Cross Road Health Ministries, Inc. (CRHM) and its professional staff, employees, and volunteers follow the privacy practices described in this Notice.  CRHM and its clinics create, collect and retain your personal health information in electronic and paper records that will be maintained in a confidential manner, as required by law. This health information may include photographs obtained by authorized personnel for treatment purposes.  Cross Road Health Ministries, Inc. (CRHM) must use and disclose your health information to the extent necessary to provide you with quality health care. To do this, CRHM must share your health information as necessary for treatment, payment and health care operations.

Treatment includes sharing information among health care providers involved in your care. For example, your medical provider may share information about your condition with the pharmacist to discuss appropriate medications or with radiologists or other consultants in order to make a diagnosis.  CRHM may use your health information as required by your insurer or HMO to obtain payment for your treatment and clinic stay. We also may use and disclose your health information to improve the quality of care, e.g., for review of complaints, and staff training purposes.

Your health information may be used for the purposes listed below, unless you ask for restrictions on a specific use or disclosure:

• Religious affiliation to a chaplain or member of the clergy.
• Family members or close friends involved in your care or payment for your treatment.
• Disaster relief agency if you are involved in a disaster relief effort.
• Appointment reminders.
• To inform you of treatment alternatives or benefits or services related to your health. (You will have an opportunity to refuse to receive this information.)
• As required by law.
• Public health activities, including disease prevention, injury or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medication or product problems; notifications of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect or domestic violence (if you agree or as required by law).
• Health oversight activities, e.g., audits, inspections, investigations, and licensure.
• Information for lawsuits and disputes we are required to provide by law.
• Law enforcement (e.g., in response to a court order or other legal process; to identify or locate an individual being sought by authorities; about the victim of a crime under restricted circumstances; about a death that may be the result of criminal conduct; about criminal conduct that occurred on CRHM administrative or clinic premises; and in emergency circumstances relating to reporting information about a crime, or other event reportable by law.)
• Coroners, medical examiners, and funeral directors.
• Organ and tissue donation.
• Certain research projects.
• To prevent a serious threat to health or safety.
• To military command authorities if you are a member of the armed forces or a member of a foreign military authority.
• National security and intelligence activities.
• Protection of the President or other authorized persons for foreign heads of state, or to conduct special investigations.
• Inmates. (Medical information about inmates of correctional institutions may be released to the Institution.)
• Workers’ Compensation. (Your health information regarding benefits for work related illnesses may be released as appropriate.)
• To carry out health care treatment, payment, and operations functions through business associates, e.g., to install a new computer system.

Except as described above, we will not use or disclose your protected health information unless you authorize (permit) Cross Road Health Ministries, Inc. in writing to disclose your information. You may revoke your permission, which will be effective only after the date of your written revocation.

If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

Except as described above, we will not use or disclose your protected health information unless you authorize (permit) Cross Road Health Ministries, Inc. in writing to disclose your information. You may revoke your permission, which will be effective only after the date of your written revocation.

Cross Road Health Ministries, Inc. is required by law to provide you with this Notice. We will be governed by this Notice for as long as it is in effect. CRHM may change this Notice and these changes will be effective for health information we have about you as well as any information we receive in the future. Each time you register at a CRHM clinic for health care services, you may receive a copy of the Notice in effect at the time.

CRHM will let you know promptly if a breach occurs that may have compromised the privacy and security of your information.

CRHM will let you know promptly if a breach occurs that may have compromised the privacy and security of your information.

• you have a complaint;
• you have any questions about this Notice;
• you wish to request a form to change your restrictions on uses and disclosures for health care treatment, payment, or operations; or
• you wish to obtain a form to exercise your individual rights described in section 5.

or designee in writing at PO Box 5 Glennallen, Alaska 99588 or you may drop off your complaint form at any CRHM clinic.

For more general information about Notice of Privacy Practices or making a complaint, see   https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html

CRHM may change the terms of this notice, and the changes will apply to all information we have about you.  The notice will be available upon request, in our clinics and on our website.

This notice is effective April 14, 2003; revised 5/1/2024.