Rice County, KS

NOTICE OF PRIVACY PRACTICES

This notice of Privacy Practices is effective as of April 14, 2003

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.

Privacy Officer

Rice County Emergency Medical Service (EMS)

Terry L. David

1488 Highway 56

Lyons, KS  67554

Phone 620-257-5200

 

Understanding your medical information its uses and disclosures:

Certain laws require that you be provided “Notice” of our privacy practices that relate to your medical information. Our privacy practices are contained with this “Notice.” This “Notice” applies to the protected health records of your care provided by Rice County and its employees, staff and volunteers. Your primary care physician, other health care or treatment providers, or your health insurance plan may have different privacy policies or “Notices” regarding the doctor’s, other provider’s, or the plan’s use and disclosure of your health information that are created outside of Rice County.

This “Notice” contains information in the following general categories:

            What is your health record/information?

            What are your health information rights?

What are the responsibilities of Rice County when it comes to your health information?

            How will Rice County use and disclose your medical information?

Other Uses and Disclosures revoking previous permission to use or disclose your health information.

            What should you do if you have a complaint concerning your medical records?

Rice County, Kansas

  If changes are made to this “Notice” how to obtain a revised copy.

What is your health record/information?

Each time you receive health-related treatment or care from a health department or another healthcare provider, a record of your visit is made. Typically, this record contains a history of your illnesses or injuries, symptoms, exam and laboratory results, treatment plans and treatments provided, and notes on future care. Depending on your health care situation, your record with each healthcare provider may contain more or different information. How your health information is used, is described on the following pages.

What are the responsibilities of Rice County when it comes to your health information?

Rice County is required by law to:

Keep your health information private and only disclose it when required to do so by law;

Explain Rice County’s legal duties and privacy practices in connection with your health records;

Obey the rules found in this “Notice”

Inform you when Rice County is unable to agree to a requested restriction that you have given us;

Accommodate your reasonable request for an alternative means of delivery, regarding destination, when sending your health information.  Rice County will not use or disclose your health information without your authorization, except as explained in this “Notice” or as required by law. Certain laws may require Rice County to disclose your health information without your authorization. Rice County is obligated to follow those laws.

What are your health information rights?

Although your health record is the physical property of Rice County, the information belongs to you.  You have the right to:

Inspect and Copy Your Records. You have the right to inspect and obtain a copy of certain health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes, information compiled in reasonable anticipation of, or use in, civil, criminal, or administrative actions or proceedings, information that is subject to special laws or other information not contained in the medical or billing records.  To inspect and obtain a copy of your protected health information maintained in the designated record set by Rice County, you must submit your request in writing. This request should include name, address, and description of records to be copied, and phone number, if necessary for contact or follow up. Information should include personal identification for requester and that of the client who’s protected health information is being requested. Personal identifiers include Social Security number and date of birth. A written request must be completed prior to Rice County providing the requested information. You must submit your request in writing to a Rice County Privacy Officer listed on page one. If you request a copy of the information, we may charge a reasonable fee for copying, including labor, supplies, and the cost of postage.

Rice County may deny your request to inspect and copy in certain very limited circumstances.

Certain reasons for the denial are not review able and some are review able. If you are denied access to health information, you will be told in writing. In certain circumstances, however, you may request that the denial be reviewed. If the original denial of access to the medical records was made by a licensed health care provider as allowed by law, another licensed healthcare professional chosen by Rice County will review your request and the denial. The person conducting the review will not be the person who denied your request. Rice County will comply with the outcome of the review. You will be advised in writing of this reviewing official’s decision.

Request an Amendment of Your Records.  If you feel that health information Rice County has

about you is incorrect or incomplete, you may ask us to correct or supplement the information. You have the right to request an amendment for as long as the information is kept by or for Rice County. To request an amendment, your request must be made in writing and submitted to a Rice County Privacy Officer listed on page one. In addition, you must provide a reason that supports your request.

Rice County may deny your request for an amendment if it is not in writing or does not include a reason to support the request. If your request for an amendment is denied, you have the right to file a statement of disagreement that will be included with any future disclosures of your health information.  Rice County may deny your request if you ask us to amend information that:

Was not created by Rice County, unless the person or entity that created the information is no longer available to make the amendment;

Is not part of the health information kept by or for Rice County;

Is not part of the information which you would be permitted to inspect and copy, or is accurate

and complete.

Accounting of Disclosures. You have the right to request, in certain circumstances, an “accounting of disclosures.” An “accounting” is a list of the disclosures Rice County has regarding your health information. An “accounting” will not include:

Internal uses of information for treatment, payment, or operations;

Disclosures made to you or made at your request, or

Disclosures made to family members or friends in the course of providing care.

