Notice of Privacy Practices

Effective Date: October 1, 2015

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

OUR PLEDGE TO PROTECT YOUR PRIVACY

(THIS NOTICE APPLIES TO RESEARCH SUBJECTS, THERAPEUTIC AND CLINICAL TEST PATIENTS)

Stanford Blood Center (the Blood Center for purposes of this notice) in its role as an indirect healthcare provider understands that medical information about you is personal, and we are committed to protecting the privacy of your health information we create or receive about you. When you visit one of our donor centers or drawing locations, we create a record of the information given by you or by others concerning you, and of the care and services you receive at Blood Center. These records are created in order to provide you with quality care and services, and to comply with certain legal requirements. This notice applies to all electronic and paper records of your care and interactions generated by the Blood Center, whether such record is made by the Blood Center personnel or your personal physician.

We are required by law to:

Make sure that your health information is kept private (with certain exceptions);
Give you this Notice of our legal duties and privacy practices with respect to health information about you; and
Follow the terms of the Notice currently in effect.

WHO WILL FOLLOW THIS NOTICE

This notice describes the Blood Center's practices and that of:

Any health care professional authorized to enter information into your chart, file, or medical record;
All Blood Center departments covered by the Health Insurance Portability and Accountability Act (HIPAA);
Any member of a volunteer group we allow to help you while you are being treated at the Blood Center and
All employees, staff and other Blood Center personnel

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The following sections describe different ways that we may use and disclose health information:

FOR TREATMENT
We may use your medical information to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technologists, technicians, medical students, or Blood Center personnel who are involved in taking care of you while you are at the Blood Center. For example, if we are drawing your blood for therapeutic purposes by request of your physician, we may need to tell your doctor about your visits to the Blood Center. Or, if you are donating blood for your own use during elective surgery, we may share the results of the infectious disease tests we perform on your blood with your surgeon or physician.

We may disclose medical information about you to people outside of the Blood Center who may be involved in your medical care after you leave, such as family members. For example, if you have an adverse reaction to a blood donation, we might tell the person who is taking you home what happened and what to observe for.

FOR PAYMENT
We may use and disclose health information about you so that the treatment and services you receive may be billed to you and payment may be collected from you, an insurance company or a third party. For example, we may need to give information about care that you received at the Blood Center to your health plan, so your health plan will pay us or reimburse you for the activity.

FOR HEALTHCARE OPERATIONS

We may use and disclose medical information about you for Blood Center operations. These uses and disclosures are necessary to run the Blood Center and to make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
We may combine medical information about Blood Center patients to decide what additional services Blood Center should offer, what services are not needed, and whether certain new treatments are effective.
We may disclose information to doctors, nurses, technologists, technicians, medical students, and other Blood Center personnel for quality assurance and learning purposes.
We may combine the medical information we have with medical information from other Blood Centers to compare how we are doing and see where we can make improvements in the care and services that we offer. In this case, all identifiers are removed.

BUSINESS ASSOCIATES
The Blood Center may contract with outside companies to perform business services for us, or seek accreditation with outside agencies. An example is the College of American Pathologists (CAP). In certain circumstances, we may need to share your medical information with such associates so they can perform services on our behalf. In addition, we will have a written contract in place with the business associate requiring it to protect the privacy of your medical information.

APPOINTMENT REMINDERS AND OTHER COMMUNICATION
We may use and disclose health information to contact you as a reminder that you have an appointment for care at the Blood Center. We will communicate with you using the information (such as telephone number and email address) that you provide. Unless you notify us to the contrary, we may use the contact information you provide to communicate general information about your care such as appointment location, department, date and time.

HEALTH-RELATED BENEFITS AND SERVICES
We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

INDIVIDUALS INVOLVED IN YOUR CARE

We may release medical information about you to a friend or family member who is involved in your medical care.
We may give information to someone who helps pay for your care.
Unless there is a specific written request from you to the contrary, we may also tell your family or friends your condition and that you are a donor or patient at the Blood Center (if we have a reason to believe these individuals are involved in your care).
In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort, so that your family may be notified about your condition, status and location.

RESEARCH
As a community Blood Center dedicated to advancing transfusion and transplantation medicine, we may, under certain circumstances, use and disclose medical information about you for research purposes. We generally ask for your written authorization before using your medical information or sharing it with others in order to conduct research. Under limited circumstances we may use and disclose your medical information without your authorization. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patient's need for privacy of their medical information.

TO PREVENT A SERIOUS THREAT TO HEALTH OR SAFETY
We may use and disclose certain information about you when necessary to prevent a serious threat to your health and safety or the health and safety of others. Any disclosure, however, would only be to someone able to help prevent the threat, such as law enforcement, or to a potential victim.

SPECIAL SITUATIONS THAT DO NOT REQUIRE US TO OBTAIN YOUR AUTHORIZATION

WORKERS COMPENSATION
We may release medical information about you for Workers' Compensation or similar programs. These programs provide benefits for work-related injuries or illness.

PUBLIC HEALTH ACTIVITIES
We may disclose health information about you for public health activities. These activities include, but are not limited to the following:

To prevent or control disease, injury or disability;
To report births and deaths;
To report the abuse or neglect of children, elders and dependent adults;
To report reactions to medications or problems with products;
Notify appropriate public health authorities if you have a positive result on a reportable blood test,
Notify people of recalls of products they may be using or
Notify the appropriate government authority, if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law.

HEALTH OVERSIGHT ACTIVITIES
We may disclose health information to a health oversight agency such as the California Department of Health and Human Services for activities authorized by law. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. (For example, audits, investigations, inspections, and licensure.)

