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Medical Record Law allows UHCS to use or disclose your health information without your specific permission only under certain conditions or circumstances. Following are descriptions of those conditions and circumstances.

• Treatment: UHCS may use healthcare information about you to provide you with health treatment or services, to coordinate or manage your health care services, or to facilitate consultation or referral as part of your treatment.
• Payment: UHCS may use and disclose your health information to your insurance company or other third parties as required for you to obtain reimbursement for claims you may file to recover costs of care at UHCS.
• Health Care Operations: UHCS may use and disclose your health information within UHCS for operations purposes, i.e., your record may be reviewed internally for the purpose of improving services to all UWW students.

Contact UHCS at 262-472-1300 for additional information and examples of uses and disclosures.

Medical Record Law allows UHCS to use or disclose your health information without your consent or authorization for certain functions and activities described below:

• Public Health Risks: UHCS may disclose your medical records for public health activities.
• Victims of Abuse, Neglect, or Domestic Violence: If you have been a victim of abuse, neglect, or domestic violence, UHCS may make this disclosure to the appropriate governmental authority as required or permitted by federal, state, or local law.
• Health Oversight Activities: UHCS may disclose your health information to a health oversight agency for activities authorized by law, including audits, investigations, inspections, licensure, or disciplinary activities, and other similar proceedings. UHCS may not disclose your health information if you are subject of an investigation that is not directly related to your receipt of health care or public benefits.
• Judicial and Administrative Proceedings: As permitted or required by state or federal law, UHCS may disclose your health information in response to a court order.
• Law Enforcement: If we determine that a student's condition is such that they represent a substantial probability of serious harm to self or others, we may, per Wisconsin law, contact the police and request an emergency detention or other action to protect the safety of that student or others.
• Coroners and Medical Examiners: UHCS may disclose protected health information to a coroner or medical examiner to identify a deceased person or determine the cause of death.
• Research: Under certain circumstances UHCS may use and disclose your health information for research purposes.
• Serious Risk of Harm: If there is a serious risk of harm to your health or safety, or to the health or safety of another, UHCS may use and disclose information from your clinical record for the purpose of preventing such harm when, in the judgment of the clinician, the risk is unlikely to be reasonably reduced or managed through clinical care.
• Specialized Government Functions: Medical Record Law authorizes UHCS to use or disclose your medical records for certain specific legal purposes, such as for reporting communicable diseases as required under public health laws. In accordance with the Patriot Act, we may be required to disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials. By law we cannot reveal when we have disclosed such information to the government.
• Workers Compensation: UHCS may release your medical records for workers compensation or similar programs. These programs provide benefits for work-related injuries or illness.

What are my rights and responsibilities as a patient/client?

1. The right to be treated with respect, consideration and dignity without regard to race, national origin, age, gender, sexual orientation, religion, political belief, or handicap.
2. The right to request and receive information concerning your diagnosis, evaluation, treatment and prognosis, in easily understandable terms. This includes your right to review your medical record and/or receive a copy of it. When it is medically inadvisable to give such information to you, such as being physically, mentally or emotionally incapacitated, the information will be provided to a person designated by you or to a legally authorized person.
3. The right to receive enough information to give informed consent before a procedure is performed and when possible, to participate in all decisions affecting your health.
4. The right to have the opportunity to participate in decisions involving your health care, except when such participation is contraindicated for medical reasons, such as being physically, mentally or emotionally incapacitated.
5. The right to be informed regarding your treating professional’s credentials, record keeping, goals, techniques to be used, limitations of treatment, and to receive a response to any other questions you may have. The right to expect your health care provider to adhere to all ethical standards of their profession.
6. The right to refuse any medical or counseling services and to request and receive information about the potential risks and benefits associated with not receiving care.
7. The right to privacy regarding all aspects of your treatment.
8. The right to have your personal health information held in confidence as protected by state and federal law. This information cannot be shared with anyone outside UHCS without your written permission or under circumstances prescribed by law, such as a life threatening situation; court order; reporting of certain communicable diseases and actual or potential abuse of vulnerable individuals; or providing confidential information to authorized officials conducting security investigations under the Patriot Act (which prohibits us from notifying you when a release occurs). Student workers handling your record must meet the same confidentiality standards as staff. Serious breach of confidentiality is grounds for dismissal for students or staff.
9. The right to receive and review a current copy of our NOTICE OF PRIVACY PRACTICES. It can be found on the UHCS web site which is updated as indicated.
10. The right to reasonable response to your request for services, to offer suggestions for improving services, to file a grievance, information on procedures for filing a grievance and how to make external appeals. Procedures for expressing suggestions, complaints and grievances are posted on our website or are available with the receptionist.
11. The right to quality health care, health maintenance and health education with an emphasis on prevention. Upon request, we can provide information regarding:
    1. Diagnostic and clinical services on-site, our hours, fees, and special preventive and therapeutic services for certain high risk groups
    2. Contact information for health care providers when UHCS is closed
    3. Our policies on treatment of un-emancipated minors
    4. Health education programs
    5. Access to in-patient care, dental services, and consultation by specialists
12. The right to expect that when we are not open, you will have information on how to access urgent or emergency care.
13. The right to be informed of continuing health care needs and the right to expect reasonable continuity of care when referrals to other agencies or services are made. In addition, you have a right to know about our relationships with other institutions and services as they affect your care.
14. The right to expect UHCS to inform you of any plans to engage in research affecting your care, and to give you the right to refuse to participate.
15. The right to expect UHCS to advocate control of environmental problems or factors affecting your health, (e.g. nutrition, sanitation, noise, crowding, safety, stress, etc.)
16. The responsibility to take an active role in your own health care by:
    1. Providing us complete and accurate information to the best of your ability about your health, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities
    2. Following the treatment plan prescribed by your provider
    3. Providing a responsible adult to transport you home from our facility and remain with you for 24 hours, if required by the provider
    4. Informing your provider about any living will, medical power of attorney, or other directives that could affect your care
    5. Accepting personal financial responsibility for any charges (student bill, purple points, cash or check)
    6. Being respectful of all health care providers and staff, as well as other patients
    7. Canceling appointments, allowing us to schedule this time with another patient needing services
17. The right to change health care providers if other qualified health care providers are available.
18. UHCS is an integrated health and counseling service. All providers involved in your care have full and ready access to your health or counseling chart for the purpose of coordinating your care. You have a right to limit sharing of information between providers. If you have concerns, discuss with your provider.
19. The right to receive this information in the manner you prefer.