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
Certain laws require that you be provided “Notice” of our privacy practices
that relate to your medical information. Our privacy practices are contained
with this “Notice.” This “Notice” applies to the protected health records of
your care provided by Sedgwick County and its employees, staff and volunteers.
Your primary care physician, other health care or treatment providers, or your
health insurance plan may have different privacy policies or “Notices” regarding
use and disclosure of your health information that is created outside of
This “Notice” contains information in the following general categories:
Each time you receive health-related treatment or care from a health
department or another healthcare provider, a record of your visit is made.
Typically, this record contains a history of your illnesses or injuries,
symptoms, exam and laboratory results, treatment plans and treatments provided,
and notes on future care. Depending on your health care situation, your record
with each healthcare provider may contain more or different information. How
your health information is used, is described on the following pages.
What are the responsibilities of Sedgwick County when it comes to your health
Sedgwick County is required by law to:
Sedgwick County will not use or disclose your health information without your
authorization, except as explained in this “Notice” or as required by law.
Certain laws may require Sedgwick County to disclose your health information
without your authorization. Sedgwick County is obligated to follow those laws.
Although your health record is the physical property of Sedgwick County, the
information belongs to you. You have the right to:
Inspect and Copy Your Records. You have the right to inspect and obtain a
copy of certain health information that may be used to make decisions about your
care. Usually, this includes medical and billing records, but does not include
psychotherapy notes, information compiled in reasonable anticipation of, or use
in, civil, criminal, or administrative actions or proceedings, information that
is subject to special laws or other information not contained in the medical or
To inspect and obtain a copy of your protected health information maintained
in the designated record set by Sedgwick County, you must submit your request in
writing. This request should include name, address, description of records to be
copied, and phone number, if necessary for contact or follow up. Information
should include personal identification for requester and that of the client
whose protected health information is being requested. Personal identifiers
include Social Security number and date of birth. A written request must be
completed prior to Sedgwick County providing the requested information. You must
submit your request in writing to a Sedgwick County Privacy Officer listed on
page one. If you request a copy of the information, we may charge a reasonable
fee for copying, including labor, supplies, and the cost of postage.
Sedgwick County may deny your request to inspect and copy in certain very
limited circumstances. Certain reasons for the denial are not reviewable and
some are reviewable. If you are denied access to health information, you will be
told in writing. In certain circumstances, however, you may request that the
denial be reviewed. If the original denial of access to the medical records was
made by a licensed health care provider as allowed by law, another licensed
healthcare professional chosen by Sedgwick County will review your request and
the denial. The person conducting the review will not be the person who denied
your request. Sedgwick County will comply with the outcome of the review. You
will be advised in writing of this reviewing official’s decision.
Request an Amendment of Your Records. If you feel that health information
Sedgwick County has about you is incorrect or incomplete, you may ask us to
correct or supplement the information. You have the right to request an
amendment for as long as the information is kept by or for Sedgwick County. To
request an amendment, your request must be made in writing and submitted to a
Sedgwick County Privacy Officer listed on page one. In addition, you must
provide a reason that supports your request.
Sedgwick County may deny your request for an amendment if it is not in writing
or does not include a reason to support the request. If your request for an
amendment is denied, you have the right to file a statement of disagreement that
will be included with any future disclosures of your health information.
Sedgwick County may deny your request if you ask us to amend information that:
Accounting of Disclosures. You have the right to request, in certain
circumstances, an “accounting of disclosures.” An “accounting” is a list of the
disclosures Sedgwick County has regarding your health information. An
“accounting” will not include:
To request this list or “accounting” of disclosures, you must submit your
request in writing to a Sedgwick County Privacy Officer listed on page one. Your
request must state a time period, (which may not be longer than six years, and
may not include dates before April 14, 2003.) Your request should indicate in
what form you want the list (e.g., on paper or electronically.) Sedgwick County
may charge you for the costs of providing the list. We will notify you of the
costs involved and you may choose to withdraw or modify your request at that
time before any costs are incurred.
