English-Notice of Privacy

Notice of Privacy Policies

Montgomery County Health Department

NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION

This Document Describes How Medical Information About You May

Be Used And Disclosed And How You Can Get Access To This Information.  Please Read This Notice Carefully.

This Notice of Privacy Practices applies to Montgomery County Health Department. We are committed to safeguarding your personal (protected) health information and to provide you with notice of our legal duties and privacy practices. We are required to abide by the terms of this notice so long as it remains in effect. We reserve the right to change the terms of this notice as necessary if the law changes and to make any new notice effective for all protected health information maintained by us.

OUR PRIVACY PROMISE TO YOU

Your health information is personal. Montgomery County Health Department is legally required to protect the privacy of your data. It does so in all aspects of its business. Montgomery County Health Department has policies about protecting the privacy of your data. These policies comply with State and Federal laws. Montgomery County Health Department uses and gives out your health information only for: 1) business operations related to providing your health care; 2) when required by law; 3) in responding to health or natural emergencies; or 4) when necessary to protect the public health and safety.

OUR RESPONSIBILITIES

The Montgomery County Health Department is required to:

Maintain the privacy of your health information. We will not use or disclose your health information without your authorization, except as described in this notice.

Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.

Abide by the terms of the notice currently in effect.  Notify you if we are unable to agree to a requested restriction/amendment.

Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

Notify you if this notice is revised. We reserve the right to change this Notice of Privacy Practices. We reserve the right to make the new notice’s provisions effective for all medical information that we maintain, including that created or received by us prior to the      effective date of the new notice.

Notice of Privacy Policies

Understanding Your Health Record/Information

Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. This record contains 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 identifies you, or there is a reasonable basis to believe

the information may identify you. For example, this information, often referred to as your health or medical record, serves as a:

Basis for planning your care and treatment means of communication among the many health professionals who are involved in your care.

Means by which you or a third-party payer can check that services billed were actually provided.

Your health record contains protected health information (PHI).

State and Federal law protects this information.  Understanding that we expect to use and share your health information helps you to:

1) make sure it is correct;

2) better understand who what, when, where and why others may access your health information; and

3) make more informed decisions when authorizing sharing with others.

Your Health information Rights

Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you. Under the Federal Privacy Rules, 45 CFR Part 164, you have the right to:

Request a restriction on certain uses and sharing of your information (though we are not required to agree to any such request). This means you may ask us not to use or share any part of your protected health information for purposes of treatment, payment or health care operation. You may also ask that this information not be disclosed to family members or friends who may be involved in your care.

Request that we send you confidential communications by alternative means or at alternative locations. Rule 522

Obtain a paper copy of the notice of information practices upon request.

Inspect and obtain a copy of your health record. Rule 524

Request that your health record containing protected health information (PHI) be changed. Rule 526

Obtain a listing of certain health information we were authorized to share for purposes other than treatment, payment or health care operations after April 14, 2003. Rule 528

Take back your authorization to use or share health information except to the extent that action has already been taken.

How We May Use and Disclose Your Personal (Protected) Health Information

Your personal health information is protected by law. We restrict the use and disclosure of personal health information to employees, business associates, and other individuals      or entities as necessary to carry out treatment, health care operation, and the other purposes as permitted by law and described in this notice. We may use and disclose your      protected health information to you in the manner and for the purposes described in this notice. We will not use or disclose your protected health information without your written authorization for any purposes except those specifically listed in this notice as not     requiring written authorization.

You may revoke your written authorization at any time by notifying us in writing to:

Privacy Officer, Montgomery County Health Department, 117 Civic Center, Mt. Sterling, entucky 40453. Your revocation will not affect any use or disclosure made by us in reliance on your prior authorization while it was in effect.

Use or Disclosure for Health Care/Treatment. We may use medical information about you to provide, coordinate or manage your health care and related services by both us and other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities that become involved in your care. We may consult with other health care providers concerning you and as part of the consultation share your medical information with them. Similarly, we may refer you to another health care provider and as part of the referral share medical information about you with that provider. For example, we may conclude you need to receive services from a physician with a particular specialty. When we refer you to that physician, we also will contact that physician’s office and provide medical information about you to them so they have information they need to provide services for you.

Use and Disclosures for Payment

We may use and disclose medical information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company, or a third party payor. 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 may also 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.

Use and Disclosure for Regular Health Operations

We may use and disclose medical information about you for our own health care operations. These are necessary for us to operate Montgomery County Health Department and to maintain quality health care for our patients. For example, we may use medical information about you to review the services we provide and the performance of our employees in caring for you. We may disclose medical information about you to train our staff and students working in Montgomery County Health Department. We also may use the information to study ways to more efficiently manage our organization.

When we may use or disclose protected health information without your written consent or authorization

We may use and disclose personal (protected) medical information about you without your written authorization for the following reasons.

To Contact You.

We may contact you by either by telephone or by mail at your home, your office, or at any alternate address or telephone number you have provided us to use. These contacts may be to remind you of an appointment, or relay other information regarding any health care services being provided by our agency. Telephone messages for you may be left on an answering machine, by voice mail, or we may utilize an automated service to remind you of any appointments. If you want to request that we communicate to you in a certain way or at a certain location, you may call or write to: HIPAA Privacy Officer, Montgomery County Health Department, 117 Civic Center, Mt. Sterling, Kentucky 40353, (859) 498-3808.

