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. Community Services (CS) is required by the Health Insurance Portability and Accountability Act (HIPAA), a federal law, to maintain the privacy of your health information and to provide you with this notice. CS is required to meet all procedures and standards defined in this notice.
Your Rights - You have the right to:
Your Choices - You have some choices in the way that we use and share information as we:
Our Uses and Disclosures - We may use and share your information as we:
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
Ask us to correct your medical record
Request confidential communications
Ask us to limit what we use or share
Get a list of those with whom we’ve shared information
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
File a complaint if you feel your rights are violated
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
In the case of fundraising:
We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
The uses and disclosures described below do not require your consent, authorization, or opportunity to agree or object.
Help with public health and safety issues
Comply with the law
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond to lawsuits and legal action
Alcohol and Drug Abuse Information
The privacy of information held by PWC Community Services which identifies, or could identify, a person as an alcohol or drug abuser, is controlled by a specific federal privacy law. The privacy standards of 42 CFR Part 2 are often more restrictive than the standards set out in this Notice, and we must follow the more restrictive standards. Generally, PWC Community Services may not say to a person outside the program that you attend the program, or disclose any information identifying you as an alcohol or drug abuser unless: (1) you authorize it in writing; (2) the disclosure is allowed by a court order; or (3) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Violation of Federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations. Federal law and regulations do not protect any information about a crime committed by a patient either at PWC Community Services or against any person who works for the PWC Community Services or about any threat to commit such a crime. They also do not protect against any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.
· We are required by law to maintain the privacy and security of your protected health information.
· We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
· We must follow the duties and privacy practices described in this notice and give you a copy of it.
· We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you.
Effective Date of this Notice –
Date of Origin: 4/14/03
Date Revised: 3/15/07, 9/23/13, and 12/29/15
Privacy Officer: Laurie Olivieri
8033 Ashton Avenue, Suite 107
Manassas, VA 20109
703-792-7740, [email protected]