Right to Request Restrictions. You have the right to request
a restriction on the health information that Sedgwick County uses or discloses
about you for treatment, payment or healthcare operations. You also have the
right to request a limit on the health information Sedgwick County discloses
about you to someone who is involved in your care or the payment for your care
(i.e., a family member or friend.) For example, you could ask that:
Sedgwick County is not required to agree to your request. Only the Privacy
Officer can agree to your request. If the Privacy Officer does agree, Sedgwick
County will notify you in writing and comply with your request. If Sedgwick
County agrees to a restriction we may:
You may also terminate any restriction.
To request restrictions, you must make your request in writing to a Sedgwick
County Privacy Officer listed on page one. In your request, you must tell us:
Request Confidential Communications. You have the right to request that
Sedgwick County communicates with you about medical matters in a certain way or
at a certain location. For example, you can ask that Sedgwick County only
contact you at work or by mail. To request confidential communications, you must
make your request in writing to a Sedgwick County Privacy Officer listed on page
one. Sedgwick County will not ask you the reason for your request. Sedgwick
County may ask you for clarification so we can understand your request. You are
not required to give an explanation. Sedgwick County will accommodate all
reasonable requests. Your request must specify how or where you wish to be
Receive Notice of Any Breach of Your Health Information. If your health
information is acquired, accessed, used, or disclosed in a manner not permitted
under the HIPAA Rules which compromises the security or privacy of the protected
health information, you have a right to receive notice from Sedgwick County of
Any unintentional acquisition, access, or use of your health information by a
member of Sedgwick County’s workforce or a person acting under the authority of
Sedgwick County or its business associate, if such acquisition, access, or use
was made in good faith and within the scope of authority and does not result in
further use or disclosure in a manner not permitted under the HIPAA Rules.
Any inadvertent disclosure by a person who is authorized to access your
health information at Sedgwick County or its business associate to another
person authorized to access protected health information at Sedgwick County or
its business associate, or organized health care arrangement in which Sedgwick
County participates, and the information received as a result of such disclosure
is not further used or disclosed in a manner not permitted under the HIPAA
A disclosure of protected health information where Sedgwick County or its
business associate has a good faith belief that an unauthorized person to whom
the disclosure was made would not reasonably have been able to retain such
Regarding an Electronic Health Information Exchange. Sedgwick County may
participate in an electronic health information exchange, or HIE. New technology
allows a provider or a health plan to make a single request through a health
information organization, or HIO, to obtain electronic records for a specific
patient from other HIE participants for purposes of treatment, payment, or
health care operations. HIOs are required to use appropriate safeguards to
prevent unauthorized uses and disclosures.
You have two options with respect to HIE. First, you may permit authorized
individuals to access your electronic health information through an HIO. If you
choose this option, you do not have to do anything.
Second, you may restrict access to all of your information through an HIO
(except access by properly authorized individuals as needed to report specific
information as required by law). If you want to restrict access to your records
through the exchange, you must submit a request for restriction through the
Kansas Health Information Exchange, Inc. Contact the KHIE Support Center at
785-783-8984 or visit www.khie.org for more information. You cannot restrict
access to certain information only; your choice is to permit or restrict access
to all of your information. Please be aware that the inability to access
restricted information may result in a health care provider not having access to
information necessary to provide appropriate care.
Even if you restrict access through an HIO, providers and health plans may
share your information directly through other means (e.g., facsimile or secure
e-mail) without your specific written authorization. Your information will also
be available through the exchange by a properly authorized individual as
necessary to report specific information to a government agency as required by
law (for example, reporting of certain communicable diseases or suspected
incidents of abuse).
For your protection, each request for restrictions is subject to verification
procedures. Please allow sufficient time for your request to be processed. Your
failure to provide all information required for verification may result in
additional delay or denial of your request.
If you receive health care services in a state other than Kansas, different
rules may apply regarding restrictions on access to your electronic health
information. Please communicate directly with your out- of-state health care
provider regarding those rules.
If you have questions regarding HIE or HIOs, please visit http://www.khie.org
for additional information.