To Individuals Involved in Your Care

We may disclose your personal (protected) health information to a family member, friend, or other person involved in your health care. Under normal situations, we would obtain your written authorization to do so. However, if you are unable to do so because of a medical emergency, accident, incapacity or similar situation and we determine that disclosure would be in your best interest, we may disclose your personal health information without your written authorization. In these situations, we may disclose personal health information only to the extent necessary for your health care treatment or payment.

To Obtain or Share Childhood Immunizations Records

A policy of the Kentucky Department for Public Health permits the sharing of childhood immunization information with other local health departments within and outside the state as well as other facilities or institutions which require evidence of immunizations pursuant to state law, and other providers outside of local health departments who areproviding health care to a patient simultaneously or subsequently.

For Public Health Risks:

We may disclose personal (protected) health information about you for public health activities. These activities general include the following:

1) to prevent or control disease, injury or disability;

2) to report births and deaths;

3) to report child abuse or neglect;

4) to report reactions to medications or problems with products;

5) to notify people of recalls of products they may be using;

6) to notify person or organization required to receive information on FDA- regulated products;

7) to notify a person who may have been exposed to a disease or may be at risk for contracting or preading a disease or condition;

8) to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence (we will only make this disclosure if you agree or when required or authorized by law).

For Health Oversight Activities

We may disclose personal (protected) health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

To Coroners and Medical Examiners/Funeral Directors:

We may disclose medical information about you to a coroner or medical examiner for purposes such as identifying a deceased person and determining cause of death. We may disclose medical information about you to funeral directors as necessary for them to carry out their duties.

To Avert Serious Threat to Health or Safety:

We may use or disclose personal (protected) health information about you if we believe the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public. We also may release information about you if we believe the disclosure is necessary for law enforcement authorities to identify or apprehend an individual who admitted participation in a violent crime or who is an escapee from a correctional institution or from lawful custody.

For Judicial and Administrative Proceedings

If you are involved in a lawsuit or a dispute, we may disclose personal (protected) health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or other lawful process by someone else involved in a dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

For National Security and Intelligence:

In the event of a state or national emergency, we may disclose medical information about you to authorized state or federal officials to conduct intelligence, counter-intelligence, and other national security activities authorized by law. An example of this would be if you were or exposed infected with a biological or chemical agent as a result of a terrorist act and state and federal officials were conducting an investigation.

For Protective Services for the President:

We may disclose personal (protected) medical information about you to authorized federal officials so they can provide protection to the President of the United States, certain other federal officials, or foreign heads of state.

For Security Clearances:

We may use personal (protected) medical information about you to make medical suitability determinations and may disclose the results to officials in the United States Department of State for purposes of a required security clearance or service abroad.

On Inmates; On persons in Custody:

We may disclose personal (protected) medical information about you to a correctional institution or law enforcement official having custody of you. The disclosure would be made without your written authorization only if the disclosure is necessary:

(a) to provide health care to you;

(b) for the health and safety of others; or,

(c) the safety, security and good order of the correctional institution.

For Workers Compensation:

We may disclose personal (protected) medical information about you to the extent necessary to comply with workers’ compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.

To Business Associates:

Some of our services are performed through contractual agreements or business relationships with other providers known as business associates. At times, it may be necessary for us to provide certain portions of your personal (protected) health information to one or more of these persons or businesses that assist us with our health care operations. In all cases, we require these business associates to appropriately safeguard the privacy of your personal (protected) health information. Any subcontract entered by the business associate with whom we contract shall mandate that the subcontractor is required to abide by the same statutes and regulations regarding confidentiality of personal medical records as is the business associate.

Other Reasons:

Privacy laws also allow us to release personal (protected) health information for research purposes (under certain circumstances) as well as health information for cadaveric organ, eye, or tissue donation purposes. Due to the scope of our practice, disclosure for these purposes would be extremely rare, if at all.

COMPLAINTS

If you believe your privacy rights have been violated, and wish to make a complaint you may file a complaint by calling or writing any of the addresses listed below:

The HIPAA Privacy Officer at:

Montgomery County Health Department

117 Civic Center

Mt. Sterling, Kentucky 40353

859-498-3808

The Secretary of Health and Human Services at:

Secretary of Health and Human Services, Room 615F

200 Independence Ave. SW

Washington, D.C. 20201. For additional information, call

877-696-6775 United States Office of Civil Rights by calling 866-OCR-PRIV (866-627-7748) or 866-788-4989 TTY.

POLICY OF NON-RETALIATION

Montgomery County Health Department cannot take away your health care benefits or retaliate in ANY way if you choose to file a privacy complaint or exercise any of your privacy rights.

WHERE DO I SEND QUESTIONS OR REQUESTS?

To submit questions about your privacy rights or to submit a written request to Montgomery County Health Department regarding your privacy right, you may write or call our HIPAA Privacy Officer at: Montgomery County Health Department, 117 Civic Center, Mt. Sterling, Kentucky 40353, (859) 498-3808