- Fire & Rescue
- Emergency Medical Services
Emergency Medical Services
Preparing for an Emergency :
EMS Patient Medical History Form
In a medical emergency first responders ask patients many questions that may appear irrelevant to the patients or their family, questions regarding medication allergies, or past surgical history for example. However, a patient’s past medical history information is extremely valuable during patient assessment and can greatly affect the care given. Take a few minutes to fill out the Patient Medical History Form before an emergency occurs and placing it where it can be easily located by ambulance crews. The time you spend now will be time saved if the ambulance has to come to your door.
Customer Service Feedback:
Notice Of Privacy Practices
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.
Rockingham County Department of Fire & Rescue (RCFR) 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 RCFR is permitted to use and disclose PHI about you.
RCFR 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 situations where we may use it only after we obtain your written authorization, if we are required to do so.
Uses and Disclosures of PHI: RCFR 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 your 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, making medical necessity determinations and reviews, utilization review, and collecting 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 for data collection purposes, fundraising and certain marketing activities.
Use and Disclosure of PHI Without Your Authorization. RCFR is permitted to use or convey PHI without your written authorization, or opportunity to object, in certain situations, unless prohibited by a more stringent state law, including:
· For Rockingham County Fire & Rescue use in treating you or in obtaining payment for services provided to you or in other health care operations;
· For 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;
· To a family member, other relative, or close personal friend or other individual involved in your care if we obtain your oral or written 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 your ambulance crew;
· For health care fraud and abuse detection or for activities related to compliance with the law;
· 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, discovery request, 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 worker’s 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 also use or disclose health information about you in a way that does nor 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 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 10 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.
We have available forms to request access to your PHI. We will provide a written response if we deny you access and let you know your appeal rights. To assure your records are discussed and disclosed only to the proper person (you or your legally authorized representative), we normally require you to appear in person at our office to access or discuss your medical information. However, we will honor reasonable requests by you to receive communications about your medical information by alternative means or at alternative locations. If you wish to inspect and copy your medical information, you should contact our Privacy Officer, whose address and phone number is 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 if you think it is inaccurate or incomplete. 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, like when we believe the information you have asked us to amend is correct and complete. If you wish to request that we amend the medical information that we have about you, you should contact our 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 or to which we have transported you, or information for which you have already given us written authorization to disclose.
We are required to keep this record of disclosures for the past seven years, for federal privacy regulations, whichever is later. If you wish to request an accounting of the medical information about you that we have used or disclosed that is not exempt from the accounting requirement, you should contact our 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 the 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. Rockingham County Department of Fire & Rescue is not required to agree to any restrictions you request, but any restrictions agreed to by Rockingham County Department of Fire & Rescue in writing are binding on Rockingham County Fire & Rescue.
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. 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: RCFR 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 our Assistant Chief of Administration listed at the end of this Notice.
HIPPA Notice: Other uses and disclosures not described in the covered entity’s NPP will be made only with the authorization of the individual. Fundraising communications and an individual’s right to opt out of such communications in the event that the covered entity intends to engage in fundraising activities. The statement need not include the mechanism for opting out of such communications as each solicitation from the covered entity must reference the mechanism for opting out. Individuals have the right to restrict certain disclosures of PHI to a health plan where the individual or someone on his or her behalf pays out of pocket for the health care item or service provided. Individuals have the right to be notified following a breach of their unsecured PHI. The statement is only required to be a simple statement of the right to breach notification, and a covered entity is not required to disclose how the entity will evaluate whether PHI has been compromised under the Breach Notification Rule or include a description of the regulatory requirements.
Your Legal Rights and Complaints: You also have the right to complain to us, or 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 the government. Should you have any questions, comments, or complaints you may direct all inquiries to our Privacy Officer listed at the end of this Notice.
Billing Questions / Records Requests
All billing questions or requests for medical records should be directed to:
EMS Management & Consultants
Patient Customer Service: 800.814.5339