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.

I. Who We Are

This notice describes the privacy practices of Fletcher Allen Health Care and our employees. This notice applies to all of the medical records generated by any Fletcher Allen facility, including Fletcher Allen physician offices.

II. Our Privacy Obligation

We are required by law to maintain the privacy of your health information and provide you with a description of our privacy practices. When we use or disclose health information we are required to abide by the terms of this Notice or other Notice in effect at the time of the use or disclosure.

III. Electronic Health Records

Fletcher Allen uses an electronic health record to store and retrieve much of your health information. One of the advantages of Fletcher Allen’s electronic health record is the ability to share and exchange health information among Fletcher Allen personnel and other community health care providers who are involved in your care. When Fletcher Allen enters your information into the electronic health record, it may share that information by using shared clinical databases or health information exchanges. Fletcher Allen may also receive information about you from other health care providers in the community who are involved with your care by using shared databases or health information exchanges. If you have any questions or concerns about the sharing or exchange of your information, please discuss them with your provider.

IV. Uses and Disclosures With Your Consent or Authorization

A. Use and Disclosure With Your Consent. Before we provide medical care, except in an emergency or other special circumstances, we will ask you to read and sign a written consent ("Your Consent"), authorizing us to use and disclose your health information for the following purposes:

To provide treatment
To obtain payment for services
To support health care operations such as quality improvement and customer service, as described below:

Treatment. We may use your medical information to provide treatment or other services. We may disclose your medical information to health care professionals who are involved in your care. For example, a doctor treating you for a broken leg needs to know if you have diabetes because diabetes may slow the healing process. Different departments in the hospital may share medical information about you in order to coordinate prescriptions, lab work, meals, and x-rays.

Payment. We may use and disclose medical information about you for billing purposes. For example, we may need to give your insurance company information about your surgery. We may also tell your health plan about the treatment you are going to receive to determine whether your plan will cover it.

Health Care Operations. We may use and disclose your medical information for health care system operations. For example, members of the medical staff and/or quality improvement teams may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to support our ongoing efforts to continually improve our quality of care. We may also use medical information about patients to evaluate the need for new services. We may disclose information to doctors, nurses, and students for educational purposes. And we may combine patient medical information with that of other hospitals to see where we can make improvements. To protect your privacy, we may remove information that identifies you from this information.

B. Use or Disclosure With Your Authorization. As described above, Your Consent only permits us to use your health information to treat you, receive payment for services, and for health care operations. We may use or disclose your health information for any reason other than these only when (1) you authorize us to use or disclose this information by signing an Authorization Form ("Your Authorization") or (2) there is an exception described in Section IV below.

V. Uses and Disclosures Without Your Consent or Your Authorization

A. Use or Disclosure of Health Information Without Your Consent or Your Authorization. At Fletcher Allen, we may use or disclose your health information without your consent or your authorization under the following circumstances: (1) when you require emergency treatment (2) when we are required by law to disclose your health information, and (3) when we attempt to obtain Your Consent but are unable to do so because you are unconscious or otherwise incapacitated and we reasonably infer that you would have consented without these barriers to communication.

B. Use or Disclosure for a Fletcher Allen Hospital Directory. Unless you object, we may include limited information about you in a hospital directory while you are an inpatient here. This information may include your name, room number, general condition (e.g., good, fair, etc.) and your religious affiliation. Information in the directory may be disclosed to anyone who asks for you by name or to members of the community clergy. Your religious affiliation will be disclosed only to members of the community clergy. If you like, you may:

opt out of the hospital directory and request that we not disclose any information to anyone who asks for you by name;
and/or
remove your religious affiliation from the directory.

Please talk to the admissions staff if you would like to remove your name and denomination from the hospital directory.

C. Disclosures to Individuals Involved in Your Care or Payment for Your Care. We may release relevant health information about you to a friend or family member who is involved in your medical care or helps pay for your care.

D. Disaster Relief Efforts. We may disclose your medical information to an organization (e.g., Red Cross) assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

E. Fundraising Communications. We may contact you to request a tax deductible contribution to support important activities at Fletcher Allen. In connection with any fundraising, we may disclose your demographic information and the dates when you received care here to our fundraising staff.

F. Marketing Communications. We may use or disclose your health information to identify health-related services and products that may be beneficial to your health and we may contact you about these services and products.

G. Business Associates. Some of our services, such as laboratory tests, are provided through contracts with business associates. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third party payer for the services provided. We require that our business associates protect your health information.

