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Health Director
Mary Gomez, MN

 

Contact Us

health@cochise.az.gov
 

Toll Free
1-800-423-7271

 

Benson   
126 W. 5th Street 
Benson, AZ 85602

(520) 586-8200

 

Bisbee  

(Main Office)
1415 Melody Lane Bldg. A 
Bisbee, AZ 85603
(520) 432-9400


Douglas  
1012 North G Avenue Ste 101
Douglas, AZ 85607
(520) 805-5600
 

 

Sierra Vista  

4115 E. Foothills Drive
Sierra Vista, AZ 85635
(520) 803-3900


Willcox 
450 S. Haskell Avenue
Willcox, AZ 85643
(520) 384-7100
 

Cochise Health & Social Services

horses2.jpgNOTICE OF PRIVACY PRACTICES

  • Original Effective Date:       April 14, 2003
  • Review Date:                      June 16, 2009

THIS NOTICE WILL TELL YOU HOW WE WILL USE AND SHARE YOUR RECORDS.  THIS NOTICE WILL TELL YOU HOW TO GET THIS INFORMATION.  PLEASE READ IT CAREFULLY.

A federal rule, named the "HIPAA Privacy Rule  (the Rule), asks that we give you details in writing about our privacy practices.  We know that this Notice is long.  The Rule asks us to tell you many specific things in this Notice.

 

I.                    OUR COMMITMENT TO PROTECT YOUR HEALTH INFORMATION

In this Notice, we tell you the ways that we may use and share health information about our members.  The Rule says that we have to protect the privacy of your records.  This includes things that can identify you or that someone else can use to identify you.  This information is called "protected health information" or "PHI" (records).  This Notice tells you about your rights as our member.  This Notice tells you what we are required to do when we use and share your records.  The law says we have to:

  • Keep protected health information or PHI (records) about you private;
  • Send you this Notice telling you about what the law requires.  Tell you how we use your records; and
  • Comply with the terms of our Notice of Privacy Practices that is currently in effect.

Cochise Health & Social Services (CHSS) staff are required to follow privacy policies.  These policies allow our staff to use your records only to perform their job duties.  CHSS also protects the privacy of your records in our offices and in our computers.

CHSS may make changes or update this Notice.  This may affect the records we may already have about you.  You will receive a copy of any revised Notice.  The revised Notice will also be posted on our website at http://cochise.az.gov/cochise_health.aspx?id=8342  You can also call our Privacy Officer for a copy of the Notice.

 

II.                  HOW WE MAY USE AND SHARE YOUR RECORDS 

CHSS may use and share your records to provide services for you.  CHSS may use and share your records to provide treatment for you.  CHSS may use and share your records to provide payment for your medical care.  CHSS may use and share your records to operate our business.  These are examples and may not list everything.

Services/Treatment:  CHSS may use and share your records to set up services for your medical care.  CHSS may use and share your records to make sure our providers have the information they need to take care of you.  For example, we may use and share your records about your medicines, lab work, an x-ray, or other health care services.  We may use and share your records when we refer you to another health care provider.  For example, CHSS may use and share your records with a specialist your doctor has asked you to see.  This may include records about your medicines and other services that you are receiving.

Payment:  We may use and share your records to pay for your treatment and services.  We may share your medical history with our providers.  We may ask our providers for records about the services they did for you.  For example, we ask for medical records to make sure you are receiving the right amount of care before we pay for the services.  We may use and share records for billing, claims management, and collection activities.  We may use and share your records with your other medical insurance companies. 

We may share your records with another health care provider or health plan.  This will help them comply with the federal Rule to pay for your services.  For example, we may allow a health insurance company to review your records so that they can decide how much should be paid for your care.

Health Care Operations:  We may use and share your records to perform business activities.  They are called health care operations.  Health care operations include things that help us improve the quality of care we provide.  They also help reduce health care costs.  We may use and share your records in the following operations:

  • To look at and review the quality of the care our members receive.  To look at and review the efficiency of the care our members receive.  To look at and review the cost of care our members receive.  For example, we may use your records to help our doctors and staff decide how to improve the medical treatment we provide.
  • To review and evaluate the skills of the providers who take care of you.  To review and evaluate the qualifications of the providers who take care of you.  To review and evaluate the performance of the providers who take care of you.
  • To cooperate with agencies that we work with, like AHCCCS.  AHCCCS assesses the quality of the care that we provide.
  • To cooperate with various people who review our activities.  For example, doctors who review the services we provide to you may see your records.  Accountants, lawyers, or others who assist us to follow the law and manage our business may see your records.
  • To assist AHCCCS to determine eligibility.
  • To resolve grievances.
  • To review our activities and share your records if another health plan took over our services.
  • To plan and develop our business.  For example, to analyze how we manage our costs.
  • To manage our daily business activities.  This will include activities to comply with the federal Rule and other laws.
  • To create reports about how many services were provided.  This is called "utilization".  These reports do not identify our members.

