Foundation Health Partners (FHP) is committed to protecting the confidentiality of information about you and is required by law to do so. This notice describes how we may use information about you within FHP and how we may disclose it to others outside FHP. We will notify you if there is a breach of your unsecured protected health information. This notice also describes the rights you have concerning your own health information. FHP includes Tanana Valley Clinic, Fairbanks Memorial Hospital, and Denali Center.

Treatment: FHP may use information about you to provide you with medical services and supplies. We may also disclose information about you to others that need the information to treat you, such as doctors, physician assistants, nurses, medical and nursing students, technicians, therapists, emergency service and medical transportation providers, medical equipment providers, and others involved in your care. For example, we will allow your physician to have access to your medical record to assist in your treatment and for follow up care.

We may make your medical information available electronically through an electronic health information exchange to other health care providers and health plans that request your information for their treatment and payment purposes. Foundation Health Partners works with healthEconnect Alaska, which is the non-profit organization, entrusted by the Alaska Department of Health & Social Services to exchange health information electronically.  To learn more about healthEconnect Alaska and other health information exchanges that we participate in, you may contact the FHP Privacy Office at (907) 458-6986.  

Exchange of electronic health information can provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions about your care. You may choose to opt out from healtheConnect Alaska or any other exchange we participate in by contacting the FHP Privacy Office at (907) 458-6986 and requesting an Opt Out form.   Completed forms can be returned by email to privacy@foundationhealth.org or mailed to Fairbanks Memorial Hospital Attn: Privacy Department 1650 Cowles Street, Fairbanks AK 99701. Opt-out forms are also available at any FHP registration or reception desk or can be downloaded at www.foundationhealth.org.

We may also use and disclose information about you to contact you to remind you of an upcoming appointment, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you.

Facility Directory: Unless you object, FHP will include your name, location in our facility, your general condition (e.g., fair, stable, critical) and your religious affiliation in our facility directory. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Information in the facility directory may be shared with clergy.

Family Members and Others Involved in Your Care: FHP may disclose information about you to a family member or friend who is involved in your medical care. If you do not want the facility to disclose information about you to family members or others, you must notify the registration and nursing staff at the facility. In the event of a disaster, we may disclose information to help a family member or friend locate you. In the unlikely event you are unable to make decisions about your own care, treatment and services, we may involve a surrogate decision maker to help plan your care and treatment.

Payment: FHP may use and disclose information about you to get paid for the medical services and supplies we provide to you. For example, your health plan or health insurance company may request to see parts of your medical record before they will pay us for your treatment.

Health Care Operations: FHP may use and disclose information about you if it is necessary to improve the quality of care we provide to patients or for health care operations. We may use information about you to conduct quality improvement activities, to obtain audit, accounting or legal services, or to conduct business management and planning. 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.

Fundraising: Many of our patients like to make contributions to support the care provided by FHP. FHP or its institutionally related foundations may contact you in the future to raise funds for this purpose. You will be provided the option of not receiving these communications. Your medical information is not shared for the purpose of fundraising.

Research: FHP may use or disclose information about you for research projects, such as studying the effectiveness of a treatment you received. These research projects must go through a special process that protects the confidentiality of your information.

Required by Law: Federal, state, or local laws do not require patient consent to disclose information which is required to be reported. For instance, we are required to report child abuse and neglect, gunshot wounds, etc. Public policy has determined that these types of needs outweigh the patient’s right to privacy. FHP is also required to give information to the state workers’ compensation program for work- related injuries.

Public Health: FHP may report certain medical information for public health purposes. For instance, we are required by law to report births, deaths, and communicable diseases to the state. We may also need to report patient problems with medications or medical products to the manufacturer and to the Food and Drug Administration.

Public Safety: FHP may disclose medical information for public safety purposes in limited circumstances. We may disclose medical information to law enforcement officers or to the court in response to a search warrant or other court order. We may also disclose medical information to assist law enforcement in identifying or locating a person, to prosecute a crime of violence or to report deaths that may have resulted from criminal conduct at the facility. We may also disclose information about you to law enforcement and others to prevent a serious threat to health or safety.

Health Oversight Activities: FHP may disclose medical information to a government or oversight agency that oversees FHP facilities or its personnel, such as the state’s department of health services, or other federal agencies that oversee Medicare, or licensing agencies who govern physicians and other health care professionals.

Coroners, Medical Examiners and Funeral Directors: FHP may disclose medical information concerning deceased patients to coroners, medical examiners and funeral directors to assist them in carrying out their duties.

Organ and Tissue Donation: FHP may disclose medical information to organizations that handle organ or tissue donation or transplantation.

Military Veterans, National Security and Other Government Purposes: If you are a member of the armed forces, we may release information about you as required by military command authorities or to the Department of Veterans Affairs. We may also disclose medical information to federal or state officials for intelligence and national security purposes.

