More LA Smiles
“More LA Smiles” is a UCLA-led Consortium, funded by CA DHCS through the California Medi-Cal 2020 Demonstration (otherwise known as the UCLA Dental Transformation Initiative).
More LA Smiles is committed to protecting personal and professional information about you (“User Information”). We are required by law to: maintain the privacy of your User Information; provide you with information about our legal duties and privacy practices; inform you of your rights and the ways in which we may use User Information, and whether and how we disclose it to other entities and persons.
Your User Data
At times throughout various functions of the website, we will require the following information input from a user through registration and interest forms:
- Name (First/Last)
- Practice/Organization Name
- Practice/Organization Address (Street/City/State/ZIP)
- Email Address
- Professional Credentials
- License Number
- Provider Number
Additional analytics collected in the background of our site, include:
- Geographical Information
- Demographic Information
- User IP
How Your Data Is Used
For Operations. We may use and disclose User Information about you for the following purposes: to review the quality and safety of our services, including our website, or for business planning, management and administrative services. We may also contact you about other benefits or services we provide. We may use and disclose your User Information to an outside company that performs services for us such as accreditation, legal, computer or auditing services. These outside companies are called “business associates” and are required by law to keep your User Information confidential. Using strict measures to comply with HIPAA, we may also disclose information to doctors, nurses, technicians, medical and other students, and other health system personnel for performance improvement and educational purposes.
For Event Reminders. We may contact you to remind you about an event that you have registered through More LA Smiles.
Marketing or Sale of User Information. Most uses and disclosures of your User Information for marketing purposes or any sale of your User Information would require your written authorization.
As Required By Law. We will disclose User Information about you when required to do so by federal or state law.
Health Oversight Activities. We may disclose User Information to governmental, licensing, auditing, and accrediting agencies as authorized or required by law.
Lawsuits and Other Legal Proceedings. We may disclose User Information to courts, attorneys and court employees in the course of conservatorship, writs and certain other judicial or administrative proceedings. We may also disclose User Information about you in response to a court or administrative order, or in response to a subpoena, discovery request, warrant, or other lawful process.
Law Enforcement. If asked to do so by law enforcement, and as authorized or required by law, we may release User Information:
- To identify or locate a suspect, fugitive, material witness, certain escapees, or missing person;
- About a suspected victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
- About a death suspected to be the result of criminal conduct;
- About criminal conduct at More LA Smiles; and
- In case of a medical emergency, to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Other uses and disclosures of User Information. Other uses and disclosures of User Information not covered by this Notice will be made only with your written authorization. If you authorize us to use or disclose your User Information, you may revoke that authorization, in writing, at any time. However, the revocation will not be effective for information that we have already used and disclosed in reliance on the authorization.
Your rights regarding your User Information
Your User Information is the property of More LA Smiles and the UCLA Dental Transformation Initiative. You have the following rights regarding the User Information we maintain about you:
Right to Inspect and Copy. With certain exceptions, you have the right to inspect and/or receive a copy of your User Information. If we have the information in electronic format then you have the right to get your User Information in electronic format if it is possible for us to do so. If not we will work with you to agree on a way for you to get the information electronically or as a paper copy.
To inspect and/or to receive a copy of your User Information, you must submit your request in writing to More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024. If you request a copy of the information, there is a fee for these services.
We may deny your request to inspect and/or to receive a copy in certain limited circumstances. If you are denied access to User Information, in most cases, you may have the denial reviewed. Another licensed health care professional chosen by More LA Smiles will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Request an Amendment or Addendum. If you feel that User Information we have about you is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record). You have the right to request an amendment or addendum for as long as the information is kept by or for More LA Smiles.
Amendment. To request an amendment, your request must be made in writing and submitted to the More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024. You must be specific about the information that you believe to be incorrect or incomplete and you must provide a reason that supports the request.
We may deny your request for an amendment if it is not in writing, we cannot determine from the request the information you are asking to be changed or corrected or your request does not include a reason to support the change or addition. In addition, we may deny your request if you ask us to amend information that:
- Was not created by More LA Smiles
- Is not part of the User Information kept by or for More LA Smiles;
- Is not part of the information which you would be permitted to inspect and copy; or
- More LA Smiles believes to be accurate and complete.
Addendum. To submit an addendum, the addendum must be made in writing and submitted to the More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024.An addendum must not be longer than 250 words per alleged incomplete or incorrect item in your record.
Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures we have made of your User Information.
To request this accounting of disclosures, you must submit your request in writing to More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024. Your request must state a time period that may not be longer than the six previous years. You are entitled to one accounting within any 12-month period at no cost. If you request a second accounting within that 12-month period, there will be a charge for the cost of compiling the accounting. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the User Information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the User Information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend.
To request a restriction, you must make your request in writing to the More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, only to you and your spouse. We are not required to agree to your request except in the limited circumstance described below. If we do agree, our agreement must be in writing, and we will comply with your request unless the information is needed to provide you emergency care.
We are required to agree to a request not to share your information with your health plan if the following conditions are met:
- We are not otherwise required by law to share the information
- The information would be shared with your insurance company for payment purposes;
- You pay the entire amount due for the health care item or service out of your own pocket or someone else pays the entire amount for you.
Right to Request Confidential Communications. You have the right to request that we communicate with you about your User Information in a certain way or at a certain location. For example, you may ask that we contact you only at home or only by mail.
To request confidential medical communications, you must make your request in writing to the More LA Smiles, UCLA Dental Transformation Initiative, 10960 Wilshire Blvd. Suite 1500 Los Angeles, CA 90024. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. 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 agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
Copies of this Notice are available throughout More LA Smiles, or you may obtain a copy at our website, morelasmiles.org.
Right to be Notified of a Breach. You have the right to be notified if we or one of our Business Associates discovers a breach of unsecured User Information about you.
Changes to More LA Smiles’ privacy practices and this notice
We reserve the right to change More LA Smiles’ privacy practices and this Notice. We reserve the right to make the revised or changed Notice effective for User Information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice throughout More LA Smiles. In addition, at any time you may request a copy of the current Notice in effect.