PRIVACY PRACTICES
Stevens County Hospital/Medical Clinic
Notice of Privacy Practices

Your privacy regarding your healthcare information is a high priority for us. Stevens County Hospital/Medical Clinic is committed to the highest degree of confidentiality and safety for your records. We take all necessary steps to ensure that your records are available only to properly authorized individuals and/or agencies.

IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT:
STEVENS COUNTY HOSPITAL PRIVACY OFFICER: 620-544-8511

Your Rights Regarding Electronic Health Information Technology:

Stevens County Healthcare participates in electronic health information technology or HIT. This technology allows a provider or a health plan to make a single request through a health information organization or HIO to obtain electronic records for a specific patient from other HIT participants for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate safeguards to prevent unauthorized uses and disclosures.

You have two options with respect to HIT. First, you may permit authorized individuals to access your electronic health information through an HIO. If you choose this option, you do not have to do anything.

Second, you may restrict access to all of your information through an HIO (except as required by law). If you wish to restrict access, you must submit the required information either online at www.KanHIT.org or by completing and mailing a form. This form is available at www.KanHIT.org You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information.

If you have questions regarding HIT or HIOs, please visit www.KanHIT.org for additional information.

If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on access to your electronic health information. Please communicate directly with your out-ofstate health care provider regarding those rules.

Understanding Your Health Records and Information: Each time you visit SCH, a record of your visit is made. This record may contain your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment and billing-related information. This notice is about the health information we keep while you are receiving care at Stevens County Hospital (SCH), or Stevens County Medical Clinic (SCMH).

Our Responsibilities: The law requires that the Hospital/Clinic must do the following regarding the handling of your healthcare information:
*Maintain the privacy of your health information
*Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
*Abide by the terms of this notice
*Notify you if we are unable to agree to a requested restriction
*Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations

USES AND DISCLOSURES: How we may use and disclose health information about you
The following categories describe examples of the way we use and disclose health information:

For Treatment: We may disclose health information about you to doctors, technicians or other hospital personnel who are involved in your care. For example, a doctor treating your broken hip may need to know if you have diabetes because it could slow the healing process. Different facility departments may also share information about you in order to coordinate your needs, such as prescriptions, lab work, therapies and meals. We may also disclose your health information to service providers outside SCH/SCMC who may be involved in your treatment while you are a patient in Stevens County Hospital or at the Clinic.

For Payment: We will use your health information to obtain payment for the services we provide to you. To obtain prior approval, or to determine whether your plan will cover the treatment, we may disclose information about treatment or services.

For Health Care Operations: We may use or give out your health information to ensure we are giving you the best possible care. For example, we may use your health information to see how well our staff takes care of you. We may also combine health information about treatments. We may also disclose information to doctors, nurses, technicians and students for review and learning purposes. We may also combine health information we have with that of other hospitals to see where we can make improvements. We may remove identifying information from this disclosure to protect your privacy.

We May Also Use and Disclose Health Information:
*To business associates we have contracted with to perform a service and to bill for it
*To remind you of your appointment at our hospital/clinic
*To assess your satisfaction with our services
*To inform you of possible treatment alternatives
*To inform you of health-related benefits or services
*To contact you as part of fundraising efforts
*For population-based activities relating to improving health or reducing health care costs
*For conducting training programs or reviewing competence of health care professionals

When disclosing information—primarily appointment reminders and billing/collections efforts—we may leave messages on your answering machine/voice mail.

Business Associates: We may disclose your medical information to other entities that provide services to organizations for SCH that require the release of patient health information. Examples include: physician services in the emergency department and radiology, certain laboratory tests and entities contracted to provide billing services. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Directory: We may include certain limited information about you in SCH’s directory while you are a patient at SCH so your family, friends and clergy can visit you and know generally how you are doing. However, you may specifically request that we not include you in the registry when you register.

Individuals Involved in Your Care or Payment for Your Care: We may release health information about you to a friend or family member who is involved in your care or who helps pay for your care. Also, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

Research: We may disclose information to researchers. In many circumstances, your information may only be released with your written authorization. However, your information may be disclosed without your authorization when the research has been approved by a special committee that has reviewed the research proposal and established safeguards to ensure privacy for your health information, and under other certain other limited circumstances. Medical information about people who have died can be released without authorization under certain circumstances.

As required by law, we may also use and disclose health information regarding the following types of entities, including but not limited to:
*Food and Drug Administration
*Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability
*Correctional Institutions
*Workers Compensation Agents
*Organ and Tissue Donation Organizers
*Military Command Authorities
*Health Oversight Agencies
*Funeral Directors, Coroners and Medical Examiners
*National Security and Intelligence Agencies
*Protective Services for the President and Others

Law Enforcement/Legal Proceedings: We may disclose health information for law enforcement as required by the law or in response to a valid subpoena, discovery request, warrant, summons or similar process.

YOUR HEALTH INFORMATION RIGHTS:

Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you.

You have the right to:

Inspect and Copy: You have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care. This right does not apply to a very narrow category of medical information referred to as “psychotherapy notes.” Usually this includes medical and billing records. We may charge a fee for the costs of copying or other supplies associated with your request. We may deny your request to inspect and/or copy your medical information in certain circumstances. If you are denied access, you may request that the denial be reviewed. A licensed health care professional chosen by us will review your request and the denial. We will comply with the outcome of the review.

Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. Such a request must be in writing and you must state a reason for the amendment. We are not required by law to honor your request if we determine, among other things, that the record is accurate and complete.

An Accounting of Disclosures: You have the right to request an accounting of disclosures. This list of certain disclosures we make of your health information for purposes other than treatment, payment or health care operations where an authorization was not required.

Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operation. You can also ask that we limit information about you to a person who is giving you care or paying for care, such as a family member or friend. For example, you could ask that we not give out information about some treatment you have had or that we not tell certain people specific to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain manner or at a certain location. For example, you may ask that we only contact you at work or by mail.

A Paper Copy of this Notice: You have a right to a paper copy of this notice upon request.

We reserve the right to make changes to this notice and our protected health information policies in order to remain compliant with the HIPAA Privacy Rule.

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

Complaints: If you believe that your privacy rights have been violated, you may file a complaint with us. This complaint must be filed in writing and you may send it to the Privacy Officer or Administration. You may also file a complaint with the Secretary of the Department of Health and Human Services. Filing a complaint will not affect the quality of the services you receive and you may not be retaliated against for filing a complaint.