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NOTICE OF PRIVACY PRACTICES OF SOUTHEAST COLORADO HOSPITAL
DISTRICT
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.
Your health information is personal, and we are committed to protecting it.
Your health information is also very important to our ability to provide you
with quality care, and to comply with certain laws. This Notice applies to all
records about your care that occurs at our Hospital District, whether the
records are made by Hospital District personnel or by your physician. (Your
physician may have a different policies and a different notice regarding your
health information that is created in the physician's office.)
I. We Are Legally Required to Safeguard Your Protected Health Information.
We are required by law to:
maintain the privacy of your health information, also known as
"protected health information" or "PHI;"
provide you with this Notice, and
comply with this Notice.
II. Future Changes to Our Practices and This Notice. We
reserve the right to change our privacy practices and to make any such change
applicable to the PHI we obtained about you before the change. If a change in
our practices is material, we will revise this Notice to reflect the change. You
may obtain a copy of any revised Notice by contacting Administration at
Southeast Colorado Hospital District. We will also make any revised Notice
available at our Business Office, each nursing station, Medical Records
Department, and Reception Desks.
III. How We May Use and Disclose Your Protected Health Information. The
law requires us to have your written authorization to some uses and disclosures.
In other circumstances, the law allows us to use or disclose PHI without your
written authorization. This Section III gives examples of each of these
circumstances.
- Uses and Disclosures for Treatment, Payment and Health Care Operations
.
We may use or disclose your PHI to provide treatment to you. For
example, we may disclose your PHI to physicians, nurses, and other health care
personnel who are involved in your care. We may also use and disclose your PHI
to contact you as a reminder that you have an appointment for treatment at our
Hospital District, to tell you about or recommend possible treatment options
or alternatives, or about health-related benefits or services that may
interest you.
We may also use or disclose your PHI to your insurance carrier in
order to get paid for treatment provided to you. For example, we may
use your PHI to create the bills that we submit to the insurance company, or
we may disclose certain portions of your PHI to our business associates who
perform billing and claims processing services to us.
We may also use or disclose your PHI in order to operate this Hospital
District. For example, we may use your PHI to evaluate the quality of care
you received from us, or to evaluate the performance of those involved with
your care. We may also provide your PHI to our attorneys, accountants and
other consultants to make sure we are complying with the laws that affect us.
We may also provide your contact information (such as name, address and phone
number) and the dates you received services from us, to a foundation that
helps us with our fundraising efforts.
- Uses and Disclosures That Require Us to Give You the Opportunity to
Object.
If you do not object, we may include your name, location in our
Hospital District and general condition in the patient directory that
we use when responding to requests by those who ask for you by name. If you do
not object, we will also disclose information from the directory and your
religious affiliation to clergy who visit the Hospital District. Unless you
object, we may provide relevant portions of your PHI to a family member,
friend or other person you indicate is involved in your health care or in
helping you get payment for your health care. In an emergency or when you are
not capable of agreeing or objecting to these disclosures, we will disclose
PHI as we determine is in your best interest, but will tell you about it
later, after the emergency, and give you the opportunity to object to future
disclosures to family and friends. Unless you object, we may also disclose
your PHI to persons performing disaster relief notification activities.
- Certain Uses and Disclosures Do Not Require Your Written Authorization
Other than Treatment, Payment and Health Care Operations.
The law allows
us to disclose PHI without your written authorization in the following
circumstances:
(1) When Required by Law. We disclose PHI when we are required to do
so by federal, state or local law.
(2) For Public Health Activities. For example, we disclose PHI when
we report suspected child abuse, the occurrence of certain diseases, or
adverse reactions to a drug or medical device.
(3) For Reports About Victims of Abuse, Neglect or Domestic Violence.
We will disclose your PHI in these reports only if we are required or
authorized by law to do so, or if you otherwise agree.
(4) To Health Oversight Agencies. We will provide PHI as requested to
government agencies who have authority to audit or investigate our
operations.
(5) For Lawsuits and Disputes. If you are involved in a lawsuit or
dispute, we may disclose your PHI in response to a subpoena or other
lawful request, but only if efforts have been made to tell you about the
request or to obtain a court order that will protect the PHI requested.
(6) To Law Enforcement. We may release PHI if asked to do so by a law
enforcement official, in the following circumstances: (a) in response to
a court order, subpoena, warrant, summons or similar process; (b) to
identify or locate a suspect, fugitive, material witness or missing
person; (c) about the victim of a crime if, under certain limited
circumstances, we are unable to obtain the person's agreement; (d) about
a death we believe may be due to criminal conduct; (e) about criminal
conduct at our Hospital District; and (f) in emergency circumstances, to
report a crime, its location or victims, or the identity, description or
location of the person who committed the crime.
(7) To Coroners, Medical Examiners and Funeral Directors. We may
disclose PHI to facilitate the duties of these individuals.
(8) To Organ Procurement Organizations. We may disclose PHI to
facilitate organ donation and transplantation.
(9) For Medical Research. We may disclose your PHI without your
written authorization to medical researchers who request it for approved
medical research projects; however, with very limited exceptions such
disclosures must be cleared through a special approval process before
any PHI is disclosed to the researchers, who will be required to
safeguard the PHI they receive.
(10) To Avert a Serious Threat to Health or Safety. We may disclose
your PHI to someone who can help prevent a serious threat to your health
and safety or the health and safety of another person or the public.
