ROOKS COUNTY HEALTH DEPARTMENT
NOTICE OF PRIVACY PRACTICES – EFFECTIVE
APRIL 2003
THIS NOTICE DESCRIBES HOW MEDICAL
INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY. You
have the right to a paper copy of this Notice; you may request a copy at any
time.
HOW WE MAY USE AND DISCLOSE HEALTH
INFORMATION ABOUT YOU.
We
may use and disclose your health information for the following purposes without
your express consent or authorization. We
will obtain your express written authorization before using or disclosing your
information for any other purpose. You
may revoke such authorization, in writing, at any time to the extent we have not
relied on it.
Treatment.
We may use your
health information to provide you with medical treatment.
We may disclose information to doctors, nurses, technicians, medical
students, or other personnel involved in your care.
We also may disclose information to persons outside our organization
involved in your treatment, such as other health care providers, family members,
and friends.
We may use and disclose health information to discuss
with you treatment options or health-related benefits or services or to provide
you with promotional gifts of nominal value.
We may use and disclose your health information to remind you of upcoming
appointments. Unless you direct us
otherwise, we may leave messages on your telephone answering machine identifying
our organization and asking for you to return our call.
We will not disclose any health information to any person other than you
except to leave a message for you to return the call.
Payment.
We may use and
disclose your health information as necessary to collect payment for services we
provide to you. We also may provide
information to other health care providers to assist them in obtaining payment
for services they provide to you.
Health
Care Operations. We
may use and disclose your health information for our internal operations.
These uses and disclosures are necessary for our day-to-day operations
and to make sure patients receive quality care.
We may disclose health information about you to another health care
provider or health plan with which you also have had a relationship for purposes
of that provider’s or plan’s internal operations.
Business Associates.
We provide some services through contracts or arrangements with business
associates. We require our business
associates to appropriately safeguard your information.
Creation
of de-identified health information.
We may use your health information to create de-identified health
information. This means that all
data items that would help identify you are removed or modified.
Uses
and disclosures required by law.
We will use and/or disclose your health information when required by law
to do so.
Disclosures
for public health activities.
We may disclose your health information to a government agency authorized
(a) to collect data for the purpose of preventing or control disease, injury, or
disability; or (b) to receive reports of child abuse or neglect. We also may
disclose such information to a person who may have been exposed to a
communicable disease if permitted by law.
Disclosures
about victims of abuse, neglect, or domestic violence.
We may disclose your health information to a government authority if we
reasonably believe you are a victim of abuse, neglect, or domestic violence.
Disclosures
for judicial and administrative proceedings.
Your protected health information may be disclosed in response to a court
order or in response to a subpoena, discovery request, or other lawful process
if certain legal requirements are satisfied.
Disclosures
for law enforcement purposes.
We may disclose your health information to a law enforcement official as
required by law or in compliance with a court order, court-ordered warrant, a
subpoena, or summons issued by a judicial officer; a grand jury subpoena; or an
administrative request related to a legitimate law enforcement inquiry.
Disclosures
regarding victims of a crime.
In response to a law enforcement official’s request, we may disclose
information about you with your approval. We
may also disclose information in an emergency situation or if you are
incapacitated if it appears you were the victim of a crime.
Disclosures
to avert a serious threat to health or safety.
We may disclose information to prevent or lessen a serious threat to the
health and safety of a person or the public or as necessary for law enforcement
authorities to identify or apprehend an individual.
Disclosures
for specialized government functions.
We may disclose your protected health information as required to comply
with governmental requirements for national security reasons or for protection
of certain government personnel or foreign dignitaries.
YOUR RIGHTS REGARDING YOUR HEALTH
INFORMATION.
Right to Inspect and Copy.
You have the right to inspect
and copy health information maintained by our organization.
To do so, you must complete a specific form providing information needed
to process your request. If you
request copies, we may charge a reasonable fee.
We may deny you access in certain limited circumstances.
If we deny access, you may request review of that decision by a third
party, and we will comply with the outcome of the review.
Right To Request Amendment.
If you believe your records contain inaccurate or incomplete information,
you may ask us to amend the information. To
request an amendment, you must complete a specific form providing information we
need to process your request, including the reason that supports your request.
Right to an Accounting of Disclosures.
You have the right to request a list of disclosures of your health
information we have made, with certain exceptions defined by law.
To request this list, you must complete a specific form providing
information we need to process your request.
Right to Request Restrictions.
You have the right to request a restriction on our uses and disclosures
of your health information for treatment, payment, or health care operations.
You must complete a specific form providing information we need to
process your request. Our Privacy
Officer is the only person who has the authority to approve such a request.
Right to Request Alternative Methods
of Communication.
You have the right to request that we communicate with you in a certain
way or at a certain location. You
must complete a specific form providing information needed to process your
request. Our Privacy Officer is the
only person who has the authority to act on such a request.
We will not ask you the reason for your request, and we will accommodate
all reasonable requests.
COMPLAINTS
If
you believe your rights with respect to health information have been violated,
you may file a complaint with our organization or with the Secretary of the U.S.
Department of Health and Human Services. To
file a complaint with our organization, please contact the Privacy Officer @ Rooks County Health Department, 426
Main,
We
reserve the right to change our privacy practices Notice and to make the revised
Notice reflecting such practices effective with respect to all protected health
information regardless of when the information was created.