Notice of Privacy Practices for Community Health Centers of the Rutland Region

Get An Electronic Or Paper Copy Of Your Medical Record – You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your medical record.
• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request Confidential Communications

• You can ask us to contact you in a specific way (for example, cell, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.

Ask Us To Limit What We Use Or Share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get A List Of Those With Whom We Have Shared Information

• You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get A Copy Of This Privacy Notice – You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose Someone To Act For You

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  We will make sure the person has this authority and can act for you before we take any action.

File A Complaint If You Feel Your Rights Are Violated

• You can complain if you feel we have violated your rights by contacting the Community Health Privacy Officer at 802-855-2097 or patientrelations@chcrr.org.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to:
  200 Independence Avenue, S.W., Washington, DC 20201, or calling 1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  We will not retaliate against you for filing a complaint.You can complain if you feel we have violated your rights by contacting the Community Health Privacy Officer at 802-855-2097 or patientrelations@chcrr.org.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to: 200 Independence Avenue, S.W., Washington, DC 20201, or calling 1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.

For Certain Health Information, You Can Tell Us Your Choices About What We Share –

• If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care.
• Share information in a disaster relief situation.
• Include your information in a directory. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious/imminent threat to health or safety.

In These Cases We Never Share Your Information Unless You Give Us Written Permission

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In The Case Of Fundraising

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Health Information Exchange –

We participate in one or more health information exchanges (HIEs) such as the Vermont Information Technology Leaders (VITL) statewide exchange and may electronically share health information for treatment, payment and healthcare operations purposes with other participants in the HIE. An HIE allows health care providers to efficiently access a patient’s past medical history when the patient received care from other providers who participate in the HIE.

Vermonters have options for sharing information via the Vermont Health Information Exchange that include:

• Participating – no action is necessary.
• Learning more before deciding – more information is available at vthealthinfo.com and by calling the Vermont Health Information Exchange Hotline at 1.888.980.1243. The Health Care Advocate, a resource that is independent of the Health Information
• Exchange, is also available to answer questions through their helpline at 1.800.917.7787.
• Not participating – Vermonters can opt out of participating by filling out an online form at vthealthinfo.com, downloading a form from the same site to print, fill out, and mail in, or by calling the Vermont Health Information Exchange Hotline at 1.888.980.1243

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research.

We have to meet many conditions in the law before we can share your information for these purposes.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

 

Help With Public Health And Safety Issues

– We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do Research – We can use or share your information for health research.

Comply With The Law – We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond To Organ And Tissue Donation Requests – We can share health information about you with organ procurement organizations.

Work With A Medical Examiner Or Funeral Director – We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Workers’ Compensation, Law Enforcement, And Other Government Requests – We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security,
  and presidential protective services

Respond To Lawsuits And Legal Actions – We can share health information about you in response to a court or administrative order or in response to a subpoena.

Drug and Alcohol Abuse Treatment Records: Community Health Centers of the Rutland Region (CHCRR) will not release any drug or alcohol abuse treatment records protected under 42 CFR Part 2 (Part 2) without written authorization from the patient or his or her legal representative that meets the statute’s requirements for disclosure.

Psychotherapy Notes: In accordance with Vermont State Law, Community Health Centers of the Rutland Region will not release psychotherapy treatment notes unless the patient specifically requests in writing as part of a valid authorization to disclose information that said notes should be released. This means that authorizations requesting the “entire medical record” will NOT include psychotherapy notes unless they are specifically requested.

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/ understanding/consumers/index.html.

Help With Public Health And Safety Issues

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do Research

We can use or share your information for health research.

Comply With The Law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond To Organ And Tissue Donation Requests

We can share health information about you with organ procurement organizations.

Work With A Medical Examiner Or Funeral Director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address Workers’ Compensation, Law Enforcement, And Other Government Requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond To Lawsuits And Legal Actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Drug and Alcohol Abuse Treatment Records: Community Health Centers of the Rutland Region (CHCRR) will not release any drug or alcohol abuse treatment records protected under 42 CFR Part 2 (Part 2) without written authorization from the patient or his or her legal representative that meets the statute’s requirements for disclosure.

Psychotherapy Notes: In accordance with Vermont State Law, Community Health Centers of the Rutland Region will not release psychotherapy treatment notes unless the patient specifically requests in writing as part of a valid authorization to disclose information that said notes should be released. This means that authorizations requesting to “entire medical record” will NOT include psychotherapy notes unless they are specifically requested.

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request in our office and on our website.