Hippa Privacy Policies
HIGHLAND TOWNSHIP FIRE DEPARTMENT
NOTICE OF PRIVACY PRACTICES
THIS
NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY
THE PRIVACY OF YOUR HEALTH INFORMATION IS IMPORTANT TO US
Your health
information is
personal, and we are committed to protecting it. Your health
information is also
important to our ability to provide you with quality care, and to
comply with
certain laws. This notice applies to all records about care provided to
you by
Highland Township Fire Department. (Your
physician may have different policies and a different notice regarding
your
health information that is created in the physician’s office.)
I.
We Are Legally Required to Safeguard Your Health Information.
We are required by
law to:
A.
Maintain the privacy of your health information.
B.
Provide you with this Notice, and
C.
Comply with this notice.
II.
Future Changes to Our Practices and This Notice.
We reserve the right
to
change our privacy practices and terms of this Notice at any time,
provided
changes are permitted by applicable law. We reserve the right to make
changes in
our privacy practices and the new terms of our Notice effective for all
health
information that we maintain, including health information we created
or
received before we made the changes. In the event we make a material
change in
our privacy practices, we will change this Notice and provide it to you.
You may request a
copy of our
Notice at any time by contacting our Privacy Officer at (248) 887-9050.
We will
also make any revised notice available on our website at www.htfd.com.
III.
How We May Use and Disclose Your Health Information.
The law requires us
to have
your authorization for some uses and disclosures. In other
circumstances, the
law allows us to use or disclose health information without your
authorization.
This section gives examples of each of these circumstances.
A.
Certain Uses and
Disclosures Do
Not Require Your Authorization. The law
allows us to disclose Health Information without your authorization in
the
following circumstances:
(1)
When Required by Law.
(2)
For Public Health Activities.
(3)
For Reports about Victims of Abuse, Neglect or Domestic Violence.
(4)
To Health Oversight Agencies.
(5)
For Lawsuits and Disputes.
(6)
To Law Enforcement. We may release Health Information if asked
to do so
by a law enforcement official, in the following circumstances: (a) in
response
to a court order, subpoena, warrant, summons or similar process; (b) to
identify
or locate a suspect, fugitive, material witness or missing person; (c)
about the
victim of a crime if, under certain limited circumstances, we are
unable to
obtain the person’s agreement; (d) about a death we believe may be due
to
criminal conduct; (e) about criminal conduct at our facility; and (f)
in
emergency circumstances, to report a crime, its location or victims, or
the
identity, description or location of the person who committed the crime.
(7)
To Coroners, Medical Examiners and Funeral Directors.
(8)
To Organ procurement Organizations.
(9)
For Medical Research. We may disclose your Health Information
without
your authorization to medical researchers who request it for approved
medical
research projects.
(10)
To avert a Serious Threat to Health or Safety.
(11)
For Specialized Government Functions.
(12)
To Worker’s Compensation or Similar Programs.
IV.
Other Uses and Disclosures of Your Health Information.
Other
uses and disclosures of your Health Information that are not covered by
this
notice or the laws that apply to us will be made only with your written
authorization. If you give us written authorization for a use or
disclosure of
your Health Information, you may revoke that authorization, in writing,
at any
time. If you revoke your authorization we will no longer use or
disclose your
Health Information for the purposes specified in the written
authorization,
except that we are unable to retract any disclosures we have already
made with
your permission. In addition, we can use or disclose your Health
Information
after you have revoked your authorization for actions we have already
taken in
reliance on your authorization. We are also required to retain certain
records
of the uses and disclosures made when the authorization was in effect.
V.
Your Rights Related to Your Health Information.
You have the
following
rights:
A.
The Right to Request Limits on Uses and Disclosures of Your
Health
Information. You have the right to ask us to limit how we use and
disclose
your Health Information. Any such request must be submitted in writing
to our
Privacy Officer. We are not required to agree to your request. If we do
agree,
we will put it in writing and will abide by the agreement except when
you
require emergency treatment.
