Notice of Privacy Practices for Health Care Providers
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.
If you have any questions about this Notice of Privacy Practices, contact the Bremer County Privacy Officer:
Bremer County Privacy Officer
403 3rd Street SE
Waverly, IA 50677
(319) 352-0082
This Notice of Privacy Practices describes how Bremer County may use and disclose your protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information (“PHI”). “PHI” is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
Bremer County is required to abide by the terms of this Notice of Privacy Practices. Bremer County may change the terms of this notice at any time. The new notice will be effective for all PHI that Bremer County maintains at that time. Upon request, Bremer County will provide you with any revised Notice of Privacy Practices.
PERMITTED USES AND DISCLOSURES OF PHI
Your PHI may be used and disclosed by Bremer County for the purpose of providing or accessing health care services for you. Your PHI may also be used and disclosed to pay your health care bills and to support the business operation of Bremer County.
The following categories describe ways that Bremer County is permitted to use and disclose health care information. Examples of types of uses and disclosures are listed in each category. Not every use or disclosure for each category is listed; however, all of the ways Bremer County is permitted to use and disclose information falls into one of these categories:
- Treatment:
Bremer County may use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party that has already obtained your permission to have access to your PHI. For example, Bremer County would disclose your PHI, as necessary, to a home health agency that provides care to you. Another example is that PHI may be provided to a facility to which you have been referred to ensure that the facility has the necessary information to treat you.
- Payment
Bremer County may use and disclose health care information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. Bremer County may also discuss your PHI about a service you are going to receive to determine whether you are eligible for the service, and for undertaking utilization review activities. For example, authorizing a service may require that your relevant PHI be discussed with a provider to determine your need and eligibility for the service.
- Healthcare Operations
Bremer County may use or disclose, as needed, your PHI in order to support its business activities. These activities include, but are not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, Bremer County may use or disclose your PHI, as necessary, to contact you to remind you of your appointment or to provide information about alternate services or other health-related benefits.
Bremer County may share your PHI with third-party “business associates” that perform various activities (e.g., billing, transcription services) for Bremer County. Whenever an arrangement between the Covered Entity and a business associate involves the use or disclosure of your PHI, Bremer County will have a written contract that contains terms that will protect the privacy of your PHI.
USES AND DISCLOSURES OF PHI REQUIRING YOUR WRITTEN AUTHORIZATION
Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization at any time, in writing, except to the extent that Bremer County has taken an action in reliance on the use or disclosure indicated in the authorization.
Bremer County may also keep psychotherapy notes. These are given a higher degree of protection and cannot be disclosed without your express permission except to carry out certain treatment, payment, or health care operations, including allowing the note taker to use them for treatment, using the notes for training programs, or using the notes in defense of a legal proceeding. You have the opportunity to specifically authorize disclosure of psychotherapy notes on the Authorization for Release of PHI form.
We will not use or disclose your PHI for marketing purposes without your written authorization unless the marketing is conducted through a face-to-face communication or involves a gift of nominal value.
We will not accept payment of any kind for your PHI without your written authorization. Sale of PHI is prohibited only as it is defined by law and does not include accepting payment for your treatment.
You may revoke an authorization at any time by notifying us in writing. If this should ever be the case, please be aware that revocation will not impact any uses or disclosures that occurred while the authorization was in effect.
Bremer County may use and disclose your PHI in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use or disclosure of the PHI, then Bremer County may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the PHI that is relevant to your health care will be disclosed.
- Others Involved in Your Healthcare
Unless you object, Bremer County may disclose to a member of your family, a relative, a close friend, or any other person you identify, your PHI that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, Bremer County may disclose such information as necessary if Bremer County, based on its professional judgment, determines that it is in your best interest. Bremer County may use or disclose PHI to notify or assist in notifying a family member, personal representative, or any other person that is responsible for your care of your location, general condition, or death. Finally, Bremer County may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other Individuals involved in your health care.
- Emergencies
Bremer County may use or disclose your PHI in an emergency treatment situation. If this happens, Bremer County shall try to obtain your acknowledgment of receipt of the Notice of Privacy Practices as soon as reasonably practicable after the delivery of treatment.
USES AND DISCLOSURES OF SUBSTANCE USE DISORDER (SUD) RECORDS
Bremer County may use and disclose Substance Use Disorder (SUD) treatment record that we create, maintain, receive, or transmit in accordance with federal law, including 42 CRF Part 2.
