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Brewster-Southeast Joint Fire District
PRIVACY POLICY NOTICE
Brewster-Southeast Joint
Fire District
(BSJFD) is required by law to maintain the privacy of
certain confidential health care information, known as
Protected Health Information (PHI), and to provide you with
a notice of our legal duties and privacy practices with
respect to your PHI. BSJFD is also required to abide by the
terms of the version of the Notice currently in effect.
Uses and Disclosures of
PHI: BSJFD may
use PHI for the purpose 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 obtaining verbal and written information about
your medical condition and treatment from you as well as
from others, such as doctors and nurses who give orders to
allow us to provide treatment to you. We may give your PHI
to other health care providers involved in your treatment,
and may transfer your PHI via radio or telephone to the
hospital or dispatch center.
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
submitting bills to insurance companies, making medical
necessity determinations and collecting 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, as well as certain other management functions.
Use and Disclosures of
PHI Without Your Authorization:
BSJFD is permitted to use
PHI without your written authorization, or opportunity to
object, in certain situations, and unless prohibited by a
more stringent state law, including:
·
For the
treatment, payment or health care operations activities of
another health care provider who treats you;
·
For health
care and legal compliance activities;
·
To a family
member, other relative, or close personal friend or other
individual involved in your care if we obtain your verbal
agreements to do so or if we give you an opportunity to
object to such a disclosure and you do not raise an
objection, and in certain other circumstances where we are
unable to obtain your agreement and believe the disclosure
is in your best interests;
·
To a public
health authority in certain situations as required by law
(such as to report abuse, neglect or domestic violence;
·
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 proceeding 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
responding to a warrant;
·
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;
·
We may also
use or disclosure 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. 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 your PHI, including:
The right to access, copy
or inspect your PHI.
This means you may 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 of
$10.00 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. You have the right 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.
You also have the right to receive confidential
communications of your PHI. If you wish to inspect and copy
your medical information, you should contact our privacy
officer.
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 our privacy officer.
The right to request an
accounting. You
may request an accounting from us of certain disclosures of
your medical information that we have made in the six years
prior to the date of your request. We are not required to
give you an accounting if 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, contact our privacy officer.
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. BSJFD is not required to agree to any restrictions you
request, but any restrictions agreed to by BSJFD in writing
are binding on BSJFD.
Internet and the Right to
Obtain Copy of Paper Notice on Request.
A copy of this Notice will be posted on the Brewster Fire
Department website. You may also request a paper copy of the
Notice by mail.
Revisions to the Notice.
BSJFD 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 BSJFD
web site. You can get a copy of the latest version of this
Notice by contacting our privacy officer.
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 of to the government. Should you have any
questions, comments or complaints you may direct all
inquiries to our privacy officer.
Privacy Officer Contact
Information:
William Rieg
Privacy Officer
Brewster-Southeast Joint Fire District
501 North Main Street
Brewster, NY 10509
845-279-6105
Effective Date of the
Notice: April 14, 2003 |
