You have the right to request the Department of Health to restrict the use and disclosure of your protected health information to carry out treatment, payment, or health care operations. You may also limit disclosures to individuals involved with your care. The department is not required to agree to any restriction.
You have the right to be assured that your information will be kept confidential. The Department of Health will make contact with you in the manner and at the address or phone number you select. You may be asked to put your request in writing. If you are responsible to pay for services, you may provide an address other than your residence where you can receive mail and where we may contact you.
You have the right to inspect and receive a copy of your protected health information that is maintained by the Department of Health within 30 days of the Department’s receipt of your request.to obtain a copy of your protected health information. You must complete the Department’s Authorization to Disclosure Confidential Information form and submit the request to the county health department or Children’s Medical Services office. If there are delays in getting you the information, you will be told the reason for the delay and the anticipated date when you will receive your information.
Your inspection of information will be supervised at an appointed time and place. You may be denied access as specified by law.
If you choose to receive a copy of your protected health information, you have the right to receive the information in the form or format you request. If the Department cannot produce it in that form or format, it will give you the information in a readable hard copy form or another form or format that you and the Department agree to.
The Department cannot give you access to psychotherapy notes or certain information being used in a legal proceeding. Records are maintained for specified periods of time in accordance with the law. If your request covers information beyond that time the Department is required to keep the record, the information may no longer be available.
If access is denied, you have the right to request a review by a licensed health care professional who was not involved in the decision to deny access. This licensed health care professional will be designated by the department.
You have the right to correct your protected health information. Your request to correct your protected health information must be in writing and provide a reason to support your requested correction. The Department of Health may deny your request, in whole or part, if it finds the protected health information:
- Was not created by the department.
- Is not protected health information.
- Is by law not available for your inspection.
- Is accurate and complete.
If your correction is accepted, the department will make the correction and tell you and others who need to know about the correction. If your request is denied, you may send a letter detailing the reason you disagree with the decision. The department may respond to your letter in writing. You also may file a complaint, as described below in the section titled Complaints.
You have the right to receive a summary of certain disclosures the Department of Health may have made of your protected health information. This summary does not include:
- Disclosures made to you.
- Disclosures to individuals involved with your care.
- Disclosures authorized by you.
- Disclosures made to carry out treatment, payment, and health care operations. • Disclosures for public health.
- Disclosures to health professional regulatory purposes.
- Disclosures to report abuse of children, adults, or disabled.
- Disclosures prior to April 14, 2003.
This summary does include disclosures made for:
- Purposes of research, other than those you authorized in writing.
- Responses to court orders, subpoenas, or warrants.
You may request a summary for not more than a 6 year period from the date of your request.
If you received this Notice of Privacy Practices electronically, you have the right to a paper copy upon request.
The Department of Health may mail or call you with health care appointment reminders.