Adopted April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU IS USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY

 

UNDERSTANDING YOUR  HEALTH RECORD INFORMATION:

Each time you come to us at FCHC (or any other health care provider, hospital) a record of your visit is made.  Typically this contains symptoms, examination, test results, diagnosis, treatment and a plan for your future care.  This information often referred to as your medical record, serves as a:

  • a basis for planning your care and treatment
  • means of communication among the many health providers that provide you care
  • legal document describing the care  you received
  • means by which you or a third party payer can verify that services billed were provided
  • tool for educating health professionals (medical students)
  • a source of data for medical research
  • a source of information for public health officials charged with improving the health of the nation
  • a source of data for facility planning and marketing
  • a tool where we can assess and continually work to improve the care we render

 

OUR PLEDGE TO YOU:

All staff at Florida Community Health Centers (FCHC) is committed to protecting your medical information because it is personal.   We are also required by law to maintain the privacy of protected health information. Your information is kept in a medical record that helps us to provide you quality care while maintaining a legal document.

This notice will help you understand how we use and disclose medical information without your authorization. We will describe your rights and certain obligations we have regarding the use and disclosure of medical information.

Law requires us to:

  • Make sure that medical information that identifies you is kept confidential (private), Give you notice of our legal duties and privacy practices concerning medical information about you, Follow the terms of the notice that is currently in effect, Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
  • We have the right to change our practices and make new provisions effective for all protected health information.  Should we improve our practice, we will provide a revised notice by posting in a visible location within our centers.

 

FOR MORE INFORMATION  OR TO REPORT A PROBLEM:

If you have questions and would like additional information, you may contact the Director of Quality Improvement/Corporate Compliance Officer at (561)844-9443 Ext.1190

If you believe your privacy rights have been violated, you can file a complaint in writing, via email or phone call to the Director of Quality Improvement/Corporate  Compliance Officer at (561)-844-9443 Ext.1190 or mail to:

Florida Community Health Centers
Attn: DQI/CCO Confidential
5827 Corporate Way
West Palm Beach, FL. 33407

OR you can file a complaint with the Secretary of Health and Human Services, Office of Civil Rights.

 

YOUR HEALTH INFORMATION  RIGHTS:

Your health record is the physical property of Florida Community Health Centers, but the information belongs to you.  

You have the right to:

  • Request a restriction on specific uses and disclosures of your information as provided by law. All requests for restrictions must be in writing, and be specific.  For example, you can limit use or disclosure to which this would apply.
  • Obtain a paper copy of this notice of information practices upon request.You may obtain a copy by requesting from the Center where your record is kept.
  • Inspect and copy your health record as provided by law (may include medical and billing records). You must submit your request in writing. There may be a fee for our costs of copying your medical history.
  • Amend your health record as provided by law. You must submit a request to amend your record in writing and the reason that supports your decision to change your medical record.  Without an explanation for an amendment, your request may be denied.
  • Obtain an accounting of trackable disclosures as provided by law. You must submit your request in writing and state a time period, not to exceed six (6) years, but beginning Aprill4, 2003. The first list we provide you will be free. We may charge for additional lists within a 12 month period. We will let you know the charge before we provide you copies.
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken
  • The right to receive confidential communications of protected health information.

 

HOW WE MAY USE &/OR DISCLOSE MEDICAL INFORMATION:

  • For Treatment:

We will use the medical record document to continue to provide you medical care/treatment.  We may send the medical record to any other provider who may also be taking care of you (for example when we send you to a specialist).  Our providers and support staff have complete access to your chart.  If it is necessary to discuss your care with a member of your family because they help with your care; we have the choice to talk to them for your benefit.  In some instances, we will ask for your signed medical release, but it is not always necessary

  • For Payment:

We may use and disclose medical information about you so that the treatment and services you receive may be billed and payment may be collected.  A bill may be sent to you or a third party payer (Medicaid/Medicare). The information on the bill will include information about you as well as diagnosis, procedure &/or supplies used.

  • For Health Care  Operations:

We sometimes may use or disclose medical information about you for us to continue providing quality care.   For example, our Quality Improvement Department may assess your case and others like your's, to assess the care and outcomes in all charts. This helps us to continually improve the quality and effectiveness of the healthcare we provide.

  • Appointment Reminders:

We may use or disclose your medical information to contact you by phone or post­ the card that you have or missed an appointment with our provider.

  • Business Associates:

There are some services in our organization provided through contacts with Business Associates.  Examples include Radiology Imaging Associations (RIA); Laboratory Corporation of America (LabCorp); Smart Corporation (a copy service), Joint Commission of Accreditation of Health Care Organizations (JCAHO).  We may disclose your health information to them so that they can perform the job that we have asked them to do and bill you or your third-party payer for services rendered.  For the information to be protected, we require our business associates to safeguard your information appropriately.

  • Notification:

We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, as to your location, and general condition.

  • Communication with Family:

Health providers, using their best judgment, may disclose to a family member, another relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

  • Research:

We may disclose information to researchers once Senior Staff has approved the project at Florida Community Health Centers. We will ensure your privacy is maintained by removing all identifiable data.

  • Medical Examiner/Coroner/Funeral Director:

We may release information to a coroner or medical examiner. This sometimes is necessary to identify a deceased person or determine the cause of death.   We may release to Funeral Directors consistent with laws allowing us to provide them the pertinent information needed to file a death certificate.

  • Organ and Tissue Donation:

If you are an organ donor, we may release medical information to the organizations that
handle organ procurement or donation bank(s), as deemed necessary to facilitate organ/tissue donation or transplantation.

  • Workers Compensation:

We may use or disclose information pertaining to those dates of service related to work-related illness or injury.  We restrict the medical information to only those services pertaining to workers compensation as provided by law.

  • Public Health:

We are required by law to disclose certain medical information for public health activities. These can be things such as communicable diseases, children/elder abuse or neglect or domestic violence.

  • Correctional Institution:

If you are an inmate or in the custody of law enforcement officials we may release medical information about you for your continued health care and the health and safety of other individuals and of the correctional institution.

  • Law Enforcement:

We may disclose health information if asked to do so by a law enforcement official within the rules of the law. This may include: Response to a court order or subpoena or similar process To identify or locate a suspect, witness, fugitive or missing person about a death that may be the result of criminal conduct.

 

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 permission. If you provide us permission to use or disclose health information about you, you have the right to revoke that permission at any time, in writing.