C.  USES AND DISCLOSURES THAT WE MAY MAKE UNLESS YOU OBJECT

Ø      Providing information from the BAH directory  The BAH directory information includes your name, location in the hospital, religious affiliation.  BAH may release location and general condition information to individuals who ask for you by name.  This may include your family and friends or even the media in some circumstances.  We are allowed to release facility directory information to the clergy even if they do not ask for you by name.  If you do not want us to make these disclosures, you must notify the person that registers you or you may call Bay Area Hospital, Admitting Department, 541-269-8151, or your Patient Care area.

Ø      Family or friends involved in your care.  Health professionals, using their best judgment, will disclose to a family member or close personal friend, or anyone else you identify, medical information relevant to that person’s involvement in your care.   If you do not want these disclosures you must notify the health professionals taking care of you.   BAH may also give information to someone who helps pay for your care. 

Ø      In the Event of a Disaster.  BAH may disclose medical information about you to other health care providers and to an entity assisting in a disaster relief effort to coordinate care so that your family can be notified about your condition and location.

Ø      Appointment Reminders  BAH may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the hospital.

Ø      If you do not want us to make any of the following  disclosures that are listed below in this section C, you must notify Bay Area Hospital, Privacy Officer, 541-269-8150 or the Bay Area Hospital, Patient Care Services Supervisor, 541-269-8111.

Ø      Treatment Alternatives  BAH may use and disclose medical information to inform you about or recommend possible treatment options or alternatives that we offer that may be of interest to you.

Ø      Health-Related Benefits and Services.  BAH may use and disclose medical information to inform you about health-related benefits or services that may be of interest to you.

Ø      Soliciting funds for BAH  BAH may use demographic information about you to contact you in an effort to raise money for BAH and its operations.  BAH may disclose medical information to a foundation related to the hospital so that the foundation may contact you in raising money for BAH.   Only BAH would release contact information, such as your name, address and phone number and when you received treatment.

D.  USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

BAH may use or disclose your medical information for the following purposes:

Ø      Research when approved by the Institutional Review Board (or Privacy Board).  Under certain circumstances, BAH may use and disclose medical information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition.  All research projects, however, are subject to a special approval process through the Institutional Review Board.  Before BAH uses or discloses medical information for research without your authorization, the project will have been approved through this research approval process.

Ø      To organ procurement organizations, for purposes of organ and tissue donation.   If you are an organ donor, BAH may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Ø      To the military as required by military command authorities.  If you are a member of the armed forces, BAH may release medical information about you as required by military command authorities. BAH may also release medical information about foreign military personnel to the appropriate foreign military authority.

Ø      As authorized by law in connection with the Workers’ Compensation Program.  BAH may release medical information about you for workers’ compensation or similar programs, to the extent authorized by law.  These programs provide benefits for work-related injuries or illness.

Ø      To support public health activities.  These activities typically include reports to such agencies as the Oregon Department of Human Services as required or authorized by state law.  These reports may include, but not necessarily be limited to, the following:

Ø      To prevent or control disease, injury or disability;

Ø      To report births and deaths;

Ø      To report child abuse or neglect;

Ø      To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;

Ø      To notify the appropriate government authority if BAH believes a patient has been the victim of abuse or neglect.  BAH will only make this disclosure if the patient agrees or when required or authorized by law.

Ø      To the Food and Drug Administration relative to adverse events concerning food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Ø      To health oversight agencies such as state and federal regulatory agencies.  BAH may disclose medical information to a health oversight agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensure.  These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Ø      Pursuant to lawful subpoena or court order.  If you are involved in a lawsuit or a dispute, BAH may disclose medical information about you in response to a court or administrative order.  BAH may also disclose medical information about you in response to a civil subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell patients about the request or to obtain an order protecting the information requested.

Ø      To law enforcement officials for certain law enforcement purposes.  BAH may disclose your medical information to law enforcement officials as required by law or as directed by court order, warrant, criminal subpoena or other lawful process, and in other limited circumstances for purposes of identifying or locating suspects, fugitives, material witnesses, missing persons or crime victims.

Ø      To coroners, medical examiners and funeral directors.  BAH may release medical information to a coroner or medical examiner as necessary to identify a deceased person and carry out BAH duties as required by law.  Oregon law specifically requires BAH to report to the medical examiner when an injury apparently resulted from a gunshot wound.

Ø      For national security and intelligence activities.  BAH may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Ø      When required to avert a serious threat to health or safety.  BAH may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or other persons.

Ø      Protective Services for the President and Others.  BAH may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Ø      Inmates.  If you are an inmate of a correctional institution or under the custody of a law enforcement official, BAH may release medical information about you to the correctional institution or law enforcement official.  This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

Ø      As required by federal, state or local law.  BAH will disclose medical information about you when required to do so by federal, state or local law.

