The City of Hoover Fire Department 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. The City of Hoover Fire Department is also required to abide by the terms of the version of this Notice currently in effect. This notice takes effect April 14,2003, and will remain in effect until we replace it.

We reserve the right to change our privacy practices and terms of this notice at any time, provided such applicable law permits the change. Before we make a significant change in our privacy practices, we will change this notice and make the new notice available upon request.

Uses and Disclosures of PHI: The City of Hoover Fire Department 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 use your health information or disclosure it to a physician or other health care providers involved in providing treatment to you.

For payment. This includes disclosures of your PHI we must undertake in order to get reimbursed for the services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations and collecting outstanding accounts.

For health care operations. This disclosure includes quality assurance activities, licensing, and training programs to ensure that our personnel meet our standards of care and follow established policies and procedures, as well as certain other management functions. We may disclose your PHI to another health care provider or organization that is subject to federal privacy rules and that has a relationship to you in order to support their health care operation.

On Your Authorization: You may give us written authorization to use your PHI or to disclose it to anyone for any purpose. If you give us authorization, you may revoke it in writing at any time. Your revocation will not affect any uses or disclosures permitted by your authorization while it was in effect.

To Your Family and Friends: We may disclose your PHI to a family member, friend or other person to the extent necessary to help with your health care or with payment for your health care. Before this disclosure you will be provided with an opportunity to object. If you are not present or are incapacitated or in an emergency we will disclose your PHI based on our professional judgement regarding your best interest.

Health Information Contacts: This pertains to disclosure of your PHI in order to provide you with health information requirements. (Such as voicemail, postcards or letters)

Disaster Relief: Your PHI may be disclosed to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Public Benefit: Your PHI may be disclosed as authorized by law when deemed to be in the public interest or benefit, including:

• Public health activities, including disease and vital statistic reporting, abuse reporting, FDA oversight and to employers regarding work-related illness or injury.
• Abuse, neglect or domestic violence.
• Disclosure to health oversight agencies.
• In response to court, administrative orders and other lawful processes.
• Disclosure to law enforcement officials pursuant to subpoenas and other lawful processes, concerning crime victims, suspicious deaths, reporting crimes and purposes of identifying or locating a suspect or other person.
• Disclosure to coroners, medical examiners and funeral directors.
• Organ procurement organizations.
• In connection with certain research activities.
• Disclosure to the military and federal officials for lawful intelligence, counterintelligence and national security activities.
• PHI may be disclosed to correctional institutions regarding inmates.
• Disclosure of PHI as authorized by state worker’s compensation laws.
• We may also use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Patient Rights: As a patient, you have a number of rights with respect to your PHI, including:

The right to access, copy or inspect your PHI. This means you may 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. You also have the right to receive confidential communications of your PHI. If you wish to inspect and copy your medical information, you should contact our privacy officer.

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 are permitted by law to deny your request to amend your medical information only in certain circumstances, like 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 our privacy officer.

The right to request an accounting. You may request an accounting from us of certain disclosures of your medical information that we have made in the six years (but not before April 14, 2003) 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 a 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, contact our privacy officer.

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. The Hoover Fire Department is not required to agree to any restrictions you request, but any restrictions agreed to by us in writing are binding.

Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request. We will prominently post a copy of this Notice on our web site. www.hooveral.org 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.

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 our privacy officer.

Privacy Officer Contact Information:

Emergency Medical Services Officer
City of Hoover Fire Department
250 Municipal Drive
Hoover, Alabama 35216
Fax: (205) 444-7607
Telephone: (205) 822-4635 ; (205) 444-7655

Copyright 2006 City of Hoover, Alabama
100 Municipal Drive, Hoover, Alabama  35216 - (205) 444-7500
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