Notice of Information Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read it carefully. Effective April 14, 2003

The Medical Center's Responsibilities
This organization is required by law to:

• Make sure the medical information that identifies you is kept private
• Give you this notice of our legal duties & privacy practices with respect to medical information we collect & maintain about you
• Follow the terms of the notice that is currently in effect
• Notify you if we are unable to agree to a requested restriction
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will provide a revised notice upon your next encounter at one of our facilities, make the revised notice available on our web site or mail you a copy at your written request.

Who Will Follow These Practices
These practices will be followed in the Medical Center, Family Health Center, Outreach Program, Wellness Center, and our Immediate Health Care Centers in. The practices will be followed by our entire workforce, members of the Medical Staff, volunteers, clergy and healthcare professionals and students in training.

This notice will also explain your rights and certain duties we have regarding the use of your information.

We will not use or disclose your information without your written authorization, except as described in this notice.

How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosure we will explain what we mean. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories.

For Treatment
We may use or disclose your medical information for the purpose of providing, or allowing others to provide, treatment to you. For example, your primary care physician may disclose your health information to another doctor for the purpose of a consultation. Your health information may also be shared with other people that may help you with medical care after you leave the hospital.

For Payment
We may use and disclose medical information about you so that the treatment and services you receive may be billed to, and payment may be collected from you, an insurance company, or a third party, including a collection service.

The information on the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.

We may also tell your health plan about a treatment you are going to receive in order to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations
Members of the medical staff, the Risk Manager, or the members of various quality improvement teams may use information from your health record to assess the care and outcomes in your case and others like it. We also may combine information with other hospitals to find how we can improve the care given. This information is used in an effort to continually improve the quality and effectiveness of the healthcare and services we provide. Health care operations also includes reviewing the competence of health care professionals, conducting training programs in which students learn to practice or improve their skills as health care professionals, and accreditation, licensing, certification or credentialing activities.

Business Associates
There are some services provided in our organization through contracts with business associates. Examples include physician services in radiology, anesthesiology, certain laboratory tests and a copy service that we use when making copies of your records. When these services are contracted, we may disclose your health information to our business associate so they can perform the job we've asked them to do and bill you or your third-party payer for services rendered. To protect your health information we require the business associate to appropriately safeguard your information.

Notification
We may use and disclose medical information to notify you that you have an appointment for treatment or medical care at one of the facilities or the hospital. We also may disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, of your location and general condition.

Alternative Treatment – Health Related Benefits and Services
We may use and disclose medical information to tell you about alternative treatment options or health-related benefits or services that may be of interest to you. For example, you may receive notices of classes on subjects such as Managing Diabetes, Coping with Cancer or Living with Congestive Heart Failure.

Fundraising Activities
We may contact you in an effort to raise money for the hospital and its operations. If you do not want the hospital to contact you for fundraising efforts, you must notify the Vice President of St. Vincent's Foundation in writing.

Hospital Directories
We may include certain limited information about you in the general hospital directory while you are a patient on a general medical/surgical unit at the hospital. This directory does not include patients who are being treated in our mental health unit. This information includes your name, location in the hospital, your condition such as satisfactory, serious, or critical, and your religious affiliation.

The directory information, except for your religious affiliation, may also be released to people who ask for you by name. This is so your family, friends and clergy can visit you in the hospital and generally know how you are doing. If you do not want to have your name included in the Directory, you must notify the person who is registering you at the time of admission/treatment.

We also may include your name on locator boards In clinical areas, such as the emergency department, to assist the staff in knowing the specific treatment area where you are located.

Communication with Individuals Involved in Your Care or Payment for Your Care
Health professionals, using their best judgment, may disclose to a family member, or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

Research
We may use and disclose health information about you for officially approved research as permitted by law, when a waiver of authorization is obtained from an Institutional Review Board, or through a limited set of information. Otherwise, we will only use or disclose your information for research with your specific authorization.

As Required by Law
We will disclose information about you when required to do so by federal, state or local law or in response to a valid subpoena. By law we will disclose information to your employer if you are involved in an injury, work related illness or for workplace surveillance. We may release your health information to authorized federal officials for lawful intelligence, counterintelligence, and other national security activities. We may also disclose your information to provide protection to the President or other persons or foreign heads of state or for the conduct of special investigations.

To Avert a Serious Threat to Health or Safety
We may use and disclose information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

For Certain Law Enforcement Purposes
We may disclose information about you to report certain injuries, such as gunshot wounds, or to assist in identifying or locating a suspect, fugitive, material witness or missing person. In such cases limited identification and clinical information would be disclosed. Disclosure might be made for suspected victims of crime, or to disclose the death of an individual who may have died as the result of a crime. We also would disclose information relevant to a crime committed on Medical Center property.

To Funeral Directors or Coroners
We may disclose information to a funeral director as necessary to carry out their duties and to a coroner for purposes of identifying the deceased person or determining the cause of death

SPECIAL SITUATIONS
Organ & Tissue Donation
We may disclose health information to organ procurement organizations or other entities engaged in procurement, banking or transplantation of organs for the purpose of tissue donation and transplant.

