THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date: 4/22/2012
Updated: 1/08/2015, 7/10/2017, 9/4/2019, 10/17/2025

Primo Center understands your privacy is important. We are required by law to maintain the privacy of protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this notice. We will handle this information only as allowed by federal and state law, adhering to the most stringent law that protects your health information.

If at any time you believe your privacy rights have been violated, you may verbally or in writing contact:

• Agency’s Privacy Officer
• State Advocate
• Secretary of Health and Human Services of the Federal Government

Addresses and phone numbers to use are listed at the end of this notice. You will not suffer any change in services or retaliation for filing a complaint.

Each time you receive a service plan, progress notes, diagnoses, treatment, and plan for future care or treatment, your privacy rights apply.

Your federally defined rights under 45 CFR Parts 160 and 164 (HIPAA Privacy Standards):

• You have the right to inspect or request copies of your medical records. This process will be kept confidential. In certain situations, such as if access would cause harm, we can deny access. Requests must be made in writing to your Primary Service Coordinator. If denied, you will receive a timely, written notice of the decision and reason, and a copy of this notice becomes part of your record.
• You have the right to request amendment of your medical records if you believe information in the records is inaccurate or incomplete. This request must be made in writing to your Primary Service Coordinator. We may deny the request for proper reasons, but you will receive a written explanation of the denial.
• You have the right to receive an accounting of the agency’s disclosures of your protected health information that were not for the purpose of treatment, payment, or health care operations. You also have the right to know the names of anyone, other than agency employees, who received information about you from the agency.
• You have the right to request a restriction regarding the use or disclosure of your protected health information. Requests must be submitted to your Primary Service Coordinator. The Privacy Officer will review each request seriously. While the agency is not required to agree, if we do, we are bound by that agreement except under certain emergency circumstances.
• You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. Requests must be made in writing to your Primary Service Coordinator. We will agree to all reasonable requests.
• You have the right to obtain a paper copy of this Privacy Notice at any time upon request.

USE AND DISCLOSURE OF YOUR INFORMATION

Upon signing the agency’s Consent to Treatment form, you are allowing us to use and disclose necessary information about you within the agency and with business associates in order to provide treatment/services, receive payment, and conduct our day-to-day health care operations.

Examples

In order to effectively provide treatment or services, your Primary Service Coordinator may consult with various service providers within the agency. During those consultations, health information about you may be shared.

In order to receive payment for services provided, your health information may be sent to those companies or groups responsible for payment coverage, and a monthly bill is sent to the Responsible Party identified by you.

In day-to-day health care operations, trained staff may handle your physical medical record to assemble or file documentation. Certain data elements are entered into our computer system for billing and state statistical reporting to the Illinois Department of Human Services (IDHS) or the Department of Health and Human Services (DHHS). As part of quality improvement efforts, your record may be reviewed for accuracy and completeness, or during accreditation processes.

ENHANCING YOUR HEALTHCARE

Some agency programs provide the following support to enhance your overall health care and may contact you to provide:

• Appointment reminders by call or letter
• Information about treatment alternatives
• Information about health-related benefits and services that may be of interest to you

The Community Food Security (CFS) afternoon snack programs are required by the USDA to maintain a log of those participating.

INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR THAT CARE

Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.

SPECIFIC CIRCUMSTANCES FOR DISCLOSURE

This agency is allowed by federal and state law in certain circumstances to disclose specific health information about you. These circumstances include:

• As required by law (e.g., public health reporting for contagious diseases)
• Judicial and administrative proceedings (e.g., court orders, inspector general requests)
• Law enforcement purposes (e.g., reporting gunshot wounds, missing persons, criminal conduct on premises)
• To avert a serious threat to health or safety (e.g., responding to a specific threat made by a person served)
• Children or incapacitated adults who are victims of abuse, neglect, or exploitation
• Specialized government functions, including military and national security activities
• Correctional facilities, as necessary about an inmate
• Workers’ compensation, to facilitate processing and payment
• Coroners and medical examiners, for identification or cause of death
• To the Department of Health and Human Services in connection with an investigation of compliance with federal regulations

OTHER USES AND DISCLOSURES BY AUTHORIZATION ONLY

We are required to obtain your authorization to use or disclose your protected health information for any reason other than for treatment, payment, or health care operations, and those specific circumstances outlined previously. The Authorization to Use/Disclose form states what information will be given to whom and for what purpose, and must be signed by you or your legal representative. You may revoke this authorization at any time by written statement, except to the extent that action has already been taken in reliance on it.

CHANGES TO PRIVACY PRACTICES

Primo Center reserves the right to change its privacy policies and related practices at any time, as allowed by law, and to make those changes effective for all protected health information maintained. Revised Privacy Notices will be posted at all service sites and available upon request by mail, discussion with an agency representative, or electronically.

For additional information concerning our Privacy Policy or the laws pertaining to privacy, please contact:

Felicia Blakley
Chief Executive Officer
Privacy Officer