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Notice of Privacy Practices

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.

Eastern Iowa Health Center (“EIHC”) is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Your health information includes your individually identifiable medical, insurance, demographic and medical payment information (examples include information about your diagnosis, medications, insurance status, medical claims history, address and policy and/or social security number). If you have any questions about this Notice, please contact our Privacy Officer, identified below.

Use and Disclosure of Health Information

EIHC collects health information from you and stores it in a record and on a computer. This record is the property of EIHC, but the information in the record belongs to you. EIHC may use your health information for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. EIHC has established policies to guard against unnecessary disclosure of your health information. Some information, such as HIV-related information, alcohol and/or substance abuse records and mental health records may be entitled to special confidentiality protections under applicable state or federal law. EIHC will abide by these special protections as they pertain to applicable cases involving
these types of records. EIHC may use or disclose your health information for the following purposes:

Treatment
EIHC may use your health information to coordinate care within EIHC and with others involved in your care such as your attending physician, service providers, and other health care professionals who have agreed to assist EIHC in coordinating care. EIHC may also disclose your health information to individuals outside of EIHC involved in your care including family members, clergy who you have designated, pharmacists, suppliers of medical equipment, dieticians or other health care professionals.

Conduct Health Care Operations
EIHC may use and disclose health information for its own operations in order to facilitate the function of EIHC and as necessary to provide quality services to all of EIHC’s clients. Health care operations include such activities as evaluating the quality of health care services, compliance with federal and state regulations, case management and care coordination, professional review and performance evaluation, business planning and development and general administrative activities of EIHC. For example, EIHC may use your health information to evaluate its staff performance, combine your health information with other EIHC clients in evaluating how to more effectively serve all of its clients, disclose your health information to EIHC staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings unless you tell us you do not want to be contacted.

Obtain Payment
EIHC may include your health information on invoices to collect payment from third parties for the care you receive from EIHC. For example, EIHC may be required by the federal or state government to provide information regarding your health care status so that the federal or state government will reimburse you or EIHC. EIHC may also need to obtain prior approval from your insurer or state or federal government and may need to explain your need for services that would be provided to you.

Appointment Reminders
EIHC may contact you as a reminder that you have an appointment for treatment or service.

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

Fundraising Activities
EIHC may use information about you including your name, address, phone number, and the dates you received services in order to contact you or your family to raise money for EIHC. If you do not want EIHC to contact you or your family, notify the Privacy Officer and indicate that you do
not wish to be contacted.

Business Associates
EIHC may disclose your health information to our third-party service providers (called “Business Associates”) that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use a Business Associate to assist us in maintaining our practice management software. All of our Business Associates are obligated, under contract with us, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.

Other Use and Disclosure of Health Information

Legally Required
EIHC will disclose your health information when it is required to do so by any federal, state or local law.

Public Health Activities
EIHC may disclose your health information for public activities and purposes in order to prevent or control disease, injury, disability, report abuse or neglect, report domestic violence, report to the Food and Drug Administration problems with products and reactions to medications, to report disease or infection exposure and, with parent or guardian permission, to send proof of required immunization(s) to a school.

Abuse, Neglect or Domestic Violence
EIHC may notify the appropriate government authority if we believe an individual has been the victim of abuse, neglect or domestic violence. Unless such disclosure is required by law (for example, to report
a particular type of injury), we will only make this disclosure if you agree or in other limited circumstances when such
disclosure is authorized by law.

Health Oversight Activities
EIHC may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. EIHC may not disclose your health information if you are the subject of the investigation and your health information is not directly related to your receipt of healthcare or public benefits.

Judicial and Administrative Proceedings
EIHC may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process but only when EIHC makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

Law Enforcement Purposes
EIHC may disclose your health information to a law enforcement official for purposes, such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena or other law enforcement purpose.

Deceased Person Information
EIHC may disclose your health information to coroners, medical examiners and funeral directors.

Organ, Eye or Tissue Donation
EIHC may release health information to organ, eye or tissue procurement, transplantation or banking organizations or entities as necessary to facilitate organ, eye or tissue donation and transplantation.

Health and Safety
In the event of a serious health threat to health or safety, EIHC may, consistent with applicable law and ethical standards of conduct, disclose your health information if EIHC in good faith believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

Specialized Governmental Functions
EIHC may disclose your health information for military, national security, prisoner and government to benefit purposes.

