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Lincoln Community Health Center, Inc.
Notice of Privacy Practices
Effective Date: 04.14.2003
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 NOTICE CAREFULLY.
Who We Are:
This Notice describes the privacy practices of Lincoln Community Health Center, Inc.
and the privacy practices of:
- all of our doctors, nurses, and other health care professionals authorized to enter
information about you into your medical chart.
- all of our departments, including, e.g., our medical records and billing
departments.
- all of our health center sites and off site programs as follows:
HIV Early Intervention Clinic located at the Durham County Health Department
Health Care for the Homeless located at the Community Shelter for HOPE
Promising Practices – Collaborative Program with Duke University Health Systems
Just For Us – Collaborative Program with Duke University Health Systems
John H. Lucas, Sr. Wellness Center located at Hillside High School
Lyon Park Clinic – Collaborative Program with Duke University Health Systems
Latino Access to Coordinated Healthcare (LATCH) – Collaborative Program with
DUHS
- all of our employees, staff, volunteers and other personnel who work for us or on
our behalf.
Our Pledge:
We understand that health information about you and the health care you receive is personal. We
are committed to protecting your personal health information. When you receive treatment and
other health care services from us, we create a record of the services that you received. We need
this record to provide you with quality care and to comply with legal requirements. This notice
applies to all of our records about your care, whether made by our health care professionals or
others working in this office, and tells you about the ways in which we may use and disclose your
personal health information. This notice also describes your rights with respect to the health
information that we keep about you and the obligations that we have when we use and disclose
your health information.
We are required by law to:
- make sure that health information that identifies you is kept private in accordance
with relevant law.
- give you this notice of our legal duties and privacy practices with respect to your personal
health information.
- follow the terms of the notice that is currently in effect for all of your personal health
information.
How We May Use and Disclose Your Health Information:
We may use and disclose your personal health information for these purposes:
For Treatment. We may use health information about you to provide you
with health care treatment or services. We may disclose health information about you to the
doctors, nurses, technicians, medical students and others who are involved in your care.
They may work at the Health Center, at the hospital if you are hospitalized under our
supervision, or at another doctor's office, lab, pharmacy or other health care provider to
whom we may refer you for treatment, consultation, x-rays, lab tests, prescriptions or other
health care service. They may also include doctors and other health care professionals who
work at the Health Center, or elsewhere, whom we consult about your care. For example,
we may consult with a specialist who lends his/her services to the Health Center about your
care or disclose to an emergency room doctor who is treating you for a broken leg that you
have diabetes, because diabetes may affect your body's healing process.
For Payment. We may use and disclose health information about you to
bill and collect payment from you, your insurance company, including Medicaid and
Medicare, or other third party that may be available to reimburse us for some or all of your
health care. We may also disclose health information about you to other health care
providers or to your health plan so that they can arrange for payment relating to your care.
For example, if you have health insurance, we may need to share information about your
office visit with your health plan in order for your health plan to pay us or reimburse you for
the visit. We may also tell your health plan about treatment that you need to obtain your
health plan's prior approval or to determine whether your plan will cover the
treatment.
For Health Care Operations. We may use and disclose health information
about you for our day-to-day operations, and may disclose information about you to other
health care providers involved in your care or to your health plan for use in their day-to-day
operations. These uses and disclosures are necessary to run the Health Center and to make
sure that all of our patients receive quality care, and to assist other providers and health plans
in doing so as well. For example, we may use health information to review the services that
we provide and to evaluate the performance of our staff in caring for you. We may also
combine health information about our patients with health information from other health care
providers to decide what additional services the Health Center should offer, what services
are not needed, whether new treatments are effective or to compare how we are doing with
others and to see where we can make improvements. We may remove information that
identifies you from this set of health information so others may use it to study health care
delivery without learning who our patients are.
Appointment Reminders. We may use and disclose health information
about you to contact you as a reminder that you have an appointment at the Health Center.
Health-Related Services and Treatment Alternatives. We may use and
disclose health information to tell you about health-related services or recommend treatment
options or alternatives that may be of interest to you. Please let us know if you do not wish
us to contact you with this information, or if you wish to have us use a different address
when sending this information to you.
Fundraising Activities. We may use health information about you to
contact you in an effort to raise money for our not-for-profit operations. We may disclose
health information about you to a foundation related to the Health Center so that the
foundation may contact you in raising money for the Health Center. We will only release
contact information, such as your name, address and phone number and the dates you
received treatment or services from us. Please let us know if you do not want us to contact
you for fundraising efforts.
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
health care or the person who helps pay for your care.