We may share your records with your former medical care provider.  We may share your records with your former medical insurance company.  They also have to comply with the federal Rule to protect your privacy.  For example, they may need records to review the quality of the care they provide you.  They may need records about the efficiency or the cost of the care you received.

Our providers may use your records for "organized health care arrangements."  An example of an "organized health care arrangement" is care that is provided by a hospital and the doctors who see patients at the hospital.

Communication from Our Office:  We may contact you to remind you of appointments.  We may contact you to give you information about services.  We may contact you to give you information about your health.

  

HOW WE CAN USE AND SHARE YOUR RECORDS WITHOUT YOUR WRITTEN AUTHORIZATION

When You Have The Opportunity to Agree or Object: You have the right to agree or object when we use and share your records in some situations.  If you do not object, then we may share or use these types of records:

Persons Who Help Take Care of You.  Persons Who Help You Pay For Your Care.  We need your permission to share your records.  Persons you may want us to share your records with are your family member, close friend, or someone else.  These persons may help you with your care or help you pay for your care.  The Nurse will ask you who you want us to discuss your care with.  This person may not always be available.  If this happens, CHSS staff will use our professional judgment to decide whom to speak to about your care.  We will be careful to keep your best interests in mind.  For example, you may be sent to a hospital.  We may share information with your family or friends about where you are.  We may share information with your family or friends about your illness or death.  If there is a disaster, we may give them information to help them help you.  You may need someone to help you pick up prescriptions, medical supplies, x-rays, or other things.  If this happens, CHSS staff will use our professional judgment to decide whom to allow to help you.

When You DO NOT Have the Opportunity to Agree or Object: You do not have the right to agree or object when we use and share your records in some situations.  If this happens, we will comply with certain conditions that may apply.  Here is a list of some of these situations:

Required by Law:  We may use and share your records as required by federal, state, or local law.  If we share this information, we will comply with the law.  We will also limit what we share as required by the law.

Public Health Activities:  We may use or share your records with public health agencies.  We may also use or share your records with other public health people who are authorized.   They may need these records to carry out certain activities.  Here is a list of some of these activities:

  • To prevent or control disease, injury, or disability;
  • To report disease, injury, birth, or death;
  • To report child  or adult abuse or neglect;
  • To report reactions to medicines or problems with products or devices.  The federal Food and Drug Administration regulate these.  To report other activities related to quality, safety, or effectiveness of FDA-regulated products or activities.
  • To locate and notify persons of recalls of products they may be using;
  • To notify a person who may have been exposed to a communicable disease.  This is necessary in order to control who may be at risk of contracting or spreading the disease; or
  • To report to your employer, under limited circumstances, information related primarily to workplace injuries or illness, or workplace medical surveillance.

Abuse, Neglect, or Domestic Violence:  We may share information with the proper government agencies.  The law says we must make a report in certain cases.  These cases include domestic violence, abuse, or neglect.  We will make a report if we believe one of our members is a victim.

Health Oversight Activities:  We may share records with a health oversight agency.  This oversight may include audits and investigations.  This oversight may also include inspections, licensure and disciplinary activities.  These agencies monitor the health care system.  These agencies also monitor government health programs.  These agencies have to comply with certain laws.

Lawsuits and Other Legal Proceedings:  We may use or share your records when a court orders us to.  We may use or share your records when an administrative tribunal orders us to.  We may also share information in response to subpoenas, discovery requests, or other required legal processes when efforts have been made to advise you of the request or to obtain an order protecting the information requested.

To Enforce the Law:  In certain cases, we may share your records with officers who enforce the law.  Here is a list of some of these cases:

  • About a suspected crime victim if, in certain limited cases, we are unable to obtain a person's agreement because of incapacity or emergency;
  • To alert law enforcement of a death that we suspect was the result of criminal conduct;
  • Required by law;
  • In response to a court order, warrant, subpoena, summons, administrative agency request, or other authorized process;
  • To identify or locate a suspect, fugitive, material witness, or missing person.
  • To make a report about a crime or suspected crime committed at our office.  This may include a report about the nature of the crime.  This may include a report about the location of the crime or the victim.  This may include a report about the identity of the person who committed the crime.

Coroners, Medical Examiners, Funeral Directors:  We may share records with a coroner or medical examiner to identify a dead person.  These records may be needed to find the cause of death.  We may share records with funeral directors, as stated by law, to help them carry out their jobs.

Organ and Tissue Donation:  If you are an organ donor, we may share your records with agencies that help procure, locate, and transplant organs.  These records will help them to facilitate an organ, eye, or tissue donation and transplantation.

