To family members, or guardian, of our patients:
This notice describes how information about your family member may be used and disclosed and how you can gain access to this information. Please review carefully.
Notice of Information Practices
- The National Prion Disease Pathology Surveillance Center may use and disclose protected health information for treatment, payment and healthcare operations. Payment is not accepted from patients or their families. Healthcare operations include, but are not limited to, internal quality control and assurance including auditing of records.
- The National Prion Disease Pathology Surveillance Center is permitted or required to disclose protected health information without consent for public health requirements. Protected health information will be disclosed to the Department of Health of the State in which your family member resides and to the Centers for Disease Control and Prevention (CDC) after the family member has died.
- The National Prion Disease Pathology Surveillance Center will not make any other use or disclosure of a family member's protected health information, except to a covered entity.
- The National Prion Disease Pathology Surveillance Center will abide by the terms of this notice currently in effect at the time of disclosure.
- The National Prion Disease Pathology Surveillance Center reserves the right to change the terms of its notice and to make new notice provisions effective for all protected health information that it maintains.
- The National Prion Disease Pathology Surveillance Center will provide, upon request, each next of kin with a copy of its Notice of Information Practices at the time specimens and tissues are ready to be sent to the Center.
- Any person/patient may file a complaint to this Center and to the Secretary of Health and Human Services if they believe their family member's privacy rights have been violated. To file a complaint with the Center, please contact a Privacy Officer at the National Prion Disease Pathology Surveillance Center, Institute of Pathology, 2085 Adelbert Road, Room 419, Cleveland, Ohio 44106 and/or by phone at 216-368-0587.
- It is the National Prion Disease Pathology Surveillance Center's policy that no retaliatory action will be made against any individual who submits or conveys a complaint of suspected or actual non-compliance of the privacy standards.
- The name, title and telephone number of the Privacy Officers for the National Prion Disease Pathology Surveillance Center are Brian Appleby, M.D. (Center Director) and Shashirekha Shetty, Ph.D. (CLIA Director), who can be reached at 216-368-0587.
- The effective date of this notice is March 17, 2003.