Disclosure of Medical Information

I.        HOW THE BLESSING SYSTEM MAY USE OR DISCLOSE YOUR HEALTH INFORMATION

Federal law requires The Blessing System to maintain the privacy of individually identifiable health information and to provide you with notice of its legal duties and privacy practices with respect to such information.  The Blessing System must abide by the terms and conditions of this Privacy Notice, as The Blessing System may revise this Privacy Notice from time to time. 

A.    Uses or Disclosures of Health Information for Treatment, Payment, & Health Care Operations

The Blessing System may use your individually identifiable health information for treatment, payment and health care operations.  Examples of treatment, payment and health care operations include:

• Treatment could include consulting with or referring your case to another health care provider.  The type of health information that The Blessing System could use or disclose includes, but is not limited to, such health conditions as blood type, diagnosis of your condition or pregnancy status. We may disclose medical information about you to doctors, nurses, technicians, medical students or other personnel who are involved in taking care of you.  Information may be shared among departments and  organizations to  coordinate the different things you may need, such as prescriptions, lab work, meals, x-rays, home care, hospice, or medical equipment needs.  We may share or disclose medical information about you through The Blessing System’s health information exchange as part of treatment or health care operations activities. We may also provide your physician or a subsequent provider with copies of various reports that should assist him or her in treating you once you are discharged from our care.  We may disclose medical information about you to people outside the Blessing System who may be involved in your continuing medical care including other health care providers, transport companies, other health care facilities, family members or others that are part of your care. To learn more about how Health Information Exchange works, click here to visit the CareQuality website.

• Payment could include The Blessing System’s efforts to obtain reimbursement from you or a responsible third party for services that The Blessing System has provided to you. 

• Health Care Operations could include activities such as quality assessment and improvement activities and audits of the process of billing you or a third party for health care services The Blessing System provides to you.  As part of The Blessing System’s treatment of you and operation of a health care organization, The Blessing System may contact you, by phone or by mail, to provide appointment reminders or to provide information about treatment alternatives or other health-related services that may be of interest to you. We may also use and disclose medical information to assess your satisfaction with our services, for future communications in newsletters, mailouts regarding treatment options disease management programs, wellness programs or other community based initiatives our facility is partnering.  The Blessing System may also contact you for fundraising purposes, although you will be provided the opportunity to opt out of any future fundraising communications.  We will also use your information for conducting training programs and reviewing competence of health care professionals.

B.      Uses or Disclosures The Blessing System May Make Without Your Consent or Authorization

In addition to treatment, payment and health care operations, and unless this Privacy Notice recites a more stringent restriction in Section C, the law permits or requires The Blessing System to use or disclose individually identifiable health information without your written consent or authorization to:  (i) comply with public health reporting and notification requirements, including reporting of adverse product events to the Food and Drug Administration, (ii) report suspected abuse, neglect or domestic violence, as required by law, (iii) submit information to health oversight agencies for oversight activities, such as audits, authorized by law, (iv) respond to a final order or subpoena of a court or administrative tribunal, (v) assist law enforcement personnel, as required by law, or to fulfill a law enforcement request for certain limited information for the purpose of identifying or locating a suspect, witness, or victim in an investigation, or to report a potential crime (vi) assist a medical examiner or funeral director, (vii) assist an organ procurement organization or organ bank in facilitating organ or tissue donation and transplantation, (viii) further research, provided that The Blessing System complies with federal requirements, (ix) avert a serious and imminent threat to public health safety, (x) assist with government activities related to the military, veterans, or national security, (xi) comply with workers’ compensation or similar laws, (xii) allow individuals responsible for your care to assist you in the event of your incapacity or an emergency, and (xiii) as otherwise required by law.  With your oral agreement, The Blessing System may also disclose certain information for purposes of its patient directory or to inform relatives or other individuals directly involved in your care or payment for your care regarding your condition.  

