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St. Lawrence notice of Privacy Practices
I. 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.
II. Our Duty to Safeguard Your Protected Health Information
Individually identifiable information about your past,
present or future health or condition, the provision of health care to you, or
payment for the health care is considered "Protected Health Information" ("PHI").
We are required to extend certain protections to your PHI, and give you this
Notice about our privacy practices that explain how, when and why we may use
or disclose your PHI. Except in specified circumstances, we must use or disclose
only the minimum necessary PHI to accomplish the intended purpose of the use
or disclosure.
We are required to follow privacy practices described in
this Notice, though we reserve the right to change our privacy practices and
the terms of this Notice at any time. If we do so, we will post a new Notice.
You may request a copy of the new notice from the Privacy Officer.
III. How We May Use and Disclose Your Protected Health Information.
We use and disclose PHI for a variety of reasons. We have
a limited right to use and/or disclosure your PHI for purposes of treatment,
payment or our health care operations. For uses beyond that, we must have your
written authorization unless the law permits or requires us to make the use or
disclosure without your authorization. If we disclose your PHI to an outside
entity to perform a function on our behalf, we must have in place an agreement
from the outside entity that it will extend the same degree of privacy protection
to your informationthat we must apply to your PHI. However, the law provides
that we are permitted to make some uses/disclosures without your consent or authorization.
The following offers more description and some examples of our potential uses/disclosures
of your PHI.
Uses and Disclosures Relating to Treatment, Payment, or Health
Care Operations.
Generally, we may disclose your PHI as follows:
For Treatment: We may disclose your PHI to doctors,nurses,
and other health care personnel who are involved in providing your health care.
For example, your PHI will be shared among members of your treatment team, or
with our central pharmacy staff. Your PHI may also be shared with outside entities
performing ancillary services relating to your treatment, such as lab work or
x-rays, or for consultation purposes, for St. Lawrence/ Morris Hall Boards and/or
community mental health agencies involved in provision or coordination of your
care.
To obtain payment: We may use/disclose your PHI in order to bill and collect
payment for your health care services. For example, we may contact your employer
to verify employment status, and/or release portions of your PHI to Medicare/Medicaid
and/or a private insurer to get paid for services that we deliver to you.
For health care operations: We may use/disclose your PHI in
the course of operating our hospital. For example, we may take your photograph
for medication identification purposes, use your PHI in evaluating the quality
of services provided, or disclose your PHI to our accountant or attorney for
audit purposes.
Appointment reminders: Unless you provide us with alternative
instructions, we may send appointment reminders and other similar materials to
your home.
Uses and Disclosures Requiring Authorization: For
uses and disclosures beyond treatment, payment and operations purposes we are
required to have your written authorization, unless the use or disclosure falls
within one of the exceptions described below. Authorizations cannot be revoked
to the extent that we have already undertaken an action in reliance upon your
authorization.
Uses and Disclosure of PHI from Medical Records Not Requiring
Authorization: The law provides that we may use/disclose your PHI from medical
records without authorization in the following circumstances:
When required by law: We may
disclose PHI when a law required that we report information about suspected abuse,
neglect or domestic violence, or relating to suspected criminal activity, or
in response to a court order. We must also disclose PHI to authorities that monitor
compliance with these privacy requirements.
For public health activities: We may disclose PHI when
we are required to collect information about disease or injury, or to report
vital statistics to the public health authority.
For health oversight activities: We may disclose PHI
to a protection and advocacy agency, or another agency responsible for monitoring
the health care system for such purposes as reporting or investigation of unusual
incidents.
Relating to decedents: We may disclose PHI relating
to an individual's death to coroners, medical examiners or funeral directors,
and to organ procurement organizations relating to organ, eye, or tissue donations
or transplants.
For research purposes: In certain circumstances, and
under supervision of a privacy board or IRB, we may disclose PHI to research
staff and their designees in order to assist medical research.
To avert threat to health or safety: In order to avoid
a serious threat to health or safety, we may disclose PHI as necessary to law
enforcement or other persons who can reasonably prevent or lessen the threat
of harm.
For specific government functions: We may disclose
PHI of military personnel and veterans in certain situations, to correctional
facilities in certain situations, to government benefit programs relating to
eligibility and enrollment, and for national security reasons, such as protection
of the President.
