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.
If you have any questions about this Notice
of Privacy Practices contact WCPH & HC’s Privacy Officer at:
319-653-7758
This Notice of Privacy Practices
describes how Washington County Public Health & Home Care (WCPH & HC)
may use and disclose your protected health information (PHI) to carry out
treatment, payment or health care operations and for other purposes that are
permitted or required by law. It also
describes your rights to access and control your PHI. “Protected health information” is
individually identifiable information about you, including demographic
information, that may identify you and that relates to your past, present or
future physical or mental health or condition and related health care services. Where appropriate, WCPH & HC will use
only minimum necessary and de-identified health information.
WCPH
& HC is required to abide by the terms of this Notice of Privacy Practices.
WCPH & HC may change the terms of this notice at any time as required to
comply with or implement federal law.
The new notice will be effective for all PHI that WCPH & HC
maintains at that time. Upon request,
WCPH & HC will provide you with any revised Notice of Privacy
Practices.
PERMITTED
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Your PHI may be used and disclosed by WCPH & HC for the
purpose of providing or accessing health care services for you. Your PHI may also be used and disclosed to
pay your health care bills and to support the business operations of WCPH &
HC.
The
following categories describe ways that WCPH & HC is permitted to use and
disclose health care information.
Examples of types of uses and disclosures are listed in each
category. Not every use or disclosure
for each category is listed; however, all of the ways WCPH & HC is
permitted to use and disclose information falls into one of these categories:
1) Treatment:
WCPH & HC may use and disclose your PHI to provide,
coordinate or manage your health care and any related services. This includes the coordination or management
of your health care with a third party that has already obtained your
permission to have access to your PHI.
For example, WCPH & HC would disclose your PHI, as necessary, to a
hospital or pharmacy that provides care to you.
Another example is that PHI may be provided to a facility, such as a
nursing home, to which you have been referred, to ensure that the facility has
the necessary information to treat you.
2) Payment
WCPH & HC may use and disclose health care information
about you so that the treatment and services you receive may be billed to and
payment may be collected from you, an insurance company or a third party. For example, we may need to give your
insurance company information about the health care services we provide to you
so your insurance company will pay us for those services or reimburse you for
amounts you have paid. We also may need
to provide your insurance company or a government program, such as Medicare or
Medicaid, with information about your medical condition and the health care you
need to receive to determine if you are covered by that insurance or
program.
3) Healthcare Operations
WCPH & HC may use and disclose, your PHI in order to
support its business activities. These
activities include, but are not limited to, quality assessment activities,
employee review activities, licensing and conducting or arranging for other
business activities. For example, WCPH
& HC may use or disclose your PHI, as necessary,
to contact you to remind you of your appointment or to provide information
about alternate services or other health-related benefits.
WCPH
& HC may share your PHI with third party “business associates” that perform
various activities for WCPH & HC.
Whenever an arrangement between WCPH & HC and a business associate
involves the use or disclosure of your PHI, WCPH & HC will have a written
contract that contains terms that will protect the privacy of your PHI.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRING
YOUR WRITTEN AUTHORIZATION
Other uses and disclosures of your PHI will be made only with your
written authorization, unless otherwise permitted or required by law as
described below. You may revoke this
authorization, at any time, in writing, except to the extent that WCPH & HC
has taken an action in reliance on the use or disclosure indicated in the
authorization.
WCPH & HC may use and disclose your PHI in the following
instances. You have the opportunity to
agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or
object to the use or disclosure of the PHI, then WCPH & HC may, using
professional judgment, determine whether the disclosure is in your best
interest. In this case, only the PHI
that is relevant to your health care will be disclosed.
1)
Others
Involved in Your Healthcare
Unless you object, WCPH & HC may disclose to
a member of your family, a relative, a close friend or any other person you
identify, your PHI that directly relates to that person’s involvement in your
health care. If you are unable to agree
or object to such a disclosure, WCPH & HC may disclose such information as
necessary if WCPH & HC, based on its professional judgment, determines that
it is in your best interest. WCPH &
HC may use or disclose PHI to notify or assist in notifying a family member,
personal representative or any other person that is responsible for your care
of your location, general condition or death.
Finally, WCPH & HC may use or disclose your PHI to an authorized
public or private entity to assist in disaster relief efforts and to coordinate
uses and disclosures to family or other individuals involved in your health
care.
