NOTICE OF PRIVACY PRACTICES

Effective: Jan. 1, 2006

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.

WHO WILL FOLLOW THIS NOTICE

This joint notice applies to our staff, volunteers, board members, business associates and doctors while they are treating you in our facility.  It describes how we will use and share your information, how we are required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to your protected health information (PHI).  PHI is information about you, including demographic information, that may identify you and that relates to your health or condition and related health care services.  We are required to abide by the terms of the notice currently in effect.  If you have questions about any part of this notice or if you want more information about our privacy practices, please contact our Chief Privacy Officer at 727-820-8024. 

I.  How we (including our affiliated entities and doctors who are treating you) may use or share your health information

We are committed to protecting the privacy of your health information.  The law permits us to use or share your health information for the following purposes:

1. Treatment.  We may use or share your PHI with physicians, nurses, students, and other health care personnel to provide you treatment or services   For example, your PHI may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose and treat you.  
2. Payment.  We may use or share your PHI to obtain payment for your health care services, including to a collection agency or credit bureau.   We may also share your PHI with other providers so they may obtain payment for services.  We may also use or share your PHI so that we may locate you for collection purposes, including using services with change of address information to ensure your statements are mailed to the most current address on file with the postal service.  For example, obtaining approval for payment of services from your health plan may require that your PHI be shared with your health plan.  We may also provide your PHI to our business associates or other providers� business associates, such as billing companies, collection agencies, and vendors who mail billing statements. 
3. Health Care Operations.  We may use or share your PHI or a limited data set in order to operate our facilities.  Our hospitals and its medical staff members have an organized health care arrangement and may use or share your PHI for the operations of the organized health care arrangement.  For example, we may use your PHI in order to evaluate the quality of health care services that you received, to evaluate the performance of the health care professionals who provided health care services to you, for medical review purposes, or auditing.  In addition, we report traumas, birth defects and cancer cases (Florida Cancer Registry) to the departments of health for quality improvement and licensing purposes and quarterly data to the Agency for Health Care Administration (AHCA) as required for licensing.  We may also provide your PHI to accountants, attorneys, consultants, and others in order to make sure we�re complying with the laws that affect us.
4. Directory.  We will use and share your name, the location at which you are receiving care, your condition (in general terms), and your religious affiliation in our facility directory unless you object.  All of this information, except religious affiliation, will be given to people that ask for you by name, such as visitors.  Members of the clergy will be told your religious affiliation. The opportunity to consent may be obtained retroactively in emergency situations.
5. Notification and Communication with Family.  We may release your PHI to a relative, close friend, or any other person you identify, information that directly relates to that person�s involvement in your health care or who helps pay for your care unless you object.   If you are unable to agree or object to the release, we may release information as necessary if we determine that it is in your best interest based on our professional judgment, such as emergency situations.  We may use or release PHI to notify or assist in notifying a family member, personal representative, or any other person that is responsible for your care to tell them your location or general condition.  Finally, we may use or share your PHI to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and releases to family or other individuals involved in your health care. 
6. Required by law, court, or law enforcement.  We may release PHI when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with crime; or when ordered by a court. 
7. Public Health.  As required by law, we may release PHI or a limited data set to public health authorities for purposes related to preventing or controlling disease, injury or disability; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.  We are required to report all births and deaths to the Office of Vital Statistics for certificate purposes.
8. Health Oversight Activities.  We may release PHI to health agencies for activities authorized by law.  These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and Compliance with civil rights laws.  For example, we may release PHI to the Secretary of the Department of Health & Human Services so they can determine our compliance with privacy laws.     
9. Deceased Person Information.  We may release your health information to coroners, medical examiners, and funeral directors.
10. Organ Donation.  We may release your health information to organizations involved in procuring, banking or transplanting organs and tissues, such as Lions Bank and Life Link. 
11. Research.  We may release your health information or limited data set to researchers conducting research that has been approved by an Institutional Review Board.  
12. Public Safety.  We may release your health information to appropriate persons in order to prevent or lessen a serious and near threat to the health or safety of a particular person or the general public.
13. Specific Government Functions.  We may share your health information for military or national security purposes. 
14. Worker�s Compensation.  We may share your health information as necessary to comply with worker�s compensation laws.  We report any injuries referred to us from an employer to the Department of Worker�s Compensation and any work-related deaths to OSHA.  All employers are given health information regarding work-related injuries they have referred to us.  
15. Appointment Reminders & Health Related Benefits.  We may use your PHI to contact you to provide appointment reminders or to give information about other treatments or health-related benefits and services that may be of interest to you.
16. Fund-Raising.  We may contact you to participate in fund-raising activities.    
17. Florida State Specific Requirements.  When Florida�s laws are more stringent than federal privacy laws, the state law preempts the federal law.  
18. Organized Health Care Arrangement.  Each hospital and its medical staff members have organized and are presenting you this document as a joint notice.  Each hospital is listed on this Notice.  Information may be shared as necessary to carry out treatment, payment and health care operations.  Physicians may have access to PHI in their offices to assist in reviewing past treatment as it may affect treatment at the time.  Your physician may have different policies or notices regarding the physician�s use and disclosure of your health information created in the physician�s office or clinic. 
19. Affiliated Covered Entity.   PHI will be made available to staff at local affiliated entities as necessary to carry out treatment, payment and health care operations.  Caregivers at other facilities may have access to PHI at their locations to assist in reviewing past treatment information as it may affect treatment at this time.  You may contact the Chief Privacy Officer for more information on specific sites included in this affiliated covered entity. 
20. Diagnostic and therapeutic information regarding psychiatric, drug/alcohol abuse, or sexually transmitted diseases (including HIV status) will not be disclosed without your specific permission, unless required by law. 

