Notice of Privacy Practices

Our Pledge Regarding Your Medical Information

Public Health - Dayton & Montgomery County (Public Health) is committed to protecting the privacy of medical information we create or obtain about you. This Notice tells you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of your medical information. We are required by law to: (1) make sure your medical information is protected; (2) give you this Notice describing our legal duties and privacy practices with respect to your medical information; and (3) follow the terms of the Notice that is currently in effect.

Your Rights

The records of your medical information are the property of Public Health; however, you have the following rights regarding medical information we maintain about you:

Get an electronic or paper copy of your PHI:

• You can request to see and/or get an electronic or paper copy of your medical and billing records. Please visit the Medical Records webpage for instructions or call (937) 225-4189.
• We will provide a copy or a summary of your health information, usually within 30 days of your request.

Ask us to correct your medical record:

• If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend it. All requests must be submitted in writing to the Medical Records Department at This email address is being protected from spambots. You need JavaScript enabled to view it. and must include the reason for your request.
• We may deny your request, but we will tell you why in writing within 60 days. We may deny your request if the record:
  • was not created by Public Health
  • is not part of the records kept by or for Public Health
  • is not part of the information which you would be permitted to inspect and copy
  • is determined by us to be accurate and complete

Your Choices: Request confidential communications:

• You can ask us to contact you in a certain way or at a certain location (for example, home, cellular or office phone, or to send mail or email to a different address). We will say “yes” to all reasonable requests.
• If we are unable to contact you using the requested ways or locations, we may contact you using any information we have.

Ask us to limit what we use or share:

• You can ask us not to use or share certain health information for treatment, payment, or our operations.
• We are not required to agree to your request. We will comply with your request unless the information is needed to provide you with emergency treatment or we are required or permitted by law to disclose it.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer for payment or operational purposes.
• To request a restriction, you must submit a written request to the Medical Records Department at This email address is being protected from spambots. You need JavaScript enabled to view it. or to the Registration Desk in person.

Get a list of those with whom we have shared information: (Right to an accounting of disclosures)

• You have the right to receive a list of certain disclosures we have made of your medical information in the six years before your request, unless a shorter time period is requested, including who we shared it with, and why.
• We will include all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).
• You are required to submit your request in writing to the Medical Records Department at This email address is being protected from spambots. You need JavaScript enabled to view it. or to the Registration Desk in person.

Get a copy of this Privacy Notice:

• You can ask for a paper copy of this notice at any time, even if you have previously agreed to receive it electronically
• Copies of this Notice will be available
• throughout Public Health facilities
• by contacting Public Health at (937) 225-5700
• at the Public Health website

How We May Use and Disclose Your Medical Information

We abide by all applicable laws related to the protection of your medical information. All of the ways we are permitted to use and disclose information will fall within one of the following categories:

Treatment: We can use and share your PHI with other professionals who are treating you. Example: sharing COVID-19 vaccination, flu vaccination, or other medical records with a new primary care physician for continuity of care.

Run our organization: We can use and share your PHI to run our practice, improve your care, and contact you when necessary.

Example: we may disclose your information to nurses, medical students, and other Public Health personnel for performance improvement and educational purposes.

Payment: We can use and disclose your medical information to bill and collect payment from health plans or other entities.

Example: We may need to provide information about your vaccinations administered at Public Health to your insurance company for payment or reimbursement.

Health Information Exchange (HIE): Public Health is actively involved in sharing health data. As a public health entity, Public Health collects, shares, and manages health information for public health purposes.

For example, information about your medical care, conditions, and medications can be made available to Public Health, your primary care physician, and the hospital that treats you if they participate in the HIE as well.

How else can we use or share your health information?

We may use or disclose your medical information without your authorization as permitted or required by law, including:

Public Health staff may contact you to schedule visits and for other coordination of care activities

Help with public health and safety issues, such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

To organizations assisting in disaster relief efforts so that your family can be notified of your condition and location

Educational institutions

To health oversight agencies for activities authorized by law

To business associates that provide services on our behalf, such as billing, software maintenance, and legal services

Unless you object, to individuals who are involved in your care or paying for your care, such as a friend, family member, or another individual

For workers’ compensation claims

To governmental, licensing, auditing, and accrediting agencies

Respond to organ and tissue donation requests

For health research (unidentified PHI)

To coroners, medical examiners, and funeral directors when an individual dies

To the military, if you are a member of the armed forces, and we are authorized or required to do so by law

For law enforcement purposes, as permitted or required by law

To a correctional institution, as authorized or required by law, if you are an inmate or under the custody of law enforcement officials

For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions: if required by court order, subpoena, or other lawful instructions, or to defend ourselves against a lawsuit brought against us

As required by law For more information, see: HHS Health Information Privacy.

Other uses and disclosures of medical information not covered by this Notice will be made only with your written authorization. We are not allowed to sell or receive anything of value in exchange for your medical information. If you provide us authorization to use or disclose medical information about you, you may revoke your authorization in writing at any time. However, this revocation would not apply to uses and disclosures made based on your initial authorization.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing.

If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information, see: HHS Notice of Privacy Practices.

Additional Rights and Privacy Protections for Substance Use Disorder Programs

Uses and Disclosures of Part 2 Substance Use Disorder Records

Your substance use disorder treatment records (Part 2 records) receive heightened protection compared to standard PHI. Substance use disorder records cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order. It can be released based on a court order after notice and an opportunity to be heard is provided to you or the holder of the record, as provided in 42 CFR part 2.

Permitted Uses and Disclosure of Part 2 Records Without Consent

• To communicate with other staff within the substance use disorder program who have a need for the information in connection with their duties to provide diagnosis, treatment, or referral for treatment
• To qualified service organizations providing services on our behalf, who agree in writing to protect the information in the same way that we are required to protect the information
• To law enforcement agencies or officials if you commit or threaten to commit a crime in our facilities or against our personnel or based on a court order (must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed)
• To report suspected child abuse and neglect consistent with state or District law
• To medical personnel in a medical emergency under certain conditions
• For research purposes consistent with approval of the Institutional Review Board
• To qualified personnel for audit or program evaluation purposes who have agreed to protect the information
• To a public health authority, if the information has been de-identified.

Permitted Uses and Disclosures that Require Consent

Public Health will require that you provide consent for all future uses or disclosures for treatment, payment, and healthcare operations purposes in order to ensure you receive the highest level of coordinated care.

Public Health will make uses and disclosures of your Part 2 records not described in this Notice only with your consent./p>

You can revoke your consent at any time by submitting a request to the Medical Records Department. Please note that this action cannot undo any disclosures that have already been made.

REDISCLOSURE NOTICE:

Information disclosed with your authorization may be re-disclosed by the recipient and may no longer be protected by law. Once we send your health information to another person or organization (like a doctor, insurance company, or lawyer) as you requested, that information might be shared again by them. If that happens, the federal privacy laws (HIPAA) that protect our records might not apply to them anymore.

Non-Discrimination Notice

Public Health complies with applicable Federal, State, and jurisdictional civil rights laws. Our policies prohibit discrimination, which includes an unfavorable difference in treatment (including bullying, abuse or harassment) of an individual because of their race, color, religion, ethnicity, ancestry, national origin, age, marital status, socioeconomic status, language, physical or mental disability, sex, actual or perceived sexual orientation, gender identity or expression, HIV/AIDS status or on the basis of an association with another individual on account of that individual’s actual or perceived sexual orientation, gender expression or HIV/AIDs status or any other protected status as defined by Federal, State or local law.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our Public Health website.