Effective as of April 8, 2003

Wyoming County Notice of Privacy Practices

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.

Wyoming County uses health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of Wyoming County.

How Wyoming County May Use of Disclose Your Health Information

For Treatment: Wyoming County may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services to your, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.

• With your permission, we may share your health information with a family member, relative, or close personal friend who is involved in your care or payment for that care.
• We may use or disclose your health information if you need emergency treatment or if we are required by law to treat you but are unable to obtain your consent.

For Payment: Wyoming County may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payor, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.

For Health Care and Business Operations: Wyoming County may use and disclose health information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:

• Evaluate the performance of our staff;
• Assess the quality of care and outcomes in your cases and similar cases;
• Learn how to improve our facilities and services; and
• Determine how to continually improve the quality and effectiveness of the health care we provide.

Appointments: Wyoming County may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual.

Required by Law: Wyoming County may use and disclose information about you as required by law. For example, Wyoming County may disclose information for the following purposes:

• For judicial and administrative proceedings pursuant to legal authority;
• To report information related to victims of abuse, neglect or domestic violence; and
• To assist law enforcement officials in their law enforcement duties;

Public Health: Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.

Decedents: Health information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.

Organ/Tissue Donation: Your health information may be used or disclosed for cadaveric organ, eye or tissue donation purposes.

Health and Safety: Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

Government Functions: Your health information may be disclosed for specialized government functions such as protection pf public officials or reporting to various branches of the armed services.

Workers’ Compensation: Your health information may be used or disclosed in order to comply with laws and regulations related to Workers’ Compensation.

Other Uses: Other uses and disclosures will be made only with your written authorization and you may revoke the authorization except to the extent Wyoming County has taken in reliance on such.

Your Health Information Rights

You have the right to:

• Request a restriction on certain uses and disclosures or your information; however, Wyoming County is not required to agree to a requested restriction;
• Obtain a paper copy of the notice of information practices upon request;
• Inspect and obtain a copy of your health record for a reasonable fee; if denied, you have the right to seek a review of the denial;
• Request amendments to your health record;
• Request communications of your health information by alternative means or at alternative locations;
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken; and
• Receive an accounting of disclosures made of your health information.

Complaints

You may complain to Wyoming County and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a compliant or assisting an investigation.

Obligations of Wyoming County of Wyoming

Wyoming County is required to:

• Maintain the privacy of protected health information;
• Provide you with this notice of its legal duties and privacy practices with respect to your health information;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
• Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations; and
• Obtain your written authorization to use of disclose your health information for reasons other than those listed above and permitted under law.

Wyoming County reserves the right to change its information practices and to make the new provision s effective for all protected health information it maintains. Revised notices will be made available to you at your site of treatment.

Contact Information

If you wish to exercise your rights or have any questions or complaints, please contact:

Wyoming County HIPAA Privacy Officer

143 N. Main Street

Warsaw, NY 14569

Telephone 585-786-8846 x 1500

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