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 the
Cynthia Emery
This Notice of
Privacy Practices describes how Carroll County (hereafter referred to as
“County”) may use and disclose your protected health information 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 protected health information. “Protected health information” is 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.
The County is
required to abide by the terms of this Notice of Privacy Practices. The County
may change the terms of this notice, at any time. The new notice will be
effective for all protected health information that the County maintains at
that time. Upon request, the County will provide you with any revised Notice of
Privacy Practices.
PERMITTED USES
AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Your protected
health information may be used and disclosed by the County for the purpose of
providing or accessing health care services for you. Your protected health
information may also be used and disclosed to pay your health care bills and to
support the business operation of the County.
The following
categories describe ways that the County 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 the County is permitted to use and disclose
information falls into one of these categories:
1) Treatment:
The County may use and disclose your protected
health information 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 protected health information. For example, the County would
disclose your protected health information, as necessary, to a home health
agency that provides care to you. Another example is that protected health
information may be provided to a facility to which you have been referred to
ensure that the facility has the necessary information to treat you.
2) Payment
The County 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. The County may also discuss your protected health
information about a service you are going to receive to determine whether you
are eligible for the service, and for undertaking utilization review
activities. For example, authorizing a service may require that your relevant
protected health information be discussed with a provider to determine your
need and eligibility for the service.
3) Healthcare Operations
The County may use or disclose,
as-needed, your protected health information 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, the County may use or
disclose your protected health information, as necessary, to contact you to
remind you of your appointment or to provide information about alternate
services or other health-related benefits.
The County may share your protected
health information with third party “business associates” that perform various
activities (e.g., billing, transcription services) for the County. Whenever an
arrangement between the County and a business associate involves the use or
disclosure of your protected health information, the County will have a written
contract that contains terms that will protect the privacy of your protected
health information.
USES AND
DISCLOSURES OF PROTECED HEALTH INFORMATION THAT MAY BE MADE WITHOUT YOUR
AUTHORIZATION, BUT FOR WHICH YOU WILL HAVE AN OPPORTUNITY TO OBJECT
The County may use
and disclose your protected health information in the following instances. You
have the opportunity to agree or object to the use or disclosure of all or part
of your protected health information. If you are not present or able to agree
or object to the use or disclosure of the protected health information, then
the County may, using professional judgment, determine whether the disclosure
is in your best interest. In this case, only the protected health information
that is relevant to your health care will be disclosed.
1) Others
Involved in Your Healthcare
Unless you object, the County may
disclose to a member of your family, a relative, a close friend or any other
person you identify, your protected health information that directly relates to
that person’s involvement in your health care. If you are unable to agree or
object to such a disclosure, the County may disclose such information as
necessary if the County, based on its professional judgment, determines that it
is in your best interest. The County may use or disclose protected health
information 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, the County may use or disclose
your protected health information 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
The County may use or disclose your
protected health information in an emergency treatment situation. If this
happens, The County shall try to obtain your acknowledgment 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 OPPORTUNITY TO OBJECT
The County may use
or disclose your protected health information in the following situations
without your consent or authorization. These situations include:
1) Required
By Law
The County may use or disclose your protected
health information 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
The County may disclose your
protected health information 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. The County may also disclose your protected health
information, if directed by the public health authority, to a foreign
government agency that is collaborating with the public health authority.
3) Communicable
Diseases
The County may disclose your
protected health information, 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
The County may disclose your
protected health information 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
The County may disclose your
protected health information to a public health authority that is authorized by
law to receive reports of child abuse or neglect. In addition, the County may
disclose your protected health information 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
The County may disclose your
protected health information 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
The County may disclose protected
health information 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) Law Enforcement
The County may also disclose
protected health information, 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 county premises, and (6) medical emergency (not on
the county’s premises) and it is likely that a crime has occurred.
9) Coroners,
Funeral Directors, and Organ Donation
The County may disclose protected
health information 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 protected health
information 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. Protected health information may be used and
disclosed for cadaveric organ, eye or tissue donation
purposes.
10) Research
The County may disclose your protected
health information 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 protected health
information.
11) Criminal Activity
Consistent with applicable federal
and state laws, the County may disclose your protected health information, 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.
The County may also disclose protected health information if it is necessary
for law enforcement authorities to identify or apprehend an individual.
12) Military
Activity and National Security
When the appropriate conditions
apply, the County may use or disclose protected health information 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. The County may also disclose your protected health
information 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.
13) Workers’
Compensation
Your protected health information may
be disclosed by the County as authorized to comply with workers’ compensation
laws and other similar legally-established programs.
14) Inmates
The County may use or disclose your
protected health information if you are an inmate of a correctional facility
and the County created or received your protected health information in the
course of providing care to you.
USES AND
DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRING YOUR WRITTEN
AUTHORIZATION
All other uses and
disclosures of your protected health information 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 the County has already taken an action in reliance on the use
or disclosure indicated in the authorization.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
The following are a
list of your rights with respect to your protected health information 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 protected health information about you that is
contained in a designated record set for as long as the County maintains the
protected health information. A “designated record set” contains medical and
billing records and any other records that the County uses in making decisions
about you. The County may charge a
reasonable fee for you to copy any protected health information about you that
you have a right to access.
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 protected health
information that is subject to law that prohibits access to protected health
information. 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 the County 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 the County not to use or disclose any part of your protected health
information for the purposes of treatment, payment or healthcare operations.
You may also request that any part of your protected health information 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.
The County is not
required to agree to a restriction that you may request. If the County believes
that it is in your best interest to permit use and disclosure of your protected
health information, your protected health information will not be restricted.
If the County does agree to the requested restriction, it may not use or
disclose your protected health information 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 the County. You may request a
restriction in writing to the County Privacy Officer.
RIGHT TO REQUEST
CONFIDENTIAL COMMUNICATIONS FROM THE COUNTY BY ALTERNATIVE MEANS OR AT AN
ALTERNATIVE LOCATION
The County will
accommodate reasonable requests. The County may also condition this
accommodation by asking you for information as to how payment will be handled
or specification of an alternative address or other method of contact. The
County will not request an explanation from you as to the basis for the
request. Please make this request in writing to the County Privacy Officer.
RIGHT TO REQUEST AN AMENDMENT TO YOUR PROTECTED HEALTH
INFORMATION
This means you may
request an amendment of protected health information about you in a designated
record set for as long as the County maintains this information. In certain
cases, the County may deny your request for an amendment. If the County denies
your request for amendment, you have the right to file a statement of
disagreement with the County and the County 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 the County 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 the County or to the Secretary of Health and Human Services if you
believe your privacy rights have been violated by the County. You may file a
complaint against the County by notifying the County Privacy Officer. The
County will not retaliate against you for filing a complaint.
You may contact the
Carroll County Privacy Officer, Cynthia
Emery at 712-792-4845 for
further information about the complaint process.
WHO WILL FOLLOW THIS NOTICE
All designated County healthcare
component services, employees and volunteers of those services will follow this
Notice of Privacy Practices. In addition, all designated
healthcare component services
of Carroll County may share health information with each other for treatment,
payment or health care operation purposes.
The listing of designated healthcare component services is addressed in the Hybrid
Entity Resolution and can be obtained by contacting the Privacy Officer at
712-792-4845.
This notice was
published and becomes effective on April 14, 2003.