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

Effective Date April 14, 2003

Purpose: The Department and its professional staff, employees, and volunteers in an effort to better serve our community are following the privacy practices described in this Notice. The Department maintains your medical information in records that will be maintained in a confidential manner, as required by law. However , the Department must use and disclose your medical information to the extent necessary to provide you with quality health care. To do this, the Department must share your medical information as necessary for treatment, payment, and health care operations.

1. What are Treatment, Payment, and Health Care Operations?

Treatment includes sharing information among health care providers involved in your care. For example, a report is given to the Emergency Room Staff to provide you with proper medical treatment. The Department may use your medical information as required by your insurance company, managed care or other personal health plan to obtain payment for your treatment. We also may use and disclose your medical information to improve the quality of care, e.g., for review and training purposes.

2. How will the Department Use My Medical Information?
 
Your Medical information may be used, unless you ask for restrictions on a specific use or disclosure, for the following purposes:

• Family members or close friends involved in your care or payment for your treatment
• Disaster relief agency if you are involved with a disaster relief effort
• To inform you of treatment alternatives or benefits or services related to your health (You will have the opportunity to refuse to receive this information)
• Fundraising activities by the Department
• As required by law.
• Public health activities, including disease prevention; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or product problems; notifications of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect or domestic violence (if you agree or as required by law).
• Health oversight activities, e.g., audits, inspections, investigations, and licensure
• Lawsuits and disputes.
• Law enforcement (e.g., in response to a court order or other legal process; to identify or locate an individual being sought by authorities; about the victim of a crime under restricted circumstances; about a death that may be the result of criminal product; about criminal conduct that occurred on the Department's premises; and in emergency circumstances relating to reporting information about a crime.)
• Coroners, medical examiners, and funeral directors
• Organ and tissue donation
• Certain research projects.
• To prevent a serious threat to health or safety.
• To military command authorities if you are a member of the armed forces or a member of a foreign military authority.
• National security and intelligence activities
• Protection of the President or other authorized persons for foreign heads of state, or to conduct special investigations.
• Inmates. (Medical information about inmates of correctional institutions may be released to the institution.)
• Workers' Compensation. ( Your medical information regarding benefits for work-related illnesses may be released as appropriate.)
• To carry out health care treatment, payment, and operations functions through business associates, e.g., to install a new computer system.

3. You Have Rights Regarding Your Medical Information
 
You have the following rights regarding your medical information, provided that you make a written request to invoke the right.

• Right to request restriction. You may request limitations on your medical information we use or disclose for health care treatment, payment, or operations (e.g, you may ask us not to disclose that you have had a particular surgery), but we are not required to agree with your request. ;If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

• Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify how or where you wish to be contacted.

• Right to inspect and copy. You have the right to inspect and copy your medical information regarding decisions about your care. We may charge a fee for copying, mailing and supplies. Under limited circumstances, your request may be denied; you may request review of the denial by another licensed health care professional chosen by the Department. The Department will comply with the outcome of the review.

• Right to request amendment. If you believe that the medical information we have about you is incorrect or incomplete, you may request an amendment. The Department is not required to accept the amendment.

• Right to accounting of disclosures. You may request a list of the disclosures of you medical information that have been made to persons or entities other than for health care treatment or operations in the past six (6) years,but not prior to April 14, 2003. After the first request there may be a charge.

• Right to a copy of this Notice. You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy. You may obtain an electronic copy of this Notice from this website

4. Requirements Regarding This Notice.

The Department is required by law to with this Notice. We will be governed by this Notice for as long as it is in effect. The Department may change this Notice and these changes will be effective for medical information we have about you as well as any information we receive in the future.

Each time you receive health care services you may receive a copy of the Notice in effect at the time.

5. Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Department or with the Secretary of the United Stated Department of Health and Human Service. You will not be penalized or retaliated against in any way for making a complaint to the Department or the Department of Health and Human Services.

Contact the Privacy Officer If:

• You have a complaint;
• You have any questions about this Notice
• you wish to request restrictions on uses and disclosures for health care treatment, payment or operations; or
• You wish to obtain a form to exercise your rights described in paragraph 5.

Santa Fe Fire & Rescue Privacy Officer
Chris Anderson
12506 Hwy. 6
Santa Fe, TX, 77510
(409)-925-7331