Ø      Incidental disclosures.  Certain incidental disclosures of your medical information occur as a byproduct of lawful and permitted use and disclosure of your medical information.  For example, a visitor may inadvertently overhear a discussion about your care occurring at the nurse’s station.  These incidental disclosures are permitted if the hospital applies reasonable safeguards to protect your medical information.

Ø      Limited data set information.  BAH may disclose limited health information to third parties for purposes of research, public health and health care operation purposes.  This health information includes only the following identifiers:

Ø      Admission, discharge, and service dates;

Ø      Dates of birth and, if applicable, death;

Ø      Age; and

Ø      Five-digit zip code or any other geographic subdivision, such as state, county, city, precinct and their equivalent geocodes (except street address).

Before disclosing this information, BAH must enter into an agreement with the recipient of the information that limits who may use or receive the data and requires the recipient to agree not to re-identify the data or contact you.  The agreement must contain assurances that the recipient of the information will use appropriate safeguards to prevent inappropriate use or disclosure of the information.

E.  USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

Other uses and disclosures for purposes other than described in this document require your express authorization.  For example, BAH must obtain your authorization before disclosing your medical information to a life insurer or to an employer, except under special circumstances such as when disclosure to the employer is required by law.  You have the right to revoke an authorization at any time, except to the extent BAH has already relied on it in making an authorized use or disclosure.  Your revocation of an authorization must be in writing.

Bay Area Hospital hopes that if you choose to revoke an authorization, you will help us comply with your wishes by identifying the authorization you are choosing to revoke.  Ways of telling us which authorization you are revoking might include indicating who you authorized to receive information or the approximate time frame in which you signed the authorization.

F.  DISCLOSURES TO BUSINESS ASSOCIATES

Bay Area Hospital contracts with outside companies that perform business services for BAH, such as billing companies, management consultants, quality assurance reviewers, accountants or attorneys.   In certain circumstances, BAH may need to share your medical information with a business associate so it can perform a service on behalf of BAH.  BAH will limit the disclosure of your information to a business associate to the amount of information that is the minimum necessary for the company to perform services for BAH.  In addition, BAH will have a written contract in place with the business associate requiring it to protect the privacy of your medical information.

YOUR RIGHTS

You have the right to:

Ø      Request to inspect and copy your medical information used to make decisions about your care.  You have the right to inspect and copy medical information that may be used to make decisions about your care.  Usually, this includes medical and billing records, but does not include psychotherapy notes.  To inspect and copy medical information that may be used to make decisions about your care, you must submit a request in writing.  If you request a copy of the information, BAH may charge a fee for the costs of copying, mailing or other supplies associated with your request.   BAH may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to medical information, you may request that the denial be reviewed.

Ø      Request an amendment to your medical record.  If you believe that medical information that may be used to make decisions about your care is incorrect or incomplete, you may ask BAH to amend the information.  This request must be in writing.  Your request must include a reason for the amendment.  BAH may deny your request if BAH believes the records are complete and accurate, if the records were not created by us and creator of the record is available, or if the records are otherwise not subject to patient access.  BAH will put any denial in writing and explain our reasons for denial.  You have the right to respond in writing to our explanation of denial, and to require that your request, our denial, and your statement of disagreement, if any, be included in future disclosures of the disputed record.

Ø      Request that BAH send you confidential communications by alternative means or at alternative locations.  For example, you may ask that BAH only contact you at work or by mail.  BAH will honor all reasonable requests.

Ø      Request additional restrictions on the use and disclosure of your medical record   You have the right to request a restriction or limitation on the medical information BAH uses or discloses about you for treatment, payment or health care operations.  You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.  For example, you could ask that we not use or disclose information about a particular procedure that you underwent.  To request a restriction, you must put your request in writing. BAH is not required to agree to your request for restrictions.  If BAH does agree, BAH will comply with your request unless the information is needed to provide you with emergency treatment.

Ø      Request an accounting of disclosures.   You may request, in writing, an accounting of disclosures we made of your medical information in the previous six years, beginning April 14, 2003.  You are not entitled to an accounting of disclosures made for purposes of treatment, payment or healthcare operations, disclosures you authorized, disclosures to you, incidental disclosures, disclosures to family or other persons involved in your care, disclosures to correctional institutions and law enforcement in some circumstances, disclosures of limited data set information or disclosures for national security or law enforcement purposes.

Ø      Receive a paper copy of this notice if you received the notice electronically.  You may obtain a paper copy of this notice at any time by requesting a copy from any member of our staff.

Please direct requests discussed above to the Bay Area Hospital Privacy Officer at 541-269-8150 or the Bay Area Hospital Patient Care Services Supervisor at 541-269-8111.