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, Columbia County,
Florida, Board of County Commissioners 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
Columbia County, Florida, Board of County Commissioners 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.
Columbia
County, Florida, Board of County Commissioners 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 LISA K.B. ROBERTS, OUR PRIVACY OFFICER,
AT (386) 758-1005 OR T.D.D. (386) 758-2139.
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:
Columbia
County, Florida, Board of County Commissioners 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 Columbia County, Florida, Board of County Commissioners
is permitted to use and disclose PHI about you.
Columbia
County, Florida, Board of County Commissioners 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:
Columbia County, Florida, Board of County Commissioners 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, and certain marketing activities.
Use and
Disclosure of PHI Without Your Authorization.
Columbia County, Florida, Board of County Commissioners is
permitted to use PHI without your written authorization,
or opportunity to object in certain situations, including:
·
For
Columbia County, Florida, Board of County Commissioners 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 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 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, such as 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. Columbia County, Florida, Board
of County Commissioners is not required to agree to any
restrictions you request, but any restrictions agreed to by
Columbia County, Florida, Board of County Commissioners are
binding on Columbia County, Florida, Board of County
Commissioners.
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:
Columbia County, Florida, Board of County Commissioners 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:
Lisa K.B. Roberts, Privacy Officer
Columbia County, Florida
Board of County Commissioners
135 N.E. Hernando Avenue
Post Office Drawer 1529
Lake City,
Florida 32056-1529
(386)
758-1005
T.D.D.
(386) 758-2139
Effective Date of the Notice:
4/21/05
Implementation Date: 4/14/03
Revision Date: 4/21/05
