Effective June 27, 2019

This detailed notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Who will follow this notice?

  • Any health care professional authorized to enter information into your health records.
  • All Health and Wellness Center (HWC) departments, including Health Services and Counseling and Psychological Services.
  • Any volunteer providing services to you while you are at the HWC.
  • All employees, staff, and other HWC personnel.

Understanding Your Health Record/Information

While you are a student at Penn State Altoona, the Health and Wellness Center is one of your primary healthcare providers. Each time you visit the HWC, a record of your visit is made. Typically, this record contains your health history, symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information—often referred to as your health record—serves as:

  • a basis for planning your care and treatment
  • a means of communication among the many health professionals who contribute to your care
  • a legal document describing the care you received
  • a means by which you or a third-party payer can verify that services billed were actually provided
  • a tool for educating health professionals
  • a source of data for health research
  • a source of information for public health officials charged with improving the health of the nation
  • a source of data for facility planning and marketing
  • a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Understanding what is in your record and how your health information is used helps you to:

  • ensure its accuracy
  • better understand who, what, when, where, and why others may access your health information
  • make more informed decisions when authorizing disclosure to others

How We May Use and Disclose Health Information About You

We will use your health information for treatment.

For example, information obtained by a nurse, clinician (a physician, nurse practitioner, physician assistant), or another member of your healthcare team will be recorded in your health record and used to determine the course of treatment that should work best for you. Your clinician will document in your record his/her expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations. In that way, the clinician will know how you are responding to treatment. If the HWC staff refers you to another clinician or hospital, information regarding your visit may be shared with these healthcare providers.

We will use your health information for payment.

For example, a bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular healthcare operations.

For example, members of the clinical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide. We may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you.

Business Associates. There are some services provided in our organization through contracts with business associates. Examples include UPMC Altoona and reference laboratories. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we have asked them to do. We require these associates to agree that they will protect the privacy of your health information in the same manner that we do.

Appointment Reminders. We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or health care at the Health and Wellness Center.

Treatment Alternatives. We may use and disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services. We may use and disclose health information to tell you about health-related benefits or services that may be of interest to you.

Individuals Involved in Your Care. In life-threatening or extreme emergency situations, we may use or disclose health information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition. We may release health information about you to a friend or family member who is involved in your health care. In addition, we may disclose health information about you to an organization assisting in a disaster relief effort so that your family can be notified about your condition, status, and location. You have the opportunity to agree to, prohibit or restrict the use or disclosure of health information to these individuals.

Research. Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who receive one medication to those who receive another for the same condition. All research projects are subject to a special approval process. This process evaluates a proposed research project and its use of health information, trying to balance the research needs with patients’ needs for the privacy of their health information. Before we use or disclose health information for research, the project will have been approved through this research approval process.

As Required by Law. We will disclose health information about you when required to do so by federal, state, or local law.

To Avert a Serious Threat to Health and Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent that threat.

Coroners, Medical Examiners, and Funeral Directors. We may disclose health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also disclose health information about patients of the Health and Wellness Center to funeral directors as necessary to carry out their duties.

Public Health Risks. We may disclose health information about you for public health activities. These activities generally include the following:

  • to prevent or control disease, injury or disability
  • to report births and deaths
  • to report child abuse or neglect
  • to report reactions to medications or problems with products
  • to notify people of recalls of products they may be using
  • to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
  • to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law

Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Military and Veterans. If you are a member of the United States armed forces or foreign military personnel, we may disclose health information about you as requested by military command authorities to assure the proper execution of the military mission if the appropriate military authority has published a notice in the Federal Register with the following information:

  1. appropriate military command authorities or the appropriate foreign military authority, and;
  2. purposes for which the protected health information may be issued or disclosed.

Workers’ Compensation. We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.

Lawsuits and Disputes. In connection with a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or another lawful process by someone else involved in the dispute. We may use and disclose health information in defending or asserting a lawsuit involving your treatment at the Health and Wellness Center.

Law Enforcement. We may disclose health information if asked to do so by a law enforcement official:

  • in response to a court order, subpoena, warrant, summons or similar process
  • to identify or locate a suspect, fugitive, material witness, or missing person
  • about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement
  • about a death we believe may be the result of criminal conduct
  • about criminal conduct at the Health and Wellness Center, and
  • in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

National Security and Intelligence Activities. We may disclose health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services of the President of the United States and Others. We may disclose health information about you to authorized federal officials so they may provide protection to the President of the United States, other authorized persons or foreign heads of state or conduct special investigations.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose health information about you to the correctional institution or law enforcement official. This disclosure would be necessary (1) for the institution to provide you with healthcare; (2) to protect your health and safety or the health and safety of others; (3) for the safety and security of the correctional institutions.

We will not sell your health information or use it for marketing or fundraising purposes without receiving written authorization.

UPMC Altoona

In order to provide the best continuity of care, the local hospital, UPMC Altoona, will provide information to the Health and Wellness Center regarding any services that you receive there. If you would prefer that this information not be shared with HWC, please let the UPMC staff know at the time of your visit.

Notification of Breach of Unsecured Health Information

In the event of a breach of your health information, you will receive notification from the Health and Wellness Center or the responsible Business Associate.

Your Rights Regarding Health Information About You

You have the following rights regarding the health information we maintain about you:

Right to Inspect and Copy. You have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this includes health and billing records but does not include psychotherapy notes.

To inspect and copy health information that may be used to make decisions about you, you must submit your request in writing to the Director of the Health and Wellness Center. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the Health and Wellness Center will review your request and the denial. The person conducting the review will not be the person who denied your request.

Right to Amend. If you feel that the health/disability information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Health and Wellness Center.

To request an amendment, your request must be made in writing and submitted to the Director of the Health and Wellness Center. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

  • was not created by us unless the person or entity that created the information is no longer available to make the amendment
  • is not part of the health information kept by or for the Health and Wellness Center
  • is not part of the information which you would be permitted to inspect and copy or
  • is accurate and complete

Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of health/disability information about you. This list will not include disclosures we made to you, disclosures made for the purposes of treatment, payment, or our operations or those authorized by you.

To request this list or accounting of disclosures, you must submit your request in writing to the Director of the Health and Wellness Center. Your request must state a time period, which may not be longer than six (6) years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). This first list you request within a (12) twelve-month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. We are not required to agree to your request. To request restrictions, you must make your request in writing to the Director of the Health and Wellness Center. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosure to your spouse.

You have the right to pay out of pocket for specific services and restrict the disclosure of information pertaining to these services to third-party payers.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing to the Director of the Health and Wellness Center. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of this notice you may stop by the Health and Wellness Center.

Changes To This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the Health and Wellness Center and on the website noted above. This notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at the Health and Wellness Center for treatment or health care services, we will offer you a copy of the current notice in effect.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Health Operations Manager at the Health and Wellness Center, Penn State or with the Secretary of the Department of Health and Human Services. To file a complaint with the Health and Wellness Center, contact the Health Operations Manager at 814-949-5540 or by mail at Health Operations Manager, Penn State Altoona Health and Wellness Center, 3000 Ivyside Park, Altoona, PA 16601. To file a complaint with Penn State, contact the Penn State Privacy Office at 814-863-5915 or by mail at Privacy Office, Penn State University, James M. Elliott Building, 120 South Burrowes Street, Suite 333, State College, PA 16801 or email [email protected]. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Other Uses of Health Information

Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records of the care that we provided to you.