CPC
GENERAL
ASSISTANCE
PAYEE
SERVICES
HIPAA Privacy Policy
The following is an overview of the Lee County Privacy
Protection policy. The
CPC/General Assistance/Payee offices will provide the full copy of the counties HIPAA
(Health Information Portability and Accountability Act) and Privacy Practices Document for
individuals upon their written
request. This document is also available
on the
site: www.leecounty.org
If you have questions about this notice or if you think that we may have violated your privacy
rights, please contact:
Ryanne Wood
933 Avenue H-
Fort
Telephone: (319)372-5681
Toll Free: (866) 218-7574
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.
OUR PLEADGE REGARDING MEDICAL INFORMATION
The privacy of your medical information is important to us. We understand that your medical
information is personal and we are committed to protecting it. We create a record of the care
and services you receive at Lee County CPC/General Assistance Offices. We need this record
to provide you with quality care and to comply with certain legal requirements. This notice will
tell you about the ways we may use and share medical information about you. We also describe
your rights and certain duties we have regarding the use and disclosure of medical information.
OUR LEGAL DUTY
Law Requires Us to:
•Keep your medical information private.
•Give you this notice describing our legal duties, privacy practices, and your rights regarding
your medical information.
We Have the Right to:
•Change our privacy practices and the terms of this notice at any time, provided that the
changes are permitted by law.
•Make the changes in our privacy practices and the new terms of our notice
effective for all medical information that we keep, including information
previously created or received before the changes.
Notice of Change to Privacy Practices:
•Before we make an important change in our privacy practices, we will
change this notice and make the new notice available upon request.
USE AND DISCLOSURE OF YOUR MEDICAL
INFORMATION
The following section describes different ways that we use and disclose medical information.
Not every use or disclosure will be listed. However, we have listed all of the different ways we
are permitted to use and disclose medical information. We will not use or disclose your medical
information for any purpose not listed below, without your specific written authorization. Any
specific written authorization you provide may be revoked at any time by writing to us.
FOR TREATMENT: We may use medical information about you to provide you with medical
treatment or services. We may disclose medical information about you to doctors, nurses, counselors,
hospitals, pharmacies, or other people /institutions who are taking care of you. We may also share
medical information about you with other contracted care providers to assist them in treating you.
FOR PAYMENT: We may use and disclose your medical information for payment purposes.
FOR HEALTH CARE OPERATIONS: We may use and disclose your medical information for
our health care operations. These are necessary for us to operate our office and to maintain quality
health care for our consumers. We may also use the information to study ways to more effectively
manage our office and develop services to consumers in the community.
USE AND DISCLOSURE OF
YOUR MEDICAL INFORMATION
In addition to using and disclosing your medical information for treatment, payment, and health
care operations, we may use and disclose medical information for the following purposes.
Inner Office Directory: Unless you notify us that you object, the following medical information
about you will be placed in our directory: your name; your address; your condition described in
general terms; your service provider(s) and dates of service. Notification: Medical information to
notify or help notify: a family member, your personal representative or another person responsible
for your care. We will share information about your location, general condition, or death. If you are
present, we will get your permission if possible before we share, or give you the opportunity to
refuse permission. In case of emergency, and if you are not able to give or refuse permission, we will
share only the health information that is directly necessary for your health care, according to our
professional judgment. We will also use our professional judgment to make decisions in your best
interest about allowing someone to pick up medicine, medical supplies, or medical information for you.
Disaster Relief: Medical information with a public or private organization or person who can legally
assist in disaster relief efforts.
Research in Limited Circumstances: Medical information for research purposes in limited
circumstances where the research has been approved by a review board that has reviewed the research
proposal and established protocols to ensure the privacy of medical information.
Funeral Director, Coroner, and Medical Examiner: To help them carry out their duties, we may
share the medical information of a person who has died with a coroner, medical examiner, funeral
director, or an organ procurement organization.
