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.
The San Francisco Fire Department, its officers, agents and employees are required by law to maintain the privacy of certain protected health information (PHI), to provide you with a notice of its legal duties and privacy practices with respect to your protected health information, and to abide by the terms of the notice currently in effect.
The San Francisco Fire Department may use your PHI for the purposes of treatment, payment and/or health care operations. These terms are defined as follows:
Treatment: Any oral, written and/or electronic communication through the 911-dispatch system regarding your medical condition and certain information regarding identity such as your name and address. Any oral, written and/or electronic communications of treatment provided to you by the department as relayed to other health care professionals (to include hospital staff, mental health workers, adult/child protective services staff and law enforcement medical personnel).
Payment: Any procedures, practices and/or actions necessary to obtain reimbursement for services rendered by San Francisco Fire Department personnel such as determining medical necessity, submitting claims to insurance carriers, tracking and reporting on collected accounts and collection on outstanding accounts.
Health Care Operations: Continuous quality improvement activities, training programs that ensure the quality of services provided, surveys of patient opinions regarding department services and the creation of statistical reports (that do not contain individual identification).
The San Francisco Fire Department may use and disclose PHI in other circumstances permitted and required by State and Federal law, including but not limited to: The identification of a deceased person, or the cause of said person's death for Medical Examiner inquest purposes; limited law enforcement activities to identify and/or locate a suspect, or to prevent a crime; any and all programs, actions and/or activities related to national security and defense; clinical oversight of the current health care system; medical-legal processing as required by a court or an administrative order or in response to a subpoena.
All other uses and disclosures of PHI will be made only with your authorization. You have the right to revoke an authorization at any time, in writing, except to the extent that this information has already been used or disclosed in reliance on that authorization.
PROTECTED HEALTH INFORMATION AND PATIENT RIGHTS:
YOU HAVE THE RIGHT to access, inspect and make copies of your PHI. The access, inspection and copying of your PHI must be at a time that is mutually acceptable to all parties and is restricted to the patient's PHI only.
YOU HAVE THE RIGHT to amend your PHI. We do not have to comply with your request if we believe the PHI already provided is correct and accurate.
YOU HAVE THE RIGHT to an accounting of most non-routine uses and disclosures of your PHI. We do not have to give you an account of PHI we use or disclose to carry out treatment, payment and health care operations, or the use and disclosure of PHI for which you have already given actual or implied authorization.
YOU HAVE THE RIGHT to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to any requested restrictions.
YOU HAVE THE RIGHT to receive confidential communications of your PHI.
You have the legal right to file a complaint with the San Francisco Fire Department, as well as with the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not suffer retaliation for filing such a complaint.
The San Francisco Fire Department reserves the right to change its privacy practices and the terms of this Notice, and to apply the revised practices to PHI previously created or received without prior notification. It is your right to request a copy of any revised Notice by contacting the San Francisco Fire Department Compliance Officer. A current copy of this Notice is also posted on our web site at: www.sf-fire.org
If you have any questions or comments regarding your protected health information, or would like to exercise any of the patient rights listed above, you may contact the San Francisco Fire Department Compliance Officer at:
San Francisco Fire Department
698 Second Street
San Francisco, CA 94107
Phone: (415) 558-3384
Fax: (415) 558-3407
Effective Date of Revised Notice: 4/14/04