Military & Veterans
If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation
We may release medical information about you to the extent authorized by and to the extent necessary to comply with laws relating to workers' compensation or similar programs established by law. These programs provide benefits for work-related injuries or illness.

Public Health
As required by law, we may disclose medical information about you for public health activities. These activities generally include the following:

• To prevent or control disease, injury or disability
• To report births, deaths & certain diseases
• To report child abuse or neglect
• To report suspected abuse
• To report reactions to medications or problems with products
• To notify people of recalls of products they may be using
• 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

Health Oversight Activities
We 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.

Your Health Information Rights
Although your health record is the physical property of the healthcare provider or facility that compiled it, the information contained within it belongs to you. Click here to download an Adobe Acrobat PDF file that contains a form to request access to protected health information.

You have the right to:

• Request Restrictions on the use and disclosure of your health information for treatment, payment or operations purposes or notification purposes. We are not required to agree to your request. If we do agree, we will abide by that restriction unless you are in need of emergency treatment and the restricted information is needed to provide that treatment. You may submit a written request to the Privacy Officer listed on the final page of this notice.
• Limit Communications - You have the right to receive confidential communications about your own information by alternative means or at alternative locations. This means you may, for example, designate that we contact you only in writing or contact you at work rather than at home. To request alternative means or alternative locations, you must submit your request in writing to the Privacy Officer at St. Vincent's Medical Center.
• Inspect and have copies made of your health record by submitting a written request to the Health Information Services Department in the Medical Center or the Manager of one of the other St. Vincent's facilities. In accordance with Connecticut regulations, you may be charged $.65 per page plus postage. Despite your general right to access your information, it may be denied in some limited circumstances. For example, access may be denied if you are an inmate at a correctional institution or if you are a participant in a research program that is still in process.
  
  Access to information that was obtained from someone other than a health care provider under a promise of confidentiality can be denied if allowing you access would reasonably be likely to reveal the source of the information. The decision to deny access under these circumstances is final and not subject to review.
  
  In addition, access may be denied if (1) access to the information is reasonably likely to endanger the life and physical safety of you or anyone else. (2) the information makes reference to another person and your access would reasonably be likely to cause harm to that person, or (3) you are the personal representative of another individual and a licensed health care professional determines that your access to the information would cause substantial harm to the patient or someone else. If access is denied for these reasons, you have the right to have the decision reviewed by a health care professional who did not participate in the decision. If access is ultimately denied, the reasons will be provided to you in writing.
• Request Amendment - You may request that your health information be amended. The request may be denied if the information in question (1) was not created by us (unless you show that the original source of the information is no longer available to make amendments), (2) is not part of our records, (3) is not the type of information that would be available for you to inspect, or (4) is accurate and complete. If your request is denied, you may submit a written statement disagreeing with the denial, which we will keep on file and include with future disclosures of the information to which it relates. Requests shall be submitted in writing to the Privacy Officer.
• An Accounting of Disclosures - You have the right to an accounting of disclosures of your health information made during the 6 year period preceding the date of your request. However, the accounting won't include disclosures: (1) made for treatment, payment or operations, (2) made to you, (3) of information contained in our facility directory, or to those persons involved in your health care or for purposes of notifying your family or friends about your whereabouts, (4) for national security or intelligence purposes, (5) to correctional institutions or law enforcement officials who had you in custody at the time of disclosure, (6) that occurred prior to April 14, 2003, (7) made pursuant to an authorization signed by you, (8) disclosures that are part of a limited data set, (9) disclosures that are incidental to another authorized use/disclosure, (10) disclosures made to health oversight agencies, but only if the agency or official asks us not to account to you and only for the limited time covered by the request. The accounting will include the date of each disclosure, the name of the entity or person who received the information, that person's address if known, and a brief description of the information and the purpose of the disclosure. To request an accounting of disclosures, submit a request in writing to the Privacy Officer.
• Paper Copy of this Notice - You have the right to obtain a paper copy of this Notice upon request.
• Complaints - You can complain to us and to the Federal Secretary of the Department of Health and Human Services if you believe your privacy rights have been violated. To lodge a complaint with us, please register a written complaint with our Privacy Officer at the Medical Center, 2800 Main St., Bridgeport, CT 06606. Should you have any concerns, you may phone the Privacy Officer at 203-576-5050. You may also contact the Compliance Officer at St. Vincent's by calling 203-576-5551.
  
  To file a complaint with the Office of Civil Rights you must file the complaint in writing, either on paper or electronically. You must name the individual or entity that is the subject of the complaint and describe the acts or omissions believed to be in violation of the requirements. Your complaint must be filed within 180 days of when you knew or should have known the act or omission occurred. Individuals registering complaints will not be subject to retaliation in any form.

NOTIFICATION OF ORGANIZED HEALTH CARE ARRANGEMENT BETWEEN ST. VINCENT'S MEDICAL CENTER AND ST. VINCENT'S MEDICAL STAFF
The hospital, the members of its Medical Staff (including your physician) and other health care providers affiliated with the Hospital have agreed, as permitted by law, to share your health information among themselves for purposes of treatment, payment or health care operations. This enables us to better address your health care needs.

Request Access to Protected Health information (PDF)