THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

If you have any questions about this notice,

please contact our business office at (425) 747-4004 x4293.

Kindering Center is required by law to maintain the privacy of your child’s health and education information, to provide you a notice of our legal duties and privacy practices, and to follow the information practices that are described in this notice. Kindering Center respects your privacy.  We understand that your child and family’s personal information is very sensitive.  For example, your child’s personal information includes demographics, treatment plans, documentation of diagnosis, and treatment records.  Described as follow are the ways we may use and disclose information that identifies your child.  

 HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION.

Treatment.  We will use health information to provide treatment to your child.  This includes use and disclosure of health information among Kindering Center staff and volunteers as it relates to your child’s treatment.  In addition, with your written consent we may disclose health information to your child’s doctors, nurses, technicians, or other personnel, including people outside the Center, who are involved in your child’s medical care.       

Payment.  With your authorization, we may disclose health information so that we or others may bill and receive payment from you, an insurance company, or a third party for the treatment and services your child received. For example, we may provide your health plan with information including diagnosis, procedures performed, progress, goals or recommended care, so they will pay for your child’s treatment.  If your child participates in IDEA Part C services, your child’s health and education information will be disclosed to Washington State Infant Toddler Early Intervention Program; King County DDD (if eligible); Bellevue or Lake Washington School District (if applicable); and Children with Special Health Care Needs.  These disclosures include the minimum necessary information required for payment and may consist of third party reports.

Routine Operations.  We may use your child’s health and education information to carry out routine operations for the Center, which may include the disclosure of information to persons with a legitimate educational interest.  Such persons may include, but are not limited to, those employed at the Center as administrators, supervisors or support staff; persons serving on our board of directors; and businesses with whom we contract for services (including consultants, interpreters, lawyers, auditors).  These uses and disclosures are necessary to make sure that all of our children receive quality care and to operate and manage the Center. 

Transition Services.  At age three if your child will be participating in a qualifying preschool program, Kindering Center may forward your child’s education record, including applicable health information, to the school in which your child intends to enroll.  

Fund Raising.  Fund raising is an important aspect of the operations at Kindering Center.  Therefore, we will include your family on our list of persons to receive notice of our fund raising efforts.  This list is for the benefit of Kindering Center only and will not be disseminated for other purposes without your prior written consent.

OTHER USES AND DISCLOSURES

We may also use or disclose your child’s information to meet special reporting requirements, for public health reasons, or for other purposes.  Such disclosures permitted by law that do not require your written consent include:

• Family and friends involved in your child’s care or payment.
• Disclosures to public health authorities to prevent or control disease.
• Disclosures to public authorities as part of a report of child abuse, neglect or domestic violence.
• Data for health or educational oversight activities, such as audits, investigations or inspections.
• To avert a serious threat to health or safety or to prevent serious harm to an individual.
• To secure emergency medical treatment for your child in the event of an accident or injury.
• Participation in a qualifying research project.
• As required by law, such as for law enforcement or in response to a lawful subpoena or court order.
• Coroners or medical examiners, as necessary, to carry out their duties.
• To provide you with information about treatment alternatives or new health-related services that may be of interest to you.
• Appointment reminders.

All other uses and disclosures will be made ONLY with your written authorization, which you have the right to revoke in most cases.

YOUR RIGHTS

You have the following rights regarding health and education information we have about your child:

Right to Inspect and Copy.  You have a right to inspect and copy health information that may be used to make decisions about your child’s care or payment for your child’s care.  This includes medical and billing records, other than psychotherapy notes.  To inspect a copy of this health information, you must make your request in writing to our Quality Assurance Coordinator.

Right to Amend.  If you feel that the health or education information we have is inaccurate or misleading, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Center. To request an amendment, you must make your request in writing to our Quality Assurance Coordinator.  While we accept requests for amendment, we are not required to agree to the amendment.

Right to an Accounting of Disclosures.  You have the right to request a list of certain disclosures and a record of access regarding your child’s health and education information.  The list does not include disclosures we made directly to you, disclosures to friends/family members, disclosures you specifically authorized in writing, disclosures to third party payers or disclosures related to our daily business operations.  To request an accounting of disclosures, you must make your request in writing to our Quality Assurance Coordinator.

Right to Request Restrictions.  You have the right to request a restriction or limitation on the health information we use or disclose. You also have the right to request a limit on the health information we disclose to someone involved in your child’s care or the payment for your child’s care, like a family member or friend. To request a restriction, you must make your request in writing to our Quality Assurance Coordinator.  We are not required to agree to your request.  If we agree, we will comply with your request unless the information is needed to provide your child with emergency treatment.

Right to Request Confidential Communication.  You have the right to request that we communicate with you in a certain way or at a certain location. For example, you can ask that we contact you only by mail or at work.  Please contact our Quality Assurance Coordinator to request confidential communication.  Your request must specify how or where you wish to be contacted.  We will accommodate reasonable requests.

Right to a Paper Copy of This Notice.  You may obtain a copy of this notice at our web site http://www.kindering.org.  You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  Even if you have received this notice electronically, you are still entitled to a paper copy of this notice. 

CHANGES TO THIS NOTICE

We reserve the right to change this notice.  The new notice will apply to health and education information we already have, as well as any information we receive in the future.  We will post a copy of our current notice at the Center. The notice will contain the effective date on the first page. 

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Kindering Center or with the U.S. Department of Education.

 To file a complaint with Kindering Center, contact:

Quality Assurance Coordinator

Kindering Center

16120 N.E. Eighth Street

Bellevue, WA   98008

(425) 747-4004 x4293

All complaints must be made in writing. You will not be penalized for filing a complaint.

This notice is effective in its entirety as revised on

August 1, 2003.