Notice of Privacy Practices

This notice is effective on April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATIONAL.
PLEASE READ IT CAREFULLY.

OUR LEGAL DUTY

We are required by law to maintain the privacy of your health information.  We are also required to give you this Notice about our privacy practices, our legal duties, and your rights concerning your health information.  We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect April 14, 2003.

We reserve the right to change our privacy practices and the terms of this notice at any time and to make the new Notice effective for all the medical information that we maintain.  We reserve the right to make changes retroactive. If we make changes to the Notice, we will (1) post the new Notice in our waiting area and (2) have copies of the new Notice available upon request.  You may contact us using the information listed at the end of this notice.

USES AND DISCLOSURES OF HEALTH INFORMATION

We use and disclose medical information about you to provide treatment, to obtain payment for that treatment, to operate our business efficiently, or for other mandated or authorized purposes.  This section of our Notice explains in some detail how we may use and disclose medical information about you in order to provide health care, obtain payment for that health care, and operate our business efficiently.  This section then briefly mentions several other circumstances in which we may use or disclose medical information about you.  Not every use or disclosure in a category will be listed.  However, all of the ways we are permitted to use and disclose your health information will fall in one of these categories.

Treatment: We may use and disclose medical information about you to provide health care treatment to you.  In other words, we may use and disclose medical information about you to provide, coordinate or manage your health care and related services. For example, if we refer you to a physician for a service that we cannot provide, your health information will be provided to that office.

Payment: We may use and disclose medical information about you to obtain payment for health care services that you received. This means that, within the health department, we may use medical information about you to arrange for payment (such as preparing bills and managing accounts). We also may disclosemedical information about you to others (such as insurers, collection agencies, and consumer reporting agencies). In some instances, we may disclose medical information about you to an insurance plan beforeyou receive certain health care services because, for example, we may want to know whether the insurance plan will pay for a particular service.

Health care operations: We may use and disclose medical information about you in performing a variety of business activities that we call “health care operations”. The “health care operations” activities allow us to, for example, improve the quality of care we provide and reduce health care costs.  For example, we may use or disclose medical information about you in performing the following activities:

• Reviewing and evaluating the skills, qualifications, and performance of health care providers taking care of you.
• Providing training programs for students, trainees, health care providers or non-health care professionals to help then with practice or improve their skills.
• Cooperating with outside organizations that evaluate, certify, or license health care providers, staff or facilities in a particular field or specialty.
• Reviewing and improving the quality, efficiency and cost of care that we provide to you and to other patients.
• Improving health care and lowering costs for groups of people who have similar health problems and helping manage and coordinate the care for these groups of people.
• Cooperating with outside organizations that assess the quality of the care others and we provide, including government agencies and private organizations.
• Planning for our organization’s future operations.
• Resolving grievances within our organization.
• Reviewing our activities and using or disclosing medical information in the event that control of our organization significantly changes.
• Working with others (such as lawyers, accountants, and other providers) who assist us to comply with this Notice and other applicable laws.

Persons involved in your care: We may disclose medical information about you to a relative, close personal friend or any another person you identify if that person is involved in your care and the information is relevant to your care.  If the patient is a minor, we may disclose medical information about the minor to a parent, guardian or other person responsible for the minor except in limited circumstances.  We may also use or disclose medical information about you to a relative, another person involved in your care or possibly a disaster relief organization (such as the Red Cross) if we need to notify someone about your location or condition.  You may ask us at any time not to disclose medical information about you to persons involved in your care. We will agree to your request and not disclose the information except in certain limited circumstances (such as emergencies) or if the patient is a minor.  If the patient is a minor, we may not be able to agree to your request.

Required by law: We will use and disclose medical information about you whenever we are required by law to do so.  There are many state and federal laws that require us to use and disclose medical information.  For example, state law requires us to report certain injuries to the police and to report known or suspected child abuse or neglect to the Department of Social Services.  We will comply with those state laws and with all other applicable laws.

To provide appointment reminders: We may disclose limited medical information about you to send you reminders about an appointment such as voicemail messages, telephone calls, postcards or letters.

National priority uses and disclosures: When permitted by law, we may use or disclose medical information about you without your permission for various activities that are recognized as “national priorities”. In other words, the government has determined that under certain circumstances (described below), it is so important to disclose medical information that it is acceptable to disclose medical information without the individual’s permission.  We will only disclose medical information about you in the following circumstance when we are permitted to do so by law.