Restrict Disclosure of Your Health Information to Health Plans. You have the
right to request Sedgwick County not disclose your health information to a
health plan if:
The disclosure is for the purpose of carrying out payment or health care
operations and is not otherwise required by law; and
The health information pertains solely to a health care item or service for
which you, or a person other than the health plan on behalf of you, has paid
Sedgwick County in full.
Receive your Health Information in Electronic Form. If Sedgwick County
maintains your health information in one or more designated record sets
electronically and if you request an electronic copy of such information,
Sedgwick County must provide you with access to your health information in the
electronic form and format requested by the you, if it is readily producible in
such form and format; or, if not, in a readable electronic form and format as
agreed to by the Sedgwick County and you.
A Paper Copy of This “Notice.” You have the right to a paper copy of this
“Notice.” You may ask Sedgwick County to give you a copy of this “Notice” at any
time. Even if you have agreed to receive this “Notice” electronically, you are
still entitled to a paper copy of this “Notice.” To obtain a paper copy of this
“Notice” you may contact a Sedgwick County Privacy Officer listed on page one.
You may also obtain a copy of this “Notice” at our website,
Types of Uses and Disclosures that Require Authorization under 45 CFR Ã‚Â§
Sedgwick County will not use or disclose your health information without your
written authorization in the following circumstances:
Other uses and disclosures of health information not covered by this “Notice”
or the laws that apply to Sedgwick County will be made only with your written
permission. For certain disclosures of your information, you must complete an
“Authorization for Uses and Disclosure of Protected Health Information” form and
submit it to Sedgwick County. If you provide Sedgwick County permission to use
or disclose health information about you, you may revoke that permission, in
writing, at any time. To revoke any permission already given to Sedgwick County
or permission given to us in the future, you must revoke that permission in
writing by sending it to a Sedgwick County Privacy Officer listed on page one.
If you revoke your permission, Sedgwick County will no longer use or disclose
health information about you for the reasons covered by your written
authorization. You understand that we are unable to take back any disclosures we
have already made with your permission, and that we are required to retain our
records of the care that we provided to you.
For Treatment. Sedgwick County may use health information about you to
provide you with health-related treatment or care. Sedgwick County may disclose
health information about you to other treatment providers who are involved in
your care. The following are several examples.
Different departments of Sedgwick County may share health information about
you in order to coordinate the different services you need (i.e., medications,
lab work, x-rays, etc.). Sedgwick County also may disclose health information
about you to people outside Sedgwick County who may be involved in your medical
care while you are a client of Sedgwick County (e.g., other doctors, nurses,
advanced registered nurse practitioners, family members, clergy, etc.).
For Payment. Sedgwick County may use and disclose health information about
you for billing purposes so Sedgwick County can collect payment from you, an
insurance company or a third party. For example, Sedgwick County may need to
give your health insurance company information about a procedure you received at
Sedgwick County so we can be paid or you can be reimbursed for the procedure.
Sedgwick County may also tell your health plan about a treatment you are going
to receive in order to obtain prior approval or to determine whether your plan
will cover the treatment.
For Health Care Operations. Sedgwick County may use and disclose health
information about you for operations. These uses and disclosures are necessary
to run Sedgwick County and make sure all of our clients receive quality care.
For example, Sedgwick County may use health information to review our treatment
and services and to evaluate the performance of our staff in caring for you.
Sedgwick County may disclose information to doctors, nurses, medical students,
and other personnel for review and learning purposes. Additional uses and
disclosures for “health care operations” include:
Treatment Alternatives. Sedgwick County may use and disclose health
information to tell you about, or recommend, possible treatment options or
alternatives that may be of interest to you.
Health-Related Benefits and Services. Sedgwick County may use and disclose
health information to tell you about health-related benefits or services that
may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. Sedgwick County
may release health information about you to a friend or family member who is
involved in your health-related treatment or care. Sedgwick County may also give
information to someone who helps pay for your care. Sedgwick County may disclose
health information about you to an entity assisting in disaster relief effort so
that your family can be notified about your condition, status and location. The
amount of information disclosed will depend on that person’s particular
involvement in your care. If you want this information restricted, you must tell
us by using the required procedure.