Specialized Government Function: Subject to certain requirements, we may disclose or use health
information for military personnel and veterans, for national security and intelligence activities, for
protective services for the President and others, for medical suitability determinations for the
Department of State, for correctional institutions and other law enforcement custodial situations, and
for government programs providing public benefits.
Court Orders and Judicial and Administrative Proceedings: We may disclose medical information
in response to a court or administrative order, subpoena, discovery request, or other lawful process,
under certain circumstances. Under limited circumstances, such as a court order, warrant, or grand
jury subpoena, we may share your medical information with law enforcement officials. We may s
hare limited information with a law enforcement official concerning the medical information of a suspect,
fugitive, material witness, crime victim or missing person. We may share the medical information of an
inmate or other person in lawful custody with a law enforcement official or correctional institution
under certain circumstances.
Public Health Activities: As required by law, we may disclose your medical information to public
health or legal authorities charged with preventing or controlling disease, injury or disability, including
child abuse or neglect. We may also disclose your medical information to persons subject to jurisdiction
of the Food and Drug Administration for purposes of reporting adverse events associated with product
defects or problems, to enable product recalls, repairs or replacements, to track products, or to conduct
activities required by the Food and Drug Administration. We may also, when we are authorized by law
to do so, notify a person who may have been exposed to a communicable disease or otherwise be at risk
of contracting or spreading a disease or condition.
USE AND DISCLOSURE OF
YOUR MEDICAL INFORMATION
Victims of Abuse, Neglect, or Domestic Violence: We may disclose medical information to
appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect,
or domestic violence or the possible victim of other crimes. We may share your medical information
if it is necessary to prevent a serious threat to your health or safety or the health or safety of others.
We may share medical information when necessary to help law enforcement officials capture a person
who has admitted to being part of a crime or has escaped from legal custody.
Workers Compensation: We may disclose health information when authorized and necessary
to comply with laws relating to workers compensation or other similar programs.
Health Oversight Activities: We may disclose medical information to an agency providing health
oversight for oversight activities authorized by law, including audits, civil, administrative, or criminal
investigations or proceedings, inspections, licensure or disciplinary actions, or other authorized activities.
Law Enforcement: Under certain circumstances, we may disclose health information to law
enforcement officials. These circumstances include reporting required by certain laws (such as the
reporting of certain types of wounds), pursuant to certain subpoenas or court orders, reporting limited
information concerning identification and location at the request of a law enforcement official, reports
regarding suspected victims of crimes at the request of a law enforcement official, reporting death, crimes
on our premises, and crimes in emergencies.
YOUR INDIVIDUAL RIGHTS
You Have a Right to:
1.Look at or get copies of your medical information. You may request that we provide copies in a format
other than photocopies. We will use the format you request unless it is not practical for us to do so. You
must make your request in writing. You may get the form to request access by using the contact information ‘
listed at the end of this notice. You may also request access by sending a letter to the contact person listed
in this notice. If you request copies we will charge you $1.00 for each page, and postage if you want the
copies mailed to you. Contact us using the information listed at the end of this notice for a full explanation
of our fee structure.
2. Receive a list of all the times we or our business associates shared your medical information for
purposes other than treatment, payment and health care operations and other specified exceptions.
3. Request that we place additional restrictions on our use or disclosure of your medical information.
We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement
(except in the case of an emergency).
4. Request that we communicate with you about your medical information by different means or to
different locations. Your request that we communicate your medical information to you by different
means or at different locations must be made in writing to the contact person listed at the
end of this notice.
5. Request that we change your medical information. We may deny your request if we did not create
the information you want changed or for certain other reasons. If we deny your request, we will provide
you a written explanation. You may respond with a statement of disagreement that will be added to the
information you wanted changed. If we accept your request to change the information, we will make
reasonable efforts to tell others, including people you name, of the change and to include the changes in
any future sharing of that information.
6. If you have received this notice electronically, and wish to receive a paper copy, you have the right to
obtain a paper copy by making a request in writing to the Lee County CPC office.