To request this list or “accounting” of disclosures, you must submit your request in writing to a Rice County Privacy Officer listed on page one. Your request must state a time period, (which may not be longer than six years and may not include dates before April 14, 2003.) Your request should indicate in what form you want the list (e.g., on paper or electronically.) Rice County may charge you for the costs of providing the list. We will notify you of the costs involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction on the health information that Rice County uses or discloses about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health information Rice County discloses about you to someone who is involved in your care or the payment for your care (i.e., a family member or friend.) For example, you could ask that:

• Rice County not use or disclose information about a procedure you had done, or

Rice County not share specific information with certain people.

Rice County is not required to agree to your request. Only the Privacy Officer can agree to your request. If the Privacy Officer does agree, Rice County will notify you in writing and comply with your request. If Rice County agrees to a restriction we may:

Terminate any restriction with or without your agreement, or

Inform you that Rice County is terminating our agreement to the restriction.

You may also terminate any restriction.

How to make a request.

To request restrictions, you must make your request in writing to a Rice County Privacy Officer

listed on page one. In your request, you must tell us:

What information you want to limit;

Whether you want to limit our use, disclosure or both;

To whom you want the limits to apply (e.g., disclosures to your spouse).

Request Confidential Communications. You have the right to request that Rice County

communicates with you about medical matters in a certain way or at a certain location. For example, you can ask that Rice County only contact you at work or by mail. To request confidential communications, you must make your request in writing to a Rice County Privacy Officer listed on page one. Rice County will not ask you the reason for your request. Rice County may ask you for clarification so we can understand your request. You are not required to give an explanation.  Rice County will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

A Paper Copy of This “Notice”. You have the right to a paper copy of this “Notice”. You may ask Rice County to give you a copy of this “Notice” at any time. Even if you have agreed to receive this “Notice” electronically, you are still entitled to a paper copy of this “Notice”. To obtain a paper copy of this “Notice” you may contact a Rice County Privacy Officer listed on page one. You may also obtain a copy of this “Notice” at our website, www.oocities.org/ricecoems

How will Rice County use and disclose your health information?

For Treatment.  Rice County may use health information about you to provide you with health related treatment or care. Rice County may disclose health information about you to other treatment providers who are involved in your care. For example:

A nurse caring for you during your pregnancy will need to know if you have diabetes because

diabetes affects the growth of the baby during the pregnancy. The nurse may need to tell the

dietitian that you have diabetes so that your nutritional needs during pregnancy are considered in

your care.

CDDO staff may disclose treatment information to a Business Associate or Affiliate to request

services on your behalf.

Department on Aging staff may disclose treatment information to a Business Associate or

Affiliate to request services on your behalf.

Different departments of Rice County also may share health information about you in order to

coordinate the different services you need (i.e., medications, lab work, x-rays, etc.) Rice County

also may disclose health information about you to people outside Rice County who may be involved in your medical care while you are a client of Rice County (e.g., other doctors, nurses, advanced registered nurse practitioners, family members, clergy, etc.).

For Payment. Rice County may use and disclose health information about you for billing purposes so Rice County can collect payment from you, an insurance company or a third party. For example, Rice County may need to give your health insurance company information about a procedure you received at Rice County so we can be paid or you can be reimbursed for the procedure. Rice County may also tell your health plan about a treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations. Rice County may use and disclose health information about you for operations. These uses and disclosures are necessary to run Rice County and make sure all of our clients receive quality care. For example, Rice County may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. Rice County may disclose information to doctors, nurses, medical students, and other personnel for review and learning purposes. Additional uses and disclosures for “health care operations” include:

Activities related to improving health or reducing health care costs;

Protocol development;

Care management;

Training, certification, licensing, credentialing or other related activities;

Insurance-related functions;

Medical review and auditing functions, including fraud and abuse detection and compliance

programs;

Conducting or arranging for legal services for Rice County, or its personnel; and

Business planning and development, business management and general administrative activities

Internal grievance resolution.

Appointment Reminders. Rice County may use and disclose health information to contact you, a family member or friend involved in your health-related treatment or care (or as authorized by you) to remind you of an appointment for treatment or care at Rice County. Unless you tell us not to, we may also leave a reminder on your answering machine/voice mail system.

