College of San Mateo Wellness Center/Health Services is a confidential clinic and the privacy of each client’s protected health information (PHI) is maintained. With the exception of Health Services staff, and specifically noted exceptions, PHI is not accessible to anyone without your written permission.

The law allows Health Services to use or disclose health information for treatment, payment, health care operations, notification/communication with family (in emergency circumstances), and health oversight activities. (A paper copy of a full explanation is available upon request).

The law allows us to use or disclose your PHI without written authorization for the following purposes:

1. Required by Law
   The law requires us to report abuse, neglect or domestic violence, respond to judicial or administrative proceedings (e.g. subpoenas), or to law enforcement officers (e.g. court orders).
2. Treatment
   We may use or disclose health information about you to provide you with treatment or services.  For example, information may be shared with our doctors, nurse practitioners, physician assistants, nurses, health assistants, and other health care personnel to create and carry out a plan for your treatment.  We may, at your request and with your permission, share information with providers outside of our system who may be involved in your treatment.
3. Health Care Operations
   We may use and disclose health information about you for health care operations.  For example, we may use your information to review the quality of health services you receive. This information is anonymized and is for internal review purposes only.
4. Public Health
   On occasion, the law requires us to report a client’s health information to public health authorities for reasons related to: preventing or controlling disease; injury or disability; reporting abuse or neglect; reporting problems with products and reactions to medications to the Food and Drug Administration; and reporting disease or infection exposure.
5. Worker’s Compensation
   We may disclose health information as necessary to comply with worker’s compensation laws. In the case of employees, we report work related injuries to the district business office.

1. Right to Request Special Privacy Protections
   You have the right to request restrictions on certain uses and disclosures of your health information. We reserve the right to accept or reject these requests, and will notify you about our decision.
2. Right to Request Confidential Communications
   You have the right to request your health information in a specific way or at a specific location. (You may want us to call and leave messages on your cell phone only.) We will comply with reasonable requests submitted in writing.
3. Right to Inspect and Copy
   You have the right to inspect or copy your health information.  CSM Health Services may charge you a normal duplicating fee. Your health record is destroyed 7 years after your last visit here. There may be limited circumstances for which we would deny your request for access, and this decision will be discussed with you at the time of your request.
4. Right to Amend or Supplement
   You have right to amend health information that you believe to be incorrect or incomplete. We reserve the right to deny your request. At your request for amendment, we will review the amendment process.
5. Right to Accounting of Disclosures
   You have the right to receive an accounting of certain types of disclosures for the PHI we have made.
6. Right to Paper Copy of Notice of Privacy Practices
   You have the right to a paper copy of the Notice of Privacy Practices.
7. Right to Choose Someone to Act for You
   You have the right to choose someone to act for you, for example by giving them medical power of attorney.  A legal guardian or person with medical power of attorney can make choices about your health information.  We will verify that this person has authority before we take any action.
8. Right to Request Us to Share Information
   You have the right to ask us to share information with your family, close friends or others involved in your care. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest.
9. Right to Revoke Your Authorization
   There may be other disclosures of your health information that will require your written authorization.  You generally have the right to revoke an authorization.
10. Right to Complain about Violation of Rights
    If you feel your rights have been violated, you have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, by sending a letter to: 200 Independence Ave., S.W., Room 509F, HHH Building, Washington, DC 20201, calling 1-800-368-1019 or visiting hhs.gov/ocr/privacy/hipaa/complaints. If you are concerned that CSM Health Services has violated your privacy rights, or if you disagree with a decision made about access to your records, you also may contact our privacy officer/director (or appointed designee) at (650) 574-6396. You will not be penalized for filing a complaint.

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments website is provided. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.