Washington
Fire Department
Notice of Privacy Practices
This notice applies to the information and records the
Washington Fire Department maintains about your health, health status and the
health care and service you receive from the Washington Fire Department. The Washington Fire Department is required
by law to give you this notice. It will
tell you about the ways in which the Washington Fire Department may use and
disclose health information about you and describes your rights and our
obligations regarding the use and disclosure of that information.
The Washington Fire Department may use health information
about you to provide you with medical treatment or services. The Washington Fire Department may disclose
health information about you to doctors, nurses, technicians, office staff or
other personnel who are involved in taking care of you and your health. For example, this includes such things as
verbal and written information that the Washington Fire Department obtains
about you and uses 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 the Washington Fire Department gives
to other health care personnel to whom the Washington Fire Department transfers
your care and treatment, and includes transfer of personal health information
via radio or telephone to the hospital or dispatching center as well as
providing the hospital with a copy of the report the Washington Fire Department
creates in the course of providing you with treatment and transport. Various personnel at our department may
share information about you and disclose information to others who do not work
in our department in order to coordinate your care. Family members and other healthcare providers may be part of your
medical care and may require information about you that the Washington Fire
Department maintains.
The Washington Fire Department may use and disclose health
information about you so that the treatment and services provided to you may be
billed to and payment may be collected from you, an insurance company or third
party payor. For example, the Washington
Fire Department may need to give your health plan information about a service
you received so that your health plan will reimburse you or the department for
the services.
The Washington Fire Department may use and disclose health
information about you for operations and to ensure that you and our other
patients receive quality care. For
example, the Washington Fire Department may use your health information to
evaluate the performance of our staff in caring for you. The Washington Fire Department may use health
information about all or many of our patients to help us plan for future
services, how we may become more efficient, or whether certain treatments are
effective.
The Washington Fire Department will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written authorization. The Washington Fire Department must obtain your authorization separate from any consent the Washington Fire Department may have obtained from you. If you give us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, the Washington Fire Department will no longer use or disclose information about you for the reasons covered by your written authorization, however, The Washington Fire Department cannot withdraw any uses or disclosures previously made with your permission. If The Washington Fire Department has substance abuse or HIV information about you, the department cannot release that information without written authorization from you. In order to disclose these types of records for purposes of treatment, payment or healthcare operations, the Washington Fire Department will have to have both signed consent and written authorization that complies with the law governing substance abuse or HIV.
The Washington Fire Department may use and disclose health information about you without your permission for the following reasons, subject to all applicable legal requirements and limitations.
Public Safety The Washington Fire Department may use and
disclose health information about you when necessary to prevent a serious
threat to you or your health and safety or the health and safety of the public
or another person.
Required by Law
The Washington Fire
Department will disclose health information about you when required to do so by
federal, state or local law.
Research Information
The Washington Fire Department may use and disclose health
about you for research projects that are subject to a special approval
process. The department will ask you
for your permission if the researcher will have access to your name, address or
other individually identifiable information that reveals who you are.
Organ and Tissue Donation
If you are an organ/tissue donor, The Washington Fire
Department may release information to organizations that handle organ
procurement or organ, eye or tissue transplantation or to an organ donation
bank, as necessary to facilitate such donation and transplantation.
Military, Veterans, National Security and Intelligence
If you are or were a member of the armed forces, or part of
the national security or intelligence communities, The Washington Fire
Department may be required by military command or other government authorities
to release health information about you. The department may also release
information about foreign military personnel to the appropriate foreign
military authority.
Workers' Compensation
The Washington Fire Department may release health
information about you for workers' compensation or similar programs. These
programs provide benefits for work-related injuries or illness.
Public Health Risks
The Washington Fire Department may disclose health
information about you for public health reasons in order to prevent or control
disease, injury or disability; or report births, deaths, suspected abuse or
neglect, non-accidental physical injuries, reactions to medications or problems
with products.
Health Oversight
The Washington Fire Department may disclose health
information to a health oversight agency for audits, investigations,
inspections, or licensing purposes. These disclosures may be necessary for
certain state and federal agencies to monitor the health care system,
government programs, and compliance with civil rights laws.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, The
Washington Fire Department may disclose health information about you in
response to a court or administrative order. Subject to all applicable legal
requirements, the department may also disclose health information about you in
response to a subpoena.