- Additional Protections for SUD Records
SUD records are subject to additional enhanced privacy protections under 42 CFR Part 2. In many situations, we may not use or disclose SUD information—even for purposes normally allowed under HIPAA such as treatment, payment, or healthcare operations—unless you provide written consent or another specific exception applies under federal law. If you have provided written consent for us to use or disclose SUD records for treatment, payment, and health care operations to the extent the HIPAA regulations permit, such uses and disclosures are provided for in this notice.
2) Limitations on Use and Disclosure of SUD Records
SUD records cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order that meets strict requirements under federal law. This prohibition applies even if we did not create the SUD records but received them from another provider.
3) Re-Disclosure of Information
42 CFR Part 2 allows entities who create, maintain, receive, or transmit SUD Records to obtain a single consent for all treatment, payment, and operation purposes. If we receive SUD Records pursuant to such consent, we may further disclose those SUD Records only subject to HIPAA except for the purpose of civil, criminal, administrative, or legislative proceedings against you without valid consent or a court order.
YOUR RIGHTS CONCERNING SUD RECORDS
RIGHT TO RECEIVE NOTICE OF SUD PRIVACY PROTECTIONS
You have the right to receive clear information about how your SUD records are protected, how they may be used or disclosed, and what your rights are under federal confidentiality laws.
RIGHT TO RESTRICT DISCLOSURES
You may request that we restrict the use or disclosure of your SUD records. While we are not always required to agree to requested restrictions, we will follow all legally required limitations on disclosure. To request that we restrict the use or disclosure of your SUD records, please contact us using the information listed at the end of this notice.
RIGHT TO OPT OUT OF FUNDRAISING COMMUNICATIONS
If we intend to use SUD information for fundraising communications, you will have the right to opt out before receiving such communications. We will provide a clear and conspicuous option to decline future fundraising contacts involving any SUD-related information.
THE COVERED ENTITY’S RESPONSIBILITIES FOR SUD RECORDS
We are required to:
- Maintain the confidentiality of SUD records in accordance with HIPAA and 42 CFR Part 2.
- Comply with stricter protections when they apply.
- Notify you of your privacy rights and our legal duties relating to SUD information.
- Include all required privacy protections in this Notice of Privacy Practices.
If we receive SUD records from another provider-such as during coordination of care, referrals, or medical history review-we must continue to safeguard those records under the same heightened federal protections.
This SUD section of our Notice of Privacy Practices reflects the requirements of the 2024 Final Rule aligning HIPAA with 42 CFR Part 2, with a compliance deadline of February 16, 2026. We may update this Notice as laws change, and any revisions will be posted on our website and available upon request.
OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE WITHOUT YOUR AUTHORIZATION OR OPPORTUNITY TO OBJECT
Bremer County may use or disclose your PHI in the following situations without your consent or authorization. These situations include:
- Required By Law
Bremer County may use or disclose your PHI to the extent that the law requires the use or disclosure. You will be notified, as required by law, of any such uses or disclosures.
- Public Health
Bremer County may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury, or disability. Bremer County may also disclose your PHI if directed by the public health authority to a foreign government agency that is collaborating with the public health authority.
- Communicable Diseases
Bremer County may disclose your PHI, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease.
- Health Oversight
Bremer County may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
- Abuse or Neglect
Bremer County may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, Bremer County may disclose your PHI if it believes that you have been a victim of abuse, neglect, or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
- Food and Drug Administration
Bremer County may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post-marketing surveillance, as required.
- Legal Proceedings
Bremer County may disclose PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request, or other lawful process.
- Law Enforcement
Bremer County may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on Bremer County premises, and (6) medical emergency (not on the Bremer County’s premises) and it is likely that a crime has occurred.
- Coroners, Funeral Directors, and Organ Donation
Bremer County may disclose PHI to a coroner or medical examiner for identification purposes, determining the cause of death, or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. PHI may be used and disclosed for cadaveric organ, eye, or tissue donation purposes.
- Research
Bremer County may disclose your PHI to researchers when their research has been approved by an Institutional Review Board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI.
- Criminal Activity
Consistent with applicable federal and state laws, Bremer County may disclose your PHI if it believes that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Bremer County may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an Individual.
- Military Activity and National Security
When the appropriate conditions apply, Bremer County may use or disclose PHI of Individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military service. Bremer County may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
- Workers’ Compensation
Your PHI may be disclosed by Bremer County as authorized to comply with workers’ compensation laws and other similar legally established programs.
