Does HIPAA require me to get a written patient authorization before I can disclose any patient information to anyone?
No. You don't need patient authorization to disclose information for “treatment, payment, or some health care operations" purposes.
Have I violated HIPAA if a patient gets a glimpse of a sign-in sheet, or overhears something I say to or about another patient?
HIPAA tries to be practical enough so that the day-to-day provision of health care won't be impeded. As long as you take “reasonable safeguards,” you haven't violated HIPAA, if the disclosure was incidental to an otherwise HIPAA compliant use.
I ate at a restaurant near my home and became sick later that evening. How do I report this to the health department?
All reports of possible foodborne illness reported to this Division are investigated. If you believe that you became ill due to a food product purchased in Orange County, you may call (714) 433-6000 to report the incident. Be prepared to answer questions about the onset time, duration, and types of symptoms. Try to compile a list of all foods, and drinks consumed for the two days prior to the first signs of illness, as this information is critical for the investigation.

Some commercially distributed prepackaged foods are regulated by other State or Federal agencies. The Environmental Health Division can assist in making referrals to the correct agency.

What does the new HIPAA law mean to me?

You will likely see little difference in the way your medical care providers or health plans do business. However, you will receive from your health care providers a privacy notice describing your privacy rights and who to contact if you have questions or complaints regarding your privacy rights.

If you are receiving Mental Health, Alcohol and Drug Abuse, HIV or Sexually Transmitted Disease treatment, stricter Federal and State laws protect your privacy. HIPAA recognizes that there are situations where stricter protection of privacy may be required and allows for stricter State or Federal laws to control your privacy rights.

What is the “minimum necessary” standard?
We need to ensure that employees and outside agencies have only the patient information needed to do their job. This will require HCA to have policies and procedures that limit the amount of information that we can disclose, request, and use. Some of these limits can be instituted electronically, by having different levels of access in IRIS, the HCA Enterprise System. Other limits will be reflected in the procedures we use.
Why volunteer/intern with County of Orange Health Care Agency?
The County of Orange Health Care Agency offers interns and volunteers an excellent opportunity to:
  • Build resumes and explore career options
  • Apply skills and knowledge to the workplace
  • Fulfill college/university internship requirements
  • Network with professionals who are dedicated to making a positive difference in Orange County
  • Participate in an experience-based learning partnership
What is the NPP?
Notice of Privacy Practices (NPP)
This is the document that informs our patients about our privacy practices and their privacy rights.
What does this notice/document include?

The following information needs to be in plain language:

  • How the County may use and disclose private information, including a statement of our legal duties;
  • Patients' rights, including information about how to exercise these rights, and how to complain if rights have been violated;
  • Whom to contact to ask questions and to get more information; and
  • The effective date of the NPP.
When should patients receive the NPP?
Direct treatment providers are required to give the NPP to patients at their first delivery of service. In cases of emergency treatment, it should be provided as soon as is practical.
How do I report a food facility for health code violations?
The Environmental Health Division investigates consumer complaints regarding food, safety and sanitation at all retail food facilities in Orange County. If you have a consumer complaint regarding an Orange County food facility, please call (714) 433-6000 to report the complaint. Please provide the name and address of the facility you want investigated and explain the conditions you are reporting.
I'm a case coordinator, and I'd like to talk to the patient's primary physician about some health issues. Do I need to be careful to give and ask the doctor for only the “minimum necessary” information?
No. The minimum necessary standard does not apply to conversations between health care providers for treatment purposes.
What does “Treatment” include?
Treatment includes direct services such as psychotherapy, case management, assessment, and medication visits. It also includes consulting with other medical professionals, and making referrals.
What does HIPAA consider to be a reasonable safeguard?

For the most part, reasonable safeguards are the types of things that we already do to protect confidentiality.  For instance:

  • Speak quietly when there is a chance you could be overheard.
  • Avoid discussing patients information in public areas.
  • Keep patient files in locked cabinets or secure areas.
  • Computers with private information need to be password protected.
What is the typical time commitment required for County of Orange Health Care agency placements?
Placements typically require a time commitment of 10 to 20 hours per week for three to six months. In some instances, a lengthier time commitment is expected.
When does the HIPAA law go into affect?

