Notice of Privacy Practices

Buchanan County Public Health Department

Notice of Privacy Practices 


This Notice of Privacy Practices describes how the Buchanan County Public Health Department (BCPHD) may use and disclose your/your child’s protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” (PHI) is information about you/your child, including demographic information, that may identify you/your child and that relates to past, present or future physical or mental health or condition and related health care services.

Buchanan County is required to abide by the terms of this Notice of Privacy Practices. We may change the terms of this notice at any time. The new notice will be effective for all protected health information that BCPHD maintains at that time. We are required to provide you/your child with any updated notice that contains substantial changes. Our Notice of Privacy Practices is also available on our website at

BCPHD does not utilize PHI for marketing or fundraising purposes, nor does it sell PHI to any other organization. We do not engage in any underwriting activities nor do we make genetic information contained in our PHI available to any organization that does.


Your/your child’s PHI may be used and disclosed by the BCPHD without your written authorization. There are three primary categories:

Treatment: We may use or disclose your PHI for the purpose of treating you/your child, arranging for treatment of you/your child or coordinating among treatment providers or individuals involved in you/your child’s care such as case managers, service providers, and therapist.

Payment: We may use or disclose your PHI to obtain payment for services provided to you/your child through BCPHD funding, Medicare, Medicaid, or another third party payor.

Healthcare Operations: We may use or disclose your/your child’s PHI for internal activities that are necessary to operate our department and ensure that you/your child receives quality services.

Other Uses or Disclosures Without Your Permission:

We may also use or disclose your PHI for certain other purposes allowed by 45 CFR §164.512 or other applicable laws and regulations, including the following:

  • In the event of an emergency we may disclose your/your child’s PHI to emergency personal.
  • To avoid a serious threat to your/your child’s health or safety or the health or safety of others.
  • As required by state or federal law such as reporting abuse, neglect or certain other events.
  • For certain public health activities such as reporting certain diseases.
  • For certain health oversight activities such as audits, investigations or licensure actions.
  • In response to a court order, warrant or subpoena in a judicial or administrative proceeding.
  • For certain specialized government functions such as the military or correctional institutions.
  • For research purposes if certain conditions are satisfied.
  • To provide proof of immunizations to schools where certain conditions are satisfied.
  •  In response to certain requests by law enforcement to locate a fugitive, victim or witness or to report a death or certain crimes.
  • To correctional facilities or law enforcement officers when necessary for you/your child to receive health care or to protect safety and health of you or others.
  • To coroners, funeral directors or organ procurement organizations as necessary to allow them to carry out their duties.
  • In the event of communication barrier PHI may be disclosed to translator.

 Disclosures We May Make Unless You Object:

Unless you object, we may disclose your/your child’s PHI to a member of your family, relative, friend or other person who is involved in your/your child’s healthcare if we determine it is in your/your child’s best interest based on our professional judgment or payment for your healthcare. We will limit the disclosure to the information relevant to that person’s involvement in your healthcare or payment. Finally, we may use or disclose your/your child’s protected health information to an authorized public or private entity to assist in disaster relief efforts.

 Disclosures With Your Permission:

No other disclosures of PHI will be made unless you give written authorization for the specific disclosure. You may revoke a written Consent or Authorization for us to use or disclose your/your child’s PHI. The revocation will not affect any previous use or disclosure of your/your child’s information.


Right to request confidential communications by alternative means: We will accommodate any reasonable request, as long as you provide means to handle payment transactions by an alternative address or other method of contact. Please make this request in writing to BCPHD.

Right to request restrictions on use and disclosure of you information: You have the right to request restrictions on any part of your/your child’s PHI for particular purpose of treatment, payment or healthcare operations to a third party. We will honor a request to not provide PHI to a third party payor in regards to services provided to you/your child that you or someone on your behalf has paid in full out of pocket. We are not obligated to agree to your request if we believe that it is in your/your child’s best interest to permit the disclosure of you/your child’s PHI. Please make this request in writing to BCPHD and include information you want limited, if you want the limit our use, disclosure or both, and to whom you want the limits to apply.

Right to review and copy you/your child’s PHI: You have the right to view and obtain a copy of your/your child’s PHI. Requests must be submitted in writing to BCPHD. BCPHD will make records available for inspection within 10 working days of receipt of written requests. Requests are subject to limitations including but not limited to psychotherapy notes, personal information about BCPHD staff or PHI of other people. Under Iowa State Code 125.140.9, and Case Law Carey vs. Population Services International, a minor has the same capacity as an adult to consent to certain health services without parental permission. These include substance abuse services, sexually transmitted disease counseling/treatment and family planning services. Access to a minor’s protected health information is restricted in these situations. Depending on the circumstances, a decision to deny access may be reviewable.

Medical records shall be viewed during working hours of the department under supervision of the Director or other delegated staff. BCPHD may charge a reasonable fee for this service.

Right to request amendment: You have the right to request an amendment to your/your child’s record if you believe it contains an error. BCPHD will attach the request to the medical record, with a notation at the point of the original entry indicating that a correction request has been filed. Nothing in the chart will be removed, erased, or crossed off.

Right to an accounting of certain disclosures: You have the right to make a written request for disclosures for purposes other than treatment, payment or healthcare operations. This does not include disclosures which you authorized, or those which occurred in the context of treatment for you/your child. The right to receive this information is subject to certain exceptions, restrictions and limitations.

Right to get notice of a breach: You have the right to be notified in the event of a breach of you/your child’s PHI.

Right to a paper copy of this notice: You have the right to obtain a paper copy of this Notice form us upon request, even if you have agreed to accept this notice electronically.


If you feel you/your child’s privacy rights have been violated, you may file a complaint in writing to Buchanan County Attorney’s Office at P.O. Box 68, Independence, Iowa 50644 or calling 319-334-3710 for further directions, or with the Office of Civil Rights in the U.S. Department of Health and Human Services. We will not retaliate against you if you file a complaint.


We reserve the right to change the privacy practice and the terms of this notice whenever there is a material change to the uses or disclosures, your individual rights, our legal duties, or other privacy practices stated in this Notice. We will post a copy of the current Notice in the BCPHD office and our website.

Notice of Privacy Practice  (pdf file)