Hackettstown First Aid & Rescue Squad
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION PURSUANT TO FEDERAL REGULATIONS. PLEASE REVIEW IT CAREFULLY
At Hackettstown First Aid & Rescue Squad (“HFARS”), we understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from HFARS. We need this record to provide you with quality care and to comply with certain legal requirements. This Joint Notice (“Notice”) applies to all of the records of your care generated by HFARS, whether made by HFARS personnel or any other health practitioners.
This Notice will tell you about the ways in which HFARS may use and disclose medical information about you, referred to below as protected health information (“PHI”). This Notice also describes your rights and certain obligations HFARS has regarding the use and disclosure of PHI. This Notice describes HFARS’s practices and that of: all EMT’s and health care practitioners who are members of HFARS’s medical staff and have clinical privileges; any health care practitioner authorized to enter information into your prehospital care chart; all departments, and of HFARS, anywhere located; any member of a group we allow to help you while you are in the HFARS care; all employees, staff and other HFARS personnel. All these persons, entities, sites and locations may share PHI with each other for treatment, payment or operations as described in this Notice.
MICU and HFARS. HFARS and paramedics who provide health care services are separate legal entities and with limited exceptions, the paramedics are not employees of HFARS. The MICU may have different policies or notices regarding their use and disclosure of your medical information created in their offices or hospital and are responsible for their own compliance with privacy regulations.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU. HFARS may use or disclose your PHI for the purposes described in more detail below, without obtaining written authorization from you. In addition, HFARS and the members of its medical staff who participate in the organized health care arrangement described below may share your PHI with each other as necessary to carry out their treatment, payment and health care operations related to the organized health care arrangement.
For Treatment. HFARS may use and disclose PHI in the course of providing, coordinating, or managing your medical treatment, including the disclosure of PHI for treatment activities of another health care provider. These types of uses and disclosures may take place between physicians, nurses, technicians, students, and other health care professionals who provide you health care services or are otherwise involved in your care. For example, if you are being treated by an EMT we will transfer care to a nurse or physician at the hospital who is assisting in your care. HFARS may also disclose PHI about you to people outside the hospital, such as family members, clergy or others who provide services that are part of your care.
For Payment. HFARS may use and disclose PHI in order to bill and collect payment for the health care services provided to you. For example, HFARS may need to give PHI to your health plan in order to be reimbursed for the services provided to you. HFARS may also disclose PHI to its business associates, such as billing companies, claims processing companies, and others that assist in processing health claims. HFARS may also disclose PHI to other health care providers and health plans for the payment activities of such providers or health plans.
For Health Care Operations. HFARS may use and disclose PHI as part of its operations, including for quality assessment and improvement, such as evaluating the treatment and services you receive and the performance of staff and EMS personnel in caring for you, patient surveys, provider training, underwriting activities, compliance and risk management activities, planning and development, and management and administration. HFARS may disclose PHI to doctors, nurses, technicians, students, attorneys, consultants, accountants, and others for review and learning purposes, to help make sure HFARS is complying with all applicable laws, and to help HFARS continue to provide quality health care to its patients. HFARS may also disclose PHI to other health care providers and health plans for such entity’s quality assessment and improvement activities, credentialing and peer review activities, and health care fraud and abuse detection or compliance, provided that such entity has, or has had in the past, a relationship with the patient who is the subject of the information.
For Sharing PHI Among HFARS And Its Medical Staff. HFARS and the EMT’s and other health care providers who are members of the HFARS medical staff work together in an organized health care arrangement to provide medical services to you when you are a patient of HFARS. HFARS and the medical staff members will share PHI that they collect from you at HFARS with each other as necessary to carry out their treatment, payment and health care operations relating to the provision of care to patients of HFARS.
As Required by Law and Law Enforcement. HFARS may use or disclose PHI when required to do so by applicable law and when ordered to do so in a judicial or administrative proceeding. HFARS may also use or disclose PHI to identify or locate a suspect, fugitive, material witness, or missing person, when dealing with gunshot and other wounds, about criminal conduct, to report a crime, the location of the crime or victims, or the identity, description, or location of a person who committed a crime, or for other law enforcement purposes.
For Public Health Activities and Public Health Risks. HFARS may disclose PHI to government officials in charge of collecting information about births and deaths, preventing and controlling disease, reports of child abuse or neglect and of other victims of abuse, neglect, or domestic violence, reactions to medications or product defects or problems, or to notify a person who may have been exposed to a communicable disease or may be at risk of contracting or spreading a disease or condition.
For Health Oversight Activities. HFARS may disclose PHI to the government for oversight activities authorized by law, such as audits, investigations, inspections, licensure or disciplinary actions, and other proceedings, actions or activities necessary for monitoring the health care system, government programs, and compliance with civil rights laws.
Coroners, Medical Examiners, and Funeral Directors. HFARS may disclose PHI to coroners, medical examiners, and funeral directors for the purpose of identifying a decedent, determining a cause of death, or otherwise as necessary to enable these parties to carry out their duties consistent with applicable law.
Organ, Eye, and Tissue Donation. HFARS may release PHI to organ procurement organizations to facilitate organ, eye, and tissue donation and transplantation.
Research. Under certain circumstances, HFARS may use and disclose PHI for medical research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition.
To Avoid a Serious Threat to Health or Safety. HFARS may use and disclose PHI, to law enforcement personnel or other appropriate persons, to prevent or lessen a serious threat to the health or safety of a person or the public.