- Inmates
Bremer County may use or disclose your PHI if you are an inmate of a correctional facility and Bremer County created or received your PHI in the course of providing care to you.
- Required Uses and Disclosures
Under the law, Bremer County shall make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine Bremer County’s compliance with the requirements of 45 C.F.R. section 164.500 et. seq.
YOUR RIGHTS
The following is a list of your rights with respect to your PHI and a brief description of how you may exercise these rights:
RIGHT TO INSPECT AND COPY YOUR PHI
This means you may inspect and obtain a copy of PHI about you that is contained in a designated record set for as long as Bremer County maintains the PHI. A “designated record set” contains medical and billing records and any other records that Bremer County uses in making decisions about you.
Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and PHI that is subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have the right to have this decision reviewed. Please contact the Bremer County Privacy Officer if you have questions about access to your medical record.
RIGHT TO REQUEST A RESTRICTION OF YOUR PHI
This means you may ask Bremer County not to use or disclose any part of your PHI for the purposes of treatment, payment, or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Bremer County is not required to agree to a restriction that you may request, except in the case of a disclosure you have restricted under 45 C.F.R. §164.522(a)(1)(vi) related to restricted disclosures to health plans if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, and the PHI pertains solely to a health care item or service for which you have (or someone other than you but not the health plan has) paid out-of-pocket, in full. If Bremer County believes that it is in your best interest to permit use and disclosure of your PHI, your PHI will not be restricted. If Bremer County agrees to the requested restriction, it may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with Bremer County. You may request a restriction in writing to the Bremer County Privacy Officer. To request a restriction, you must provide us, in writing, 1) what information you want to limit; 2) whether you want to limit our use, disclosure, or both; and 3) to whom you want the limits to apply.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS FROM THE COVERED ENTITY BY ALTERNATIVE MEANS OR AT AN ALTERNATIVE LOCATION
Bremer County will accommodate reasonable requests. Bremer County may also condition this accommodation by asking you for information as to how payment will be handled, or specification of an alternative address or other method of contact. Bremer County will not request an explanation from you as to the basis for the request. Please make this request in writing to the Bremer County Privacy Officer.
RIGHT TO REQUEST AN AMENDMENT TO YOUR PHI
This means you may request an amendment of PHI about you in a designated record set for as long as Bremer County maintains this information. In certain cases, Bremer County may deny your request for an amendment. If Bremer County denies your request for amendment, you have the right to file a statement of disagreement with Bremer County, and Bremer County may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. All requests for amendments must be in writing.
RIGHT TO RECEIVE AN ACCOUNTING OF CERTAIN DISCLOSURES OF YOUR PHI
This right applies to disclosures for purposes other than treatment, payment, or healthcare operations as described in this Notice of Privacy Practices. It excludes disclosures Bremer County may have made to you, to family members or friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003.
RIGHT TO OBTAIN A PAPER COPY OF THIS NOTICE
You have the right to obtain a paper copy of this notice, upon request, even if you have agreed to accept this notice electronically.
THE COVERED ENTITY’S DUTIES AND OTHER INFORMATION
Bremer County is required by law to maintain the privacy of PHI and to provide you with this notice of our legal duties and privacy practices with respect to PHI, and abide by the terms of the notice currently in effect.
We must inform you of any breach of your PHI that compromises your PHI and that is held or transmitted in an unsecured manner, within 60 days after we discover, or by exercising reasonable diligence, should have discovered the breach.
We reserve the right to change our policies and practices regarding how we use or disclose PHI, or how we will implement Individual rights concerning PHI. We reserve the right to change this notice and to make the provisions in our new notice effective for all information we maintain. If we change these practices, we will publish a revised Notice of Privacy Practices. The revised notice will be posted and available at our places of service.
COMPLAINTS
You may file a complaint with Bremer County or the Secretary of Health and Human Services if you believe your privacy rights have been violated by Bremer County. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, SW, Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. You may file a complaint against Bremer County by notifying the Bremer County Privacy Officer. Bremer County will not retaliate against you for filing a complaint.
You may contact the Bremer County Privacy Officer for further information about the complaint process.
Bremer County Privacy Officer
403 3rd Street SE.
Waverly, IA 50677
(319) 352-0082
This notice was published and became effective on February 13, 2026.