NOTICE
OF PRIVACY PRACTICES
POLICY:
Except for inmates, an
individual has a right to adequate notice of the uses and disclosures of
protected health information (PHI) that may be made by the County agency and of
the individual's rights and the County's legal duties with respect to such PHI.
The law dictates a
specified set of core elements that a valid Notice of Privacy Practices must
contain. Therefore, all County employees must use the
PROCEDURES:
I. Distribution
of Notice
The County will distribute its Notice of Privacy
Practices as follows:
A.
Provide to any person who requests it.
B.
Provide to each individual the County has a direct treatment
relationship with no later than the first service delivery, including service
delivered electronically, after the Privacy compliance date of April 14, 2003.
C. In emergency treatment situations, the Notice
shall be provided to the individual as soon as reasonably practicable after the
emergency treatment situation.
D.
Have Notice available at the physical service delivery site.
E.
Post Notice in a clear and prominent location at the physical service
delivery site.
F.
Prominently post and make electronically available the Notice on any web
site the County maintains that provides information about its customer services
or benefits.
G.
The County may provide the Notice to an individual by e-mail but only if
the individual agrees to electronic notice in writing and such agreement has
not been withdrawn.
II. Obtain
Written Acknowledgment of Receipt
A. Except
in an emergency treatment situation, the County agency involved shall make a
good faith effort to obtain a written acknowledgement of receipt of the Notice.
B. If acknowledgement is not
obtained, document why and efforts made to obtain it.
III. Documentation
A.
The agency must retain a copy of the signed Acknowledgement of Receipt
of Notice of Privacy Practices.
B. If not signed, retain
documentation of good faith efforts made to obtain such written acknowledgment.
C.
These documents shall be maintained by the Agency Privacy Officer.
IV. Notice
of Privacy Practices for Employer-Sponsored Group Health Plans
The County sponsors
health plans for its employees. The County must provide each participant in our
self-funded group plan a Notice of Privacy Practices. If the group health plan
intends to disclose or discloses PHI to its plan sponsor, broker or benefit
consultant the Notice of Privacy Practices must so state. The County is not
required to provide a Notice of Privacy Practices where the group health plan
is fully insured or if an administrator agrees by contract to provide such
Notice on the County's behalf.
Citations:
Ĝ § 164.502(i) - Uses and disclosures must be consistent with individuals right to notice
Ĝ § 164.520(a)(l) - Individuals right to notice
Ĝ §164.520(a)(2) - Exception for certain group health plans
Ĝ § 164.520(b) - Contents of notice
Ĝ §164.520(e) - Deadlines for notice
Ĝ
§ 164.520(d) - Joint notice
NOTICE
OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT
YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY
This Notice of Privacy
Practices describes how
We must follow the privacy
practices contained in this notice. However,
we reserve the right to change the privacy practices described in this notice,
in accordance with the law. Changes to
our privacy practices apply to all health information we maintain. If we change our privacy practices, you will
receive a revised copy.
You will be asked to provide a signed acknowledgment of
receipt of this notice. Our intent is to
make you aware of possible uses and disclosures of your protected health information
and your privacy rights. The delivery of your health care services will in no
way be conditioned upon your signed acknowledgment. If you decline to provide a signed acknowledgment,
we will continue to provide you treatment and will use and disclose your protected
health information for treatment, payment or health care operations when
necessary.
WE MAY USE YOUR PROTECTED
HEALTH INFORMATION WITHOUT YOUR AUTHORIZATION FOR THE FOLLO\VING REASONS:
1. Treatment. We will use your health information for treatment. For example, health information obtained by a nurse, doctor, or other medical personnel will be recorded in your medical record and used to determine which treatment options best address your health needs. The treatment selected will be documented in your medical records, so that other health care professionals can make informed decisions about your care. [If this example does not apply to your organization, you must insert at least one example that is relevant to you.}
2. Payment. We
will use your health information, as needed, to obtain payment for your health
care services. For example, in order for
an insurance company to pay for your treatment, we must submit a bill that
identifies you, your diagnosis, and the treatment provided to you. As a result, we will pass such health
information onto an insurer in order to help receive payment for your medical
bills. [If this example does not apply
to your organization, you must insert at least one example that is relevant to
you.}
.
3. Health Care Operations. We may use or disclose, as needed, your
diagnosis, treatment and outcome information in order to improve the quality or
cost of care we de1iver. These
activities may include evaluating the performance of your doctors or nurses.
and
other health care professionals, or examining the effectiveness of the treatment
provided to you when compared to patients in similar situations. [If this
example does not apply to your organization, you must insert at least one
example that is relevant to you].
4. Individuals Involved With Your Care Or
Payment Of Your Care. If family members, relatives or close
personal friends are helping care for you or helping you pay for your medical
bills, we may release important health information about you to those people.
The information released may include your location within our facility and your
general condition. In addition, we may release your medical information to
organizations authorized to handle disaster relief efforts so that your family
can be notified about your condition, status and location.
5. Business Associates. We may disclose your health information to
other persons or organizations known as business associates, who provide
services for us under contract. We
require our business associates to protect the medical information we provide to
them.
6. Health-Related Benefits And Services. We
may use and disclose your health information to tell you about health-related
benefits or services of interest. We may
use and provide your health information to tell you about possible treatment options
or other items of interest and to contact you to remind you of your appointments.