B.
The Right to Choose How
We
Communicate With You. You have
the
right to ask that we send information to you at a specific address (for
example,
at work rather than at home) or in a specific manner (for example, by
e-mail
rather than by regular mail, or never by telephone). We must agree to
your
request as long as it would not be disruptive to our operations to do
so. You
must make any such request in writing, addressed to our Privacy Officer.
C.
The Right to See and
Copy Your
Health Information. You
have the right to review or get copies of your health information, with
limited
exceptions. You may request that we provide copies in a format other
than
photocopies. We will use the format you request unless we cannot
practicably do
so. You must make a request in writing to obtain access to you health
information. We will charge you a reasonable cost-base fee for expenses
such as
copies and staff time. If you request an alternative format other than
what we
provide, we will charge a cost-base fee for providing your health
information in
that format. You can send your request to our Privacy Officer.
D.
The Right to Correct or
Update
Your Health Information. If
you believe
that the Health Information we have about you is incomplete or
incorrect, you
may ask us to amend it. Any such request must be made in writing and
must be
addresses to our Privacy Officer, and must tell us why you think the
amendment
is appropriate. We will not process your request if it is not in
writing or does
not tell us why you think the amendment is appropriate. We will act on
your
request within 30 day or less if state law requires (or 60 days if the
extra
time is needed), and will inform you I writing as to whether the
amendment will
be made or denied. If we agree to make the amendment, we will ask you
who else
you would like us to notify of the amendment.
We may deny your request if you ask us to amend information that:
(1)
was not created by us, unless the person who created the
information is
no longer available to make the amendment;
(2)
is not part of the Health Information we keep about you;
(3)
is not part of the Health Information that you would be allowed
to see or
copy; or
(4)
is determined by us to be accurate and complete.
If we deny the
requested
amendment, we will tell you in writing how to submit a statement of
disagreement
or complaint, or to request inclusion of your original amendment
request in your
health Information.
E.
The Right to get a list
of the
Disclosures We Have Made. You
have the
right to get a list of instances in which we have disclosed you Health
Information. The list will not include disclosures we have made for our
treatment, payment and health care operations purposes, those made
directly to
you or your family or friends or through our facility directory, or for
disaster
relief purposes. Neither will the list include disclosures we have made
for
national security purposes or to law enforcement personnel, or
disclosures made
before April 14, 2003.
Your
request for a list of disclosures must be made in writing and be
addressed to
our Privacy Officer. We will respond to your request within 30 days, or
less if
state law requires (60 days if the extra time is needed). The list we
provide
will include disclosures made within the last six years unless you
specify a
shorter period. The first list you request within a 12-month period
will be
free. You will be charged our cost for providing any additional lists
within the
12-month period.
VI.
Questions and Complaints
If you want more
information
about our privacy practices or have questions or concerns, please
contact our
Privacy Officer.
If you believe your
privacy
rights have been violated, or you disagree with a decision we made
about access
to your Health Information or in response to a request to amend or
restrict the
use of your Health Information or to have us communicate with you by
alternative
means or at alternative locations, you may complain to our Privacy
Officer in
writing using the contact information at the end of this Notice. You
may also
submit a written complaint to the U.S. Department of Health & Human
Services
at, 200 Independence Ave. S.W., Washington DC, 20201. Or call them at
(877)
696-6775.
We support your
rights to the
privacy of your Health Information. We will not retaliate in any way if
you
choose to file a complaint with us or with the U.S. Department of
Health &
Human Services.
PRIVACY
OFFICER:
______JAMES CRUNK______________________
ADDRESS:
______250
W. LIVINGSTON, P.O. BOX 166____
______HIGHLAND, MICHIGAN 48357-0166____
TELEPHONE:
______(248) 887-9050________________________
FAX
NUMBER:
______(248) 889-9506________________________
WEBSITE:
______www.htfd.com________________________
updated 10/29/2003