In addition, The Blessing System may use and/or disclose your individually identifiable health information as follows:

• Business Associates:  There are some services provided by The Blessing System through contracts with business associates which are vendors, professionals and others who perform some treatment, payment or health care operations functions on behalf of The Blessing System and all subcontracting business associates on behalf of the Blessing System or who otherwise provide services and have access to or use your protected health information.  Examples include physicians at Illini Hospital, in the Emergency Department and radiology at Blessing Hospital and Illini Hospital, a copy service we use when making copies of your health record and patient safety organizations.  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 and bill you or your third-party payer for services rendered.  To protect your health information, however, we require the business associate to appropriately safeguard your information by requiring that they enter into an appropriate agreement with the Blessing system organization.

• Directory:  Unless you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes.  This information may be provided to members of the clergy and lay ministers assigned by your church or religious affiliation, or to other people who ask for you by name.  If you are unable to object, we may use and disclose this information consistent with your prior expressed preference, if known, and the health professional’s judgment.

• Notification:  Unless you object, health professionals, using their best judgment, may use or disclose information to notify or assist in notifying a family member, personal representative, or any person responsible for your care, your location, and general condition.  If you are unable to object, we may exercise our professional judgment to determine if a disclosure is in your best interest and disclose only information that is directly relevant to the person’s involvement with your health care.

• Communication with Family:   Unless you object, health professionals, using their best judgment, may use or disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.  If you are unable to object, we may exercise our professional judgment to determine if a disclosure is in your best interest and disclose only information that is directly relevant to the person’s involvement with your health care.

• Disaster Relief:  We may use or disclose information for disaster relief purposes.

• Incidental Uses and Disclosures:  We are permitted to use and disclose information incident to another use or disclosure of your protected health information permitted or required under law.

• Limited Data Sets:   We may use or disclose a limited data set (i.e., in which certain identifying information has been removed) of your protected health information for purposes of research, public health, or health care operations.  Any recipient of that limited data set must agree to appropriately safeguard your information.

• Proof of Student Immunization:  We may disclose information about a student or prospective student to a school limited to proof of the student’s immunization where the school is required by the state or other law to have proof of such immunization as long as we obtain and document the agreement to disclose this information from the student’s parent or guardian or other approved individual, including the student if determined to be an adult or an emancipated minor.

C.      More Stringent Protection for Your Health Information

In certain cases, Illinois law provides more stringent privacy protections of your health information than this Privacy Notice recites above.  Specifically, the following:

• If you are a patient with high blood pressure, your physician may not release your medical records to the Illinois High Blood Pressure Registry without your written permission. 

• If you are a patient of an advanced practice nurse, neither The Blessing System nor the nurse may reveal your medical records to the Advanced Practice Nursing Board or the Department of Professional Regulation without your written permission in instances in which (i) the Advanced Practice Nursing Board has taken a final adverse action against the nurse, (ii) the nurse has surrendered his or her license while under disciplinary investigation by the Advanced Practice Nursing Board, or (iii) The Blessing System has terminated or restricted the nurse’s organized professional staff clinical privileges for disciplinary violations related to your treatment.  However, please note that the nurse or The Blessing System may reveal your name or other means of identifying you as a patient without your written permission and may release such information as otherwise described in this Privacy Notice.

• If you are a patient of a physician, The Blessing System may not reveal your medical records to the Medical Disciplinary Board without your written permission in instances in which your treatment is a subject of a report relating to a physician’s professional conduct or capacity, including reports regarding a physician who is impaired by reason of age, drug or alcohol abuse or physical or mental impairment.  However, please note that The Blessing System may include your name or other means of identifying you in its reports to the Medical Disciplinary Board without your permission and may release such information as this Privacy Notice may otherwise describe.  The Blessing System may also provide copies of your hospital or medical records in cases alleging your death or permanent bodily injury, provided that the law requires The Blessing System to report such events to the Department of Professional Regulation, and the Department of Professional Regulation or the Medical Disciplinary Board has subpoenaed such records. 