Communication Barrier. LCHC may use and disclose your PHI if your
provider or another provider in the practice attempts to obtain consent from you but is unable
to do so due to substantial communication barriers and the provider determines, using
professional judgment, that you intend to consent to use or disclose under the circumstances.
Research. Under certain circumstances, we may use and disclose health
information about you for research purposes. For example, a research project may involve
comparing the health and recovery of all patients who received one medication to those who
received another for the same condition. All research projects, however, are subject to a
special approval process. This process evaluates a proposed research project and its use of
health information, trying to balance the research needs with a patient's need for privacy.
Before we use or disclose health information for research, the project will have been
approved through this special approval process, although we may disclose health information
about you to people preparing to conduct a research project. For example, we may help
potential researchers look for patients with specific health needs, so long as the health
information they review does not leave our facility. We will almost always ask for your
specific permission if the researcher will have access to your name, address, or other
information that reveals who you are or will be involved in your care.
Organ and Tissue Donation. If you are an organ donor, we may disclose
health information about you to organizations that handle organ procurement or organ, eye
or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or
tissue donation and transplantation.
As Required By Law. We will disclose health information about you when
required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose
health information about you when necessary to prevent a serious threat to your health and
safety or the health and safety of the public or another person. Any disclosure, however,
would only be to someone able to help prevent the threat.
Military and Veterans. If you are a member of the armed forces or
separated/ discharged from military services, we may release health information about you
as required by military command authorities or the Department of Veterans Affairs as may
be applicable. We may also release health information about foreign military personnel to
the appropriate foreign military authorities.
Workers' Compensation. We may release health information about you
for workers' compensation or similar programs. These programs provide benefits for work-
related injuries or illness.
Public Health Activities. We may disclose health information about you
for public health activities. These activities generally include the following:
- to prevent or control disease, injury or disability.
- to report births and deaths.
- to report child abuse or neglect.
- to report reactions to medications or problems with products.
- to notify people of recalls of products.
- to notify a person who may have been exposed to a disease or may be at risk for
contracting or spreading a disease or condition.
- to notify the appropriate government authority if we believe a patient has been the
victim
of abuse, neglect, exploitation or domestic violence. We will only make this disclosure if
you agree or when required or authorized by law.
Health Oversight Activities. We may disclose health information about you to
a
health oversight agency for activities authorized by law. These oversight activities include, for
example, audits, investigations, inspections and licensure. These activities are necessary for the
government to monitor the health care system, government programs and compliance with civil
rights laws.
Lawsuits and Disputes. We may disclose health information about you in
response
to a court or administrative order. We may also disclose health information about you in
response
to a subpoena, discovery request or other lawful process that is not accompanied by a court or
administrative order, but only if efforts have been made to tell you about the request or to obtain
an
order protecting the information requested.
Law Enforcement. We may release health information about you if asked to do
so
by a law enforcement official:
- in response to a court order, subpoena, warrant, summons or similar process.
- to identify or locate a suspect, fugitive, material witness or missing person.
- under certain limited circumstances, about the victim of a crime.
- about a death we believe may be the result of criminal conduct.
- about criminal conduct at the Health Center.
- in emergency circumstances to report a crime, the location of the crime or victims,
or the identity, description or location of the person who committed the crime.
Coroners, Health Examiners and Funeral Directors. We may release health
information about our patients to a coroner or health examiner. This may be necessary, for
example, to identify a deceased person or determine the cause of death. We may also release
health information to funeral directors as may be necessary for them to carry out their duties.
National Security and Intelligence Activities. We may release health
information about you to authorized federal officials for intelligence, counterintelligence and
other national security activities authorized by law.
Protective Services for the President and Others. We may disclose health
information about you to authorized federal officials so they may provide protection to the
President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the
custody of a law enforcement official, we may release health information about you to the
corrections institution or law enforcement official. This release would be necessary (1) for the
institution to provide you with health care, (2) to protect your health and safety or the health and
safety of others, or (3) for the safety and security of the correctional institution.
Your Rights:
You have certain rights with respect to your personal health information. This section of our
notice describes your rights and how to exercise them:
Right to Inspect and Copy: You have the right to inspect and copy the
personal health information in your medical and billing records, or in any other group of records
that we maintain and use to make health care decisions about you. This right does not include
the right to inspect and copy psychotherapy notes, although we may, at your request and on
payment of the applicable fee, provide you with a summary of these notes.
To inspect and copy your personal health information, you must submit your request in
writing to our privacy contact person identified on the first page of this notice. If you request
a copy of the information, we may charge a fee for the copying and mailing costs, and for any
other costs associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If your
request is denied, you may request that the denial be reviewed. We will designate a licensed
health care professional to review our decision to deny your request. The person conducting
the review will not be the same person who denied your request. We will comply with the
outcome of this review. Certain denials, such as those relating to psychotherapy notes,
however, will not be reviewed.