2)
Emergencies
WCPH & HC may use or disclose your PHI in an
emergency treatment situation. If this
happens, WCPH & HC shall try to obtain your acknowledgement of receipt of
the Notice of Privacy Practices as soon as reasonably practicable after the
delivery of treatment.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE
WITHOUT YOUR AUTHORIZATION OR
WCPH
& HC may use or disclose your PHI in the following situations without your
consent or authorization. These
situations include:
1)
Required
By Law
WCPH & HC may use or disclose your PHI to
the extent that the use or disclosure is required by law. You will be notified, as required by law, of
any such uses or disclosures.
2)
Public
Health
WCPH & HC may disclose your PHI for public
health activities and purposes to a public health authority that is permitted
by law to collect or receive the information.
The disclosure will be made for the purpose of controlling disease,
injury or disability. WCPH & HC may
also disclose your PHI, if directed by the public health authority, to a
foreign government agency that is collaborating with the public health
authority.
3)
Communicable
Diseases
WCPH & HC may disclose your PHI, if
authorized by law, to a person who may have been exposed to a communicable
disease or may otherwise be at risk of contracting or spreading the disease.
4)
Health
Oversight
WCPH & HC may disclose your PHI to a health
oversight agency for activities authorized by law, such as audits,
investigations and inspections.
Oversight agencies seeking this information include government agencies
that oversee the health care system, government benefit programs, other
government regulatory programs and civil rights laws.
5)
Abuse
or Neglect
WCPH & HC may disclose your PHI to a public
health authority that is authorized by law to receive reports of child abuse or
neglect. In addition, WCPH & HC may
disclose your PHI if it believes that you have been a victim of abuse, neglect
or domestic violence to the governmental entity or agency authorized to receive
such information. In this case, the
disclosure will be made consistent with the requirements of applicable federal
and state laws.
6)
Food
and Drug Administration
WCPH & HC may disclose your PHI to a person
or company required by the Food and Drug Administration to report adverse
events, product defects or problems, biologic product deviations, track
products; to enable product recalls; to make repairs or replacements, or to
conduct post marketing surveillance, as required.
7)
Legal
Proceedings
WCPH & HC may disclose PHI in the course of
any judicial or administrative proceeding, in response to an order of a court
or administrative tribunal (to the extent such disclosure is expressly
authorized), in certain conditions in response to a subpoena, discovery request
or other lawful process.
8)
Marketing
WCPH & HC may contact you to provide appointment reminders, newsletters, surveys or information about treatment alternatives and other health-related benefits and services that may be of interest to you. We will not provide your information to any third party for marketing purposes without receiving your previous authorization.
9)
Law
Enforcement
WCPH & HC may also disclose PHI, so long as
applicable legal requirements are met, for law enforcement purposes. These law
enforcement purposes include (1) legal processes and otherwise required by law,
(2) limited information requests for identification and location purposes, (3)
pertaining to victims of a crime, (4) suspicion that death has occurred as a
result of criminal conduct, (5) in the event that a crime occurs on WCPH &
HC premises, and (6) medical emergency (not on WCPH & HC’s premises) and it
is likely that a crime has occurred.
10)
Coroners,
Funeral Directors, and Organ Donation
WCPH & HC may disclose PHI to a coroner or
medical examiner for identification purposes, determining cause of death or for
the coroner or medical examiner to perform other duties authorized by law. We
may also disclose PHI to a funeral director, as authorized by law, in order to
permit the funeral director to carry out their duties. We may disclose such
information in reasonable anticipation of death. PHI may be used and disclosed
for cadaveric organ, eye or tissue donation purposes.
11)
Research
WCPH & HC may disclose your PHI to
researchers when their research has been approved by an institutional review
board that has reviewed the research proposal and established protocols to
ensure the privacy of your PHI.
12)
Criminal
Activity
Consistent with applicable federal and state
laws, WCPH & HC may disclose your PHI, if it believes that the use or
disclosure is necessary to prevent or lessen a serious and imminent threat to
the health or safety of a person or the public.
WCPH & HC may also disclose PHI if it is necessary for law
enforcement authorities to identify or apprehend an individual.
13)
Military
Activity and National Security
When the appropriate conditions apply, WCPH
& HC may use or disclose PHI of individuals who are Armed Forces personnel
(1) for activities deemed necessary by appropriate military command
authorities; (2) for the purpose of a determination by the Department of Veterans
Affairs of your eligibility for benefits, or (3) to foreign military authority
if you are a member of that foreign military services. WCPH & HC may also disclose your PHI to
authorized federal officials for conducting national security and intelligence
activities, including for the provision of protective services to the President
or others legally authorized.
14)
Workers’
Compensation
Your PHI may be disclosed by WCPH & HC as
authorized to comply with workers’ compensation laws and other similar legally
established programs.