• Threat to health or safety: We may use or disclose medical information about you if we believe it is necessary to prevent or lessen a serious threat to health or safety. 
• Public health activities: We may use or disclose medical  information about you for public health activities.  Public health activities require the use of medical information for various activities, including, but not limited to, activities related to investigating disease, reporting child abuse and neglect, monitoring drugs or devices regulated by the Food and Drug Administration, and monitoring work-related illnesses or injuries.  For example, if you have been exposed to a communicable disease (such as a sexually transmitted disease), we may report it to the state and take other actions to prevent the spread of the disease. 
• Abuse, neglect or domestic violence: We may disclose medical information about you to a government authority (such as the Department of Social Services) if you are an adult and we reasonable believe that you may be a victim of abuse, neglect, or domestic violence. 
• Health oversight activities: We may disclose medical information about you to a health oversight agency ­– which is basically an agency responsible for overseeing the health care system or certain government programs.  For example, a government agency may request information from us while they are investigating possible insurance fraud. 
• Court proceedings: We may disclose medical information about you to a court or an officer of the court (such as an attorney). For example, we would disclose medical information about you to a court if a judge orders us to do so. 
• Law enforcement: We may disclose medical information about you to a law enforcement official for specific law enforcement purposes.  For example, we may disclose limited medical information about you to a police officer if the officer needs the information to help find or identify a missing person. 
• Coroners and others: We may disclose medical information about you to a coroner, medical examiner, or funeral director or to organizations that help with organ, eye, and tissue transplants. 
• Workers’ compensation: We may disclose medical information about you in order to comply with workers’ compensation laws. 
• Research organizations: We may use or disclose medical information about you to research organizations if the organization has satisfied certain conditions about protecting the privacy of medical information. 
• Certain government functions: We may use or disclose medical information about you for certain government functions, including but not limited to  military and veterans’ activities and national security and intelligence activities.  We may also use or disclose medical information about you to a correctional institution in some circumstances. 

Treatment alternatives: We may use and/or disclose medical information about you in order to inform you of or recommend new treatment or different methods of treating a medical condition that you have or to inform you of other health related benefits and services that may be of interest to you.

Right to a copy of this notice: You have a right to have a paper copy of our Notice of Privacy Practices at any time. In addition, a copy of this Notice will always be posted in our waiting area.  If you would like to have a copy of our Notice, ask the receptionist for a copy or contact our Privacy Officer.

Right of access to inspect and copy: You have the right to inspect (which means to see or review) and receive a copy of medical information about you that we maintain in certain groups of records.  If you would like to inspect or receive a copy of medical information about you, you must provide us with a request in writing and a reason why you want to inspect your record.  We may deny your request in certain circumstances. If we deny your request, we will explain our reason for doing so in writing. We will also inform you in writing if you have the right to have our decision reviewed by another person.  If you would like a copy of the information, we will charge you a fee to cover the costs of the copy.  The fee for a copy is $0.25 (twenty-five cents) for each page of copy. We may be able to provide you with a summary or explanation of the information.

Right to have medical information amended: You have the right to have us amend (which means correct or supplement) medical information about you that we maintain in certain groups of records.  If you believe that we have information that is either inaccurate or incomplete, we may amend the information to indicate the problem and notify others who have copies of the inaccurate or incomplete information.  If you would like us to amend information, you must provide us with a request in writing.  We may deny your request in certain circumstances.  If we deny your request, we will explain our reason for doing so in writing.  You will have the opportunity to send us a statement explaining why you disagree with our decision to deny your amendment request and we will share your statement whenever we disclose the information in the future.

Right to an accounting of disclosures we have made:  You have the right to receive an accounting (which means a detailed listing) of disclosures that we have made for the previous six (6) years.  If you would like to receive an accounting, you may send us a letter requesting an accounting to the address listed below. The accounting will not include several types of disclosures, including disclosures for treatment, payment or health care operations.  It will also not include disclosures made prior to April 14, 2003.

If you request an accounting more than once every twelve (12) months, we may charge you a fee to cover the costs of preparing the accounting.  A fee of $0.25 (twenty-five cents) per sheet of copy will be charged.

Right to request restrictions on uses and disclosures: You have the right to request that we limit the use and disclosure of medical information about you for treatment, payment and health care operations.  We arenot required to agree to your request. If we do agree to your request, we must follow your restrictions (except if the information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, we may cancel a restriction at any time as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.

Right to request an alternative method of contact: You have the right to request to be contacted at a different location or by a different method.  For example, you may prefer to have all written information mailed to your work address rather than to your home address.  We will agree to any reasonable request for alternative methods of contact.  If you would like to request an alternative method of contact, you must provide us with a request in writing.

Acknowledgement

Wilkes County Health Department will make a “Good Faith” effort to obtain a written acknowledgment that the individual (or his or her personal representative) has received a Notice (except in emergency treatment situations).

Questions and Complaints

If you believe that your privacy rights have been violated or if you are dissatisfied with our privacy policies or procedures, you may file a complaint either with us or with the federal government.  We will not take any action against you or change our treatment of you in any way if you file a complaint.  You must describe the acts or omissions believed to be in violation of the applicable requirement. The complaint must be filed within 810 days of when the acts or omissions believed to have occurred. To file a written complaint with the health department, you may bring your complaint to the Privacy Officer or you may mail it to the following address:

Wilkes County Health Department
306 College Street
Wilkesboro, North Carolina 28697
Attention: Privacy Officer
Telephone Number: (336) 651-7450

You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request.