H. Public Health Activities. We may disclose health information for the following public health activities and purposes: (1) to report health information to public health authorities for the purposes of preventing or controlling disease, injury, or disability, as required by law and public health concerns; (2) to report suspected abuse, neglect, or exploitation of children or vulnerable adults to public health authorities or other government authorities authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk for contracting or spreading a disease or condition; and (5) to report information to your employer as required by law.

I. Health Oversight Activities. We may disclose your health information to a health oversight agency that ensures that Fletcher Allen is complying with the rules of government programs such as Medicare and Medicaid.

J. Judicial and Administrative Proceedings. We may disclose your health information in the course of a judicial or administrative proceeding if we receive a legal order or other lawful process requiring us to disclose your health information.

K. Law Enforcement Officials. We may disclose your health information to law enforcement officials as required by law or in compliance with a court order. We may also disclose limited health information to police or law enforcement officials for identification and location purposes and to assist in criminal investigations.

L. Health or Safety. We may disclose your health information if we reasonably believe that disclosure would prevent or lessen a serious and imminent threat to a person's or the public's health or safety.

M. Medical Examiner. We may disclose your health information to a medical examiner as authorized by law.

N. Organ and Tissue Procurement. We may disclose your health information to organizations that facilitate organ, eye, or tissue procurement, banking, or transplantation.

O. Research. We may use or disclose your health information without your consent or authorization to researchers when an institutional review board has approved a waiver of authorization for disclosure and the researcher has established protocols to ensure the privacy of your health information.

P. Workers Compensation. We may disclose your health information as necessary to comply with the Vermont Workers Compensation Statute.

VI. Organized Health Care Arrangement

Fletcher Allen and its medical staff members present this document to you as a joint notice. Physicians and other caregivers may have access to your health information in their offices to assist in reviewing past treatment as it may affect present and future treatment plans. If your doctor is not employed by Fletcher Allen, he or she may have different policies or notices regarding the doctor's use or disclosure of the medical information created in the doctor's office or clinic.

VII. Your Individual Rights

For Further Information: Complaints. If you want further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we have made about your health information, you may contact the Fletcher Allen Privacy Officer by calling Fletcher Allen Patient and Family Advocacy at (802) 847-3500. You may also file written complaints with the Secretary of the U.S. Department of Health and Human Services. Upon request, the Patient Relations Department will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with the Director or us.

Right to Request Additional Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you. 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, such as a family member or friend. For example, you could ask that we not use or disclose information about your surgical procedure. If you wish to request a restriction or limitation, you should discuss your request with the provider who is responsible for coordinating or managing your care. While we will consider all requests for restrictions carefully, we are not required to agree to your request. If we do agree, we will comply with your request, unless the information is needed to provide you emergency treatment.

Right to Receive Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work or by U.S. Mail. If you wish to receive confidential communications, you should discuss your request with Fletcher Allen registration staff. We will consider all requests for confidential communications carefully and will honor reasonable requests.

Right to Inspect and Copy Your Health Information. You have the right to obtain a copy of your medical information. Usually this includes medical and billing records, but does not include psychotherapy notes. Under very limited circumstances, we may deny you access to your medical record file. If you are denied access to your medical information, you may request that the denial be reviewed. A licensed health care professional chosen by Fletcher Allen will review your request and the denial. This person will not be the person who denied your request. We will comply with the decision of the reviewer. If you request a copy or copies of your record, you will be charged a fee for each copy.

Right to Amend Your Records. If you feel that your medical information is incorrect or incomplete, you may ask us to amend the information. While we will review each amendment request carefully, Fletcher Allen may deny your request if we believe that the information that you would like to amend is accurate and complete, or other circumstances apply. If your request for an amendment is denied, you will be notified of the reason for the denial.

Right to Receive a Paper Copy of This Notice. Upon request, you may obtain a paper copy of this Notice, even if you agreed to receive this Notice electronically.

Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures. This is a list of disclosures we make of your medical information for purposes other than treatment, payment, or health care operations.

VIII. Effective Date and Duration of This Notice

Effective Date. This Notice describes the privacy policy of Fletcher Allen Health Care that became effective on September 1, 2011.

Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new terms effective for any information created or received prior to issuing the new notice. We will post the new Notice in waiting areas or registration areas at all Fletcher Allen facilities and on our Internet site at www.fletcherallen.org. You may also obtain a new notice by contacting Fletcher Allen Patient and Family Advocacy at (802) 847-3500.