Unified Fire Authority
A Note About Personal Representatives You may exercise your rights through a personal authorized representative. Your personal representative will be required to produce evidence of his or her authority to act on your behalf before that person will be given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms:
» A power of attorney for health care purposes, notarized by a notary public;
» A court order of appointment of the person as the conservator or guardian of the individual; or
» An individual who is the parent of a minor child.
The plans retain discretion to deny access to your PHI to a personal representative to provide protection to those vulnerable people who depend on others to exercise their rights under these rules and who may be subject to abuse or neglect. This also applies to personal representatives of minors.
Change to this Notice The plans reserve the right to change this notice at any time and to make the revised or changed notice effective for health information the plans already have about you, as well as any information the plans receive in the future. The plans will post a copy of the current notice in the Employer’ s office. All individuals covered under the Plan will receive a revised notice within 60 days of a material revision to the notice.
Notice of Breach of PHI You have a right to receive a notice when there is a breach of your unsecured PHI.
Complaints If you believe your privacy rights under this policy have been violated, you may file a written complaint with the Privacy Officer at the address listed below. Alternatively, you may file a complaint with the Secretary of the U. S. Department of Health and Human Services( Hubert H. Humphrey Building, 200 Independence Avenue S. W., Washington D. C. 20221), generally within 180 days of when the act or omission complained of occurred. Note: The plans, the Employer, and nay of its affiliates will not retaliate against you for filing a complaint.
Other Uses and Disclosures of Health Information A plan must obtain your written authorization to use or disclose psychotherapy notes, to use PHI for marketing purposes, or to sell PHI. An authorization for a use or disclosure of psychotherapy notes may only be combined with another authorization for a use and disclosure of psychotherapy notes.
Plans( excluding long-term care plans) are prohibited from using or disclosing PHI that is genetic information for underwriting purposes.
Other uses and disclosures of health information not covered by this notice or by the laws that apply to the plans will be made only with your written authorization. If you authorize the plans to use or disclose your PHI, you may revoke the authorization, in writing, at any time. If you authorize the plans to use or disclose your PHI, you may revoke the authorization, in writing, at any time. If you revoke your authorization, the plans will no longer use or disclose your PHI for the reasons covered by your written authorization; however, the plans will not reverse any uses or disclosures already made.
Contact Information: If you have any questions about this notice, please contact the Privacy Officer at the Employer, Attention: Privacy Officer.
Updated and effective March 26, 2013
Family Medical Leave Act
Family & Medical Leave Act( FMLA) FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women. FMLA applies to all public agencies, all public and private elementary and secondary schools, and companies with 50 or more employees. There may be times when you need an extended leave of absence. The company has a Family and Medical Leave Policy that is in compliance with The Family and Medical Leave Act of 1993( FMLA), as amended. FMLA provides an entitlement of up to 12 weeks, which protects employees’ jobs and benefits in the event of a medical or family circumstance, which requires the employee to take time off from work without pay. In general, the employee must have worked for at least 12 months and at least, 1,250 hours within the last 12 months immediately prior to the first day of leave.
Circumstances Permitting Family and Medical Leave » Birth of an employee’ s child( within 12 months after birth)
» Adoption of a child by an employee( within 12 months after placement)
» Placement of a child with the employee for foster care( within 12 months after placement)
» Care of a child, spouse or parent having a serious health condition
» Incapacity of the employee due to a serious health condition » Military Leave
Additional leave laws may apply to you depending upon your specific state and if you or a dependent or a military member. Whenever possible leave must be requested in advance. If you have questions about FMLA or any leave requests, please contact Human Resources.
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