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Emmet County Privacy Notice
Emmet County Courthouse
609 1st Avenue North
Estherville, IA 51334
Michele Erickson, Emmet County Auditor (Privacy Officer) (712)362-4261
Emmet County Mental Health Coordinator (712)362-2452
Emmet County Public Health Administrator (712)362-2490
EMMET
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.
ABOUT THIS NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices describes how the
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 or 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
physician 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 PROTECTED HEALTH INFORMATION REQUIRING YOUR WRITTEN AUTHORIZATION
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 taken an action in reliance on the use
or disclosure indicated in the authorization.
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.
15) Required Uses
and Disclosures
Under the law,
the County must make disclosures to you and when required by the Secretary of
the Department of Health and Human Services to investigate or determine County
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 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.
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 Contact 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 Contact.
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 County Privacy Officer for further information about the complaint
process.
Michele Erickson
Emmet County Auditor
609 1st Avenue North
Estherville, IA 51334
(712)362-4261
This notice
was approved on the 1st day of April, 2003 and became effective on
April 14, 2003.
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