|
|
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. PLEASE REVIEW IT
CAREFULLY.
This Notice describes the medical information practices of the Kenai
Peninsula Borough’s Central Emergency Services (“CES”) and that of any
third party that provides billing or other services to CES.
Our Pledge Regarding Medical Information
We understand that medical information about your health is personal. We
will not disclose your personal health information to others unless you
tell us to do so, or unless the law authorizes or requires us to do so.
This Notice applies to all of the medical records we maintain. Your doctor
or other health care provider may have different policies or Notices
regarding the health care provider’s use and disclosure of your medical
information created in the provider’s healthcare facility.
This Notice will tell you about the ways in which we may use and disclose
medical information about you. It also describes our obligations and your
rights regarding the use and disclosure of medical information.
We are required by law to:
· make sure that medical information that identifies you is kept private;
· give you this Notice; and
· follow the terms of the Notice that is currently in effect.
We have the right to change our practices regarding the personal health
information we maintain. If we make changes, we will update this Notice.
You may receive the most recent copy of the Notice by calling the
Assistant Chief at (907) 262-4792, stopping by the CES offices at 231
South Binkley, Soldotna, Alaska 99669-8084.
How We May Use and Disclose Medical Information About You
The following categories describe some of the different ways that we may
use and disclose medical information.
For Treatment. We may use or disclose medical information about you to
facilitate medical treatment. We may disclose medical information about
you to healthcare providers, including doctors, nurses, technicians,
medical students, or other health care personnel who are involved in
taking care of you. For example, we may disclose medical information to
other health personnel to whom we transfer your care and treatment, and
this may include the transfer of medical information 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 transport and treatment.
For Payment. We may use and disclose medical information about you to get
reimbursed for the services we provide to you, including such things as
organizing your medical information 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 Operations. We may use and disclose medical information about you for
other CES operations. These uses and disclosures are necessary to run CES.
For example, we may use medical information in connection with: conducting
quality assessment and improvement activities; licensing; 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; fraud and abuse detection programs; creating reports that do
not individually identify you for data collection purposes; and general
CES administrative activities.
As Required by Law. We will disclose medical information about you when
required to do so by federal, state or local law. For example, we may
disclose medical information when required by a court order.
To Avert a Serious Threat to Health or Safety. We may use and disclose
medical information about you when necessary to prevent a serious threat
to your health and safety or the health and safety of the public or
another person. Any disclosure, however, would only be to someone able to
help prevent the threat. For example, we may disclose medical information
about you in a proceeding regarding the license of a physician.
Special Situations Involving Disclosure of Medical Information
Organ and Tissue Donation. If you are an organ donor, we may release
medical information to organizations that handle organ procurement or
organ, eye or tissue transplantation or to an organ donation bank, as
necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans. If you are a member of the armed forces, we may
release medical information about you as required by military command
authorities.
Workers’ Compensation. We may release medical information about you for
state workers’ compensation or similar programs.
Public Health Risks. We may disclose medical information about you for
public health activities. These activities generally include the
following:
· to prevent or control disease, injury or disability;
· to report births and deaths;
· to report child abuse or neglect;
· to report reactions to medications or problems with products;
· to notify people of recalls of products they may be using;
· to notify a person who may have been exposed to a disease or may be at
risk for contracting or spreading a disease or condition;
· to notify the appropriate government authority if we believe a patient
has been the victim of abuse, neglect or domestic violence. We will only
make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose medical information to a
health oversight agency for activities authorized by law. These oversight
activities include, for example, audits, investigations, inspections, and
licensure.
Lawsuits and Disputes. If you are involved a lawsuit or a dispute, we may
disclose medical information about you in response to a court or
administrative order. We may also disclose medical information about you
in response to a subpoena or other lawful process by someone else involved
in the dispute, but only if efforts have been made to tell you about the
request or to obtain an order protecting the information requested.
Law Enforcement. We may release medical information if asked to do so by a
law enforcement official:
· in response to a court order, subpoena, warrant, summons or similar
process;
· to identify or locate a suspect, fugitive, material witness, or missing
person;
· about the victim of a crime if, under certain limited circumstances, we
are unable to obtain the person’s agreement;
· about a death we believe may be the result of criminal conduct;
· about criminal conduct at the hospital; and
· in emergency circumstances to report a crime; the location of the crime
or victims; or the identity, description or location of the person who
committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release medical
information to a coroner or medical examiner. We may also release medical
information about patients of the hospital to funeral directors as
necessary to carry out their duties.
