| 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.
The Lee County Health Department
(LCHD) will provide health practitioners and clinicians in delivering
services to you. This may
include medical providers who are not part of LCHD's workforce.
All of these providers will follow this Notice of Privacy
Practices in delivering service to you.
These practitioners include: Medical Arts Clinic(MAC)/Swedish
American Hospital, KSB Medical Group,
The LCHD and the practitioners
involved in your care create a medical record of your health information
in order to treat you, receive payment for services delivered, and to
comply with certain policies and laws.
The uses and disclosures described in this Notice are applicable
to the health department and all of the practitioners who are part of
this Notice of Privacy Practices while they are delivering services at a
health department facility or on behalf of the health department.
This Joint Notice does not apply to service providers who are not
part of the health department when they deliver services elsewhere or
only on their own behalf. We are required by federal and state
law to maintain the privacy of your Personal Health Information (PHI).
We are also required by law to provide you with this Notice of
our legal duties and privacy practices.
In addition, the law requires us to ask you to sign an
Acknowledgment that you received this Notice.
Treatment:
We obtain medical information about you in treating you.
This medical information is called "protected health information"
or "PHI". Your PHI is used
by us to treat you. For
example, we refer to PHI in treating you at the health department.
We may also send your PHI to another physician or counselor to
which we refer you for treatment.
We may also use your PHI to contact you to tell you about
alternative treatments, or other health-related benefits we offer.
If you have a friend or family member involved in your care, we
may give them PHI about you.
Payment: We use your PHI to
obtain payment for the services that we render.
For example, we send PHI to Medicaid, Medicare, or your insurance
plan to obtain payment for our services.
Health Care Operations: We
use your PHI for our operations.
For example, we may use your PHI in determining whether we are
giving adequate treatment to our clients.
From time-to-time, we may use your PHI to contact you to remind
you of an appointment.
Legal Requirements:
We may use and disclose your PHI as required or authorized by
law. For example, we may
use or disclose your PHI for the following reasons:
Public Health: We may use
and disclose your health care information to prevent or control disease,
injury or disability, to report births and deaths, to report reactions
to medicines or medical devices,
to notify a person who may have been exposed to a disease, or to
report suspected cases of abuse, neglect or domestic violence.
Health Oversight Activities:
We may use and disclose your PHI to state agencies and federal
government authorities when required to do so.
We may use and disclose your health information in order to
determine your eligibility for public benefit programs and to coordinate
delivery of those programs.
For example, we must give PHI to the Secretary of Health and Human
Services in an investigation into our compliance with the federal
privacy rule.
Judicial and Administrative
proceedings: We may use and disclose your PHI in judicial and
administrative proceedings.
Efforts may be made to contact you prior to a disclosure of your PHI by
the party seeking the information.
Law Enforcement: We may use
and disclose your PHI in order to comply with requests pursuant to a
court order, warrant, subpoena, summons, or similar process.
We may use and disclose PHI to locate someone who is missing, to
identify a crime victim, to report a death, to report criminal activity
at our offices, or in an emergency.
Avert a Serious Threat to Health or
Safety: We may use or disclose your PHI to stop you or someone
else from getting hurt.
Work-Related Injuries: We
may use or disclose PHI to an employer if the employer is conducting
medical workplace surveillance or to evaluate work-related injuries.
Coroners, Medical Examiners, and
Funeral Directors: We may use or disclose PHI to a coroner or
medical examiner in some situations.
For example, PHI may be needed to identify a deceased person or
determine a cause of death.
Funeral directors may need PHI to carry out their duties.
Armed Forces: We may use or
disclose the PHI of Armed Forces personnel to the military for proper
execution of a military mission.
We may also use and disclose PHI to the Department of Veterans
Affairs to determine eligibility for benefits.
National Security and Intelligence:
We may use or disclose PHI to maintain the safety of the President or
other protected officials.
We may use or disclose PHI for the conduct of national intelligence
activities.
Correctional institutions and
custodial situations: We may use or disclose PHI to correctional
institutions or law enforcement custodians for the safety of individuals
at the correctional institution, those that are responsible for
transporting inmates, and others.
Research: You will need to
sign an Authorization form before we use or disclosure PHI for research
purposes except in limited situations.
For example, if you want to participate in research or a clinical
study, an Authorization form must be signed.
Fundraising:
If we undertake any fundraising activities, we may contact you
about the fundraising activity.
We do not engage in marketing activities, and need your
authorization to do so.
Illinois law:
Your Rights: You
have certain rights under federal privacy laws relating to your PHI.
Some of these rights are described below:
Restrictions: You have a
right to request restrictions on how your PHI is used for purposes of
treatment, payment and health care operations.
We are not required to agree to your request.
Communications:
You have a right to receive confidential communications about
your PHI. For example, you
may request that we only call you at home.
If your request is reasonable, we will accommodate it.
Inspect and Access:
You have a right to inspect information used to make decisions
about your care. This
information includes billing and medical record information.
You may not inspect your record in some cases.
If your request to inspect your record is denied, we will send
you a letter letting you know why and explaining your options.
You may copy your PHI in most situations. If you request a copy of your PHI, we may charge you a fee for making the copies and mailing them to you, if you ask us to mail them.
Amendments of your Records:
If you believe there is an error in your PHI, you have a right to
request that we amend your PHI.
We are not required to agree with your request to amend.
Accounting of Disclosures:
You have a right to receive an accounting of disclosures that we
have made of your PHI for purposes other than treatment, payment, and
health care operations, or release made pursuant to your authorization.
Copy of Notice:
You have a right to obtain a paper copy of this Notice, even if
you originally received the Notice electronically.
We have also posted this Notice at the health department offices.
Complaints:
If you feel that your privacy rights have been violated, you may
file a complaint with the health department by calling our Privacy
Officer at (815) 284-3371.
We will not retaliate against you for filing a complaint.
You may also file a complaint with the Secretary of Health and
Human Services in
We are required to abide with terms of
the Notice currently in effect, however, we may change this Notice.
If we materially change this Notice, you can get a revised Notice
on our website at
www.lchd.com, or by stopping by our office to pick up a copy.
Changes to the Notice are applicable to the health information we
already have.
If we seek help from individuals or
entities who are not part of this Notice in our treatment, payment, or
health care operations activities, we will require the those persons to
follow this Notice unless they are already required by law to follow the
federal privacy rule.
EFFECTIVE DATE: |