Notice of Privacy Practices for Protected Health Information (HIPAA)
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Public Health is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment, and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment, and applying for future care or treatment. It also includes billing documents for those services.
The Public Health Division (also known as “ Public Health”) creates records of health care to provide quality care and comply with legal requirements. Public Health understands your health information is personal and private, and commits to safeguarding it to the extent reasonably possible. The law requires Public Health to keep your health information private and to provide you this notice of our legal duties and privacy practices. The law also requires Public Health to follow the terms of this notice.
This notice outlines the limits on how public health will handle your health information. Under federal law, Public Health must provide a copy of this notice when you receive health care and related services from the City. The City reserves the right to change practices and make new provisions effective for all health information it maintains. You may request an updated copy of this notice at any time.
Who Will Follow This Notice
This notice describes the practices of the City of Berkeley’s Public Health Division services and that of:
- Any health care professional authorized to provide treatment and to enter information into your health record.
- All teams and services of Public Health.
- Any volunteer or student who provides services to you.
- All employees, contract staff and other health personnel.
All Public Health Services’ providers, teams and programs follow the terms of this notice. In addition, these providers, teams and clinics may share health information with each other for treatment, payment or medical operations purposes described in this notice.
Example of uses of your health information for treatment purposes:
- Nurses, doctors, or other clinic staff may record your health information, and they may share such information with other City staff.
- Public Health may disclose health information to people outside Public Health involved in your care who provide follow-up care and/or health treatment and related services.
- Public Health may use and disclose health information to contact you to remind you about appointments for treatment or health care-related services.
- In emergencies, Public Health may use or disclose health information to provide you with treatment. Public Health will use its best efforts to obtain your permission to use or disclose your health information as soon as reasonably practical.
Example of use of your health information for payment purposes:
We submit requests for payment to your health insurance company, the state or other third parties. The health insurance company, the state or business associate helping us obtain payment requests information from us regarding the medical care provided to you. We will provide information to them about you and the care given.
Example of Use of Your Information for Health Care Operations:
We may obtain services from other agencies and organizations such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guidelines development, training programs, credentialing, medical review, legal services, auditing financial data and insurance. We will share information about you with such outside entities or business associates as necessary and according to state and federal laws to obtain these services.
Your Health Information Rights and Our Responsibilities
Your Health Information Rights
The health and billing records we maintain are the physical property of public health. You have the following rights with respect to your Protected Health Information:
- Right to request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office—we are not required to grant the request but we will comply with any request granted;
- Right to confidential communication by requesting that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our office using the form we give you upon request;
- Right to obtain a paper copy of the Notice of Privacy Practices for Protected Health Information ("Notice") by making a request at our office;
- Right to inspect and copy your health record and billing record—you may exercise this right by delivering the request in writing to our office using the form we provide to you upon request and; appeal a denial of access to your protected health information except in certain circumstances;
- Right to request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our office using the form we provide to you upon request. The clinician or designee is not required to make such amendments. You may file a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information;
- Right to receive an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our office using the form we provide to you upon request. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care; and,
- Right to file complaints without fear of retaliation. By law, the City cannot penalize you for filing a complaint. If you believe that the City has violated your privacy rights, you may file a complaint during normal business hours with the Complaint Officer where you received services or with the U.S. Department of Health and Human Services.
Public Health is required to:
- Maintain the privacy of your health information as required by law;
- Provide you with a notice as to our duties and privacy practices as to the information we collect and maintain about you;
- Abide by the terms of this Notice;
- Notify you if we cannot accommodate a requested restriction or request; and
- Accommodate your reasonable requests regarding methods to communicate health information with you.
- Accommodate your request for an accounting of disclosures.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our “Notice” or by visiting our office and picking up a copy.
To Request Information or File a Complaint
If you believe your privacy rights have been violated, you may file a complaint, verbally or written, with the Complaint Officer for the facility in which you received your health services.
Additionally, if you believe your privacy rights have been violated, you may file a written complaint by delivering the written complaint to the Privacy Officer:
Health and Human Services
2180 Milvia St, 2nd floor
Berkeley, CA 94704
You may also file a complaint by calling, faxing or mailing it to the Secretary:
U.S. Department of Health and Human Services
Office for Civil Rights
Attention: Regional Manager
50 United Nations Plaza, Room 322
San Francisco, CA 94102
FAX: (415) 437-8329
We cannot, and will not, require you to waive the right to file a complaint as a condition of receiving treatment from Public Health.
You will not be retaliated against for filing a complaint.
List of Other Uses and Disclosures Allowed by the Privacy Rule
We may contact you to provide you with appointment reminders, with information about treatment follow-up and alternatives, or with information about other health-related benefits and services that may be of interest to you.
Notification – Opportunity to Agree or Object
Unless you object we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative, or other person responsible for your care, about your location, and about your general condition, or your death.
Communication with Family - Using our best judgment, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or in payment for such care if you do not object or in an emergency.
We may use and disclose your protected health information to assist in disaster relief efforts.
Opportunity to Agree or Object Not Required
PUBLIC HEALTH ACTIVITIES
As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Child Abuse & Neglect
We may disclose protected health information to public authorities as allowed by law to report child abuse or neglect.
Food and Drug Administration (FDA)
We may disclose to the FDA your protected health information relating to adverse events with respect to food, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.
Victims of Abuse, Neglect, or Domestic Violence
We can disclose protected health information to governmental authorities to the extent the disclosure is authorized by statute or regulation and in the exercise of professional judgment the doctor believes the disclosure is necessary to prevent serious harm to the individual or other potential victim.
Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities to include audits, civil, administrative or criminal investigations: inspections; licensures or disciplinary actions, and for similar reasons related to the administration of healthcare.
Coroners, Medical Examiners and Funeral Directors
We may disclose your protected health information to funeral directors or coroners consistent with applicable law to allow them to carry out their duties.
We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, or as directed by a proper court order or administrative tribunal, provided that only the protected health information released is expressly authorized by such order, or in response to a subpoena, discovery request or other lawful process.
We may disclose your protected health information for law enforcement purposes as required by law, such as when required by court order, including laws that require reporting of certain types of wounds or other physical injury.
Organ Procurement Organizations
Consistent with applicable law, we may disclose your protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs, eyes, or tissue for the purpose of donation and transplant.
We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Threat to Health and Safety
To avert a serious threat to health or safety, we may disclose your protected health information consistent with applicable law to prevent or lessen a serious, imminent threat to the health or safety of a person or the public.
For Specialized Governmental Functions
We may disclose your protected health information for specialized government functions as authorized by law such as to Armed Forces personnel, for national security purposes, or to public assistance program personnel.
If you are an inmate of a correctional institution, we may disclose to the institution or it’s agents the protected health information necessary for your health and the health and safety of other individuals.
If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.
Other Uses and Disclosures
Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization which you may revoke except to the extent information or action has already been taken.