Patient Rights/Privacy

Patient Rights
Patient Privacy Practices

Patient Rights

Bill of Rights

We at Fletcher Allen Health Care are committed to provide you competent and respectful care, to honor your legal rights, and to strive to meet reasonable expectations. This requires honest communication among you, your family and your health care team. Fletcher Allen Health Care is a teaching institution with a mission of educating health care professionals. Students and residents from multiple disciplines will be an integral part of your health care team.

Fletcher Allen Health Care invites feedback from our patients and families, including compliments, suggestions for improvement, concerns and grievances about our care and/or services. We encourage direct feedback to any staff at the time the concern arises. In addition, a specific review process is offered through our Office of Patient and Family Advocacy. This process includes appropriate investigation and resolution at point of service and/or referral to our Grievance Committee for review and written response. For more information, contact the Office of Patient and Family Advocacy at 847-3500.

Listed below is what you can expect from us and what we expect from you.

You have a right:

To receive information about patient rights when your receive care from us.
To receive necessary care regardless of your sex, age, race, religion, color, national origin, sexual orientation or other personal characteristics including source of payment of your care.
To get the information you need to understand your medical condition and prognosis.
To be involved in plans and decisions about your medical treatment.
To have an attending physician who is responsible for coordinating your care.
To expect reasonable continuity of care and be informed of continuing health care requirements following your discharge.
To receive appropriate assessment and management of your pain as part of your overall treatment plan.
To be free from restraints and/or seclusion in any form used as a means of coercion, discipline, convenience or retaliation by staff.
To decide whether to accept any and all available treatments. If you should become unable to make such decisions, your doctor/healthcare professional will ask for consent from your

Legal health care agent, including an individual with a signed Vermont Reciprocal Beneficiary Relationship document (Reciprocal Beneficiary information can be obtained from Patient and Family Advocacy 847-3500).

Family or close associates.

To prepare Advance Directives, such as Living Will or Durable Power of Attorney for Health Care. (Please call The Department of Case Management / Social Work at 847-3553 for this service).
To request and participate in an ethics consultation regarding your care. Ethics consultation may be appropriate when there is a difference of opinion about what is the best treatment for you. (Please call 847-0000 and ask the operator to page the Clinical Ethics Consultation Service.)
To expect that your personal information will be treated confidentially. The members of your health care team will share among themselves the information that is necessary to guide their care of you. As part of our continuing effort to assure the quality of care, Fletcher Allen employees from the Institute for Quality and Operational Effectiveness may review your medical record. Others may have access only if you consent or if required by law.
To be informed, or have your family informed, about the outcomes of care, including unanticipated outcomes.
To read your medical record and request amendments. Please contact your attending physician or Health Information Management (847-2846) to process such requests.
To know the maximum patient census and the full-time equivalent numbers of registered nurses, licensed practical nurses, and licensed nursing assistants who provide direct care for each shift on the unit where the patient is receiving care. (For information, please call 847-7999).
To receive Patient Protective Services in situations of physical, sexual or psychological abuse, or when there is suspicion of such abuse. Such services may be initiated by your professional caregivers, or you may initiate them yourself by calling The Department of Case Management / Social Work at 847-3553.
To participate in or not to participate in research projects.
To receive interpreter service if you need them. (Please call The Department of Case Management / Social Work at 847-3553 for this service.)
To leave the hospital against your physician’s advice unless you lack decision-making capability to make an informed decision about discharge.
To, whenever possible, stay with your children 24 hours a day (parents or guardians). Whenever possible, agents, guardians, reciprocal beneficiaries or immediate family members have the right to stay with terminally-ill patients 24 hours a day.
To be informed in writing of the availability of hospice services and the eligibility criteria for those services.
To know what hospital rules and regulations apply to your responsibilities as a patient (see below).

You can expect that we will:

Respect your personal values and beliefs.
Respect and honor your advance directive.
Respond to any reasonable request courteously and promptly.
Respect your privacy as much as possible.
Give you our names, titles, and roles.
Provide counseling if you or your family have any concerns about your care (The Office of Patient and Family Advocacy can be reached at 847-3500.)

You have a responsibility:

To provide full information about your illness and past health, so that we can provide the right care.
To provide us with complete personal information including your name and address, current health insurance data and/or the identification of the person responsible for your bill.
To be aware of what your health care insurance does and does not cover. Services not covered can be provided but may be at your expense.
To cooperate with us in our efforts to obtain payment for services provided to you and/or with our efforts to provide you with the benefits of our special financial assistance programs.
To keep scheduled appointments or call as soon as possible to cancel.
To let us know if you do not understand or cannot follow the proposed plan for your care.
To recognize the effect of you life-style on your personal health.

You have additional rights:

To receive an itemized bill and an explanation of all charges. (Please call 847-8000 for this service.)
To receive information about available financial assistance. (Please call 847-8000 for this service.)
To bring concerns to:

The Office of Patient and Family Advocacy at Fletcher Allen Health Care: 802-847-3500. Address: Fletcher Allen Health Care, 111 Colchester Avenue, Burlington, VT 05401. (concerns about the quality or safety of care.)
Division of Health Care Administration, Department of Banking, Insurance, and Securities & Health Care Administration: 1-800-631-7788 (Concerns about health care services you have received).
The Office of Health Care Ombudsman: 1-800-917-7787 (Concerns about health insurance).
Vermont Department of Health and Board of Health: 1-800-745-7371 (Concerns about health care services you have received).
Vermont Secretary of State, Office of Professional Regulation: (802) 828-2386 (Concerns about the quality of care provided by licensed professionals).
Vermont Board of Medical Practice: 800-745-7371 (Concerns about physicians).
Department of Aging and Independent Living, Division of Licensing Protection: 1-800-564-1612. (to enter a complaint against a facility or agency that provides health care services or to report abuse, neglect, or exploitation of a vulnerable adult).
Centers for Medicare & Medicaid Services: 1-800-Medicare (1-800-633-4227) (Concerns about the quality of care provided to Medicare consumers)
Joint Commission on Accreditation for Health Care: 1-800-994-6610 (concerns about the quality or safety of care).