• If you are or have been a recipient of an HIV test, The Blessing System may only disclose your test results in a manner which identifies you to those persons you (or your legally authorized representative) have designated in writing, except that The Blessing System may disclose your test results to: (i) you or your legally authorized representative; (ii) your spouse if a Western Blot Assay or a more reliable test has confirmed that your results are positive, and your physician has sought unsuccessfully to persuade you to notify your spouse, or your physician believes that you have not provided notification to your spouse as you had previously agreed; (iii) an authorized agent or employee of a health care facility or a health care provider if the health care facility or a health care provider itself has authority to obtain your test results, the agent or employee provides patient care or handles or processes specimens of your body fluids or tissues, and the agent or employee has a need to know such information; (iv) the Illinois Department of Public Health and local health authorities, in accordance with rules for reporting and controlling the spread of disease, as otherwise set forth in state law; (v) a health care facility or health care provider that procures, processes, distributes or uses either a human body part from you after you are deceased, or semen you have provided prior to the effective date of the AIDS Confidentiality Act for the purpose of artificial insemination; (vi) any health care provider or employee of a health facility, and any firefighter or emergency medical technician, involved in an accidental direct skin or mucous membrane contact with your blood or bodily fluids, which is of the nature that may transmit HIV, as a physician may determine in his or her medical judgment; (vii) any law enforcement officer involved in the line of duty in a direct skin or mucous membrane contact with your blood or bodily fluids, which is of the nature that may transmit HIV, as a physician may determine in his or her medical judgment; (viii) a temporary caretaker if you are a child who is in the temporary protective custody of the Department of Children and Family Services pursuant to Section 5 of the Abused and Neglected Child Reporting Act; (ix) your parent or legal guardian if you are a minor under 18 years of age and a Western Blot Assay or a more reliable test has confirmed that your results are positive, and if in the professional judgment of your health care provider, notification would be in your best interest and your health care provider has first sought unsuccessfully to persuade you to notify your parent or legal guardian, or if your health care provider believes that you have not provided notification to your parent or legal guardian as you had previously agreed; and (x) your school principal in accordance with state law.  Please note that a recipient of your test results may not redisclose this information except as this Privacy Notice may describe.

• If you are a patient of a physician, the physician may not disclose any information that he or she may have acquired while attending to you in a professional character that was necessary to enable him or her to professionally serve you, without your permission, or in the case of your death or disability, without the permission of your personal representative, except that the physician may disclose such information (i) in trials for homicide when the disclosure relates to the facts or immediate circumstances of the homicide; (ii) in civil or criminal malpractice actions that a person has brought against your physician; (iii) in all actions that you or your representative, a beneficiary under an insurance policy, or the executor or administrator of your estate have brought or are defending wherein your physical or mental condition is an issue; (iv) when the validity of a document as your will is at issue; (v) in any criminal action where the charge is either first degree murder by abortion or attempted abortion or abortion; (vi) in civil or criminal actions arising from a person filing a report in compliance with the Abused and Neglected Child Reporting Act; (vii) in prosecutions where Section 11-501.4 of the Illinois Vehicle Code permits the court to admit the written results of blood alcohol tests into evidence; and (viii) in prosecutions where Section 5-11a of the Boat Registration and Safety Act permits the court to admit the written results of blood alcohol tests into evidence.

• If you are a patient of a physician or other health care provider, either you or your guardian may refuse to consent to the disclosure of the nature or details of services The Blessing System has provided to you for The Blessing System’s health care operations other than peer review, utilization review or quality assurance.  A physician or other health care provider may not deny services to you if you refuse to consent to such a disclosure.

• If you are the victim of sexual assault, The Blessing System may not release your evidence collection kit to the Illinois State Police without your written permission, or if you are a minor under the age of 13, without the written permission of your parent, guardian, appropriate representative of the Department of Children and Family Services, or an investigating law officer. 

• If you are a victim of a sexual assault and The Blessing System takes photographs of your injuries, The Blessing System may not release the photographs without your written permission, or if you are a minor, without the written permission of your parent or guardian.  If you are a minor and your parent or guardian refuses to grant permission, then The Blessing System must give all existing photographs and negatives to your parent or guardian.

• If you are a resident of a nursing home facility, The Blessing System may not allow any person who is not directly involved in your care to be present during a discussion of your case, a consultation on your condition, or your examination or treatment, without your permission, which may be oral or written.  Please note that we interpret “any person who is not directly involved in your care” to mean those individuals other than facility personnel (or contractors) directly responsible for rendering care to you at the facility.  Thus, such individuals would include your family members and significant others who are “not directly involved in your care.”  Such individuals would also include facility personnel not directly involved in the rendering of care, such as the housekeeping staff in most circumstances.