Treatment Alternatives. Rice County may use and disclose health information to tell you about, or recommend, possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services. Rice County may use and disclose health information to

tell you about health-related benefits or services that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care.  Rice County may release health information about you to a friend or family member who is involved in your health-related treatment or care. Rice County may also give information to someone who helps pay for your care. Rice County may disclose health information about you to an entity assisting in disaster relief effort so that your family can be notified about your condition, status and location. The amount of information disclosed will depend on that person’s particular involvement in your care. If you want this information restricted, you must tell us by using the required procedure.

Research. Under certain circumstances, Rice County may use and disclose health information about you for research purposes. For example, a research project may study the effects of early access to health care during pregnancy. All research projects are subject to a special approval process. This process evaluates a proposed research project and its use of health information, while balancing research needs with the client’s need for privacy of their health information. Before we use disclosure of health information for research, the project must be approved through the research approval process.

As Required by Law.   Rice County will disclose health information about you when required to do so by federal, state or local law. This may include reporting of communicable diseases, wounds, abuse, disease registries, health oversight matters and other public policy requirements. We may be required to report this information without your permission.

Rice County, Kansas

To Avert a Serious Threat to Health or Safety. Rice County may use and disclose health

information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, is limited to person(s) who can help prevent the threat.

Special situations: (Sharing of information without your permission)

Military and Veterans. If you are a member of the armed forces, Rice County may release health information about you as required by military command authorities.

Workers’ Compensation. Rice County may release health information about you for workers’

compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Activities.  Rice County may disclose health information about you without your

permission for public health activities. These activities generally include the following:

To prevent or control disease, injury or disability;

To report births and deaths;

To report child abuse or neglect;

To report adverse events, reactions to medications or problems with foods or products;

To notify people of recalls of products they may be using;

To notify a person who may have been exposed to a disease or may be at risk for contracting or

spreading a disease or condition; and

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.

Health Oversight Activities.  Rice County may disclose health information without your

permission 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, licensing functions, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or in a dispute, Rice County may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a court or administrative order even if you are not involved in the lawsuit or dispute. Health information about you may be disclosed in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested or as otherwise permitted by law.

Law Enforcement. Unless state law is more restrictive than HIPAA with regard to disclosure of certain records, Rice county may release health information if asked to do so by law enforcement officials:

In response to a court order, subpoena, warrant, summons or similar process;

To identify or locate a suspect, fugitive, material witness, or missing person;

About the victim of a crime if, under certain limited circumstances, we are unable to obtain

the person’s agreement; and

In emergency circumstances to report a crime, the location of a crime or victims, or the identity,

description or location of the person who committed the crime.

 

Rice County, Kansas

Coroners, Medical Examiners and Funeral Directors. Rice County may release health

information to a Coroner or Medical Examiner (e.g., to determine the cause of death).

National Security and Intelligence Activities. Rice County may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, Rice County may release health information about you to the correctional institution. This release would be necessary:

1) For the institution to provide you with health care;

2) To protect your health and safety or the health and safety of others; or

3) For the safety and security of the correctional institution.

Other uses and disclosures revoking previous permission to use or to disclose your health information:

Other uses and disclosures of health information not covered by this “Notice” or the laws that apply to Rice County will be made only with your written permission. For certain disclosures of your information, you must complete an “Authorization for Uses and Disclosure of Protected Health Information” form and submit it to Rice County. If you provide Rice County permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. To revoke any permission already given to Rice County or permission given to us in the future, you must revoke that permission in writing by sending it to a Rice County Privacy Officer listed on page one. If you revoke your permission, Rice County will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

What should you do if you have a complaint concerning your medical records?

If you believe your privacy rights have been violated, you may file a complaint with Rice County or with the Secretary of the Department of Health and Human Services (DHHS.) To file a complaint with Rice County or to receive additional information about how to file a complaint with the DHHS, contact a Rice County Privacy Officer listed on page one. All complaints must be submitted in writing. We cannot, and will not, require you to waive the right to file a complaint as a condition of receiving treatment from Rice County. You will not be penalized for filing a complaint.

If changes are made to this “Notice”:

Rice County reserves the right to change this “Notice”. Rice County reserves the right to make

the revised or changed “Notice” applicable to health information we already have about you, as well as, any information we receive in the future. Rice County will post a current copy of the “Notice” in all identified locations. You will find the date the “Notice” became effective at the top of the first page below the title. If a material change is made to the “Notice” you will be presented with a new version of the Notice of Privacy Practices. You will be asked to sign a new Notice of Privacy Practices Acknowledgement form. In addition, each time you register for services with Rice County, a copy of the current “Notice” in effect will be given to you if you request it.