We have a legal duty to safeguard your protected health information. We will protect the privacy of your health information contained in our files, whether it deals with the provision of health care or the payment for health care provided to you. This Notice of Privacy Practices is provided in compliance with the federal privacy law, the Health Information Portability and Accountability Act. It explains how, when and why we may use and disclose your protected health information. With some exceptions, we will avoid using or disclosing any more of your health information than is necessary to accomplish the purpose of the use or disclosure. These privacy policies are consistent with the HIPAA regulatory requirements and all employees and agents of the Erie Center on Health & Aging will adhere to these policies.

The Board of Directors reserves the right to change the terms or provisions this Notice and our privacy practices at any time deemed necessary. Future changes will apply to your health information currently in our files. Be advised that, in the event of changes this Notice will be amended to reflect those changes to our policies or practices and the amended Notice will be publicly posted in our reception area. You may also request, at any time, a copy of our current Notice of Privacy Practices from the Privacy Officer. In addition, you may view and obtain an electronic copy of this Notice on our web site at www.healthyagingerie.org.

We would like to take this opportunity to answer some common questions concerning our privacy practices:

Answer: We use and disclose health information for many different reasons. Some of these uses or disclosures, require your specific authorization. Following is a description of the different categories of our uses and disclosures including some examples of each to provide clarification.

1. Uses and Disclosures Relating to Treatment, Payment or Healthcare Operations. We may, by federal law, use and disclose your health information for the following reasons:

1. For Treatment: We are permitted to disclose your health information to other physicians or health care providers who are involved in your care. For example, if you’re being treated for heart disease, we may disclose your health information to a specialist involved in your care. The reason for such a disclosure may be to provide the doctor your medical history information which is necessary to appropriately treat your condition, to coordinate your care or to schedule necessary testing.

2. To Obtain Payment for Treatment: We may use and disclose necessary health information in order to bill and collect payment for the treatment that we have provided to you. For example, we may provide certain portions of your health information to your health insurance company, Medicare or Medicaid, in order to get paid for taking care of you. To do this, we will need to provide your health information to the billing company that handles our health insurance claims.

3. For Health Care Operations: We may, at times, need to use and disclose your health information to run our medical practice. For example, we may use your health information to evaluate the quality of the healthcare that our staff has provided to you. We may also need to provide some of your health information to our accountants, attorneys and consultants in order to make sure that we’re complying with law.

1. Certain Other Uses and Disclosures are Permitted by Federal Law. We may use and disclose your health information without your authorization for the following reasons:
   1. When a Disclosure is Required by Federal, State or Local Law, in Judicial or Administrative Proceedings or by Law Enforcement. For example, we may disclose your protected health information if we are ordered by a court, or if a law requires that we report that sort of information to a government agency or law enforcement authorities, such as in the case of a dog bite, suspected child abuse or a gunshot wound.

   2. For Public Health Activities. Under the law, we need to report information about births, deaths, and various diseases to government agencies that collect that information. We are also permitted to provide protected health information to the coroner or a funeral director, if necessary, after a patient’s death.

   3. For Health Oversight Activities. For example, we will need to provide your health information, if requested to do so by a government agency that has the right to inspect our offices and/or investigate healthcare practices.

   4. For Organ Donation. If one of our patients wished to make an eye, organ or tissue donation after their death, we may disclose necessary health information to assist the appropriate organ procurement organization.

   5. For Research Purposes. In certain limited circumstances (for example, where approved by an appropriate Privacy Board or Institutional Review Board under federal law), we may be permitted to use or provide protected health information for a medical research study.

   6. To Avoid Harm. If one of our physicians or nurses believes that it is necessary to protect you, or to protect another person or the public as a whole, we may provide protected health information to the police or others who may be able to prevent or lessen the possible harm.

   7. For Specific Government Functions. We may disclose the health information of military personnel or veterans where required by U.S. military authorities. We may also disclose a patient’s health information for national security purposes, such as assisting in the investigation of suspected terrorists who may be a threat to our nation.

   8. For Workers’ Compensation. We may provide your health information as described under the workers’ compensation law, if your injury or condition was the result of a workplace injury for which you are seeking workers’ compensation.

   9. Appointment Reminders and Health-Related Benefits or Services. Unless you tell us that you would prefer not to receive them, we may use or disclose your information to provide you with appointment reminders or to give you information about alternative treatments that may help you.

   10. Fundraising Activities. For example, if our Medical Group chose to raise funds for a charitable cause or community health education program, we may use your information to contact you. If you do not wish to be contacted as part of any fundraising activities, please contact the Privacy Officer at 814-453-5071.

    

2. Certain Uses and Disclosures Require You to Have the Opportunity to Object.
   1. Disclosures to Family, Friends or Others Involved in Your Care. We may provide a limited amount of your protected health information to a family member, friend or other person known to be involved in your care or in the payment for your care, unless you tell us not to. For example, if a family member comes with you to your doctor’s appointment and you allow them to come into the examination room with you, we may disclose otherwise protected health information to them during the appointment, unless you tell us not to.

   2. Disclosures to Notify a Family Member, Friend or Other Selected Person. When you first came to our office, we asked that you provide us with an emergency contact person in case something should happen to you while you are at our office. Unless you tell us otherwise, we will disclose certain limited health information about you (your general condition, location, etc.) to your emergency contact or another available family member, should you need to be admitted to the hospital, for example.

    

3. Other Uses and Disclosures Require Your Prior Written Authorization. In situations other than those categories of uses and disclosures mentioned above, or those disclosures permitted under federal law, we will ask for your written authorization before using or disclosing any of your protected health information. If you choose to sign an authorization to disclose your health information, you can later revoke it to stop further uses and disclosures to the extent that we haven’t already taken action relying on the authorization, so long as it is revoked in writing.

Question: What Rights Do I Have Concerning My Protected Health Information?

Answer: You have the following rights with respect to your protected health information:

1. The Right to Request Limits on Uses and Disclosures of Your Health Information. You have the right to ask us to limit how we use and disclose your health information. We will certainly consider your request, but you should know that we are not required to agree to it. If we do agree to your request, we will put the limits in writing and will abide by them, except in the case of an emergency. Please note that you are not permitted to limit the uses and disclosures that we are required or allowed by law to make.

2. The Right to Choose How We Send Health Information to You or How We Contact You. You have the right to ask that we contact you at an alternate address or telephone number (for example, sending information to your work address instead of your home address) or by alternate means (for example, by e-mail instead of telephone). We must agree to your request so long as we can easily do so.

3. The Right to See or to Get a Copy of Your Protected Health Information. In most cases, you have the right to look at or get a copy of your health information that is contained in our files, but you must make the request in writing. A request form is available at the reception desk at our offices. We will respond to you within 30 days after receiving your written request. If we do not have the health information you are requesting, but we know who does, we will tell you how to get it. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial. In certain circumstances, you may have a right to appeal the decision.

Answer: If you have any questions about anything discussed in this Notice or about any of our privacy practices, or if you have any concerns or complaints, please contact the Privacy Officer at 814-453-5071. You also have the right to file a written complaint with the Secretary of the U.S. Department of Health and Human Services. We may not take any retaliatory action against you if you lodge such a complaint.

Answer: This Notice takes effect on April 1, 2003.