• If you are a resident of a skilled nursing facility, The Blessing System may not allow any person who is not directly involved in your care to be present during a discussion of your case, a consultation on your condition, or your examination or treatment, without your permission, which may be oral or written.  Please note that we interpret “any person who is not directly involved in your care” to mean those individuals other than facility personnel (or contractors) directly responsible for rendering care to you at the facility.  Thus, such individuals would include your family members and significant others who are “not directly involved in your care.”  Such individuals would also include facility personnel not directly involved in the rendering of care, such as the housekeeping staff in most circumstances.

• If you are a patient of a home health agency, The Blessing System may not allow the Department of Public Health to observe the home health agency’s care of you in your home without your permission, which may be oral or written. 

• If you are a minor under 18 years of age who is the recipient of an HIV test, and a Western Blot Assay or a more reliable test has confirmed that your results are positive, the health care provider who ordered the test may not notify your parent or legal guardian of your test results without your written permission.  However, please note that the health care provider may disclose such information to your parent or legal guardian if, in the professional judgment of the health care provider, notification would be in your best interest and the health care provider has first sought unsuccessfully to persuade you to notify your parent or legal guardian, or if the health care provider believes that you have not provided notification to your parent or legal guardian as you had previously agreed 

• If you are a minor who has sought counseling regarding your own drug or alcohol abuse, or that of a family member, from a physician who provides diagnosis or treatment or any licensed clinical psychologist or professional social worker with a master's degree or any qualified employee of (i) an organization that is a licensee or a recipient of funding by the Department of Human Services, or (ii) agencies or organizations operating drug abuse programs that are licensees or recipients of funding by the Federal Government or the State of Illinois or any qualified person who is an employee or works in association with any public or private alcoholism or drug abuse program licensed by the State of Illinois, and you have come into contact with a sexually-transmitted disease, these professionals may not inform your parent, parents, guardian, or other responsible adult of your condition or treatment without your written permission.  However, please note that these professionals may disclose such information to your parent, parents, guardian, or other responsible adult without your written permission if such action is, in the person’s judgment, necessary to protect your safety or that of a family member or other individual. 

• If you are a client of a clinical psychologist, the psychologist may not disclose any information he or she may have acquired while attending to you in a professional capacity if the psychologist did not ensure that you understood the possible uses or distributions of the information and without your permission, or in the case of your death or disability, without the permission of your personal representative, except that the clinical psychologist may disclosure such information (i) in trials for homicide when the disclosure relates to the facts or immediate circumstances of the homicide; (ii) in all proceedings in which the purpose is to determine your mental competency, or in which you have raised a defense of mental incapacity; (iii) in civil or criminal actions against the psychologist for malpractice; and (iv) when the validity of a document as your will is at issue. 