HIPAA was signed into law in 1996. Some parts of the law were put into action years ago, and your health care providers were required to comply with the privacy provisions of HIPAA by April 14, 2003. This allowed health care providers time to put into place newly required procedures and to develop forms and processes to comply with HIPAA.

Does the County of Orange Health Care Agency offer paid internships?
Internships are unpaid; however, most students view the experience as invaluable in respect to personal and professional growth.
Generally, what does the HIPAA Privacy Rule require my health care provider and health plan to do?
Most health care providers and health plans already take many of the steps required by the Privacy Rule, including training employees to understand privacy procedures and securing patient records so that they are not available to those who do not need them. HIPAA requires your health care providers to provide a privacy notice to you informing you of your patient’s privacy rights and to designate an individual to be available to answer your privacy related questions.
So we can still use sign-in sheets?
Yes, a sign-in sheet is allowed. It should not reveal any information about the patient’s condition, or other demographic information such as social security number, address, or telephone.
We are traveling abroad in a few weeks. Do we need to get any vaccines?
It depends on where you will be going. You can get general information and make appointments for travel vaccinations by calling the HCA Health Referral Line at (800) 564-8448. Information on the vaccination requirements for foreign travel is available by calling the Centers for Disease Control and Prevention (CDC) Travelers Hotline at (800) 232-4636. You can also get travel vaccine and travel health information at the CDC's website, www.cdc.gov/travel. Travel vaccinations are also offered by many private physicians in Orange County.
What about doing group psychotherapy, where private information might be revealed to other patients or family members?

This would be considered treatment, and a patient authorization would not be required by HIPAA for TPO purposes.

Who should receive the NPP?

The NPP should be given to:

  • Anyone who asks for it;
  • All new and existing patients, at the time of first delivery of service;
  • Anyone who comes to the County website (it must be and is posted on our website);
  • Anyone who comes to a County clinic (it must be prominently posted at our treatment facilities).
Does HIPAA allow health care providers to use sign-in sheets or call out my name in waiting rooms?
Yes, medical offices may use patient sign-in sheets or call out patient names in waiting rooms; however, the sign-in sheet should not include the reason for your visit, since this is private medical information that does not need to be shared with other patients.
How about calling a patient from the waiting room by name?
This would also be allowed, assuming only the patient's name is used.  “Come on in, Mr. Smith” would be fine.  “OK, Tom, let's do your drug test now” would not.
How can birth certificates be obtained?
Birth certificates can be purchased in person or by mail. We are located at 1200 N. Main Street, Ste. 100-A, Santa Ana, CA 92701. Our mailing address is P.O. Box 234, Santa Ana, CA 92702-0234.
How does a student apply for a County of Orange Health Care Agency internship?
Internships related to most academic programs are offered through the County of Orange. Students are encouraged to check the Position Descriptions listed on the County of Orange Volunteer & Internships site (follow the application procedures included with each description). If there are no posted positions on the Web site that match an applicant’s academic and/or career goals or fields of interest, the applicant may contact Health Care Agency Volunteer Services at (714) 834-6620.
What does “Payment” include?
Payment includes the activities necessary for the provider or clinic to be paid for services. This includes billing, collections, eligibility determination, and utilization review.
Can I leave a message for the patient at his or her home?
Yes, if you leave only the minimum information, such as your name and a return phone number. You should also be aware that the patient has the right to ask that you not call his home, and you must honor this request. Other reasonable requests to protect privacy also need to be accommodated. For instance, the patient may ask you to send appointment reminders in an envelope rather than by a postcard, or may ask that you send mail to a post office box.
How can death certificates be obtained?
Death certificates can be purchased in person or by mail. We are located at 1200 N. Main Street, Ste. 100-A, Santa Ana, CA 92701. Our mailing address is P.O. Box 234, Santa Ana, CA 92702-0234.
If a prospective patient calls in, do they need to receive an NPP before I can talk to them?
No. You can make an appointment, and then provide the NPP at the first face-to-face meeting. If you actually provide treatment over the phone, the NPP requirement can be met by mailing the NPP to the patient, with the acknowledgement to be signed and mailed back. This mailing must be documented in the patient's file.
May health care providers place my medical charts on exam room doors?
Yes, the Privacy Rule permits this practice as long as the clinic takes reasonable measures to protect the patient’s privacy. Examples of measures that could be reasonable would be escorting patients through the area, or placing the patient chart in the box with the front cover facing the wall.
What if the insurance company asks for my psychotherapy notes?
Psychotherapy notes may contain very personal information, and HIPAA makes a specific exception for them. Before psychotherapy notes can be disclosed, the patient needs to provide a signed, valid, HIPAA compliant authorization, which specifically refers to the psychotherapy notes.
Do we need to make structural changes, such as putting up walls or soundproofing treatment rooms?
We are not expected to make significant structural changes.
Does my child have head lice? How can it be treated?
Head lice do not jump or fly. They do not carry disease. The treatment of choice for head lice is permethrin (one of the brand names is NIX). Pyrethins (one of the brand names is RID) can also be used. Both of these products can be obtained over the counter at a drug or grocery store. Head lice treatments are available without a prescription. Follow the directions on the product for proper application. It is very important that all the eggs, called nits, be removed from the hair after treatment. The most common cause of re-infestation is not removing all the nits from the hair. If treatment failures occur with correct use of these products, your physician may want to try a product used in the treatment of scabies or a pill. There are no clinics available at Public Health to provide free treatment for head lice.

