Cathy Bodnar, Chief Compliance & Privacy Officer
1900 W Polk St.,
Suite 227AChicago, IL 60612
Phone: (866) 489-4949Email
This is a Notice of Privacy Practices, tells you how Cook County Health (CCH) may use and disclose or share your health information. In it we explain how we use and share your medical record and health information to provide you with care, receive payment for the care we provide, and for health care operations (to help us run the health and hospital system). Sometimes this is also called a HIPAA statement.
Why are you telling me about this?
We are required by law to protect the privacy of your health information and to provide you with this information and if you are affected, to notify you following a breach of unsecured protected health information. State and federal privacy laws strengthen our commitment to you, as our patient, to carefully maintain your confidentiality.
Who follows This Notice?
All Cook County Health affiliated organizations (collectively CCH), all employees, medical staff, house staff, research staff, students, agency personnel, consultants, venders, volunteers, and other care professionals allowed to review your record.
- Notice of Privacy Practices – English
- Notice of Privacy Practices – Spanish (AVISO DE PRÁCTICAS PRIVADAS)
- Notice of Privacy Practices – Polish (OBWIESZCZENIE ODNOŚNIE PRYWATNOŚCI INFORMACJI MEDYCZNYCH)
How We May Use and Share Your Health Information
We will use and share your health information to provide care and services for you.
For Example: Doctors, nurses, or other healthcare providers may review your record to treat your injury or illness. Your health information also may be shared with other healthcare professionals outside CCH to decide on the best treatment for you or to coordinate your care. We may share your health information to providers outside CCH through Health Information Exchanges. A Health Information Exchange is a secure way to quickly share your information electronically with other health professionals who are involved in your care or care coordination.
We will use and share your health information for health care business operations. There are several reasons we would do that, one important reason is to maintain and improve patient care.
For Example: We may use your health information to make sure that you and other patients get the best possible quality care and to review the performance of our doctors, nurses or other healthcare professionals. Your information may be used as part of training for students and help to meet hospital licensing and accreditation. We may use your information, such that you may be identified, for the purposes of training case reviews with our clinical staff. We may use your health information to make certain that billing is done correctly.
We may use and share your health information to receive payment for the care and services we provide to you.
For Example: We may contact Medicare, Medicaid, your insurance company, or other company or program that arranges for or pays the cost of some or all of your healthcare, and to find out if a service is covered. We may share your information through a Health Information Exchange.
In Our Patient Directory
We may include your name, the location where you receive service (hospital or clinic), your general condition (such as stable or fair), and your religious affiliation. We keep this information so your family, friends or clergy can visit you while you’re here. Unless you object, we will release your location and general condition to people who ask for you by name. Your religious affiliation will only be released to a member of the clergy. If you do object, we will not disclose any information to anyone who asks for you.
To Remind You Of An Appointment
We may contact you to remind you of an appointment or to change one. We might contact you to follow-up to see how you’re doing after an appointment.
With Individuals Involved in Your Care or Payment for Your Care
We may share health information about you with your family members, friends or any other person you tell us who is involved in your healthcare or who helps pay for it. We may tell your family or friends your condition and that you are in one of our facilities. We also may share health information about you to a disaster relief agency so that your family can be told of your condition and location. You may decide not to share this information but you must let us know.
With Others Called Business Associates
We may share your health information with another company or organization, called a business associate that we hire to provide a service to us or on our behalf. We will only share your information if the business associate has agreed in writing to keep health information private.
To Perform Research
We may use and disclose your medical information for research purposes. Most research projects, however, are subject to a special approval process. Most research projects require your permission if a researcher will be involved in your care or will have access to your name, address or other information that identifies you. However, the law allows some research to be done using your medical information without requiring your authorization.
To Share Information About Health-Related Benefits, Services and Treatment Alternatives
We may use your medical information to contact you about health-related benefits, products, and/or services, and possible treatments or alternatives that may be of interest to you. We may provide you information by a general newsletter or in person or by way of products or services of nominal value. We may disclose your medical information to a business associate to assist us in these activities. We may contact you by email or text messaging for appointment reminders, patient surveys, wellness program benefits, or other general communications if you provide us with your email address and/or mobile phone number. You expressly permit this type of contact unless you notify us that you do not want to receive text messages or emails. However, we may not sell your Protected Health Information without your written authorization.