Judicial Proceedings: FHP may disclose medical information in a lawsuit where your health status is an issue. For example, FHP may be ordered to do so by court order or search warrant.

Information with Additional Protection: Certain types of medical information may have additional protection under state or federal law. For instance, medical information about communicable disease, HIV/ AIDS, drug and alcohol abuse treatment, psychotherapy notes, genetic testing, or a court-ordered mental evaluation. FHP may obtain your authorization to release this information except as required by law.

Other Uses and Disclosures: Other uses and disclosures not described in this Notice will be made only with your written authorization such as sale of medical information. You may revoke such an authorization by sending us a written request.

Right to Request Information About You: You or your legally authorized representative are entitled to online access of documents available, review or receive paper copies, or request an electronic delivery of your health information. This includes your medical and billing information.

If you request a copy of your information, we may charge you for our costs. We will tell you in advance what this cost will be.

Right to Request to Amend or Supplement Information About You That You Believe is Incorrect or Incomplete: If when reviewing your medical records, you see health information you believe is incorrect or incomplete, you may ask us to amend your record. You may submit a request to amend your medical information by contacting Health Information Management at fmhrecords@foundationhealth.org or (907) 458-5450. You may complete the Request to Amend or Supplement Records form online.  Alternatively, our printable form can be found here. Or to amend your billing information, contact the Patient Financial Services/Business office at (907) 458-5510. 

Right to Get a List of Certain Disclosures of Information About You: You have the right to request a list of certain disclosures we made of information about you. For SUD records specifically (as described below), you have the right to receive an accounting of disclosures of your SUD records for the last 3 years. If you would like to receive such a list, contact Health Information Management at fmhrecords@foundationhealth. org or (907) 458-5450. We will provide the first list to you at no charge, but we may charge you for any additional lists you request during a twelve-month period. We will tell you in advance what this list will cost.  

Right to Request Restrictions on How FHP Will Use or Disclose Information About You for Treatment, Payment, or Health Care Operations: You have the right to request us not to use or disclose information about you to treat you, to seek payment for care, or to operate the health care system. We are not required to agree to your request, but if we do agree, we will comply with that agreement unless that information is necessary to provide you emergency treatment.

You may request that we withhold information from your health plan for the purpose of payment or health care operations provided it is not otherwise required by law. If you want to request a restriction to your medical information, you may contact Health Information Management or for billing information, you may contact the Business Office.

You have the right to pay for an item or service and elect not to have this information about you submitted to your health plan. We are not required to accept your request until you have paid for this service or item. We are not required to notify other health care providers of these types of restrictions, this is your responsibility.

If you want to request a restriction to your medical information, contact Health Information Management at (907) 458-5450. To request a restriction to your billing information, contact the Patient Financial Services/ Business Office at (907) 458-5510.

Right to Choose Someone to Act for You: If someone has authority to act as your personal representative, such as if someone has your 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.

Right to Request Confidential Communications: You have the right to request us to communicate with you in a way that you feel is more confidential. You can ask to speak with your health care providers in private, outside the presence of other patients. We will accommodate reasonable requests including alternative addresses or alternative means. For example, you can ask us not to call your home, but to communicate only by mail. To do this, submit your request in writing to Health Information Management at fmhrecords@foundationhealth.org or (907) 458-5450.

Right to a Copy of FHP’s Notice of Privacy Practices:
 You have the right to a paper copy of the Notice at any time. You may obtain a copy of the Notice from our web site at www.foundationhealth.org or you may obtain a paper copy of the Notice at patient registration sites.

Right to Submit Complaints: If you suspect that your rights have been violated under HIPAA, 42 CFR Part 2, or any other federal or state privacy law, you have the right to submit a complaint with us by using the contact information at the end of this form and/or with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. You will never be retaliated against for filing a complaint.

Our Responsibilities Regarding Your Records

We are required to:

• Obtain your consent for most uses and sharing of your information.
• Maintain the confidentiality of your health information in accordance with this notice of privacy practices, HIPAA, and 42 CFR Part 2.
• Comply with stricter protections when they apply.
• Notify you of your privacy rights and our legal duties relating to your health information in this notice and provide you with a copy of it.
• Notify you if there has been a breach of your unsecured records that may have compromised the privacy or security of your information.
• Provide contact information and implement a system that allows you to contact someone from FHP or another appropriate contact individual regarding questions, comments, requests, concerns, or complaints  dealing with your health information or this notice.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Uses and Disclosures of Substance Use Disorder Records: FHP may use and disclose Substance Use Disorder (SUD) treatment records that we create, maintain, receive, or transmit for the purposes described above and in accordance with federal law, including 42 CFR Part 2 and any Alaska laws requiring additional protections. In the event that no stricter requirements apply to the SUD records, FHP will still be required to use and disclose SUD records in compliance with HIPAA and other state and federal laws.

