Policies of Colorado State University

University Policy

Policy Title: CSU Health Network Privacy	Category: Administration
Owner: Vice President for Student Affairs	Policy ID#: 5-8031-001
Contact: CSU Health Network Web: http://health.colostate.edu/ Phone: (970) 491-7121	Original Effective Date: 4/14/2003 Last Revision: 6/4/2018

PURPOSE OF THIS POLICY

The Health Network Privacy Policy describes how personal medical information may be used and disclosed and how you can get access to this information.

POLICY STATEMENT

Health Records

Medical and mental health records (protected health information – PHI) are not included in the general university record keeping system. Health records are maintained in compliance with federal and Colorado privacy and retention regulations. A confidential health record is created for you upon proof of immunizations, receipt of off-campus medical records and/or after your first visit to the Colorado State University Health Network.

A copy of the privacy practices for the CSU Health Network can be obtained here.

If you are under 18 years of age:

If you are under 18 years of age, your parent(s) or legal guardian(s) must sign an Authorization for Treatment of a Minor, which is kept in your electronic health record.

Prior Health History

If an incoming student has a chronic medical condition, we recommend their doctor’s office send a copy of pertinent medical records to the CSU Health Network.
Additionally, be sure to complete the Health History form online.

Releasing Your Health Information

Protected health information cannot be released without your written consent/authorization unless authorized by law. If a patient is 18 years of age or older, we cannot release any information without his/her consent, even to parents. This information includes diagnosis, appointment history, test results, and billing information. A Consent/Authorization to Access or Release Protected Health Information form is available if you would like to release your PHI. This form must be filled out in person at the CSU Health Network or contact us regarding faxing/mailing this form.
To have health information shared with parents, professors, etc., an Information Exchange form needs to be completed. This form must be filled out in person at the CSU Health Network or contact us regarding faxing/mailing this form.

POLICY PROVISIONS

Patient Rights & Responsibilities

Your patient rights and responsibilities at the CSU Health Network:

You have the RIGHT:

To be treated with respect, consideration, and dignity
To be provided with personal privacy, safety and security within the health network.
To communicate in your primary language whenever possible if you are not fluent in English.
To be provided, to the degree known, information concerning your diagnosis, evaluation, treatment and prognosis.
To be informed and participate in treatment decisions, know the benefits, side effects, and possible complications of treatment
To choose your providers and know the names and professional status of those working with you
To privacy and confidentiality of your health information and health records
To receive emergency care without waiting for authorizations or fearing financial penalty.
To receive a privacy notice to inform you about how protected information will be disclosed
To request that uses and disclosure of protected health information be restricted
To consent to or refuse any care or treatment
To be informed about services and any related costs
To receive appropriate referrals to other providers and services
To file a complaint against a provider, the facility, or healthcare personnel without fear of reprisal
To be provided with help that will facilitate informed healthcare decisions in spite of language barriers, physical or mental disability, or difficulty understanding the care plan

To be provided reasonable access to care within the health network’s mission and scope of service regardless of: Ethnicity, Race, Age Gender Identity and Expression, Disability, Culture, Different Ideas and Perspectives, First Generation Status, Marital Status, Geographic Background, Religious and Spiritual Beliefs, Sex, Sexual Orientation, Socioeconomic Status, Veteran Status, or National Origin.

You have the RESPONSIBILITY:

To seek healthcare promptly
To give accurate information about your health history regarding health, medications, including over-the-counter products and dietary supplements, and allergies or sensitivities.
To ask questions or for clarification about anything you do not understand
To report any significant changes in symptoms or failure to improve
To respect CSU Health Network policies
To treat all CSU Health Network staff with courtesy and respect
To arrive for appointments at or before scheduled appointment time, keep appointments or cancel in a timely manner
To provide useful feedback about our services and policies
To know the names, purpose, and effects of medications prescribed to you
To pay promptly any bills you have incurred
To follow the treatment plan prescribed by the provider and participate in the care
To provide responsible transportation and care for 24 hours when required by the provider
To inform the provider about the existence of a living will, medical power of attorney or other advance directive that could affect your care.

FORMS AND TOOLS

Download the Consent/Authorization to Access or Release Protected Health Information Form

APPROVALS

Version 1.01 approved June 4, 2018 by Lynn Johnson, Vice President for University Operations