LAWSUITS AND DISPUTES

If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order.
We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute.

LAW ENFORCEMENT
We may release health information at the request of law enforcement officials in limited circumstances, for example:

In response to a court order, subpoena, warrant, summons or similar process,
To identify or locate a suspect, fugitive, material witness, or missing person,
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement,
About a death we believe may be the result of criminal conduct,
About criminal conduct at the Blood Center or
In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

CORONERS, MEDICAL EXAMINERS AND FUNERAL DIRECTORS

We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
We may release health information about patients of the Blood Center to funeral directors, as necessary, to carry out their duties.

ORGAN AND TISSUE DONATION
If you are a potential organ donor, we may release medical information to organizations that handle organ, eye, or tissue procurement or transplantation. The procurement or transplantation organization needs you to authorize actual donations.

MILITARY AND VETERANS

If you are a member of the armed forces, we may release medical information about you, as required by military command authorities.
We may release medical information about foreign military personnel to the appropriate foreign military authority.

NATIONAL SECURITY AND INTELLIGENCE AGENCIES
We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

INMATES
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correction institution or law enforcement official. This release may be necessary for the institution to provide you with health care; to protect your health and safety or the health and safety of others; or for the safety and security of the correctional institution.

PROTECTIVE SERVICES FOR THE PRESIDENT AND OTHERS
We may disclose medical information about you to authorize federal officials so they may provide protection to the President, other authorized persons or foreign heads of state, or to conduct special investigations.

OTHER USES OR DISCLOSURES REQUIRED BY LAW
We may also use or disclose health information about you when required to do so by federal, state or local laws not specifically mentioned in this Notice. For example, we may disclose health information as part of a lawful request in a government investigation

SITUATIONS THAT REQUIRE YOUR AUTHORIZATION

For uses and disclosures not described above, we must obtain your authorization. For example, the following uses and disclosures will be made only with your authorization:

uses and disclosures for marketing purposes;
uses and disclosures that constitute the sale of PHI;
most uses and disclosures of psychotherapy notes; and
other uses and disclosures not described in the notice

If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the activities covered by the authorization, except if we have already acted in reliance on your permission. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain records of health information.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU

RIGHT TO INSPECT AND COPY
You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but may not include some mental health information. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.

RIGHT TO AMEND
If you feel that medical information we have about you is incorrect or incomplete, 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 Blood Center.

We may deny your request for an amendment if you ask us to amend information that:

Was not created by us, or on our behalf;
Is not part of the medical information kept by or for the Blood Center;
Is not part of the information which you would be permitted to inspect and copy or
Is accurate and complete

If we deny any part of your request, we will provide you a written explanation of our reasons.

RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to request an "accounting of disclosures" which is a list describing how we have shared your health information with outside parties. This accounting is a list of the disclosures we made of your health information for purposes other than treatment, payment, health care operations, and certain other purposes consistent with law. You may request an accounting of disclosures for up to six years before the date of your request. If you request an accounting more than once during a twelve month period, we will charge you a reasonable fee.

RIGHT TO REQUEST RESTRICTIONS
You have the right to request restrictions on certain uses or disclosure of your medical information. For example, you may request that your name not appear on a list of blood donors or patients of the Blood Center. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or comply with the law.
In your request, you must tell us:

What specific information you want to limit,
Whether you want to limit our use, disclosure, or both and
To whom you want the limits to apply (For example, disclosures to your spouse).

We are legally required to accept certain requests not to disclose health information to your health plan for payment or health care operations purposes as long as you have paid out- of-pocket and in full in advance of the particular service included in your request. If the service or item is part of a set of related services, and you wish to restrict disclosures for the set of services, then you must pay in full for the related services. It is important to make the request and pay before receiving the care so that we can work to fully accommodate your request. We will comply with your request unless otherwise required by law.

RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS
You have the right to request that we communicate with you about your health information or medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work, rather than at your home. We will not ask you the reason for your request. We will work to accommodate all reasonable requests. Your request must be in writing and specify how and where you wish to be contacted.

RIGHT TO BE NOTIFIED OF A BREACH
The Blood Center is committed to safeguarding your health information and proactively works to prevent health information breaches from occurring. If a breach of unsecured health information occurs, we will notify you in accordance with applicable state and federal laws.

RIGHT TO A COPY OF THIS NOTICE
You have the right to a copy of this Notice. It is available in our Internet site or by requesting it from the Privacy Officer.

OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information, not covered by this notice or the laws that apply to us, will be made only with your written authorization. If you provide us authorization to use or disclose medical information about you for purposes not covered in this notice, you may revoke that permission, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the activities covered by your written authorization. The Blood Center is unable to take back any disclosures we have already made with your authorization, or that we are required to retain as a record of the care that we provided to you.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Blood Center or with the Secretary of the Department of Health and Human Services (200
Independence Avenue, S.W., Washington, D.C. 20201).

CHANGES TO THIS NOTICE

We reserve the right to update our privacy practices and update this notice accordingly. We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. The effective date of the notice will appear on the first page. If at any time you would like to obtain another copy of our notice, you may request one.

QUESTIONS ABOUT OUR PRIVACY PRACTICES

To obtain information about how to request a copy of your medical records, receive an accounting of disclosures of, amend, request restrictions or request confidential communications of your medical information, to file a complaint or if you have questions regarding this Notice of HIPAA Privacy Practices, please contact:

Stanford Blood Center
Local Privacy and Information Security Officer
3373 Hillview Avenue
Palo Alto, CA, 94304
650-724-4167