National Security and Intelligence Activities. We may release medical
information about you to authorized federal officials for intelligence,
counterintelligence, and other national security activities authorized by
law.
Inmates. If you are an inmate of a correctional institution or under the
custody of a law enforcement official, we may release medical information
about you to the correctional institution or law enforcement official.
This release would be necessary (1) for the institution to provide you
with health care; (2) to protect your health and safety or the health and
safety of others; or (3) for the safety and security of the correctional
institution.
Your Rights Regarding Medical Information About You
You have the following rights regarding medical information we maintain
about you:
Right to Access, Inspect and Copy. You may come to our offices and 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 medical information 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.
Right to Amend. If you feel that medical information we have about you is
incorrect or incomplete, you may ask us to amend the information. You have
the right to request an amendment for as long as the information is kept
by or for CES. To request an amendment, your request must be made in
writing and submitted to the privacy officer listed at the end of this
Notice. In addition, you must provide a reason that supports your request.
We will generally amend your information within 60 days of your request
and will notify you when we have amended the information
We may deny your request for an amendment if it is not in writing or does
not include a reason to support the request. In addition, we may deny your
request if you ask us to amend information that:
· is not part of the medical information kept by or for CES;
· was not created by us, unless the person or entity that created the
information is no longer available to make the amendment;
· is not part of the information which you would be permitted to inspect
and copy; or
· is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request a
list of disclosures of your medical information where such disclosure was
made for any purpose other than treatment, payment, or CES operations. We
are not required to give you an accounting of information we have shared
with our business associates, like our billing company or a medical
facility to/from which we have transported you. We are also not required
to give you an accounting of our uses of medical information for which you
have given us a written authorization.
To request an accounting of disclosures, you must submit your request in
writing to the privacy officer listed at the end of this Notice. Your
request must state a time period which may not be longer than six years
and may not include dates before April 14, 2003. Your request should
indicated in what form you want the list (i.e. paper or electronic). The
first list you request within a 12-month period will be free. For
additional lists, we may charge you for the costs of providing the list.
We will notify you of the cost involved and you may choose to withdraw or
modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction
or limitation on the medical information we use or disclose about you for
treatment, payment or CES operations. You also have the right to request a
limit on the medical information we disclose about you to someone who is
involved in your care or the payment for your care, like a family member
or friend. For example, you could ask that we not use or disclose
information about a transport or treatment we provided. We are not
required to agree to your request.
To request restrictions, you must make your request in writing to the
privacy officer listed at the end of this Notice. 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 limits
to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to
request that we communicate with you about medical matters in a certain
way or at a certain location. For example, you can ask that we only
contact you at work or by mail.
To request confidential communications, you must make your request in
writing to the privacy officer listed at the end of this Notice. We will
not ask you the reason for your request. We will accommodate all
reasonable requests. Your request must specify how or where you wish to be
contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy
of this Notice, and may request one at any time. Even if you have agreed
to receive this Notice electronically, you are still entitled to a paper
copy of this Notice.
Complaints
If you believe your privacy rights have been violated, you may file a
complaint with CES or with the Secretary of the Department of Health and
Human Services. To file a complaint with CES, contact the privacy officer
listed at the end of this Notice. All complaints must be submitted in
writing. You will not be retaliated against for filing a complaint.
Other Uses of Medical Information
Other uses and disclosures of medical information not covered by this
Notice or the laws that apply to us will be made only with your written
authorization. If you provide us permission to use or disclose medical
information about you, you may revoke that permission, in writing, at any
time. If you revoke your permission, we will no longer use or disclose
medical information about you for the reasons covered by your written
authorization. You understand that we are unable to take back any
disclosures we have already made with your permission, and that we are
required to retain our records of the care that we provided to you.
If you have any questions about this Notice, please contact the CES
privacy officer:
Central Emergency Services
Assistant Chief/Privacy Officer
231 South Binkley
Soldotna, AK 99669-8084
(907) 262-4792 |
|