Law Enforcement
The Washington Fire Department may release health
information if asked to do so by a law enforcement official in response to a
court order, subpoena, warrant, summons or similar process, subject to all
applicable legal requirements.
Coroners, Medical Examiners and Funeral Directors
The Washington Fire Department may release information to a
coroner or medical examiner. This may
be necessary, for example, to identify a deceased person or determine the cause
of death.
Information not Personally Identifiable
The Washington Fire Department may use or disclose health
information about you in a way that does not personally identify you or reveal
who you are.
Family and Friends The Washington Fire Department may
disclose health information about you to your family members or friends if the
Washington Fire Department obtains your verbal agreement to do so or if the
Washington Fire Department gives you an opportunity to object to such a
disclosure and you do not raise an objection. The Washington Fire Department
may also disclose information to your family or friends if we can infer from
the circumstances, based on our professional judgment that you would not
object. In situations where you are not capable of giving consent (because you
are not present or due to your incapacity or medical emergency), we may, using
our professional judgment, determine that a disclosure to your family member of
friend is in your best interest. In that situation, we will disclose only
health information relevant to the person's involvement in your care.
You have the following rights regarding health information
the Washington Fire Department maintains about you:
You have the right to inspect and copy your health
information, medical and billing records, that the Washington Fire Department
uses to make decisions about your care. You must submit a written request to
the Washington Fire Department Privacy Officer in order to inspect and/or copy
your health information. The Washington Fire Department may deny your request
to inspect and/or copy in certain limited circumstances. The Washington Fire
Department may also impose a reasonable fee for copies of healthcare records.
If you are denied access to your health information, you may ask that the denial
be reviewed. If such a review is required by law, the Washington Fire
Department will select a licensed healthcare professional to review your
request and our denial. The person conducting the review will not be the person
who denied your request, and the Washington Fire Department will comply with
the outcome of the review.
Right to Amend
If you believe health information the Washington Fire Department has 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 this department keeps the information. To request an amendment, complete and submit a Medical Record Amendment/Correction Form to the Privacy Officer. The Washington Fire Department 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, the Washington Fire Department may deny your request if you ask us to amend information that:
Accounting of Disclosures
You have the right to an “accounting of disclosures.” This
is a list of the disclosures The Washington Fire Department generates of
medical information about you for purposes other than treatment, payment and
healthcare operations. To obtain this list, you must submit your request in
writing to the Privacy Officer. It must state a time period, which may not be
longer than six years and may not include dates prior to April 14, 2003. Your
request should indicate in what form you want the list (for example, on paper,
electronically).
Right to Request Restrictions
You have the right to request a restriction or limitation of
the health information the Washington Fire Department uses or discloses about
you for treatment, payment or healthcare operations. You also have the right to
request a limit on the health information the Washington Fire Department
discloses about you to someone who is involved in your care or the payment for
it.
The Washington Fire Department is not required to Agree to Your Request
If The Washington Fire Department agrees, the department
will comply with your request unless the information is needed to provide you
emergency treatment. To request restrictions, you may complete and submit the
Request for Restrictions On Use/Disclosure of Medical Information to the
Privacy Officer.
Right to Request Confidential Communications
You have the right to request that the Washington Fire
Department communicate with you about medical matters in a certain way or at a
certain location. For example, you can ask the department to only contact you
at work or by mail. To request confidential communications, you may complete
and submit the Request for Restriction on Use/Disclosure of Medical Information
and/or Confidential Communication to the Privacy Officer. The Washington Fire
Department 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. You may ask the department staff to give you a copy of this notice at any time. You may also elect to receive an electronic copy. To obtain such a copy, contact the Privacy Officer.
Changes to this Notice
The Washington Fire Department reserves the right to change
this notice, and to make the revised or changed notice effective for medical
information the Washington Fire Department already has about you as well as any
information the Washington Fire Department receives in the future. The
Washington Fire Department will post the current notice with its effective date
and you will be entitled to a copy of the current notice.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with the Washington Fire Department or with the Department of Health and Human Services.