We may use your medical information to raise money for CCH. We may disclose certain information such as your name, address, telephone number, gender, age, and the dates you received treatment at CCHHS to our Foundation so it can contact you. Please notify us at the address or phone number at the end of this Notice if you do not want the CCH Foundation to contact you.
We are Required to Share Your Health Information
Public Health and Safety
We may share your health information for public health reasons. For example:
- to prevent or control disease, injury or disability;
- to report births and deaths;
- to report child abuse or neglect;
- to report information to the FDA about the products it oversees;
- to let you know that you may have been exposed to a disease or may be at risk for getting or spreading a disease or condition; or
- to your employer in certain limited instances.
With Law Enforcement
We must share health information about you when we are required to do so by federal, state, or local law, or by the court process.
- to respond to a court order, warrant, summons or other similar process;
- to identify or locate a suspect, fugitive, material witness or missing person; or
- to obtain information about an actual or suspected victim of a crime.
We may share information with a law enforcement official:
- if we believe a death was the result of a crime;
- to report crimes on our property; or
- in an emergency.
As a Part of Legal Proceedings
If a court or administrative authority orders us to do so, we may release your health records. We will only share the information required by the order. If we receive any other legal request, we may also release your health record. However, for other requests we will only release the information if we are told that you know about it, had a chance to object and did not.
During an Investigations
The Secretary of the Department of Health and Human Services may investigate privacy violations. If your health information is requested as part of an investigation, we must share your information with the Secretary of the Department of Health and Human Services. We will share your information if they ask for it as part of an investigation of a privacy violation. Under the same laws, we must give you information in your medical record. We are allowed to keep some information from you.
Special Governmental Functions
We may share your health information with:
Authorized federal officials
- for intelligence, counter-intelligence and other national security activities authorized by law; or
- to protect the president.
Armed forces command authorities or the Department of Veteran’s Affairs
- to see if you are fit for military duty or eligible for veterans health services; or
- to see if you are medically fit to receive a security clearance by the Department of State.
Correctional facility or law enforcement official or agency if you are an inmate or under the custody of a law enforcement official or agency, if necessary, to:
- help the correctional facility provide you with health care; or
- protect the health and safety of you and/or others.
Abuse and Neglect
The law may require us to report suspected abuse, neglect or domestic violence to state and federal agencies. Your information may be shared with these agencies for this purpose. Generally, you will be told that we are sharing this information with these agencies.
Health Oversight Activities
Certain health agencies are in charge of overseeing health care systems and government programs or to make sure that civil rights laws are being followed. We may share your information with these agencies for these purposes.
Coroners, Medical Examiners and Funeral Directors
We may share health information with a coroner or medical examiner to identify a dead person or find the cause of death. We also may release health information to funeral directors if they need it to do their job.
Organ and Tissue Donation
If you are an organ donor, we may release health information to the organizations in charge of getting, transporting or transplanting an organ, eye or tissue.
To Prevent a Serious Threat to Safety
We may use and share your medical information to prevent a serious threat to your health and safety or the health and safety of others.
We may share your health information with agencies or individuals to follow workers compensation laws or other similar programs.
Your Rights About Health Information About You
You Have a Right to Inspect and Copy
You have the right to read or get a copy of your medical record. This includes medical and billing records, but does not include psychotherapy records. To see and/ or obtain copies of your information you must complete your request in writing. If you request a copy of your medical record, we may charge a fee for the costs of copying, mailing or other expenses associated with your request. We may deny your request to see and/ or obtain a copy of your medical record. If we do so, CCH will choose an independent licensed health- care professional to review your request and our denial. We will follow the decision of the independent licensed health-care professional.
You Have a Right to Request Changes
If you believe the health information that we created is wrong or incomplete, you may ask us to change it. Once again, you must send us a written request. You must provide a reason why you want the change. We cannot take out or destroy any information already in your medical record. We also are not required to agree to make the change. If we do not agree to the change, you can write a letter about the changes. We will send you one back saying why we will not make the changes. You may then send another disagreeing with us. It will be attached to the information you wanted changed or corrected.
