your health  information when necessary to prevent a serious and imminent threat to your health or safety, or the health or  safety of another person or the public. In such cases, we will only disclose your information with someone able  to help prevent the threat. We may also disclose your health information to law enforcement officers if you tell  us that you participated in a violent crime that may have caused serious physical harm to another person, or if  we determine that you escaped from lawful custody. 

Only if required by law, may we disclose your health information to National Security and Intelligence officers. 

Military And Veterans. If you are a military personnel, we may disclose health information about you to  appropriate military command authorities for activities they deem necessary to carry out their military mission. 

Workers’ Compensation. We may disclose your health information as authorized by, and to the extent  necessary to comply with, laws relating to workers’ compensation or similar programs that provide benefits for  work-related injuries. 

Research. In most cases, we will ask for your authorization before using your health information or disclosing it  to others in order to conduct research. Under some circumstances, we may use or disclose your health  information without your written authorization if we obtain approval through a special process to ensure that the  research poses minimal risk to your privacy. For instance, this may be if an Institutional Review Board (IRB)  determines this is the case. We may also use or disclose your health information without your written  authorization to prepare a future research project or to determine if you are eligible to participate in a research  study. If you are eligible for participation in a study, we may contact you to discuss your potential participation.  In the unfortunate event of your death, we may use or disclose your health information with people who are  conducting research using the information of deceased persons. Aggregated (unidentifiable) research results of a  larger group of participants may be used for research, reporting, and presentation purposes.  Also for research, we will only share your information with business associates and covered entities who are  required to or have agreed to keep your information private and confidential. 

4. De-Identified Information  

We may use and disclose your health information if we have removed all information that has the potential to  identify you so that the health information is “completely de-identified”. We may also use and disclose  “partially de-identified” health information about you for public health purposes, research purposes, or for  health care operations activity, if the person who will receive the information signs an agreement to protect the  privacy of the information as required by law. Partially de-identified health information will not contain  information that would directly identify you, such as your name, street address, Social Security number or phone  number. 

5. Incidental Disclosures 

While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of  your health information may occur during, or as an unavoidable result of, our otherwise permissible uses or  disclosures of your health information (for example, calling your name in a waiting room during an appointment).

V. YOUR RIGHTS TO ACCESS AND CONTROL YOUR HEALTH INFORMATION You have the following rights to access and control your health information. These rights are important because  they will help you make sure that the health information we have about you is complete and accurate. They may  also help you control the way we use your information and disclose it to others, or the way we communicate with you about your treatment and care. 

1. Right to Inspect and Copy Records 

You have the right to inspect and obtain a copy of your health information that may be used to make decisions  about you and your treatment for as long as we maintain this information in our records. To inspect or obtain a  copy of your health information, please write to Esperanza at 3655 S. Grand Ave, Suite 280, Attn. CPHT, Los  Angeles, CA 90007. You should request an Access Request Form. When completing the form, your request  

should state the specific requested information and the time period to which it relates. Should you request a copy  of the information, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your  request. 

We will ordinarily respond to your request within 30 days. Should we need additional time to respond, we will  notify you to explain the reason for the delay and to provide a time frame for when you can expect an answer to  your request. 

2. Right to Amend Records 

If you believe that the health information we have about you is incorrect or incomplete, you have the right to ask  us to amend the information as long as the information is kept in our records. To request an amendment, please  write to Esperanza at 3655 S. Grand Ave, Suite 280, Attn. CPHT, Los Angeles, CA 90007. You should request  an Amendment Form. When completing the form, you should include the reasons why you think we should  make the amendment. 

Ordinarily we will respond to your request within 60 days. If we need additional time to respond, we will notify  you in writing to explain the reason for the delay and when you can expect to have a final answer to your  request. 

Should we deny part or all of your request, we will provide a written notice that explains our reasons for doing  so. You will have the right to have certain information related to your requested amendment included in your  records. For example, if you disagree with our decision to deny an amendment, you will have an opportunity to  submit a statement explaining your disagreement, which we will include in your records. We will also include  information on how to file a complaint with us or with the United States Department of Health and Human  Services. 

3. Right to an Accounting of Disclosures, Breaches of Health Information 

We will notify you following any breaches of your unsecured protected health information. However, you also  have a right to request and receive an accounting of disclosures of your protected health information in the six  years prior to the date on which the accounting is requested. The accounting will identify certain other persons  or organizations to whom we have disclosed your health information. Any accounting includes only disclosures,  

and will not include uses of your information. In addition, an accounting of disclosures does not include  information about the following disclosures: 

• Disclosures we made to you or your personal representative; 

• Disclosures we made after obtaining your written authorization; 

• Disclosures we made for treatment, payment or business operations; 

• Disclosures made from the patient directory; 

• Disclosures made to persons involved in your care or payment for your care, or for other  notification purposes; 

• Disclosures that were incidental to permissible uses and disclosures of your health information;

• Disclosures for purposes of research, public health or our business operations where your  protected health information has been partially de-identified so that it does not directly identify  you; 

• Disclosures for national security or intelligence purposes; 

• Disclosures to correctional institutions or law enforcement officers about individuals in their  lawful custody; 

• Disclosures made before April 14, 2003; or 

• Disclosures for certain research purposes as permitted by law. 

To request an accounting of disclosures, please write to Esperanza at 3655 S. Grand Ave, Suite 280, Attn.  CPHT, Los Angeles, CA 90007. You should request an Accounting Request Form. When completing the form,  your request must state a time period within the past six years for the disclosures you want us to include. You  have a right to receive one accounting within every 12-month period at no cost. However, we may charge you  for the cost of providing any additional accountings. 

Ordinarily we will respond to your request for an accounting within 60 days. If we need additional time to  prepare the accounting, we will notify you in writing about the reason for the delay and the date when you can  expect to receive the accounting. We may delay providing you with an accounting without notifying you if a law  enforcement official or government agency asks us to do so. 

4. Right to Request Additional Privacy Protections 

You have the right to request that we further restrict the way we use and disclose your health information to treat  your condition, collect payment for that treatment, or run our or another health care entity's business operations.  You may also request that we limit how we disclose information about you to persons involved in your care. To request restrictions, please write to Esperanza at 3655 S. Grand Ave, Suite 280, Attn. CPHT, Los Angeles, CA  90007. Your request should include (1) a description of the information to which you want to restrict access; (2)  whether you want to limit how we use the information, how we disclose it to others, or both; and (3) to whom  you want the limits to apply. 

We are not required to agree to your request for a restriction, except we will comply with your requested  restriction relating to disclosure of your protected health information to your health insurance company or  similar payor for the purposes of payment or health care operations that have already been paid out-of-pocket in  full by you or by someone else on your behalf. Further, in some cases, the restriction you request may not be  permitted under law. Once we have agreed to a restriction, you have the right to revoke the restriction at any time. Under some circumstances, we will also have the right to revoke the  restriction. We will notify you when doing so. 

5. Right to Request Confidential Communications  

You have the right to request that we communicate with you about your medical matters in a more confidential  way by requesting that we communicate with you by alternative means or at alternative locations. We will  accommodate reasonable requests. It is critical, however, that we have the ability to reach you by telephone.  You may request a confidential communication at your next appointment, or you may make your request in  writing to Esperanza at 3655 S. Grand Ave, Suite 280, Attn. CPHT, Los Angeles, CA 90007. Please specify in  your request how or where you wish to be contacted and how payment for your health care will be handled if we  communicate with you through this alternative method or location.