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Privacy Practices
Sun
Lakes Fire District Notice of Privacy Practices
IMPORTANT:
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY
BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE
REVIEW IT CAREFULLY.
As an essential part of
our commitment to you, Sun Lakes Fire District maintains the privacy
of certain confidential health care information about you, known as
Protected Health Information or PHI.
We are required by law to protect your health care
information and to provide you with the attached Notice of Privacy
Practices.
The Notice outlines our
legal duties and privacy practices with respect to your PHI.
It not only describes our privacy practices and your legal
rights, but lets you know, among other things, how Sun Lakes Fire
District is permitted to use and disclose PHI about you, how you can
access and copy that information, how you may request amendment of
that information, and how you may request restrictions on our use
and disclosure of your PHI.
Sun Lakes Fire District
is also required to abide by the terms of the version of this Notice
currently in effect. In most situations, we may use this information
as described in this Notice without your permission, but there are
some situations where we may use it only after we obtain your
written authorization, if we are required by law to do so.
We respect your privacy,
and treat all health care information about our patients with care
under strict policies of confidentiality that all of our staff are
committed to following at all times.
PLEASE READ THE ATTACHED
DETAILED NOTICE. IF YOU
HAVE ANY QUESTIONS ABOUT IT, PLEASE CONTACT Linda Peters, OUR
PRIVACY OFFICER, AT 480-895-9343.
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Purpose of this Notice:
Sun Lakes Fire District is required by law to
maintain the privacy of certain confidential health care
information, known as Protected Health Information or PHI, and to
provide you with a notice of our legal duties and privacy practices
with respect to your PHI. This Notice describes your legal rights,
advises you of our privacy practices, and lets you know how Sun
Lakes Fire District is permitted to use and disclose PHI about you.
Sun
Lakes Fire District is also required to abide by the terms of the
version of this Notice currently in effect. In most situations, we
may use this information as described in this Notice without your
permission, but there are some situations where we may use it only
after we obtain your written authorization, if we are required by
law to do so.
Uses and Disclosures of PHI: Sun Lakes Fire District may use PHI
for the purposes of treatment, payment, and health care operations,
in most cases without your written permission.
Examples of our use of your PHI:
For
treatment:
This includes such things as verbal and written information
that we obtain about you and use pertaining to your medical
condition and treatment provided to you by us and other medical
personnel (including doctors and nurses who give orders to allow us
to provide treatment to you). It also includes information we give
to other health care personnel to whom we transfer your care and
treatment, and includes transfer of PHI via radio or telephone to
the hospital or dispatch center as well as providing the hospital
with a copy of the written record we create in the course of
providing you with treatment and transport.
For payment:
This includes any activities we must undertake in order to
get reimbursed for the services we provide to you, including such
things as organizing your PHI and submitting bills to insurance
companies (either directly or through a third party billing
company), management of billed claims for services rendered, medical
necessity determinations and reviews, utilization review, and
collection of outstanding accounts.
For
health care operations:
This includes quality assurance activities, licensing, and
training programs to ensure that our personnel meet our standards of
care and follow established policies and procedures, obtaining legal
and financial services, conducting business planning, processing
grievances and complaints, creating reports that do not individually
identify you for data collection purposes, fundraising, and certain
marketing activities.
Use and Disclosure of PHI Without Your
Authorization:
Sun Lakes Fire District is permitted to use PHI without
your written authorization, or opportunity to object in certain
situations, including:
·
For Sun Lakes Fire District’s use in treating you or in
obtaining payment for services provided to you or in other health
care operations;
·
For the treatment activities of another health care
provider;
·
To another health care provider or entity for the payment
activities of the provider or entity that receives the information
(such as your hospital or insurance company);
·
To another health care provider (such as the hospital to
which you are transported) for the health care operations activities
of the entity that receives the information as long as the entity
receiving the information has or has had a relationship with you and
the PHI pertains to that relationship;
·
For health care fraud and abuse detection or for
activities related to compliance with the law;
·
To a family member, other relative, or close personal
friend or other individual involved in your care if we obtain your
verbal agreement to do so or if we give you an opportunity to object
to such a disclosure and you do not raise an objection.
We may also disclose health information to your family,
relatives, or friends if we infer from the circumstances that you
would not object. For example, we may assume you agree to our
disclosure of your personal health information to your spouse when
your spouse has called the ambulance for you.