All articles which have come into contact with the hair such as combs, brushes and similar items should be disinfected by machine washing and drying using the hot cycle. Carpeting and upholstered furniture should be vacuumed thoroughly. Any items which cannot be washed or vacuumed can be placed in a plastic bag for 2 weeks.

If you have concerns about head lice in a school or pre-school, we refer you to the school nurse, principal or administrator of the school. If you have already contacted the school and have further concerns, you may call the Orange County Department of Education and speak to the Coordinator of Health and Wellness, Pamela Kahn, at 714-327-1057 or pkahn@ocde.us. If you have concerns about a licensed pre-school, you may call Community Care Licensing at the Department of Social Services at (714) 558-4563. As head lice do not carry disease, Public Health does not generally become involved with cases of head lice.
Does the HIPAA Privacy Rule allow parents the right to see their children's medical records?

Yes, the Privacy Rule generally allows a parent to have access to the medical records about his or her minor child, as long as it is not inconsistent with State or other law. California has laws allowing minors to receive certain medical treatment without a parent’s consent, and in these cases, a parent would not have the right to access to those records. Please check with your provider to learn more about when a parent may or may not access a minor’s medical records.

How soon do we need to inform patients after we revise the NPP?
When material changes are made, the notice needs to be made available upon request on or after the effective date of the revision and posted in a clear and prominent location at treatment sites for patients to take with them. Health plans have to mail the NPP to individuals covered by the plan within 60 days of material revisions.
What do “Operations” include?

Operations are the activities needed to manage, maintain, and improve services.  This would include patient satisfaction surveys, chart audits for quality control, handling grievances, mandated reports to the State, and activities to maintain accreditation and to measure provider and program effectiveness.