7. As Required By Law. We will use and/ or disclose your health
information when required to do so by local, state or federal law. For example, we may have to report abuse,
neglect or domestic violence or certain physical injuries.
8. Public Health Activities. We may provide your health information for
public health activities. These activities generally include the following: to
prevent or control, disease, injury or disability; to report births or deaths;
to report reactions to medications or problem with products; to notify people
of recalls of products they may be using; to notify a person who may have been
exposed to a disease or may be at risk for getting or spreading a disease or
condition; to notify the government if we suspect a patient has been the victim
of abuse, neglect or domestic violence.
9. Health Oversight Activities. We may disclose your health information to a
health oversight agency for activities authorized by law such as audits, investigations,
licensure and inspections. These agencies might include government agencies that:
oversee the health or system, government benefit programs, other government
regulatory programs and civil rights law.
10.
Food and Drug Administration. We may disclose your health information to a
person or company required by the Food and Drug Administration to do the
following: report adverse events, product defects or problems and biological
product deviations; track products; enable product recalls; make repairs or
replacements; or post marketing surveillance as required.
11. Coroners, Medical Examiners and Funeral
Directors. We may disclose your health information to coroners, medical
examiners and funeral directors so they can carry out their duties such as
identifying the body, determining cause of death, or in the case of funeral
directors, to carry out funeral preparation.
12. Law Enforcement. We may provide health information for law
enforcement purposes, including but not limited to the following: in response
to legal proceedings; to identify or locate a suspect, fugitive, material witness
or missing person; pertaining to a victim of a crime; pertaining to a death
believed to be the result of criminal conduct; pertaining to crimes occurring
on-site; and in emergency situations to report a crime, the location of the
crime or victims involved.
13. Organ and Tissue Donation. We may disclose your health information to
people involved with obtaining, storing, or transplanting organs, eyes or
tissue of cadavers for donation purposes.
14. Military and National Security Activities.
We may disclose your health information
to authorized federal officials for conducting intelligence,
counterintelligence, and other national security activities.
15. Lawsuits
and Disputes. We may disclose your health information in
response to a court or administrative order and in certain conditions in
response to a subpoena, discovery, request or other lawful process.
16. Workers' Compensation. We may disclose your health information
to comply with workers' compensation laws and other similar programs that
provide benefits for work-related injuries or illness.
17.
To Prevent A Serious Threat To
Health Or Safety. We may use and disc1ose your health
information when needed to prevent a serious threat to your health and safety or
the health and safety of other people. The information will only be provided to
someone able to help prevent the threat.
18. Inmates. We may disclose health information to a
correctional institution or law enforcement official if you are an inmate of a
correctional institution or under the custody of a law enforcement official.
This disclosure would 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.
19. For
Research. Under certain
circumstances, and only after a special approval process, we may use and
disclose your health information to help conduct research. Such research might try to find our whether a
certain treatment is effective in curing an illness.
20. Directory. Unless
you object, we may use your health information, such as your name, location in
our facility and religious preferences directory purposes. The directory information will be released to
people who ask for you by name. The information
about your religious affiliation will only be disclosed to clergy members.
YOU HAVE
SEVERAL RIGHTS WITH REGARD TO YOUR HEALTH INFORMATION:
1. Right To Inspect And Copy.
You have the right to inspect
and obtain a copy of your health information. However, this right does not
apply to psychotherapy notes; information gathered in reasonable anticipation
of, or use in, a civil, criminal or administrative action or proceeding; and
protected health information that is subject to law that prohibits access to
protected health information.
2. Right to Request To Correct Or Amend. If you believe your health information is incorrect,
you may ask us to correct or amend the information. Such request must be in writing and must
include a reason for the correction or change. If we did not create the health information that
you believe is incorrect, or if we disagree with you and believe your health
information is correct, we may deny your request:
3. Right To Request Restrictions. You have the right to ask for restrictions on how your health information is used or disclosed for treatment, payment and health care operations. Your request must be in writing and must include (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. We are not legally required to agree with your requested restrictions.
4. Right To Request Confidential Communications.
You have the right to ask that we
communicate your health information to you using alternative means or an
alternative location. For example, you may wish to receive information about your
health status in a special, private room or through a written letter sent to a
private address. WE will accommodate
reasonable requests.
5. Right to An
Accounting Of Disclosures. In some
limited instances, you have the right to ask that we provide you with a list of
the disclosures we have made of your protected health information. All such requests must be made in writing. The disclosure must have been made after
7. Right To
Withdraw Your Authorization. Except for the situations herein, we must
obtain your specific written authorization for any other release of your health
information. If you sign an authorization
form, you may withdraw your health information long as your withdrawal is in
writing.
8. 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. {IF PROVIDER MIAINTAINS A WEB
SITE THAT PROVIDES INFORMATION ABOUT SERVICES OR BENEFITS, PROVIDER MUST POST
ITS
9 Complain. If
you believe your privacy rights have been violated, you may file a complaint
with us and with the federal Department of Health and Human Services. We will not retaliate against you for filing
such a complaint.
If you have any questions
or concerns regarding your privacy rights, the information in this notice, or
if you wish to file a complaint, please contact the following individual for
information:
____________________________________________
County Privacy Officer
This Notice of Privacy Practices
is effective