This form concerns protected health information maintained by the Detroit Health Department. As a citizen you have the right to submit complaints if you suspect that your privacy rights have been violated.

You have the following rights if you are filing a privacy complaint:

• The privacy complaint must be filed within 180 calendar days of when you became aware of the identified act or omission occurred. The time to file may be extended if you can show good cause.
• Individuals can file complaints either with the Detroit Health Department, the Michigan Department of Health and Human Services (MDHHS), or the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized for filing a complaint
   

The Notice of Privacy Practices (NPP) describes how health information about you may be used and disclosed as well as how you can get access to this information from the Detroit Health Department. The NPP is a requirement under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), specifically 45 CFR § 164.520, for any healthcare provider, health plan, and public health departments to develop and distribute a notice explaining how they may use and disclose protected health information (PHI).

The Notice of Privacy Practices applies to all programs and services within the Detroit Health Department. In addition, the NPP applies to those divisions of the Detroit Health Department that provide management, administrative or financial services for these programs to the extent that protected health information is disclosed to these divisions as required for business operations in support of the programs and services of the Detroit Health Department.