Right to Amend: If you feel that the health information we maintain about you
is incorrect or incomplete, you may ask us to amend the information. You have the right to
request an amendment for any information that we maintain about you. To request an
amendment, your request must be made in writing, submitted to our privacy contact person
identified on the first page of this notice, and must be contained on one piece of paper legibly
handwritten or typed. In addition, you must provide a reason that supports your request for an
amendment.
We may deny your request for an amendment if it is not in writing or does not include a reason to
support the request. In addition, we may deny your request if you ask us to amend information
that:
- was not created by us, unless the person or organization that created the information
is no
longer available to make the amendment,
- is not part of the health information kept by or for the Health Center,
- is not part of the information which you would be permitted to inspect and copy, or
- is accurate and complete.
Any amendment we make to your health information will be disclosed to the health care
professionals involved in your care and to others to carry out payment and health care
operations, as previously described in this notice.
Right to Receive an Accounting of Disclosures. You have the right to
receive an accounting of certain disclosures of your health information that we have made. Any
accounting will not include all disclosures that we make. For example, an accounting will
not include disclosures:
- to carry out treatment, payment and health care operations as previously described
in this notice.
- pursuant to your written authorization.
- to a family member, other relative, or personal friend involved in your care or payment
for your care when you have given us permission to do so.
- to law enforcement officials.
Right to 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 operations. You also have the right to request a limit on the health information we
disclose about you to someone who is involved in your care or the payment for your care, such as
a family member or friend. For example, you may request that we not disclose information about
you to a certain doctor or other health care professional, or that we not disclose information to
your spouse about certain care that you received.
We are not required to agree to your request for restrictions if it is not feasible for us to
comply with your request or if we believe that it will negatively impact our ability to care for
you. If we do agree, however, we will comply with your request unless the information is needed
to provide emergency treatment. To request a restriction, you must make your request in writing
to our privacy contact person identified on the first page of this notice. In your request, you must
tell us what information you want to limit and to whom you want the limits to apply.
Right to Receive Confidential Communications. You have the right to request
that we communicate with you about health matters in a certain way. For example, you can ask
that we only contact you at work or by mail to a specified address.
To request that we communicate with you in a certain way, you must make your request in
writing to our privacy contact person identified on the first page of this notice. We will not ask
you the reason for your request. Your request must specify how or where you wish to be
contacted. We will accommodate all reasonable requests.
Right to a Paper Copy of this Notice. You have the right to receive a paper
copy of this notice at any time. To receive a copy, please request it from our privacy contact
person identified on the first page of this notice. You may also obtain a copy of this notice at our
website, at www.lincolnchc.org.
Changes to this Notice:
We reserve the right to change this notice and to make the changed notice effective for all of the
health information that we maintain about you, whether it is information that we previously
received about you or information we may receive about you in the future. We will post a copy
of our current notice in our facility. Our notice will indicate the effective date on the first page,
in the top right-hand corner. We will also give you a copy of our current notice upon request.
Complaints:
If you believe your privacy rights have been violated, you may file a complaint with us or with
the Secretary of the Department of Health and Human Services. You may file a complaint by
mailing, faxing or e-mailing us a written description of your complaint or by telling us about your
complaint in person or over the telephone:
Philip A. Harewood
Chief Privacy Officer
Lincoln Community Health Center
P. O. Box 52119
Durham, NC 27717-2119
Tel: (919) 956-4022
Fax: (919) 956-4501
E-Mail: phare1@mindspring.com
Siglinde Schulz
Assistant Privacy Officer
Lincoln Community Health Center
P. O. Box 52119
Durham, NC 27717-2119
Tel: (919) 956-4015
Fax: (919) 956-4535
E-Mail: schul030@lincolnchc.org
Please describe what happened and give us the dates and names of anyone involved. Please also
let us know how to contact you so that we can respond to your complaint. You will not be
penalized for filing a complaint.
Other Uses and Disclosures of Your Protected Health Information:
Other uses and disclosures of personal health information not covered by this notice or applicable
law will be made only with your written authorization. If you give us your written authorization
to use or disclose your personal health information, you may revoke your authorization, in
writing, at any time. If you revoke your authorization, we will no longer use or disclose your
personal health information for the reasons covered by your written authorization. You
understand that we are unable to take back any uses and disclosures that we have already made
with your authorization, and that we are required to retain our records of the care that we have
provided to you.
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