Uses and Disclosures of SUD Records that do not Require Written Consent: Despite the enhanced protections in place for SUD Records, certain disclosures of these records are still permissible without your written consent. Instances where we may disclose these records without your written consent include medical emergencies, child abuse and neglect, crimes that occur on FHP premises, certain court orders, internal communications, pursuant to Qualified Service Organization Agreements (QSOAs), and for certain audits and evaluations. Additionally, we may share certain de-identified data/data that doesn’t identify you as having an SUD for specific purposes like public health, for death investigations to medical examiners and coroners, and for scientific research.

Additional Protections for SUD Records: SUD records are subject to additional enhanced privacy protections under 42 CFR Part 2. In many situations, we may not use or disclose SUD information—even for purposes normally allowed under HIPAA such as treatment, payment, or healthcare operations—unless you provide written consent or another specific exception applies under federal law. If you provide written consent for us to use or disclose SUD records for treatment, payment, and health care operations to the same extent the HIPAA regulations permit, those uses and disclosures are provided for in this notice.  

• Treatment, Payment, Operations: We are required to obtain consent to use or disclose your SUD records even for the purposes of treatment, payment, and healthcare operations. 42 CFR Part 2 allows entities who create, maintain, receive, or transmit SUD Records to obtain a single consent for all treatment, payment, and operation purposes. If we disclose or receive SUD Records pursuant to such consent, those records may be further disclosed subject only to HIPAA except for the purpose of civil, criminal, administrative, or legislative proceedings against you without valid consent or a court order.
• Limitations on Use and Disclosure of SUD Records: SUD records cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order that meets strict requirements under federal law. This prohibition applies even if we did not create the SUD records but received them from another provider.  Records shall only be used or disclosed based on a court order after notice and an opportunity to be heard is provided to the patient or the holder of the record, where required by federal law. A court order authorizing use or disclosure must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed.

Your Rights Specifically Concerning SUD Records

Right to Receive Notice of SUD Privacy Protections: You have the right to receive clear information about how your SUD records are protected, how they may be used or disclosed, and what your rights are under federal confidentiality laws. This Notice of Privacy Practices is intended to provide such notice for both HIPAA-protected health information, SUD records pursuant to 42 CFR Part 2, and other types of records that may have additional protection under federal or Alaska law. 

Right to Opt Out of Fundraising Communications: If we intend to use SUD information for fundraising communications, you will have the right to opt out before receiving such communications. We will provide a clear and conspicuous option to decline future fundraising contacts involving any SUD-related information. 

Our Additional Obligations Regarding Your SUD Records

• Notify you of how we will use and share your SUD records and of your rights regarding these records which are subject to additional federal privacy laws.
• Comply with additional duties and privacy practices described in this subsection of the notice.
• Maintain   the privacy and security of your information in accordance with more restrictive laws 

We may amend or revise our practices concerning how we will use or disclose patient medical information, or how we will implement patient rights concerning their information. We reserve the right to change this Notice and to make the provisions in our new notice effective for all your information. If we change these practices, we will publish a revised Notice of Privacy Practices.

Effective Date and Updates: This section of our Notice of Privacy Practices reflects the requirements of the 2024 Final Rule aligning HIPAA with 42 CFR Part 2, with a compliance deadline of February 16, 2026. We may update this Notice as laws change, and any revisions will be posted on our website and available upon request.

This Notice of Privacy Practices applies to FHP facilities and its personnel, volunteers, students and trainees. The Notice also applies to other health care providers that come to the facility to care for patients, such as physicians, physician assistants, therapists, emergency services providers, medical transportation companies, medical equipment suppliers and other health care providers not employed by FHP unless these health care providers give you their own Notice of Privacy Practices. FHP may share your medical information with other health care providers for their treatment, payment and health care operations.

Please tell us about any problems or concerns you have with your privacy rights or how FHP uses or discloses information about you. If you have a concern, you may contact the FHP Privacy Officer by calling (907) 458-6986 or emailing privacy@foundationhealth.org. You may also file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights (OCR). Complaints can be sent by electronic mail to OCRComplaint@hhs.gov or by mail to:  

Centralized Case Management Operations
 U.S. Department of Health and Human Services
 200 Independence Avenue, S. W.
 Room 509F, HHH Bldg.
 Washington, DC 20201

We will not penalize you or take any retaliatory action against you in any way for filing a complaint with the federal government. 

FHP is required by law to give you this Notice and to follow terms of the Notice that is currently in effect. If you have any questions about this Notice, or have further questions about how we may use and disclose information about you, please contact the Health Information Management Department or the FHP Privacy Officer.