In situations where you are not capable of objecting (because
you are not present or due to your incapacity or medical emergency),
we may, in our professional judgment, determine that a disclosure to
your family member, relative, or friend is in your best interest. In
that situation, we will disclose only health information relevant to
that person's involvement in your care. For example, we may inform
the person who accompanied you in the ambulance that you have
certain symptoms and we may give that person an update on your vital
signs and treatment that is being administered by our ambulance
crew;
·
To a public health authority in certain situations (such
as reporting a birth, death or disease as required by law, as part
of a public health investigation, to report child or adult abuse or
neglect or domestic violence, to report adverse events such as
product defects, or to notify a person about exposure to a possible
communicable disease as required by law;
·
For health oversight activities including audits or
government investigations, inspections, disciplinary proceedings,
and other administrative or judicial actions undertaken by the
government (or their contractors) by law to oversee the health care
system;
·
For judicial and administrative proceedings as required by
a court or administrative order, or in some cases in response to a
subpoena or other legal process;
·
For law enforcement activities in limited situations, such
as when there is a warrant for the request, or when the information
is needed to locate a suspect or stop a crime;
·
For military, national defense and security and other
special government functions;
·
To avert a serious threat to the health and safety of a
person or the public at large;
·
For workers’ compensation purposes, and in compliance
with workers’ compensation laws;
·
To coroners, medical examiners, and funeral directors for
identifying a deceased person, determining cause of death, or
carrying on their duties as authorized by law;
·
If you are an organ donor, we may release health
information to organizations that handle organ procurement or organ,
eye or tissue transplantation or to an organ donation bank, as
necessary to facilitate organ donation and transplantation;
·
For research projects, but this will be subject to strict
oversight and approvals and health information will be released only
when there is a minimal risk to your privacy and adequate safeguards
are in place in accordance with the law;
·
We may use or disclose health information about you in a
way that does not personally identify you or reveal who you are.
Any other use or
disclosure of PHI, other than those listed above will only be made
with your written authorization, (the authorization must
specifically identify the information we seek to use or disclose, as
well as when and how we seek to use or disclose it). You may
revoke your authorization at any time, in writing, except to the
extent that we have already used or disclosed medical information in
reliance on that authorization.
Patient Rights:
As a patient, you have a number of rights with respect to the
protection of your PHI, including:
The right to access, copy
or inspect your PHI: This
means you may come to our offices, inspect, and copy most of the
medical information about you that we maintain.
We will normally provide you with access to this information
within 30 days of your request.
We may also charge you a reasonable fee for you to copy any
medical information that you have the right to access.
In limited circumstances, we may deny you access to your
medical information, and you may appeal certain types of denials.
We have available forms to
request access to your PHI and we will provide a written response if
we deny you access and let you know your appeal rights. If you wish to inspect and copy your medical information, you
should contact the privacy officer listed at the end of this Notice.
The right to amend your
PHI: You have
the right to ask us to amend written medical information that we may
have about you. We will
generally amend your information within 60 days of your request and
will notify you when we have amended the information.
We are permitted by law to deny your request to amend your
medical information only in certain circumstances, like when we
believe the information you have asked us to amend is correct.
If you wish to request that we amend the medical information
that we have about you, you should contact the privacy officer
listed at the end of this Notice.
The right to request an
accounting of our use and disclosure of your PHI:
You may request an accounting from us of certain disclosures
of your medical information that we have made in the last six years
prior to the date of your request.
We are not required to give you an accounting of information
we have used or disclosed for purposes of treatment, payment or
health care operations, or when we share your health information
with our business associates, like our billing company or a medical
facility from/to which we have transported you.
We are also not
required to give you an accounting of our uses of protected
health information for which you have already given us written
authorization. If you
wish to request an accounting of the medical information about you
that we have used or disclosed that is not exempted from the
accounting requirement, you should contact the privacy officer
listed at the end of this Notice.
The right to request that
we restrict the uses and disclosures of your PHI:
You have the right to request that we restrict how we use and
disclose your medical information that we have about you for
treatment, payment, or health care operations, or to restrict the
information that is provided to family, friends and other
individuals involved in your health care. But if you request a restriction and the information you
asked us to restrict is needed to provide you with emergency
treatment, then we may use the PHI or disclose the PHI to a health
care provider to provide you with emergency treatment.
Sun Lakes Fire District is not required to agree to any
restrictions you request, but any restrictions agreed to by Sun
Lakes Fire District are binding on Sun Lakes Fire District.
Internet, Electronic Mail, and the Right to
Obtain Copy of Paper Notice on Request:
If we maintain a web site, we
will prominently post a copy of this Notice on our web site and make
the Notice available electronically through the web site.
If you allow us, we will forward you this Notice by
electronic mail instead of on paper and you may always request a
paper copy of the Notice.
Revisions to the Notice:
Sun Lakes Fire District reserves the right to change the
terms of this Notice at any time, and the changes will be effective
immediately and will apply to all protected health information that
we maintain. Any
material changes to the Notice will be promptly posted in our
facilities and posted to our web site, if we maintain one.
You can get a copy of the latest version of this Notice by
contacting the Privacy Officer identified below.
Your Legal Rights and Complaints:
You also have the right to complain to us, or to the
Secretary of the United States Department of Health and Human
Services if you believe your privacy rights have been violated. You
will not be retaliated against in any way for filing a complaint
with us or to the government. Should
you have any questions, comments, or complaints you may direct all
inquiries to the privacy officer listed at the end of this Notice.
Individuals will not be retaliated against for filing a
complaint.
If you have any questions
or if you wish to file a complaint or exercise any rights listed in
this Notice, please contact:
Chris Barden CEP
Sun Lakes Fire District
25020 S. Alma School Road
Sun Lakes, AZ 85248
Effective Date of the
Notice: April 14,
2003
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