Research. Under certain circumstances, Sedgwick County may use and disclose
health information about you for research purposes. For example, a research
project may study the effects of early access to health care during pregnancy.
All research projects are subject to a special approval process. This process
evaluates a proposed research project and its use of health information, while
balancing research needs with the client’s need for privacy of their health
information. Before we use disclosure of health information for research, the
project must be approved through the research approval process.
As Required by Law. Sedgwick County will disclose health information about
you when required to do so by federal, state or local law. This may include
reporting of communicable diseases, wounds, abuse, disease registries, health
oversight matters and other public policy requirements. We may be required to
report this information without your permission.
To Avert a Serious Threat to Health or Safety. Sedgwick County may use and
disclose health information about you when necessary to prevent a serious threat
to your health and safety or the health and safety of the public or another
person. Any disclosure, however, is limited to person(s) who can help prevent
Military and Veterans. If you are a member of the armed forces, Sedgwick
County may release health information about you as required by military command
Workers’ Compensation. Sedgwick County may release health information about
you for workers’ compensation or similar programs. These programs provide
benefits for work-related injuries or illness.
Public Health Activities. Sedgwick County may disclose health information
about you without your permission for public health activities. These activities
generally include the following:
Health Oversight Activities. Sedgwick County may disclose health information
without your permission to a health oversight agency for activities authorized
by law. These oversight activities include, for example, audits, investigations,
inspections, and licensure. These activities are necessary for the government to
monitor the health care system, government programs, licensing functions, and
compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or in a dispute,
Sedgwick County may disclose health information about you in response to a court
or administrative order. We may also disclose health information about you in
response to a court or administrative order even if you are not involved in the
lawsuit or dispute. Health information about you may be disclosed in response to
a subpoena, discovery request, or other lawful process by someone else involved
in the dispute, but only if efforts have been made to tell you about the request
or to obtain an order protecting the information requested or as otherwise
permitted by law.
Law Enforcement. Unless state or federal law is more restrictive than HIPAA
with regard to disclosure of certain records, Sedgwick County may release health
information if asked to do so by law enforcement officials:
Coroners, Medical Examiners and Funeral Directors. Sedgwick County may
release health information to a Coroner or Medical Examiner (e.g., to determine
the cause of death).
National Security and Intelligence Activities. Sedgwick County may release
health information about you to authorized federal officials for intelligence,
counterintelligence, and other national security activities authorized by law.
Inmates. If you are an inmate of a correctional institution or under the
custody of a law enforcement official, Sedgwick County may release health
information about you to the correctional institution. This release would be
If you believe your privacy rights have been violated, you may file a
complaint with Sedgwick County or with the Secretary of the Department of Health
and Human Services (DHHS.) To file a complaint with Sedgwick County or to
receive additional information about how to file a complaint with the DHHS,
contact a Sedgwick County Privacy Officer listed on page one. All complaints
must be submitted in writing. We cannot, and will not, require you to waive the
right to file a complaint as a condition of receiving treatment from Sedgwick
County. You will not be penalized for filing a complaint.
Sedgwick County reserves the right to change this “Notice.” Sedgwick County
reserves the right to make the revised or changed “Notice” applicable to health
information we already have about you, as well as, any information we receive in
the future. Sedgwick County will post a current copy of the “Notice” in all
identified locations. You will find the date the “Notice” became effective at
the top of the first page below the title. If a material change is made to the
“Notice” you will be presented with a new version of the Notice of Privacy
Practices. You will be asked to sign a new Notice of Privacy Practices
Acknowledgement form. In addition, each time you register for services with
Sedgwick County, a copy of the current “Notice” in effect will be given to you
if you request it.
information privacy officer contact information by department.
Mission: To assure quality public services that provide for the present and future well-being of the citizens of Sedgwick County.
© Copyright 2014
and Notice of Privacy Practices Regarding Medical Information.