Can a physician's office FAX my medical information to another physician's Office?
The HIPAA Privacy Rule allows doctors to share your medical information for treatment purposes. This can be done by fax, phone or other means. Your health care provider is required to put in place reasonable and appropriate safeguards to protect your medical information. An example would include your doctor's staff confirming that the fax number to be used is the correct one for your other physician's office before sending the fax.
Where can I get a TB skin test?
Public Health provides tuberculosis (TB) skin testing at four sites. Private physicians and clinics also provide TB testing. Two visits are required for a skin test. Skin tests are placed on one day and read two or three days later.
Find clinic locations and hours of operation.
How can I get a copy of my medical records?
You can request a copy of your medical record by filling out an Authorization to Use and Disclose Protected Health Information (PHI) form and mailing it to the Custodian of Records at 200 W Santa Ana Blvd., Suite 125, Santa Ana, CA 92701, or faxing it to (714) 835-9312.
Who oversees poor rental conditions such as: cockroaches and rats?
The Environmental Health Division of the Health Care Agency responds to complaints of a health-related nature, such as infestations of cockroaches or rats, lack of hot water, lack of heat and plumbing problems. Renters who have been unable to get the property management to correct a health-related problem can call the Environmental Health Division at (714) 433-6000. The complaint must have the name and address of the property manager or owner in order to file the complaint.
What do I do to amend my medical records?

HIPAA gives you the right to request an amendment to your medical records. You can request an amendment to your medical records through the Custodian of Records Office, (714) 834-3536, or by filling out our Request to Amend Protected Health Information (PHI) form and mailing it to the Custodian of Records at 200 W Santa Ana Blvd., Suite 125, Santa Ana, CA 92701, or faxing it to (714) 835-9312.

The County does not have to make the amendment. Examples of situations when an amendment may not be made are if the information in your records is correct or if the County did not create the information that you are requesting be amended.

Who can be called about mold in a rental home or apartment?
The Environmental Health Division of the Health Care Agency has collected advisory literature from a number of agencies regarding mold and mildew. The public may request that literature be mailed to them or may get advice over the telephone. In addition, renters who have been unable to get landlords to correct maintenance problems, which may lead to interior mold growth, can file a complaint with Environmental Health. Examples of these maintenance problems include roof leaks, breaks in plumbing lines, faulty door seals or window seals and slab leaks. Repair of these maintenance problems eliminates the source of the moisture, which is vital for the growth of mold. Environmental Health can be reached by calling (714) 433-6000. The complaint must have the name and address of the property manager or owner in order to file the complaint.
Where can free or low cost medical care be obtained?
The County of Orange Health Care Agency has several clinics serving residents by providing birth control/family planning, pregnancy testing, immunization, and well and sick child care. More information can be obtained by calling the Health Referral line at 1-800-564-8448. In addition, community clinics throughout Orange County provide low cost medical care, and two clinics provide free medical care.

The Medical Safety Net (MSN) Program provides only necessary medical services to protect the patient from the loss of life or limb, prevent significant disability and/or the serious deterioration of health. The MSN program does not cover preventive medical treatments. Please review the MSN Member Handbook for more information on eligibility qualifications, covered services, and service locations. You can also contact the MSN Program at 714-834-6248.
Where can services be obtained for alcohol and drug abuse?
The best way to obtain information on where to receive services related to alcohol or drug abuse is to phone the clinic in your area. Clinic numbers and locations can be found at Alcohol and Drug Abuse Services.
Where can services be obtained for mental health services?
The best way to obtain information or where to receive services related to mental health is to phone the clinic in your area. Clinic numbers and locations can be found at Adult Mental Health Services page.
What is the proper procedure for disposal of sharps?
Once the needles are packaged in a rigid puncture- and leak-resistant container, you may bring them to an approved home-generated sharps consolidation point. Call the Environmental Health Division at (714) 433-6000 and ask to speak to the medical waste inspector in your city.
Where can I dispose of my household chemicals like motor oil, car batteries, leftover paint or unused pesticides?
You can dispose of these types of household wastes at a Household Hazardous Waste Collection Center. There are four in Orange County that operate Tuesday through Saturday 9:00 a.m. to 3:00 p.m. with the exception of certain holidays. For locations and other information, please call (714) 834-6752.
Are there any beaches closed to swimming?
For the latest status on ocean and bay closures or postings in Orange County, call the Ocean & Bay Closure and Posting Hotline at (714) 433-6400. The message also gives additional phone numbers to be called to report sewage and waste spills, or report bather illnesses allegedly caused by the use of recreational water areas. View the Ocean & Bay Closures, Posting and Advisory status online.
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