Notice of Privacy Practices

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Ohio Department of Health

OTTAWA COUNTY HEALTH DEPARTMENT

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 THIS CAREFULLY.

 

What Protected Health Information Is

Protected Health Information (PHI) is individually identifiable information about your past, present, or future health or condition, the provision of health care to you, or payment for the health care. This notice describes the Ottawa County Health Department Privacy Practice that explains how, when and why we may use or disclose your PHI.

We are required to follow the privacy practices described in this notice, though we reserve the right to change our privacy practices and the terms of this notice at any time. If we do so, you may request a copy of the notice from the Ottawa County Health Department, 1856 E. Perry Street, Port Clinton, OH 43452.

Uses & Disclosures of Your Personal Health Information

Except for the items listed below, the Ottawa County Health Department will not use or disclose your personal health information for any purpose unless you have signed a form authorizing the use and disclosure. You have the right to revoke that authorization in writing unless we have taken any action in reliance on the authorization.

For Treatment: The Ottawa County Health Department may use or disclose your PHI to doctors, nurses and other health care personnel who are involved in your care or coordinating care. The Ottawa County Health Department may share your PHI with outside entities involved in your care including but not limited to pharmacists, laboratories, or other health care professionals.

To Obtain Payment: The Ottawa County Health Department may use or disclose your PHI in order to process bills for services rendered.

To Conduct Health Care Operations: The Ottawa County Health Department may use or disclose your health information for staff and contracted personnel for training purposes, compliance reviews, medical reviews, legal services, or quality assessment.

Appointment RemindersThe Ottawa County Health Department may contact you to provide appointment reminders. You have the right to request to receive communications regarding your personal health information from us by alternative means or at alternative locations. The Ottawa County Health Department will accommodate any reasonable request.

For Treatment AlternativesThe Ottawa County Health Department may use and disclose your health information to recommend or inform you of possible treatment options or alternatives that may be of interest to you.

Uses & Disclosures Not Requiring Your Authorization

When Required by Law: The Ottawa County Health Department may disclose PHI when it is required to do so by law. The Ottawa County Health Department is allowed to notify government authorities if the department believes a patient is the victim of abuse, neglect, domestic violence or suspected criminal activity. The Ottawa County Health Department will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

For Public Health Activities: The Ottawa County Health Department may disclose PHI for purposes in order to prevent or control disease, injury or to report vital statistics to the public health authority.

For Health Oversight Activities: The Ottawa County Health Department may disclose PHI for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.

Relating to Decedents: The Ottawa County Health Department may disclose PHI relating to an individual's death to coroners, medical examiners or funeral directors and to organ procurement organizations relating to organ, eye or tissue donations or transplants.

To Avert Threat to Health or Safety: The Ottawa County Health Department may, consistent with applicable law and ethical standards of conduct, disclose PHI in order to prevent or lessen a serious threat to health or safety to your health or to the health and safety of the public.

For Specific Government Functions: The Ottawa County Health Department may use or disclose your military and veterans health information in certain situations, to correctional facilities, government benefits program relating to eligibility and enrollment, and for national security reasons, such as protection of the President.

Use and Disclosure Requiring You to Object:  The Ottawa County Health Department may disclose a limited amount of PHI, if the department informs you in advance and you do not object, as long as law does not otherwise prohibit the disclosure. If there is an emergency situation and you cannot be given the opportunity to object, disclosure will be made if it is consistent with prior expressed wishes and disclosure is determined to be in your best interest. You must be informed and given an opportunity to object to further disclosure. As soon as you are, the Ottawa County Health Department may disclose a limited amount of PHI, if the department informs you in advance and you do not object, as long as law does not otherwise prohibit the ability to do so.

To Families, Friends or Others Involved in Your Care: The Ottawa County Health Department may share information directly related to your care, or payment for your care. The Ottawa County Health Department may share PHI to notify them about your general condition or death.

Your Rights Regarding Your Protected Health Information

To Request Restrictions on Uses/Disclosures: You have the right to ask the Ottawa County Health Department to limit how we use or disclose your PHI. You have the right to request a limit on the Ottawa County Health Department's disclosure of your health information to someone who is involved in your care or the payment of your care. The Ottawa County Health Department will consider your request, but is not legally bound to agree to the restriction.

To Choose How We Contact You: You have the right to ask that the Ottawa County Health Department send you information at an alternate address or by an alternative means. The Ottawa County Health Department must agree to your request as long as it is reasonably easy for us to do so. You have the right to ask the Ottawa County Health Department to conduct communication pertaining to your health information with you privately with no other family members present. The Ottawa County Health Department will attempt to honor your request except in emergency situations.

To Inspect and Copy Your PHI: You have a right to see your protected health information upon your written request. The Ottawa County Health Department will respond to your request within 30 days of receiving your request. If you want copies of your PHI, the Ottawa County Health Department may charge a fee for copying and assembling depending on the circumstances. You may request prior information on the cost.

To Request Amendment of Your PHI: If you believe that there is a mistake or missing information in the Ottawa County Health Department's record of your PHI, to correct or add to the record we must have your request in writing. We will respond to your request within 60 days of receiving your request. The Ottawa County Health Department may deny the request if we determine that the PHI is (1) correct and complete in the opinion of the Ottawa County Health Department (2) not created by the Ottawa County Health Department and/or not part of our records; or (3) the part you wish to amend you are not permitted to inspect or copy.

To Find Out What Disclosures Have Been Made: You have the right to get a list of when, to whom, for what purpose, and what content of your PHI has been released (other than disclosure for treatment, payment and operations). Your request for an accounting must be made in writing. The Ottawa County Health Department will respond to your request within 60 days of receiving your request. The list will not include any disclosures made before April 14, 2003. Your request can relate to disclosures going as far back as six (6) years but not earlier than April 14, 2003. In your request, you must specify the time period for the accounting to start on or after April 14, 2003. There will be no charge for up to one list each year. There may be a charge for more frequent requests.

To Receive This Notice: You have a right to receive a paper copy of this notice and/or an electronic copy by email upon request. You may obtain a copy of the current version of the Ottawa County Health Department's Notice of Privacy Practices at our website www.ottawahealth.org.

How to Complain About Our Privacy Practices

If you think we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the Health Commissioner, Ottawa County Health Department, 1856 E. Perry Street, Port Clinton, Ohio 43452 or by calling 419-734-6800. You may also file a written complaint with the Secretary of the U.S. Department of Health and Human Services, HHH Bldg., Room 440-D, Washington, DC 20201; Phone: 202-690-5896. The Ottawa County Health Department will take no retaliatory action against you if you make such complaints.

Contact Person for Information or to Submit a Complaint

If you have questions about this notice or any complaints about our privacy practices, please contact the Health Commissioner, Ottawa County Health Department, 1856 E. Perry Street, Port Clinton, OH 43452.

Effective Date

This notice is effective as of April 14, 2003.

 

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All Rights Reserved • Ottawa County Health Department
1856 E. Perry Street • Port Clinton, Ohio 43452 • (419) 734-6800
Toll-Free in Ottawa County 1-800-788-8803 • Fax: (419) 734-6888
You may contact us by email at info@ottawahealth.org
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