Uses and Disclosure for the Purpose
of Fundraising Activities: Morris Hall/St. Lawrence, Inc. may disclose
demographic information (name, address, phone number), date of birth and dates
of health care provided to The Foundation of Morris Hall/St. Lawrence, Inc. for
the purpose of raising funds for the benefit of Morris Hall/St. Lawrence, Inc.
At all times, Patient retains the right to revoke this Authorization. Such revocation
must be submitted to the Privacy Officer in writing. The revocation shall be
effective except to the extent that the Facility has already used or disclosed
information in reliance on the Authorization.
Uses and Disclosures Requiring You
to have an Opportunity to Object: In the following situations, we may
disclose a limited amount of your PHI if we inform you about the disclosure in
advance and you do not object, as long as the disclosure is not otherwise prohibited
by law. However, if there is an emergency situation and you cannot be given opportunity
to object, disclosure may be made if it is consistent with any prior expressed
wishes and disclosure is determined to be in your best interests. You may be
informed and given an opportunity to object to further disclosure as soon as
you are able to do so.
Patient Directories: Your name,
location, and general condition may be put into our patient directory for disclosure
to callers or visitors who ask for you by name. Additionally, your religious
affiliation may be shared with clergy.
To families, friends or others involved in your care: We
may share with these people information directly related to their involvement
in your care, or payment for your care. We may also share PHI with these people
to notify them about your location, general condition, or death.
IV. Your Rights Regarding Your Protected Health Information.
You have the following rights relating to your protected health information:
To request restriction on uses/disclosures: You
have the right to ask that we limit how we use or disclose your PHI. We will
consider your request to the Director of Medical Records, but are not legally
bound to agree to the restriction. To the extent that we do agree to any restriction
on our use/disclosure of your PHI, we will put the agreement in writing and abide
by it except in emergency situations. We cannot agree to limit uses/disclosures
that by law.
To choose how we contact you: You
have the right to ask that we send you information at an alternative address
or by an alternative means. We must agree to your request to the Director of
Medical Records as long as it is reasonably easy for us to do so.
To inspect and copy your PHI: Unless
your access is restricted for clear and documented treatment reasons, you have
a right to see your protected health information upon your written request to
the Director of Medical Records. We will respond to your request within 30 days.
If we deny your access, we will give you written reasons for the denial and explain
any right to have the denial reviewed. If you want copies of your PHI, a charge
for copying may be imposed, depending on your circumstances. You have the right
to choose what portions of your information you want copied and to have prior
information on the cost of copying.
To request amendment of your PHI: If
you believe that there is a mistake or missing information in our record of your
PHI, you may request, in writing to the Director of Medical Records that we correct
or add to the record. We will respond within 60 days of receiving your request.
We may deny the request if we determine that the PHI is: (i) correct and complete;
(ii) not created by us and/or not part of our records, or (iii) not permitted
to be disclosed. Any denial will state the reasons for denial and explain your
right to have the request and denial, along with an statement in response that
you provide, appended to your PHI. If we approve the request for amendment we
will change the PHI an so inform you, and tell others that need to know about
the change in the PHI.
To find out what disclosures have been
made: You have a right to get a list of when, to whom, for what purpose,
and what content of your PHI has been released other than instances of disclosure:
for treatment, payment, and operations; to you, your family, or the facility
directory; or pursuant to your written authorization. The list also will not
include any disclosures made for national security purposes, to law enforcement
officials or correctional facilities, or disclosures made before April 14, 2003.
We will respond to your written request to the Director of Medical Records for
such a list within 60 days of receiving it. Your request can relate to disclosures
going as far back as six years. There will be no charge for up to one such list
each year. There may be a charge for more frequent requests.
To receive this notice: You
have a right to receive a paper copy of this Notice and/or electronic copy by
email upon request to the Privacy Officer.
V. How to Complain about our Privacy
Practices:
If you think we may have violated your privacy rights,
or you disagree with a decision we made about access to your PHI, you may file
a complaint with the person listed in Section VI Below. You may also may file
a written complaint with with the Secretary of the U.S. Department of Health
and Human Services. We will take no retaliatory action against you if you make
such a complaints.
VI. Contact Person for Information, or
to Submit a Complaint:
If you have questions about this Notice or any complaints
about our privacy practices, please contact: The Privacy Officer.
VII. Effective Date: This Notice
was effective on April 14, 2003
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