Notice of Privacy Practices


Health Center Practice covered by this Notice: 
Charles Drew Health Center, Inc.  

Direct questions about this Notice to:
Charles Drew Health Center, Inc. Privacy Officer at 402.810.9797

Effective Date of Notice: March 2020

Notice of Privacy Practices (The Notice)

A written notice in compliance with the requirements of Health Insurance Portability and Accountability Act (HIPAA), and the Health Information Technology for Economic and Clinical Health Act (HITECH), enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009, made available from Charles Drew Health Center, Inc. to any individual or the individual’s personal representative at the first delivery of services, or at the individual’s next visit following a revision of the Notice, that describes the users and disclosures of protected health information that may be made by Charles Drew Health Center, Inc. and the individual’s rights and Charles Drew Health Center, Inc. legal duties with respect to protected health information.

Protected Health Information (PHI) – Individually identified health information that is transmitted or maintained in any form or medium, including electronic media. Protected health information does not include employment records held by Charles Drew Health Center, Inc. in its role as an employer.

How We May Use or Disclose Your Health Information

The following examples describe different ways we may use or disclose your health information. These examples are not meant to be exhaustive. We are permitted by law to use and disclose your health information for the following purposes: 

For Treatment.
We will use your health information to provide you with healthcare treatment and to coordinate or manage services with other healthcare providers, including third parties. We may disclose all or any portion of your health information to your attending physician, consulting physician(s), nurses, technicians, or other facility or healthcare personnel who have a legitimate need for such information in order to take care of you. Different departments of the facility will share your health information in order to coordinate the healthcare services you need, such as prescriptions, lab work and X-rays. We may disclose your health information to family members, friends, guardians, or personal representatives who are involved with your healthcare. We may also use and disclose your health information to contact you for appointment reminders and to provide you with information about possible treatment options or alternatives and other health related benefits and services. We also may disclose your health information to people outside the facility who may be involved in your healthcare after you leave the facility, such as other physicians involved in your care, specialty hospitals, skilled nursing care facilities, and other healthcare-related services. We may use and disclose your health information to prescription networks to obtain your prescription benefits from payers, to obtain your medication history from different healthcare providers in the community such as pharmacies, and to send your prescriptions electronically to your pharmacy.  

We will use and disclose your health information for activities that are necessary to receive payment for our services, such as determining insurance coverage, billing, payment and collection, claims management, and medical data processing. For example, we may tell your health plan about a treatment you are planning in order to receive approval or to determine whether your plan will pay for the proposed treatment. We may disclose your health information to other healthcare providers so they can receive payment for healthcare services that they provided to you, such as your personal physician, and other physicians involved in your healthcare, or ambulance services. We may also give information to other third parties or individuals who are responsible for payment for your healthcare, such as the named insured under the health policy who will receive an explanation of benefits (EOB) for all beneficiaries who are covered under the insured’s plan. 

Healthcare Operations.
We may use and disclose your health information for routine facility operations, such as business planning and development, quality review of services provided, internal auditing, accreditation, certification, licensing or credentialing activities (including the licensing or credentialing activities of healthcare professionals), education for staff, assessing your satisfaction with our services, and to other healthcare entities that have a relationship with you and need the information for operational purposes. We may use and disclose your health information to the external agencies responsible for oversight of healthcare activities such as The Joint Commission, external quality assurance and peer review organizations, and credentialing organizations. We may also disclose health information to business associates we have contracted with to perform services for or on our behalf such as patient satisfaction survey organizations. We may also disclose your health information to medical device manufacturers or pharmaceutical companies in order for those companies to carry out their legal obligations to state and federal agencies.

Disclosure to Business Associates.
We may disclosure your protected health information to our third-party service providers (called, “business associates”) that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use a business associate to assist us in maintain our practice management software. All of our business associates are obligated, under contract with us, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.  

Appointment Reminders.
We may use or disclose your health information when contacting you to remind you of an appointment. We may contact you by using a postcard, letter, phone call, voice message, or email.   

Nebraska Health Information Initiative.
Charles Drew Health Center, Inc. participates in the Nebraska Health Information Initiative (“NeHII”), a statewide internet-based health information exchange. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. You may ‘opt-out’ and prevent searching of your health information available through NeHII, by calling 1-866-978-1799, or completing and submitting an ‘Opt-Out’ form to NeHII, by mail, fax or through their website at

Future Communication.
We may provide communications to you with newsletters or other means regarding treatment options, health related information, disease management programs, wellness programs, or other community-based initiatives or activities in which our facility is participating.

Uses and Disclosures That Are Required or Permitted by Law

Public Health Activities.
We may disclose your health information to public health officials for activities such as for the prevention or control of communicable disease, bioterrorism, injury, or disability; to report births and deaths; to report suspected child, elder, or spouse abuse or neglect; to report reactions to medications or problems with medical products; to report information to the federal Centers for Disease Control or to authorized national or state cancer registries for their data aggregation.

