1603 - Notice Of Privacy Practices

Question 1

Who shall be responsible for:

1. Ensuring that TFD personnel are informed of the legal requirement to provide patients and others with TFD’s Notice of Privacy Practices in accordance with the guidelines set forth in this policy
2. Reviewing the content of TFD’s Notice of Privacy Practices to ensure it remains current with HIPAA related laws and/or TFD policy
3. Consulting with the Deputy City Attorney before making any changes in the content of TFD’s Notice of Privacy Practices
4. Maintaining this document

Answer 1

The TFD Privacy Officer or his/her designee

Question 2

Who shall be responsible for:

1. Ensuring their stations have an adequate supply of the forms associated with this document
2. Contacting the Senior Secretary at TFD Headquarters to obtain additional supplies of the forms when needed

Answer 2

Captains of ALS Engines

Question 3

Who shall be responsible for:

1. Ensuring their stations have an adequate supply of the forms associated with this document
2. Contacting the Senior Secretary at TFD Headquarters to obtain additional supplies of the forms when needed
3. Ensuring their apparatus are stocked with copies of TFD’s Notice of Privacy Practices
4. Giving copies of TFD’s Notice of Privacy Practices to patients and others in accordance with the guidelines set forth in this policy
5. Obtaining the signature of the patient or his/her designated representative in accordance with the guidelines set forth in this document

Answer 3

Paramedic Supervisors

Question 4

Who shall be responsible for:

1. Ensuring their apparatus are stocked with copies of TFD’s Notice of Privacy Practices
2. Giving copies of TFD’s Notice of Privacy Practices to patients and others in accordance with the guidelines set forth in this policy
3. Obtain the signature of the patient or his/her designated representative in accordance with the guidelines set forth in this document

Answer 4

Firefighter/Paramedics

Question 5

General Guidelines

1. TFD personnel shall give TFD’s Notice of Privacy Practices to the following individuals:

Answer 5

a. All patients transported by TFD, whether ALS or BLS
b. All ALS patients left at the scene (e.g.; not transported against medical advice or not transported because successfully treated in the field)
c. Any person who requests a copy of TFD’s Notice of Privacy Practices

Question 6

TFD personnel shall provide TFD’s Notice of Privacy Practices to patients in a manner that does not interfere with the patient’s medical treatment.
a. In most situations, TFD’s Notice of Privacy Practices should be _________

Answer 6

handed to the patient or placed with the patient’s belongings in the hospital emergency room

Question 7

The TFD Privacy Officer shall review TFD’s Notice of Privacy Practices whenever ________

Answer 7

there is a significant change to HIPAA related laws or when this policy is updated, whichever occurs first.

Question 8

TFD personnel shall obtain a signature acknowledging the receipt of TFD’s Notice of Privacy Practices on the back of the first page of the EMIR from one of the following individuals listed below in order of preference: 
a.
b.
c.
d.

Answer 8

a. The patient
b. The patient’s legal representative
c. The receiving care provider (e.g.; nurse or physician)
d. A receiving facility representative (e.g.; unit secretary or admitting clerk)

Question 9

If a signature is obtained from the receiving care provider or a receiving facility representative, TFD personnel also shall indicate ____________

Answer 9

the reason why obtaining the patient’s signature was not possible, in writing, in the space provided on the back of the first page of the EMIR.

Question 10

If no signature is obtained, TFD personnel shall:
a.
b.

Answer 10

a. Indicate the reason obtaining the patient’s signature was not possible, in writing, in the space provided on the back of the first page of the EMIR
b. Attach a hospital facesheet to the EMIR