Specialized Government Function. HFARS may use and disclose PHI of military personnel and veterans under certain circumstances. HFARS may also disclose PHI to authorized federal officials for intelligence, counter intelligence, and other national security activities, and for the provision of protective services to the President or other authorized persons or foreign heads of state or to conduct special investigations.
Workers’ Compensation. HFARS may disclose PHI to comply with workers’ compensation or other similar laws. These programs provide benefits for work-related injuries or illnesses.
Fundraising Activities. Your PHI may be used to contact you in an effort to raise money for HFARS. Your PHI may be disclosed to a foundation related to HFARS. Such disclosure would be limited to contact information, such as your name, address and phone number and the dates you required treatment or services by HFARS. If you do not want to be contacted as part of these fundraising activities, please notify the HFARS in writing.
Inmates. If you are an inmate in a correctional institution or under the custody of a law enforcement official, HFARS may release PHI about you to the correctional institution or law enforcement official for treatment, payment, or for protection of the health and safety of you or others or for the safety and security of the correctional institution.
Disclosures to You or for HIPAA Compliance Investigations. HFARS may disclose your PHI to you or to your personal representative, and is required to do so in certain circumstances described below in connection with your rights of access to your PHI and to an accounting of certain disclosures of your PHI. HFARS must disclose your PHI to the Secretary of the United States Department of Health and Human Services (the "Secretary") when requested by the Secretary in order to investigate HFARS's compliance with privacy regulations issued under the federal Health Insurance Portability and Accountability Act of 1996.
Patient Directories. Unless you object, HFARS may use some of your PHI to maintain a directory of individuals transported. This information may include your name, your location, your general condition (e.g. fair, stable, etc.), and your religious affiliation, and the information may be disclosed to members of the clergy. Except for your religious affiliation, the information may be disclosed to other persons who ask for you by name.
Disclosures to Individuals Involved in Your Health Care or Payment for Your Health Care. Unless you object, HFARS may disclose your PHI to a family member, other relative, friend, or other person you identify as involved in your health care or payment for your health care. HFARS may also notify these people about your location or condition. In addition, HFARS may disclose PHI about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
OTHER USES AND DISCLOSURES. Other types of uses and disclosures of your PHI not described above will be made only with your written authorization, which with some limitations; you have the right to revoke in writing. If you revoke your permission, HFARS will no longer use or disclose PHI about you for the reasons covered in your written authorization. You understand that HFARS is unable to take back any disclosures already made with your permission, and that HFARS is required to retain records of the care provided to you.
REGULATORY REQUIREMENTS. HFARS is required by law to maintain the privacy of your PHI, to provide individuals with notice of HFARS’s legal duties and privacy practices with respect to PHI, and to abide by the terms described in the Notice currently in effect.
Restrictions. You may request that HFARS restrict the use and disclosure of your PHI. For example, you could ask that we not use or disclose information about a transport. To request restrictions, you must make your request in writing to the Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the restrictions to apply, for example, disclosures to your spouse.
Alternative Communications. You have the right to request that communications of PHI to you from HFARS be made by particular means or at particular locations. For instance, you might request that communications be made at your work address, instead of your home address. Your requests must be made in writing and sent to the Privacy Officer. HFARS will accommodate your reasonable requests without requiring you to provide a reason for your request.
Inspect and Copy. Generally, you have the right to inspect and copy your PHI that HFARS maintains, provided that you make your request in writing to the Privacy Officer. If you request copies of your PHI, we may impose a reasonable fee to cover copying and postage. If we deny access to your PHI, we will explain the basis for denial and your opportunity to have your request and the denial reviewed by a licensed health care professional (who was not involved in the initial denial decision) designated as a reviewing official. If HFARS does not maintain the PHI you request and if we know where that PHI is located, we will tell you how to redirect your request.
Amendment. If you believe that your PHI maintained by HFARS is incorrect or incomplete, you may ask us to correct your PHI. Your request must be made in writing to the Information Officer, and it must explain why you are requesting an amendment to your PHI. We generally can deny your request if your request relates to PHI: (i) not created by HFARS; (ii) not part of the records HFARS maintains; (iii) not subject to being inspected by you; or (iv) that is accurate and complete. If your request is denied, we will provide you a written denial that explains the reason for the denial and your rights to: (i) file a statement disagreeing with the denial; (ii) if you do not file a statement of disagreement, submit a request that any future disclosures of the relevant PHI be made with a copy of your request and HFARS’s denial attached; and (iii) complain about the denial.
Accounting of Disclosures. You generally have the right to request and receive a list of the disclosures of your PHI we have made at any time during the six (6) years prior to the date of your request (provided that such a list would not include disclosures made prior to April 14, 2003). The list will not include disclosures made at your request, with your authorization, and does not include certain uses and disclosures to which this Notice already applies, such as those: (i) for treatment, payment, and health care operations; (ii) made to you; (iii) for HFARS’s patient directory or to persons involved in your health care; (iv) for national security or intelligence purposes; or (v) to correctional institutions or law enforcement officials. You should submit any such request to the Health Information Management Department. HFARS will provide the list to you at no charge, but if you make more than one request in a year you will be charged a fee of the costs of providing the list.
Right to Copy of Notice. You have the right to receive a paper copy of this notice upon request. You can view a copy of this notice at our Web site, www.78rescue.org/custom.html?id=13670 To obtain a paper copy of this notice, please contact the Privacy Officer at (908) 852-5971
Right to File a Complaint. You may complain to HFARS if you believe your privacy rights with respect to your PHI have been violated by contacting the Privacy Officer,
You also have the right to file a complaint with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.
Contact the Privacy Officer,
if you have questions about this Notice.