Disaster Relief Efforts.
We may disclose your health information to an entity assisting in a disaster relief effort, such as the American Red Cross, so that your family can be notified about your condition and location.

Health Oversight Activities.
We may disclose your health information to a health oversight agency for activities authorized by law. Such agencies include federal Centers for Medicare and Medicaid Services, and state medical or nursing boards. These oversight activities may include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor activities such as healthcare treatment and spending, government programs, and compliance with civil rights laws.

Judicial or Administrative Proceeding.
We may disclose your health information in response to a legal court or administrative order, a subpoena, discovery request, civil or criminal proceedings, or other lawful processes. 

Law Enforcement.
We may release your health information if asked to do so by a law enforcement official or if we have a legal obligation to notify the appropriate law enforcement or other agencies: In response to a court order, subpoena, warrant, summons or similar legal process; or Regarding a victim or death of a victim of a crime in limited circumstances; or In emergency circumstances to report a crime, the location or victims of a crime, or the identity, description or location of a person who is alleged to have committed a crime, including crimes that may occur at our facility, such as theft, drug diversion, or attempts to obtain drugs illegally.  

Workers’ Compensation.
We may release your health information for workers’ compensation benefits or similar programs that provide benefits for work-related injuries or illnesses if you tell us that workers’ compensation is the payer for your visit(s). Your employer or their workers’ compensation carrier may request the entire medical record pertinent to your workers’ compensation claim. This medical record may include details regarding your health history, current medications you are taking, and treatment.

Military and Veterans.
If you are a member of the armed forces, we may release your health information as required by military command authorities. We may also release health information about foreign military personnel to the appropriate foreign military authority.

If you are an inmate of a correctional institution or in the custody of a law enforcement official, we may release your health information to the institution or law enforcement official. This release would be necessary for the institution to provide you with healthcare, to protect your health and safety or the health and safety of others, or for the safety and security of the correctional institution.

Your Rights Regarding Your Health Information

Right to Inspect and Copy.
You have the right to inspect your health information and receive a copy of medical, billing, or other records that may be used to make decisions about your care. The right to inspect and receive a copy may not apply to psychotherapy visit notes. Your request to inspect and receive a copy of your health information must be submitted in writing. We may charge a fee for document requests to cover the costs of copying, mailing, or other supplies. You have the right to request your health information in electronic format. Charles Drew Health Center, Inc. will provide your health information in the form and format you request, if available or in a mutually agreeable form and format. In limited circumstances we may deny your request to inspect or receive a copy of your health information. If you are denied access to your health information, you may request that the denial be reviewed. A licensed healthcare professional chosen by Charles Drew Health Center, Inc. will review your request and the denial. The person who conducts the review will not be the same person who denied your request. We will comply with the outcome of the review. 

Right to Amend.
You have the right to request an amendment to your health information that you believe is incorrect or incomplete. Submit your request in writing, including your reason for the amendment, in the subject line state, “Request for Amendment to PHI” and send the request to the medical record custodian. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend information that:

  • Was not created by Charles Drew Health Center, Inc. unless the person or entity that created the information is no longer available to make the amendment;   
  • Is not part of the medical information kept by or for Charles Drew Health Center, Inc.;   
  • Is not part of the information that you would be permitted to inspect and copy; or   
  • Is accurate and complete. 

Right to Request Confidential Communication.
You have the right to request that we communicate with you about healthcare matters in a certain way or at a certain location. For example, you can ask that we only contact you at an alternative location from your home address, such as work, or only contact you by mail instead of by phone. Your request must specify how or where you wish to be contacted. We do not require a reason for the request. We will accommodate all reasonable requests.   

Right to Receive Notice of a Privacy Breach.
You have the right to receive written notification if Charles Drew Health Center, Inc. discovers a breach of unsecured protected health information involving your health information. Breach means the unauthorized acquisition, access, use, or disclosure of protected health information which compromises the security or privacy of the information.    

Right to Paper Copy of This Notice.
You have the right to a paper copy of this notice. If you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact Charles Drew Health Center, Inc. Privacy Officer.    

Changes To This Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you and for any information we may receive in the future. We will post a copy of the current notice in the facility and on our website at The notice will contain the effective date. Upon your initial registration to the facility for treatment or healthcare services as a patient, we will offer you a copy of the notice currently in effect. Whenever the notice is revised, it will be available to you upon request.

You may file a complaint with Charles Drew Health Center, Inc. Privacy Officer at 2915 Grant Street, Omaha, NE 68111. If you file a complaint, we will not take any action against you or change our treatment of you in any way.