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. If you have any questions about this Notice please contact a customer representative from central registration.This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical condition.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices at central registration.
Uses and Disclosures of Protected Health Information After Client Signs a Consent to Treatment Form:When you receive treatment after signing your consent form at one of the clinics within the Kansas City, Missouri Health Department, your health record is the physical property of our Department. The information in your health records belongs to you. A copy of your record may be transferred to another healthcare provider when you sign an authorization to disclose your records. Your health information rights are as follows:
- You may request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522
- You may inspect and obtain a copy of your health record as provided for in 45 CFR 164.524
- You may ask for an amendment on your health record as provided in 45 CFR 164.528
- You may obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528
- You may revoke your authorization to use or disclose health information except to the extent that action has already been taken
Examples of Disclosures for Treatment, Payment and Healthcare Operations That May Be Made Without Your Consent or Authorization: TREATMENT:
We will use and disclose your protected health information to provide, coordinate, or manage your healthcare among staff members in the direct line of service within the Kansas City, Missouri Health Department.
If you are an active member of a Medicaid plan, the Kansas City, Missouri Health Department may use your protected health information, as needed, to obtain payment for your healthcare services.
Members of our clinical staff, quality improvement teams, or other staff member who participated in your treatment may use information in your health record to assess the care and outcomes in your case. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and services we provide.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Consent or Authorization:We may use or disclose your protected health information in the following situations without your consent or authorization. These situations include:
Required By Law: We may use or disclose your protected health information to the extent that law requires the use or disclosure. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, as required by law, of any such uses or disclosures.
Public Health: State Law mandates certain communicable diseases must be reported to other public health agencies including the State Department of Health. The disclosure will be made for the purpose of controlling disease.
Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court.
You may complain to the Kansas City, Missouri Health Department or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with the Health Department by notifying our Privacy Officer. We will not retaliate against you for filing a complaint.
I HAVE READ AND UNDERSTAND THE ABOVE PROVISIONS REGARDING THE USE OF MY MEDICAL INFORMATION, AND I HAD THE OPPORTUNITY TO ASK QUESTIONS ABOUT IT.
I VOLUNTARILY, AND WITHOUT COMPULSION, GIVE MY CONSENT TO USE MY MEDICAL INFORMATION AS PROVIDED ABOVE.