To Stop a Serious Threat to Health or Safety:  We may use and share your records to prevent a threat to the health or safety of a person or to the public.  This will only be done in limited cases.   These records can only be shared with a person who is able to help prevent the threat.

Special Government Functions:  Under certain circumstances we may share your records:

  • For certain military and veteran activities.  This may include checking for eligibility for veterans for veteran’s benefits.  Also, where deemed necessary by military command authorities.
  • For national security and intelligence activities;
  • To help provide protective services for the President and others;
  • For the health or safety of inmates and others at correctional institutions or other law enforcement custodial situations for the general safety and health related to corrections facilities.

Sharing of Records required by HIPAA Privacy Rule:  We are required to share records with the Secretary of the United States Department of Health and Human Services.  The Secretary may ask for these records to make sure that we are complying with the Rule.  We are also required in certain cases to share your records when you request it.  Those requests are described in Section III of this Notice.

Worker's Compensation:  We may share your records as allowed by worker's compensation laws.  We may share your records with other similar programs.  These programs provide benefits for work-related injuries or illnesses.

When You Have to Give Us Permission to Share Your Records: All other uses and sharing of records about you will only be made with your written permission.  If you have given us permission to use or share your records, you may cancel your permission at any time.  From the time that you tell us that you wish to cancel that permission; we will not share your records.

 

III.                YOUR RIGHTS ABOUT PROTECTED HEALTH INFORMATION ABOUT YOU 

Under federal law, you have the following rights with regard to your records:

Right to Request That We Restrict Certain Records:  These are records that we may use for treatment, payment and health care operations.  You may also request that we restrict how we share your records to certain persons involved in your care that otherwise would be allowed by the Privacy Rule.  We are not required to agree to your request.  If we do agree to your request, we are required to comply with our agreement except in certain cases, including where the records are needed to treat you in the case of an emergency.  To request that we restrict your records, you must make your request in writing to our Privacy Officer.  In your request, please include (1) the records that you want to restrict; (2) how you want to restrict the records (for example, restrict use to this office, only restrict sharing with persons outside this office, or restrict both); and (3) to whom you want us to restrict the records.

Right to Receive Confidential Communications:  You have the right to ask that you receive communications about your protected records in a certain way or at a certain place.  For example, you may ask that we contact you at home, and not at work.  You must make your request in writing to our Privacy Officer.  You must tell us how you would like to be contacted (for example, by regular mail to your post office box and not your home).  We are required to meet reasonable requests.

Right to Inspect and Copy:  You have the right to ask to look at and receive a copy of certain records that we keep.  This includes your medical and billing records.  This does not include psychotherapy notes.  This does not include records about a civil, criminal, or administrative proceeding.  We may deny your request to look at and copy your records only in a few cases.  To look at and copy your records please contact our Privacy Officer.  We may charge you a reasonable fee for the copying, postage, labor and supplies.

Right to Change:  You have the right to ask that we change records about you as long as such records are kept by or for our office.  To ask for a change you must send your request in writing to our Privacy Officer.  You must also give us a reason for your request.  We may deny your request in certain cases, including if it is not in writing or if you do not give us a reason for the request.

Right to Receive an Accounting of Records We Have Shared.  You have the right to request an "accounting" of certain records about you that we shared.  This is a list made by us during a period of up to six years.  This does not include records that we may have shared for services, treatment, payment, and health care operations.  It does not include information we may have given to family members or friends that you designated and who are involved in your care.  It does not include information given to you directly or to your authorized representative, or for certain notification purposes (including national security, intelligence, correctional or law enforcement purposes) and records we shared before April 14, 2003.  To ask for an accounting, please contact our Privacy Officer.  The first list that you request in a 12-month period will be free.  We may charge you for our reasonable costs for additional lists in the same 12-month period.  We will tell you about these costs before we charge you. You may choose to cancel your request at any time before we have to charge you.

Right to a Paper Copy of this Notice: You have a right to receive a paper copy of this Notice at any time.  You can receive a paper copy of this Notice even if you have previously agreed to receive this Notice electronically.

  • To obtain a paper copy of this Notice, please contact our Privacy Officer. 

 

IV.                COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with us or the Secretary of the United States Department of Health and Human Services.  To file a complaint with our office, please contact our Grievance Manager at the address and number listed below.  We will not retaliate or take action against you for filing a complaint.

 

V.                  QUESTIONS

Do you have questions about this Notice?  Please contact our Grievance Manager or Privacy Officer at the address and telephone number listed below.

 

VI.                PRIVACY OFFICIAL CONTACT INFORMATION

Cochise Health & Social Services

Attn: Privacy Officer

1415 Melody Lane, Bldg. A

Bisbee, AZ 85603

(520) 432-9400