Clinic Policies and Privacy Information

Non-Descrimination Policy

Students, faculty, staff, and persons served in the program’s clinic are treated in a nondiscriminatory manner – that is, without regard to race, color, religion, sex, national origin, participation restriction, age, sexual orientation, or status as a parent. The institution and program comply with all applicable laws, regulations, and executive orders pertaining thereto.

Notice of Privacy Practices

This notice describes how Protecte Health Information (PHI) about you may be used and disclosed and how you may access this information. Please review it carefully. (Effective: 4/14/03)

Our Privacy Responsibilities

The Utah State University (USU) Department of Communicative Disorders and Deaf Education (COMDDE) Speech-Language-Hearing Center (USU SLHC) is committed to protecting your personal health information. The USU SLHC is required by law to: 1) maintain the privacy of your personal health information, 2) provide this notice to you, and 3) abide by the terms of this notice.

Who is Covered by this Notice ?

This notice describes the USU SLHC practices and that of: 1) any department health care professional authorized to enter information into your chart, 2) any authorized student allowed to provide services to you while you are in the USU SLHC, and 3) all employees, staff, and other facility personnel.

All these entities must follow the terms of this notice. In addition, these entities may share personal health information with each other for purposes of treatment, payment, or health care operations as described in this notice.

How We May Use and Disclose Personal Health Information About You

The following categories describe different ways that we use and disclose your personal health information.

For Treatment:
We may use and disclose personal health information to provide you with treatment or other services. For example, we may disclose personal health information about you to: 1) other facility personnel who are necessary to the provision of services to you, 2) students in the course of their training at this facility, and 3) individuals outside the facility who may be involved in your continuing health care, both during treatment at this facility and after your services are completed at this facility.

For Payment:
We may use and disclose personal health information about you so that the treatment and services you receive at the facility may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may tell your health plan about a treatment or other service 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:

We may use and disclose personal health information about you for facility operations. These uses and disclosures are necessary to run the facility and make sure that all of our patients receive quality care.?For example, we may use your personal health information when reviewing our treatment and services program and when evaluating the performance of our health care professionals and students in training.

Appointment Reminders

We may use and disclose personal health information to contact you as a reminder that you have an appointment for treatment or other services at the facility.If you do not wish to receive appointment reminders, be sure to notify your service provider at this facility.

Health-Related Benefits and Services

We may use and disclose personal health information to tell you about treatment options, health-related benefits or services that may be of interest to you.

Fundraising Activities

We may use and disclose your personal health information to contact you in an effort to raise money for the facility, as part of our University mission. We may also provide contact information (such as your name, address, and phone number) to designated University personnel for this purpose.

If you do not wish to be contacted for fundraising efforts, you must notify, in writing, the Department Head at the following address: Utah State University, Department of COMDDE, 1000 Old Main Hill, Logan, UT 84322-1000.

Individuals Involved in Your Care or Payment for Your Care

We may release personal health information about you to a family member or other designated individual who is involved in your health care. We may also give information to someone who helps pay for your care.?In addition, we may disclose personal health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

Research

Under certain circumstances, we may use and disclose personal health information about you for research purposes.All research projects, however, are subject to a special University approval process.This process evaluates a proposed research project and its use of personal health information, and tries to balance the research needs with the patients?need for privacy of their personal health information. Before we use or disclose personal health information for research, the project will have been approved through this research approval process.We may, however, disclose personal health information about you to individuals preparing to conduct a research project.An example would be to help them look for patients with specific health care needs, so long as the personal health information they review does not leave the facility.

Special Disclosure Situations.

There are limited situations when we are permitted or required to disclose personal health information without your signed authorization. These include: 1) for public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; reporting births and deaths; and reporting reactions to drugs and problems with medical devices, 2) to protect victims of abuse, neglect, or domestic violence, 3) for health oversight activities such as investigations, audits, and inspections, 3) for lawsuits and similar proceedings, 4) when requested by law enforcement as required by law or court order, 5) to coroners, medical examiners, and funeral directors, 6) for organ and tissue donation, 7) to reduce or prevent a serious threat to public health and safety, 8) for workers compensation or other similar programs if you are injured at work, 9) for specialized government functions such as intelligence, national security, military, and veterans activities, 10) when otherwise required by law.

All other uses and disclosures not described in this notice require your signed authorization. You may revoke your authorization at any time with a written statement.

Your Rights Regarding Your Personal Health Information

You have the following rights regarding your personal health information as maintained by our facility: 1) request restrictions on how we use and share your health information.?We will consider all requests for restrictions carefully but are not required to agree to any restriction, 2) request that we communicate with you only in a specified way, such as at a specific telephone number or address, 3) inspect and copy your health information, including medical and billing records. Fees may apply.?Under limited circumstances, we may deny you access to a portion of your health information and you may request a review of the denial,* 4) request corrections or additions to your health information,* 5) request an accounting of certain disclosures of your health information made by us. The accounting does not include disclosures made for treatment, payment, and health care operations and some disclosures required by law.?Your request must state the period of time desired for the accounting, which must be within the six years prior to your request and exclude dates prior to April 14, 2003.?The first accounting is free but a fee will apply if more than one request is made in a 12-month period,* and 6) request a paper copy of this notice even if you agree to receive it electronically.*

Requests marked with an asterisk (*) must be made in writing.Contact the Department Privacy Officer for the appropriate form for your request.

Changes to this Notice

We reserve the right to make changes to this notice at any time and make the new privacy practices effective for all information we maintain. Current notices will be posted in the USU Department of COMD-DE offices and on our website, http://www.coe.usu.edu/comd/. You may also request a copy of any notice at any time by contacting the Department at the number below.

If you would like further information about your privacy rights, disagree with a decision that we have made about access to your personal health information, or believe your privacy rights have been violated, you may contact the Department Privacy Officers, Heather Jensen (Audiology) or Jaclyn Littledike (Speech-Language-Pathology) at 435-797-1375. You may also file a written complaint with the Department of Health and Human Services, Office of Civil Rights, 200 Independence Avenue, S.W. Room 509F HHH Bldg., Washington, DC 20201.

You will not be penalized for filing a complaint.