You Have a Right to Request Restrictions
You have the right to ask us to restrict the uses and disclosures we make of your health information for treatment, payment, and health care operations, with one exception, we do not have to agree. You may also ask us to limit the information that we use or disclose with your family members, friends or any other person you tell us who is involved in your health care or who helps pay for it. We must agree to your request to a restriction on disclosures of your PHI to a health plan if you have paid for the health care item or service in full out of pocket. Other than that, we do not have to agree. A request for a restriction must be in writing, it must be signed and dated, and you must identify the CCH clinic or hospital that maintains the information. You should also describe the information you want restricted, tell us whether you want to limit the use or the disclosure or both, and tell us who should not receive this restricted information. You must submit your written request to the Office of Corporate Compliance, 1900 West Polk, Suite 123, Chicago, IL 60612. We will tell you if we agree with your request or not. If we do agree, we will comply with your request unless the information is needed to treat you in an emergency.
You Have a Right to an Accounting of Disclosures
You have the right to make a written request for a list of certain disclosures made of your medical information. This list is not required to include all disclosures we make. Disclosures made before April 14, 2003, disclosures made to you or which you authorized, and other disclosures are not required to be listed. Your written request must designate a time period.
You Have a Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice. Copies of this Notice will be posted and available at each location where health services are provided.
Other Uses and Disclosure of Your Health Information
Some types of medical information are very sensitive. The law, with some exceptions, may require that we obtain your written permission to disclose this information. Sensitive medical information may include genetic testing, HIV/AIDS testing, diagnosis or treatment, mental health, alcohol and substance abuse, sexual assault or in-vitro fertilization. Your permission is also required for the use and disclosure of psychotherapy notes.
Use of Your Information for Our Marketing
We may not use or disclose your protected health information for marketing purposes involving financial remuneration to us from a third party unless we have your written permission.
Sale of Your Information
We may not sell your protected health information unless we have your written permission.
All other uses and sharing of your health information not described in this Notice will be done only with your written permission. You may revoke that permission at any time by sending a request in writing to the Office of Corporate Compliance at the address below.
Changes to this Notice
We may change our privacy policies, procedures, and this Notice at any time. If we do change this Notice we reserve the right to make the revised or changed Notice effective for your health information we already have as well as any we get in the future. If we change this Notice, we will post the new Notice in common areas throughout our clinics or hospitals and on our Internet site at www.cookcountyhhs.org.
What if I need to report a problem?
Your care will not be affected if you file a complaint, nor will any action be taken against you.
If you believe CCH has violated your privacy rights in this Notice, you may file a complaint with CCHHS or with the Office for Civil Rights, U.S. Department of Health and Human Services.
To contact CCH to discuss your concern, use the information below:
Office of Corporate Compliance
Cook County Health
1950 West Polk St., 9th Floor
Chicago, IL 60612
Telephone: (877) 476-1873
English: ATTENTION: If you speak ENGLISH, language assistance services, free of charge, are available to you. Call 312-864-0185.
Spanish: ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 312-864-0185.
Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 312-864-0185.
Chinese: 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 312-864-0185.
Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 312-864-0185. 번으로전화해 주십시오.
Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 312-864-0185.
Arabic: 44-855 / 0185-864- 4-1661 ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 312 / 711
(0185-864- .رقم ھاتف الصم والبكم: 3
Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 312-864-0185.
Gujarati: ચુ ના: જો તમે જુ રાતી બોલતા હો, તો િન:ુ ક ભાષા સહાય સેવાઓ તમારા માટ ઉપલધ છે. ફોન કરો 312-864-0185.
Urdu: 0185-864- .خبردار: اگر آپ اردو بولتے ہيں، تو آپ کو زبان کی مدد کی خدمات مفت ميں دستياب ہيں ۔ کال 312
Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 312-864-0185.
Italian: ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 312-864-0185.
Hindi: यान द: यिद आप िहंदी बोलते ह तो आपके िलए मुत म भाषा सहायता सेवाएं उपलध ह। 312-864-0185.
French: ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 312-864-0185.
Greek: ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσήσαςβρίσκονται υπηρεσίεςγλωσσικήςυποστήριξης, οι οποίεςπαρέχονται δωρεάν. Καλέστε 312-864-0185.
German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 312-864-0185.