Workers ‘ Compensation
EIHC may disclose your health information as necessary to comply with workers’ compensation laws.

Authorization to Use or Disclose Health Information

For purposes not described above, including uses and disclosures of PHI for marketing purposes, disclosures that would constitute a sale of PHI and most sharing of psychotherapy notes, EIHC will ask for your authorization before using or disclosing PHI. If you authorize EIHC to use or disclose your health information, you may revoke that authorization in writing at any time. A revocation of authorization will be effective on the date it is received and will not affect previous disclosures.

Breach Notification

EIHC is required to provide you with notification if it discovers a breach of your unsecured protected health information that may have compromised the privacy or security of your information. You will be notified without unreasonable delay and no later than 60 days after discovery of the breach. Such notification will include information about what happened and what can be done to mitigate any harm.

Your Rights with Respect to Your Health Information

You have the following rights regarding your health information that EIHC maintains:

Right To Request Restrictions
You may request restrictions on certain uses and disclosures of your health information. You have the right to request that EIHC limit disclosure of your health information to someone who is involved in your care or payment for your care. EIHC is not required to agree to this request. If you have paid for services out-of-pocket, in full, you may request that EIHC not disclose PHI related solely to those services to a health plan. EIHC must accommodate this request, except where EIHC is required by law to make a disclosure. If you wish to make a request for restriction, contact the Privacy Officer, identified below.

Right To Inspect and Copy Your Health Information
You have the right to inspect and copy your health information. A request to inspect and copy records containing your health information may be made to the Privacy Officer identified below. If you request a copy of your health information, EIHC may charge a reasonable fee for copying.

Right To Receive Confidential Communications
You have the right to request that EIHC communicate with you in a certain way. For example, you may ask that EIHC only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive only confidential communications, contact the Privacy Officer
identified below. EIHC will not request that you provide any reason for your request and will attempt to honor your reasonable request for confidential communications.

Right To Amend Health Information
You or your representative has the right to request that EIHC amend your records if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by EIHC. A request for amendment should be made in writing to the Privacy Officer identified below. EIHC may deny the request if it is not in writing or does not include a reason for the amendment. The request may also be denied if your health information records were not created by EIHC, if the records you are requesting are not part of EIHC’s record, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy or if, in the opinion of EIHC, the records containing your health information are accurate and complete.

Right to Accounting of Disclosures
You have a right to receive an accounting of disclosures of your health information made by EIHC in the six years prior to the date of your request. The request for an accounting must be made in writing to the Privacy Officer identified below. EIHC will provide the first accounting during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

Right to Copy of Notice
You have a right to a paper copy of this Notice of Privacy Practices.

Duties of EIHC

EIHC is required to abide by the terms of this Notice as it may be amended from time to time. EIHC reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that it maintains. If EIHC changes this Notice, EIHC will provide a copy of the revised Notice to you or your representative. You or your representative has the right to express complaints to EIHC or to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated.

For further information, please contact:
Privacy Officer
Eastern Iowa Health Center
715 10th Avenue SE
Cedar Rapids, IA, 52401-2421

EIHC encourages you to express any concerns that you may have regarding the privacy of your information. If you are not satisfied with the manner in which EIHC handles a complaint, you may submit a formal complaint to:
Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue S.W. Room 509F
Washington, DC 20201

You will not be retaliated against in any way for filing a complaint.

This Notice of Privacy Practices applies to the following
organizations:
Eastern Iowa Health Center
EIHC, d/b/a: Eastern Iowa Women’s Health Center
EIHC, d/b/a: Eastern Iowa Walk-In Clinic
EIHC, d/b/a: Eastern Iowa Dental Center

This Notice is effective March 1, 2017.

HISTORY

Serving your health needs has been our mission from day one

LEADERS

Our talented leadership team is here for you and your family

BOARD

We are guided by highly respected members of our community

CAREERS

Take your career to new heights at Eastern Iowa Health Center

PRIVACY

Protecting the privacy of all we serve is critical to our mission

WHAT OUR PATIENTS ARE SAYING

“Dr. Livermore took time to really listen to me. It feels so good to have a doctor that cares.” – Jenny

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Your health matters.