| Calhoun
County 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
Calhoun County's Privacy Officer: |
| Russell
Wood: Privacy Officer |
Phone
Number: (641) 425-8765 |
| 123
1st Ave SW |
| PO
Box 58 |
| Hampton
Iowa 50441 |
| This
Notice Of Privacy Practices describes how Calhoun County may use and
disclose your protected health information to carry out treatment,
payment or health care opertions and for other purposes that are permitted
or required by law. It also describes your rights to access and control
your protected health informtion. "Protected health information"
is informationabout 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. |
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| Calhoun
County is required to abide by the terms of this Notice Of Privacy
Practices. Calhoun County may change the terms of this notice, at
any time. The new notice will be effective for all protected health
information that Calhoun County maintains at that time. Upon requiest,
Calhoun County will provide you with any revised Notice of Privacy
Practices. |
| Permitted
Uses and Disclosures of Proteced Health Information |
| Your
protected health informtion may be used and disclosed by Calhoun
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 Calhoun County. |
| The
following categories describe ways that Calhoun County is permitted
to use and disclose health care information. Examples of types of
uses and disclosures however, all of the ways Calhoun County is permitted
to use and disclose information falls into one of these categories: |
| 1)
Treatment: |
| Calhoun
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 pary that has already obtained your permission to have access
to your protected health information. For example, Calhoun County
would disclose your protected helath information, as necessary, to
a home health agency that provides care to you. Another example is
that protected health informationmay be provided to a facility to
which you have been referred to ensure that the facility has th necessary
information to treat you. |
| 2)
Payment |
| Calhoun
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.
Calhoun 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 eligibilty for the service. |
| 3)
Healthcare Operations |
| Calhoun
County may uise or disclose, as-needed, your protected heatlh 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, Calhoun County may use or disclose your portected
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. |
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| Calhoun
County may share your protected health information with third party
"business associates" that perform various activities (e.g.,
billing, transcription services) for Calhoun County. Whenever an arrangement
between Calhoun County and a business associate involves the use or
disclosure of your protected health information, Calhoun County will
have a written contract that contains terms that will protect the
privacy of your protected health. |
| |
| Uses
and Disclosures of Protectedd Health Information Requiring Your Written
Authorization |
| Other
uses and disclosures of your protected health inforamtion will be
made only withyour 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 Calhoun County
has taken an action in reliance on the use or disclosure indicated
in authorization. |
| |
| Calhoun
County may use and disclose your protected health informationin the
following instances. You have the opportunity to agree or object to
the use 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 Calhun 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, Calhoun 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 healthcare. If you are unable to agree or object
to such a disclosure, Calhoun County may disclose such information
as necessary if Calhoun County, based on its professional judgment,
determines that is tis in your best interest. Clahoun County may use
or diclose 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, Calhoun 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 |
| Calhoun
County may use or disclose your protected health information in an
emergency treatment situation. If this happens, Calhoun 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. |
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| Other
Permitted and Required Uses and Disclosures That May Be Made Without
Your Authorization or Opportunity to Object |
| Calhoun
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 |
| Calhoun
County may use or disclose your protected health information to
the extent that the law requires the use or disclosure. You will
be notified, as required by law, of any such uses or disclosures.
|
| 2)
Public Health |
| Calhoun
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.
Calhoun 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 |
| Calhoun
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. |
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| 4)
Health Oversight |
| Calhoun
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 |
| Calhoun
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, Calhoun 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 |
| Calhoun
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 |
| Calhoun
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. |
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| 8)
Law Enforcement |
| Calhoun
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 Calhoun County’s premises) and it
is likely that a crime has occurred. |
| 9)
Coroners, Funeral Directors, and Organ Donation |
| Calhoun
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)
Reserach |
| Calhoun
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, Calhoun 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. Calhoun
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, Calhoun 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 service.
Calhoun 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 Calhoun County as
authorized to comply with workers’ compensation laws and other
similar legally established programs. |
| 14)
Inmates |
| Calhoun
County may use or disclose your protected health information if you
are an inmate of a correctional facility and Calhoun County created
or received your protected health information in the course of providing
care to you. |
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| 15)
Required Uses and Disclosures |
| Under
the law, Calhoun County shall make disclosures to you and when required
by the Secretary of the Department of Health and Human Services
to investigate or determine Calhoun County’s compliance with
the requirements of 45 C.F.R. section 164.500 et. seq. |
| |
| Your
Rights |
| 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 Calhoun County maintains the protected health information. A “designated
record set” contains medical and billing records and any other
records that Calhoun County 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 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 Calhoun County Privacy Officer if you have questions about access
to your medical record. |
| Right
To Request Confidential Communications from Calhoun County by Alternative
Means or at an Alternative Location |
| Calhoun
County will accommodate reasonable requests. Calhoun 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. Calhoun County will not request an explanation
from you as to the basis for the request. Please make this request
in writing to the Calhoun County Privacy Officer. |
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| 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 Calhoun County
maintains this information. In certain cases, Calhoun County may deny
your request for an amendment. If Calhoun County denies your request
for amendment, you have the right to file a statement of disagreement
with Calhoun County and Calhoun County may prepare a rebuttal to your
statement and will provide you with a copy of any such rebuttal. All
requests for amendments must be in writing. |
| 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 Calhoun 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. |
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| Complaints |
| You
may file a complaint to Calhoun County or to the Secretary of Health
and Human Services if you believe your privacy rights have been
violated by Calhoun County. You may file a complaint against Calhoun
County by notifying the Calhoun County Privacy Officer. Calhoun
County will not retaliate against you for filing a complaint. |
You
may contact Calhoun County Privacy Officer: Russell Wood
123 1st Ave. SW PO BOX 58 Hampton IA 50441 (641) 425-8765
for further information about the complaint process. |
| This
notice was published and becomes effective on April 14, 2003 |
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