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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

     Indian Health Manual
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Part 2, Chapter 7:  Manual Exhibit 2-7-M

Policy and Procedure for use and Disclosure of
Protected Health Information for Involvement in the Patient's Care
and for Notification Purposes

  1. PURPOSE.  To publish the Indian Health Service (IHS) policy and procedure on the uses and disclosures of protected health information (PHI) for involvement in the patient's care and for notification purposes.

  2. AUTHORITY.  45 Code of Federal Regulations 164.510(b)(1) - 164.510 (b)(3)

  3. POLICY.  The IHS may use or disclose to family members, relatives or close personal friend or any other person identified by the patient, PHI directly relevant to that person's involvement in the patient's health care or payment.


    1. Notification.  The IHS may use or disclose PHI to notify or assist in the notification of (including identifying or locating) a family member, personal representative, or another person responsible for the care of the patient, of the patient's location, general condition, or death.

    2. Uses or Disclosures When the Patient is Present.  If the patient is present and/or available and can make health care decisions, the IHS may release the information if it:

      1. obtains the patient's agreement;

      2. provides the patient the opportunity to object to the disclosure, and the patient does not express an objection; or

      3. reasonably infers from the circumstances, based upon the exercise of professional judgment that the patient does not object to the disclosure.

    3. Limited Uses or Disclosures When the Patient Is Not Present.  When the patient is not present or when opportunity to agree or object is not possible or practicable due to the patient's incapacity or emergency condition, the following procedures shall be used:

      1. An IHS provider, using his or her professional judgment, may determine that the use or disclosure is in the best interests of the patient, and only use or disclose PHI that is directly relevant to the person’s (family member, friend, spouse, personal representative, etc) involvement.

      2. An IHS provider, using his or her professional judgment and experience with common practice, may make inferences as to the patient’s best interests and allow the patient’s family member or personal representative to pick up filled prescriptions, medical supplies, X-rays, or other forms of PHI.

    4. Verification.  Verification of identity should be completed prior to disclosing PHI of a patient.  (See Manual Exhibit 2-7-R, “Policy and Procedure for Verification of Identity Prior to Disclosure of Protected Health Information.”)

    5. Disclosures.  Dislosures for notification purposes should be noted.  (See Manual Exhibit 2-7-B, “Policy and Procedure for Matters Related to Accounting of Disclosures of Protected Health Information.”)

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