II.  Your Health Information Rights

1. You have the right to request a limit on certain uses and releases of your health information.  We will consider your request, but are not required to accept it.  These requests must be in writing and submitted to our Chief Privacy Officer. 
2. You have the right to choose how you receive your health information.  You have the right to ask that we send information to you at an alternative address or by other means (for example telephone instead of mail, post office box instead of home address).  We must agree to your request so long as we can easily provide it in the format you requested.  These requests must be in writing.
3. You have the right to see and get copies of your health information, in most cases. These requests must be in writing.  Lab results that are not part of your hospital medical record may not be released to you without permission from your physician.  Hospital records may not be copied until after discharge.     
4. You have a right to request that we correct or update information that is incorrect or incomplete.  We are not required to change your health information.  If we deny your request, we will provide you with information about our denial and how you can disagree with the denial.  These requests must be in writing.  
5. You have a right to receive a list of disclosures we have made except that we do not have to account for the disclosures described under treatment, payment, health care operations; information provided to you; information released based on your written authorization; directory listings; certain government functions; disclosures of a limited data set (which may only include date information and limited address information); and to correctional institutions or law enforcement in custodial situations.  These requests must be in writing and must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. 
6. You have a right to get a paper copy of this Notice of Privacy Practices.  You may request a copy of this notice at any time.   

III.  Changes to this Notice of Privacy Practices

We reserve the right to change this Notice of Privacy Practices at any time in the future.  We reserve the right to make the changed notice effective for health information we already have about you as well as any we receive in the future.  We will post a current copy of the Notice.  Upon request, you may obtain a copy of the current notice by contacting our Chief Privacy Officer at 727-820-8024.   

IV. When We May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, we will not use or disclose your health information without your written authorization.  If you do authorize us to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time. 

V. Incidental Disclosures

We make reasonable efforts to avoid incidental disclosures of your protected health information.  An example of an incidental disclosure is conversations that may be overheard between you and our team members in the Emergency Center.   

VI.  Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Chief Privacy Officer or with the Secretary of the Department of Health & Human Services.  To file a complaint with our Chief Privacy Officer, call 727-820-8024. 

You will not be penalized for filing a complaint. 

BayCare Health System Hospitals:
Mease Countryside Hospital
Mease Dunedin Hospital
Morton Plant Hospital
Morton Plant North Bay Hospital
St. Anthony�s Hospital
St. Joseph�s Children�s Hospital of Tampa
St. Joseph�s Hospital
St. Joseph�s Women�s Hospital
South Florida Baptist Hospital