Notice of Privacy Practices for Personal Health Information



Pike County, Pennsylvania, serves its people through many programs including health and human services. We must by law keep your health information private and secret, give you this notice, do what we say in the notice, and notify you following a breach of unsecured protected health information. We reserve the right to change the terms of this notice and to make any new provisions effective for all protected health information that we maintain. If there are changes to this notice, we will mail you a new notice to the address we have on file. We commit to keeping your personal health information private and secure. This notice takes effect on August 17, 2021.

Privacy and Routine Uses of Your Information

Pike County Workers Will Use or Share Your Health Information for

  • Treatment - to get you the health services that you need. For example, we may share information with a doctor to take care of you.

  • Payment - to get payment or to pay for services you receive. For example, the bill for your treatment may be checked with our agency to be sure it is correct and is paid.

  • Health care operations - to see how well our programs are working. For example, we may use your information to help decide what treatment plans work best.

  • Your permission - you may give us your written permission to use or share information. You can take back your permission in writing at any time. Unless you give us permission, we cannot use or share your health information except as we tell you in this notice.

  • Greatest privacy - if more than one law covers privacy, the law that gives you the most access and requires the most privacy applies to your information. We must also protect confidential sources of information.

  • Personal privacy - we cannot share certain details of mental health or drug and alcohol abuse treatment without your permission.

Privacy and Nonroutine Use of Your Information

Other Reasons That We Might Use or Share Your Health Information


  • National security, military and veterans - health information can be given to the appropriate military persons if you are or have been in the U.S military.

  • Public health - when you have been in contact with a disease or may be at risk for spreading the disease.

  • By law, for law enforcement, or court order - when we are required by law, for law enforcement purposes, or in response to a court order or court activities. This includes, but is not limited to, using or sharing your protected health information with health oversight agencies for activities authorized by law or in response to a subpoena. This does not include reporting you to law enforcement for treatment you have requested for yourself.

  • Emergency care, or to avoid harm - to provide emergency care or to prevent a serious threat to the health and safety of a person or the public, including people involved with the correctional system.

  • Family, friends, and others - to tell a family member or friend of your general condition and where you are. You can agree before your treatment that we can share information with family and friends who are involved in your treatment or in paying for that care.

  • Abuse and neglect - to receive and investigate reports of abuse or neglect as we are required to do by law.

  • Work with a medical examiner or funeral director - we can share your health information with a coroner, medical examiner, or funeral director in the event of your death

Your Rights to Privacy

You Have the Following Rights About Your Health Information

  • Right to ask for a correction or amendment to your protected health information. We cannot change a document we did not create.

  • Right to ask that a family member or another person be given your health information as your personal representative. We are not required by law to do this if we believe it may not be safe for you.

  • Right to ask that we limit how your information is used or shared. However, we are not required by law to agree to your request. If we agree, we can still give out your information to a health care provider for emergency treatment, but we will request that such health care provider not further use or disclose the protected health information.

  • Right to ask that we write or talk to you at a specific address or phone number or contact you by a way you specify.

  • Right to file a complaint with us or the Secretary of Health and Human Services if you believe your privacy rights have been violated. Written complaints must be mailed to the County’s Right to Know Officer or the Secretary of Health and Human Services at the respective addresses noted below. You will not be retaliated against by the County for filing a complaint.

  • Right to get a paper copy of this Notice.

  • Right to see and get copies of your health information records unless the records are being used at the time or contain special confidential information. You may be charged a fee for copies. We cannot show details of conversations you had with a therapist.

  • Right to take back permission. You can change your permission to share your health information; we may still be required to share it by law in a way that does not harm you.

  • We must give you a list of the other agencies we have shared your information with if you make a written request for it. We can report sharing information that happened after April 14, 2003. This list would not include sharing your information for treatment, payment, operations, or made with your permission.

  • Right to receive confidential communications of protected health information.

  • Right to receive an accounting of disclosures of your protected health information.

For More Information

If you have questions or want more information, call or write:

Pike County Right to Know Officer 
506 Broad Street 
Milford , PA 18337
Phone: 570-296-9805

To Report a Problem

If you feel your privacy rights have been violated, you may contact:

Pike County Right to Know Officer 
506 Broad Street 
Milford , PA 18337
Phone: 570-296-9805

U.S Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue
Washington, D. C. 20201