(11) For Specialized Government Functions. For example, we may
disclose your PHI to authorized federal officials for intelligence and
national security activities that are authorized by law, or so that they
may provide protective services to the President or foreign heads of
state or conduct special investigations authorized by law.
(12) To Workers' Compensation or Similar Programs. We may provide
your PHI to these programs in order for you to obtain benefits for
work-related injuries or illness.
For some types of PHI, there may be stricter restrictions on our use or
disclosure of PHI. For example, drug and alcohol abuse patient treatment
information, HIV test results, mental health information, and genetic testing
results may be subject to greater protection of your privacy.
In general, we may disclose a minor patient’s PHI to a parent or guardian,
but we may deny the parent’s access to the minor patient’s PHI in some
situations.
IV. Other Uses and Disclosures of Your Protected Health Information.
Other uses and disclosures of your PHI that are not covered by this Notice or
the laws that apply to us will be made only with your written authorization. If
you give us written authorization for a use or disclosure of your PHI, you may
revoke that authorization, in writing, at any time. If you revoke your
authorization we will no longer use or disclosure your PHI for the purposes
specified in the written authorization, except that we are unable to take back
any disclosures we have already made with your permission, and are required to
retain certain records of the uses and disclosures made when the authorization
was in effect.
V. Your Rights Related to Your Protected Health Information. You have the
following rights:
The Right to Request Limits on Uses and Disclosures of Your PHI. You
have the right to ask us to limit how we use and disclose your PHI, as long as
you are not asking us to limit uses and disclosures that we are required or
authorized to make to the Secretary of the Federal Department of Health
Services, related to our Hospital District's patient directory, or any of the
disclosures described in Section III, above. Any such request must be submitted
in writing to the appropriate Medical Records Department. We are not required to
agree to your request. If we do agree, we will put it in writing and will abide
by the agreement except when you require emergency treatment.
The Right to Choose How We Communicate With You. You have the right to
ask that we send information to you at a specific address (for example, at work
rather than at home) or in a specific manner (for example, by e-mail rather than
by regular mail, or never by telephone). We must agree to your request as long
as it would not be disruptive to our operations to do so. You must make any such
request in writing, addressed to the appropriate Medical Records Department.
The Right to See and Copy Your PHI. Except for limited circumstances,
you may look at and copy your PHI if you ask in writing to do so. Any such
request must be addressed to the appropriate Medical Records Department, which
will respond to your request within 30 days (or 60 days if the extra time is
needed). In certain situations we may deny your request, but if we do, we will
tell you in writing of the reasons for the denial and explain your right to have
the denial reviewed.
If you ask us to copy your PHI, we will charge you $14.00 for the first 10
pages, $.50 per page for 11 to 50 pages and $.33 per page for more than 50
pages. Alternatively, we may provide you with a summary or explanation of your
PHI, as long as you agree to that and to the cost, in advance.
The Right to Correct or Update Your PHI. If you believe that the PHI we
have about you is incomplete or incorrect, you may ask us to amend it. Any such
request must be made in writing and must be addressed to the appropriate Medical
Records Department, and must tell us why you think the amendment is appropriate.
We will not process your request if it is not in writing or does not tell us why
you think the amendment is appropriate. We will act on your request within 60
days (or 90 days if the extra time is needed), and will inform you in writing as
to whether the amendment will be made or denied. If we agree to make the
amendment, we will ask you who else you would like us to notify of the
amendment.
We may deny your request if you ask us to amend information that:
(1) was not created by us, unless the person who created the information is
no longer available to make the amendment;
(2) is not part of the PHI we keep about you;
(3) is not part of the PHI that you would be allowed to see or copy; or
(4) is determined by us to be accurate and complete.
If we deny the requested amendment, we will tell you in writing how to submit
a statement of disagreement or complaint, or to request inclusion of your
original amendment request in your PHI.
The Right to Get a List of the Disclosures We Have Made. You have the
right to get a list of instances in which we have disclosed your PHI. The list
will not include disclosures we have made for our treatment, payment and health
care operations purposes, those made directly to you or your family or friends
or through our Hospital District directory, or for disaster notification
purposes. Neither will the list include disclosures we have made with your
written authorization, for national security purposes or to law enforcement
personnel, disclosure of limited data set, or disclosures made before April 14,
2003.
Your request for a list of disclosures must be made in writing and be
addressed to the appropriate Medical Records Department. We will respond to your
request within 60 days (or 90 days if the extra time is needed). The list we
provide will include disclosures made within the last six years, but not prior
to April 14, 2003, unless you specify a shorter period. The first list you
request within a 12-month period will be free. You will be charged our costs for
providing any additional lists within the 12-month period.
The Right to Get a Paper Copy of This Notice. Even if you have agreed to
receive the Notice by e-mail, you have the right to request a paper copy as
well. You may obtain a paper copy of this Notice by contacting the Medical
Records Department. The Notice is also available in our Business Office, each
nursing station, and Reception Desks.
VI. Complaints. If you believe your privacy rights have been violated,
you may file a complaint with us or with the Secretary of the Federal Department
of Health and Human Services. To file a complaint with us, put your compliant in
writing and address it to our Privacy Officer at Southeast Colorado Hospital
District. We will not retaliate against you for filing a complaint. You
may also contact our Privacy Officer if you have questions or comments about our
privacy practices.
VERSION#: 0001
EFFECTIVE DATE: 04/14/03
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