Notice of Privacy Practices

Revision date: October 1, 2006

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.

Understanding your Health Information
Each time you visit Prairie View, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

Basis for planning your care and treatment.
Means of communication among the many health professionals who contribute to your care.
Legal document describing the care you received.
Means by which you or a third-party payer can verify that services billed were actually provided.
A tool in the education of health professionals who are being trained at Prairie View.
A source of information for public health officials.
A source of data for facility planning and marketing.
A tool with which we can assess and continually work to improve the care we render and the outcomes of that care.

Understanding what is in your record and how your health information is used helps you to:

Ensure its accuracy.
Better understand who, what, when, where, and why others may access your health information.
Make more informed decisions when authorizing disclosures to others.

Your Health Information Rights
Although your health record is the physical property of Prairie View, the information belongs to you. You have the right to:

Request a restriction on certain uses and disclosures of your information.
Receive a paper copy of this Notice of Privacy Practices (Notice) upon request.
Inspect and obtain a copy of your health record.
Request to amend your health record.
Receive confidential communications of your health information from Prairie View. Delivery may be requested by alternative means or to alternative locations.
Receive a list of disclosures of your health information.
Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities
Prairie View is required to:

Maintain the privacy of your health information.
Provide you with a notice of our legal duties and privacy practices with respect to information we collect and maintain about you.
Abide by the terms of this Notice.
Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
Notify you if we are unable to agree to a requested restriction.

We reserve the right to change our Notice and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will prominently display the revised Notice and provide printed copies of the revised Notice upon request. We will not use or disclose your health information without your authorization, except as described in this Notice or as required by law. We will use professional judgment to interpret this Notice in individual circumstances. All communication will be via commonly accepted methods such as face-to-face, written, telephone, fax or e-mail.

More Information or to Report a Problem
If you have questions or would like additional information regarding this Notice, you may contact the Health Information Management department at (316) 284-6321. If you believe that your privacy rights have been violated, you can file a complaint with the Chief Executive Officer at Prairie View, or with the secretary of Health and Human Services, 200 Independence Avenue SW, Washington, DC, 20201, 202-619-0257. There will be no retaliation for filing a complaint.

Examples of Uses or Disclosures
We will use your health information for treatment.

Example 1: Information obtained during the course of your treatment will be recorded in your health record and shared with other members of your treatment team.
Example 2: Sometimes therapy occurs in group settings or appointments with your family. Health information may be disclosed in these settings unless you request otherwise.
Example 3: If you request to have your prescriptions filled at the Prairie View pharmacy, the pharmacy may call the prescriber to clarify a prescription or to request permission for refills.
Example 4: Health information may be disclosed for the purpose of providing medical treatment in emergency situations.
Example 5: Health information may be disclosed for the purpose of promoting continuity of care between Prairie View and your other healthcare providers.

We will use your health information for payment.
For example: We submit requests for payment to third-party payors. The third-party payors (or other business associates helping us obtain payment) request information from us regarding medical care given. We will provide information to them about you and the care given.

We will use your health information for regular health care operations.
For example: Members of the Prairie View staff, including clinicians and others involved in risk management or performance improvement processes, may use information in your health record to assess the care you receive and the outcome of that care. This information will then be used in our effort to continuously improve the services we provide.

Abuse and Neglect: We may disclose your protected health information to public authorities as required by law to report abuse or neglect.

Appointment Reminders: We may contact you by phone or mail to provide appointment reminders. If this contact is made by phone, “Prairie View” may display on caller identification systems. We may also leave a reminder on your answering machine or voice mail system.

Business Associates: There are some services provided for Prairie View through business associates. Examples include copy services we use when making copies of your health record , dietician services (for inpatients), accountants and attorneys. We may disclose your health information to our business associates so that they can perform the jobs we’ve asked them to do. To protect your health information, we require the business associates to appropriately safeguard your information.

Coroners, Medical Examiners, Funeral Directors, and Organ Procurement Organizations: Prairie View may release health information to a coroner or medical 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 necessary to carry out their duties. Prairie View may also release your health information to organizations that handle organ procurement for organ, eyes, or tissue transplantation; or to an organ donation bank as necessary to facilitate organ or tissue donation and transplantation.

Correctional Institution: If you are an inmate of a correctional institution or under the custody of a law enforcement official, Prairie View may release your health information to the correctional institution or law enforcement official. This release would be necessary for the institution to provide you with health care; protect your health and safety or the health and safety of others; or for the safety and security of the correctional facility.

Emergencies or Disasters: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care in an emergency situation. We may also 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.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post-marketing surveillance information to enable product recalls, repairs or replacement.

Fundraising Activities: We may use your health information to contact you in an effort to raise money for Prairie View. We may also disclose health information to a foundation related to Prairie View so that the foundation may contact you to raise money. We would only release contact information such as your name, address, and phone number and the dates you received treatment or services. If you do not want Prairie View to contact you for fundraising efforts, you must notify Director of Health Information Management in writing.

Health Oversight Activities: Prairie View may disclose health information to a health oversight agency for activities authorized by law. These 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.

Hospital Directory: Unless you object, if you are hospitalized and someone asks for you by name, we may acknowledge that you are in the hospital and disclose your general condition (for example, to help them decide whether it is appropriate to visit). With your permission, we may also disclose your name, general condition, and religious affiliation to members of clergy.

Judicial/Administrative Proceedings: We may disclose your health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid court order.

Military and Veterans: If you are a member of the armed forces, Prairie View may release your health information as required by military command authorities and allowed by law. We may also release health information about foreign military personnel to the appropriate foreign military authority.

National Security and Intelligence Activities: Prairie View may release your health information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

Protective Services for the President and Others: Prairie View may disclose your health information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has evaluated a proposed research project and its use of health information. One of the responsibilities of the institutional review board is to balance the research needs with the consumers’ need for privacy. We may, however, disclose health information about you to people preparing to conduct a research project, for example, to help them look for patients with specific health needs, as long as the health information they review does not leave Prairie View.

Treatment Alternatives: We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Workers Compensation: We may disclose health information to the extent authorized by, and necessary to comply with, laws relating to workers compensation or other similar programs established by law.

Other Uses Of Health Information
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written authorization, which may be revoked at any time.