OUR PRIVACY RESPONSIBILITIES UNDER HIPAA
Hope Clinic for Women promises to protect all health records in our possession. By providing you this Notice of Privacy Rights, we wish to inform you how we may use and disclose your health information and your rights regarding the health information we have in our possession.
HEALTH INFORMATION THAT WE MAINTAIN ABOUT YOU
We maintain records of:
- Your name and (if different) the name and relationship of the person receiving treatment;
- Your billing address;
- Your telephone number;
- Your (or the patient’s, if different) condition that brings you to Hope Clinic for Women;
- The date of your visit(s) to our Clinic;
- Clinical findings such as results of Pregnancy Tests, Limited Obstetric Ultrasound and any other diagnostic test or visit.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to:
- Request restrictions on certain uses and disclosures;
- Receive communications of protected health information by alternative means or at alternative locations;
- Inspect, copy and amend your protected health information held at Hope Clinic for Women and receive an accounting of certain disclosures (of your protected health information);
- Receive a paper copy of this notice even if you have received it electronically
HOW WE USE AND DISCLOSE YOUR HEALTH INFORMATION
We only use or disclose your health information as state and federal laws require or permit. In some cases, the law requires that you authorize the disclosure. In other cases, the law allows us to disclose your health information without your authorization.
Use and Disclosure Not Requiring Your Authorization
Treatment: We may use your health information for our treatment activities, such as disclosing it to other healthcare providers as helpful to treat you.
Healthcare Operations: We may use and disclose your health information to manage our program operations, such as reviewing the quality of services you receive or as required by the State of Oregon for reporting purposes.
Business Associates: We may disclose your health information to organizations that help us with our work. We have a written agreement that requires these organizations to use your health information for only the reasons necessary to do the work, and protect it from other uses or disclosures, just like we do.
To Contact You: We may use the information in your health records to contact you if we have information about treatment or other health-related benefits and services that may be of interest to you.
Other Permitted Uses and Disclosures
Federal and State law specifically permits us to use or disclose your health information for other purposes without your consent or authorization. In our experience such disclosures are rare, and the limited information we maintain is generally not applicable. However, when authorized by law, and to the extent we may have the information, law permits us to disclose it to:
- Comply with the requirements of federal, state, or local laws, court orders or other lawful process and for administrative or court proceedings;
- Report to a public health authority for the purpose of preventing or controlling disease, injury, or disability;
- Report to the FDA for the quality, safety or effectiveness of FDA-regulated products or activities;
- Notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition;
- Report abuse, neglect or domestic violence to a government authority;
- Provide necessary information to a health oversight agency for activities such as audits, investigations, inspections, licensure of the healthcare system, government benefit programs and regulated entities;
- A law enforcement official for specified law enforcement purposes;
- Coroners or medical examiners for identification or determining cause of death;
- Funeral directors to carry out their duties with respect to the decedent;
- Organ procurement organizations for facilitating donation and transplantation;
- Researchers conducting studies approved by an Institutional Review Board;
- Prevent or lessen a serious and imminent threat to the health or safety of a person or the public;
- Authorized federal officials for specialized government functions such as military and veteran’s activities; national security/intelligence activities; protective services for the president; medical suitability determinations; correctional institutions; government entities providing public benefits and comply with workers’ compensation laws.
Uses and Disclosures with Your Authorization – Other uses and disclosures of your personal information require your written authorization. You may revoke your authorization at any time by doing so in writing.
Additional Protections for Certain Information
- Confidential HIV related information for which additional protections are provided by state law;
- Alcohol or Substance Abuse Treatment information for which additional protections are provided by state law;
- Mental Health Treatment information for which additional protections are provided by state law.
HOW YOU CAN REACH US
If you want additional information about our privacy practices or if you believe Hope Clinic for Women has violated your privacy rights, you may file a complaint by contacting the Hope Clinic for Women Privacy/Compliance Officer at: PO Box 98, Roseburg, OR 97470. Hope Clinic for Women does not retaliate against people who file a complaint.