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 (FAHC) and our employees (including physicians, nurses, and technicians) and other individuals that work at FAHC facilities. This notice applies to all of the medical records generated by any Fletcher Allen Health Care (FAHC) facility, including FAHC facilities at the Medical Center Campus (including the Vermont Children's Hospital), the Fanny Allen Campus, and the clinics, physician offices and other health care facilities owned and operated by Fletcher Allen Health Care.

II. Our Privacy Obligations

We are required by law to maintain the privacy of your health information and provide you 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. Uses and Disclosures With Your Consent or Authorization

A. Use and Disclosure With Your Consent. Before we provide medical care to you, 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 the services we provide you;
For our healthcare operations (for example, administrative activities, quality improvement, and customer service) as described below:

Treatment. We may use medical information about you to provide you treatment or services and to send you appointment reminders. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other individuals who are involved in your care. For example, a doctor treating you for a broken leg may need 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 the different things you may need, such as prescriptions, lab work, meals, and x-rays.

Payment. We may use and disclose medical information about you to bill and collect payment from you, your insurance company or a third party payer. For example, we may need to give your insurance company information about your surgery so they will pay us or reimburse you for the treatment. 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 medical information about patients for health care system operations. These uses and disclosures are necessary to run our health care facilities and make sure that our patients receive quality care. 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 continually improve the quality of the care for all patients we serve. We may also combine medical information about many patients to evaluate the need for new services. We may disclose information to doctors, nurses, and students for educational purposes. And we may combine medical information we have with that of other hospitals to see where we can make improvements. We may remove information that identifies you from this set of medical information to protect your privacy.

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 we provide you, and our health care operations. We may use or disclose your health information for any reason other than treatment, payment and health care operations 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.

IV. Uses and Disclosures Without Your Consent or Your Authorization

A. Use or Disclosure for Treatment, Payment, and Health Care Operations Without Your Consent or Your Authorization. At FAHC we may use or disclose your health information for treatment purposes, obtaining payment, and our health care operations without your consent or your authorization under the following three 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 obtain it due to substantial barriers communicating with you (for example, you are unconscious or otherwise incapacitated) and we reasonably infer that you would have consented in the absence of the communication barriers.

B. Use or Disclosure for a FAHC Hospital Directory. Unless you disagree or object, we may include certain limited information about you in a hospital directory while you are a patient in a FAHC inpatient facility. The 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 members of the community clergy. However, your religious affiliation will only be disclosed to members of the community clergy. You have these options in regard to the facility directory:

You may opt out of the facility directory and request that we not disclose any information to anyone who asks for you by name;
and/or
You may opt out of listing your religious affiliation on a list provided to community clergy who may visit you while you are hospitalized.

Please talk to the admissions staff if you would like to opt out of the facility directory or opt out of having your name and denomination provided to members of the community clergy.

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 who helps pay for your care.

D. Disaster Relief Efforts. We may disclose medical information about you 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 FAHC. In connection with any fundraising, we may disclose to our fundraising staff, demographic information about you (e.g., your name, address, phone number) and the dates when you received health care services at FAHC.

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 then contact you about the services and products.

G. Business Associates. There are some services provided at FAHC through contracts with business associates. Examples include certain laboratory tests, and a copy service we use when making copies of your medical record. 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 that were provided to you. To protect your health information, however, we require our business associates to 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 under laws addressing work-related injuries or workplace medical surveillance.

I. Health Oversight Activities. We may disclose your health information to a health oversight agency that oversees FAHC and ensures that FAHC 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 the police or other 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 certain identification and location purposes and to assist in certain 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.

V. Organized Health Care Arrangement.

FAHC and its medical staff members have organized and are presenting you this document as a joint notice. Your health information will be shared with members of our medical staff as necessary to carry out treatment, payment, and health care operations. 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 FAHC, 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.

VI. Your Individual Rights.

For Further Information: Complaints. If you desire 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 FAHC Privacy Officer by calling the FAHC Patient Relations Department 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 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, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgical procedure you had. 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 the registration personnel at the FAHC facility where you are receiving your medical care. FAHC 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 inspect and obtain a copy of the 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. 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 FAHC will review your request and the denial. The person conducting the review 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 medical information about you is incorrect or incomplete, you may ask us to amend the information. Your have a right to request the amendment for as long as the information is kept by or for FAHC. While we will review each amendment request carefully, FAHC 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 certain disclosures we make of your medical information for purposes other than treatment, payment, or health care operations.

VII. Effective Date and Duration of This Notice.

Effective Date. This Notice describes the privacy policy of Fletcher Allen Health Care that will become effective on April 14, 2003. Prior to the effective date, FAHC will continue to protect your health information as required by applicable state and federal laws, regulations, and policies.
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 all health information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new Notice in waiting areas or registration areas at all FAHC facilities and on our Internet site at www.fahc.org. You may also obtain a new notice by contacting the FAHC Patient Relations Department at (802) 847-3500.