15)
Inmates
WCPH & HC may use or disclose your PHI if
you are an inmate of a correctional facility and WCPH & HC created or
received your PHI in the course of providing care to you.
16)
Required
Uses and Disclosures
Under the law, WCPH & HC must make
disclosures to you and when required by the Secretary of the Department of
Health and Human Services to investigate or determine WCPH & HC compliance
with the requirements of 45 C.F.R. section 164.500 et. seq.
YOUR RIGHTS
The following is a list of your rights with respect to your PHI
and a brief description of how you may exercise these rights:
RIGHT TO INSPECT AND COPY YOUR PROTECTED HEALTH INFORMATION
This means you may inspect and obtain a copy of PHI about you that
is contained in a designated record set for as long as WCPH & HC maintains
the PHI. A “designated record set”
contains medical and billing records and any other records that WCPH & HC
uses in making decisions about you.
Under federal law, however, you may not inspect or copy the
following records; psychotherapy notes; information compiled in reasonable
anticipation of, or use in, a civil, criminal, or administrative action or
proceeding, and PHI that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to
deny access may be reviewable. In some circumstances, you may have a right to
have this decision reviewed. Please
contact WCPH & HC Privacy Officer if you have questions about access to
your medical record.
RIGHT TO REQUEST A RESTRICTION OF YOUR PROTECTED HEALTH
INFORMATION
This means you may ask WCPH & HC not to use or disclose any
part of your PHI for the purposes of treatment, payment or healthcare
operations. You may also request that
any part of your PHI not be disclosed to family members or friends who may be
involved in your care or for notification purposes as described in this Notice
of Privacy Practices. Your request must
state the specific restriction requested and to whom you want the restriction
to apply.
WCPH & HC is not required to agree to a restriction that you
may request if otherwise allowed by federal law. If WCPH & HC believes that it is in your
best interest to permit use and disclosure of your PHI, your PHI will not be
restricted. If WCPH & HC does agree
to the requested restriction, it may not use or disclose your PHI in violation
of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any
restriction you wish to request with WCPH & HC. You must make a written request for
restriction in writing to the WCPH & HC Privacy Officer.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS FROM WCPH & HC BY
ALTERNATIVE MEANS OR AT AN ALTERNATIVE LOCATION
You have the right to request that WCPH & HC communicate medical
information to you about you in a certain way or at a certain location. Unless
you inform WCPH & HC in writing, we may contact you by either telephone or
by mail at either your home or your workplace.
At either location, we may leave messages for you on either the
answering machine or voice mail.
If you would like to request confidential communication you must
do so in writing to your nurse or WCPH & HC Privacy Officer. Your request must state how or where you can
be contacted. We will not require you to
tell us why you are asking for the confidential communication. We will make every effort to accommodate your
reasonable request.
RIGHT TO REQUEST AN AMENDMENT TO YOUR PROTECTED HEALTH INFORMATION
This means you may request an amendment of PHI about you in a
designated record set for as long as WCPH & HC maintains this
information. In certain cases, WCPH
& HC may deny your request for an amendment. If WCPH & HC denies your request for
amendment, you have the right to file a statement of disagreement with WCPH
& HC and WCPH & HC may prepare a rebuttal to your statement and will
provide you with a copy of any such rebuttal.
RIGHT TO RECEIVE AN ACCOUNTING OF CERTAIN DISCLOSURES OF YOUR
PROTECTED HEALTH INFORMATION
This right applies to disclosures for purposes other than
treatment, payment or healthcare operations as described in this Notice of
Privacy Practices. It excludes
disclosures WCPH & HC may have made to you, to family members or friends
involved in your care, or for notification purposes. You have the right to receive specific
information regarding these disclosures that occur after April 14, 2003.
RIGHT TO OBTAIN A PAPER COPY OF THIS NOTICE
You have the right to obtain a paper copy of this notice, upon
request, even if you have agreed to accept this notice electronically.
COMPLAINTS
You may file a complaint to WCPH & HC or to the Secretary of
Health and Human Services if you believe your privacy rights have been violated
by WCPH & HC. You may file a
complaint against WCPH & HC by notifying WCPH & HC Privacy
Officer. WCPH & HC will not
retaliate against you for filing a complaint.
You
may contact the WCPH & HC Privacy Officer at (319) 653-7758 or 1-800-655-7758
for further information about the complaint process. This Notice of Privacy Practice may also be
found on the WCPH & HC Website at: co.washington.ia.us/departments/phn/index.html
This
notice was published and becomes effective on April 14, 2003.