• If you are a recipient of mental health or developmental disability services, The Blessing System may not disclose your mental health or developmental disability information (not including personal/psychotherapy notes) without your written permission except as follows:  (i) to the attorney of a recipient who is a minor in a court or administrative proceeding upon court or administrative order; (ii) upon court order for a deceased recipient’s records; (iii) to receive benefits in certain cases when a mental health or developmental disability provider is unable to obtain your written permission; (iv) to the Mental Health and Developmental Disabilities Medical Review Board; (v) to a regional human rights authority in certain cases pursuant to an investigation or its monitoring of recipient rights or services; (vi) to the Guardianship and Advocacy Commission when inspecting complaints in certain circumstances; (vii) to the Inspector General of the Department of Children and Family Services in connection with certain investigations; (viii) to certain parties when mental health or developmental disability services are provided pursuant to the Illinois Sexually Violent Persons Commitment Act; (ix) in certain judicial or administrative proceedings when the recipient’s mental condition or related treatment is an element of the claim or defense; (x) in certain judicial proceedings following a recipient’s death when the recipient’s mental or physical condition is an element of the claim or defense; (xi) in certain judicial or administrative proceedings involving a claim of recipient injury from mental health or developmental disability services the recipient received; (xii) in certain judicial or administrative proceedings involving court-ordered examination of the recipient; (xiii) in certain probate proceedings; (xiv) in certain judicial proceedings where court-ordered treatment of the recipient; (xv) in certain judicial or administrative proceedings involving the validity of or benefits under an insurance policy; (xvi) in judicial proceedings brought pursuant to the Illinois Mental Health and Developmental Disabilities Confidentiality Act; (xvii) in certain homicide investigations and proceedings; (xviii) to a coroner investigating a recipient’s death; (xix) in certain proceedings under the Illinois Juvenile Court Act; (xx) to the local law enforcement authority in certain cases when a mental health facility releases a recipient of services; (xxi) to the Inspector General of the Department of Human Services pursuant to an investigation of long-term care facility resident abuse or neglect; (xxii) pursuant to the Illinois Abused and Neglected Child Reporting Act; (xxiii) in certain civil commitment proceedings; (xxiv) in certain cases to protect the recipient or another person’s health or safety; (xxv) in certain emergency treatment cases; (xxvi) in certain proceedings and investigations pursuant to the Illinois Mental Health and Developmental Disabilities Code; (xxvii) pursuant to certain Census Bureau requirements; (xxviii) in certain cases pursuant to the Illinois Sex Offender Registration Act; (xxix) pursuant to the Illinois Rights of Crime Victims and Witnesses Act; (xxx) pursuant to certain requests by the United States Secret Service or the Department of State Police; (xxxi) to the Department of State Police and the Department of Human Services in connection with the Illinois Firearm Owners Identification Card Act; (xxxii) to a requesting peace officer who transports a recipient to or from a mental health or developmental disability facility; (xxxiii) to a peace officer or prosecuting authority investigating a criminal offense or pursuing a fugitive; (xxxiv) to law enforcement and investigating agencies when suspected criminal violation or other serious incident within a mental health or developmental disability facility; (xxxv) to the local law enforcement agency in certain cases of unauthorized recipient absence from a mental health or developmental disability facility; (xxxvi) to the law enforcement agency investigating a missing person report with respect to a recipient admitted to a mental health or developmental disability facility; and (xxxvii) to a law enforcement agency investigating a felony or sex offense.  With respect to certain of the above exceptions, Illinois law only permits limited mental health or developmental disability information to be disclosed.  Illinois law restricts redisclosure of mental health or developmental disability information.

• If you are a minor at least 12 years of age but under 18 years of age who receives mental health or developmental disability services, your parent or guardian may inspect and copy your records if you are informed and do not object or if the therapist does not find that there are compelling reasons to deny access.  Should your parent or guardian be denied access by either you or the therapist, your parent or guardian may petition a court for access.

• If you are a client of a clinical social worker, the social worker may not disclose any information he or she may have acquired while attending to you in a professional capacity without your written permission, except (i) in the case of your death or disability, with the written permission of your personal representative, a person with authority to sue on your behalf, or the beneficiary of an insurance policy on your life, health or physical condition; (ii) when a communication reveals that you intend to commit certain crimes or harmful acts; (iii) when you waive the privileged nature of communication by bringing public charges against the social worker; or (iv) when the social worker acquires the information during an elder abuse investigation. 

• If you are a client of a clinical licensed professional counselor or licensed clinical professional counselor, the counselor may not disclose any information he or she may have acquired while attending to you in a professional capacity without your written permission, except (i) in the case of your death or disability, with the written permission of your personal representative, a person with authority to sue on your behalf, or the beneficiary of an insurance policy on your life, health or physical condition; (ii) when a communication reveals that you intend to commit certain crimes or harmful acts; or (iii) when you waive the privileged nature of communication by bringing public charges against the counselor. 

NOTE:  References in this Privacy Notice to health care professionals include only those professionals that The Blessing System employs.

D.      No Other Uses or Disclosures Without Your Written Authorization

The Blessing System may not make any other uses and disclosures of your individually identifiable health information not described in this Notice without your written authorization.  You may revoke your authorization at any time if you provide written notice to The Blessing System.  The Blessing System must obtain your written authorization before disclosing your individually identifiable health information in the following situations:

• Where The Blessing System would be receiving financial remuneration from another party for disclosing this, your individually identifiable health information, for the purpose of marketing the third party’s product or service to you.

• The sale of your individually identifiable health information.

• Most uses and disclosures of psychotherapy notes.