Thousand Islands Emergency Rescue Service, Inc
885 Graves St., PO Box 524
Clayton, New York 13624

Protected Health Information (PHI) Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Thousand Islands Emergency Rescue Service, Inc. (TIERS) is required by law to maintain the privacy of certain confidential health information, known as Protected Health Information (PHI), and to provide you with this Notice of our legal duties and privacy practices regarding your PHI. TIERS is also required to abide by the terms of the version of this Notice currently in effect.

Uses and Disclosures of PHI

TIERS may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission. Examples of our use of PHI include:

For Treatment:
This includes obtaining verbal or written information about your medical condition and treatment from you or other health care providers. PHI may be shared with hospitals, physicians, nurses, or other EMS providers involved in your care, including via radio or telephone communications to facilitate emergency treatment.

For Payment:
PHI may be used to obtain payment for the services we provide, including submitting claims to insurance companies, verifying medical necessity, and collecting outstanding balances.

For Health Care Operations:
This includes quality assurance, licensing, accreditation, training programs, performance evaluations, and other management activities necessary to ensure our personnel provide care according to established standards.

Reminders and Other Services:
We may contact you to remind you of scheduled non-emergency transport appointments or to provide information about services we offer.

Use and Disclosure of PHI Without Your Authorization

TIERS may use or disclose PHI without your written authorization in certain situations, unless prohibited by more stringent state law, including:

·         To other health care providers for your treatment, payment, or health care operations.

·         For public health activities, including reporting abuse, neglect, or domestic violence.

·         To family members or others involved in your care, when verbally agreed to or if it is in your best interest.

·         For health oversight activities, audits, inspections, disciplinary proceedings, or other government investigations.

·         For judicial or administrative proceedings, as required by court order, subpoena, or other legal processes.

·         For law enforcement purposes, in limited circumstances.

·         For military, national security, and other special government functions.

·         To prevent a serious threat to health or safety of a person or the public.

·         For workers’ compensation purposes, as authorized by law.

·         To coroners, medical examiners, or funeral directors as legally authorized.

·         For organ, eye, or tissue donation and transplantation purposes.

·         For research projects subject to strict oversight and approval.

·         In de-identified form, which does not reveal your identity.

Any other use or disclosure of PHI requires your written authorization. You may revoke your authorization at any time, in writing, except for disclosures already made based on the authorization.

Patient Rights

Access to PHI:
You have the right to inspect and copy most medical information TIERS maintains about you, typically within 30 days of your request. A reasonable fee may apply for copies. Requests should be made to our Privacy Officer. Denials, in limited circumstances, may be appealed.

Amendment of PHI:
You may request amendments to your written medical information. TIERS will respond within 60 days. Requests may be denied if the information is believed to be accurate. Requests should be directed to our Privacy Officer.

Accounting of Disclosures:
You may request an accounting of disclosures of your PHI made within the last six years, excluding disclosures for treatment, payment, health care operations, or with your authorization. Requests should be made to our Privacy Officer.

Restrictions on Use or Disclosure:
You may request restrictions on how your PHI is used or disclosed. TIERS is not required to agree, but any agreed-upon restrictions are binding.

Electronic Communications and Notice Copy:
If TIERS maintains a website, this Notice will be posted there. You may request an electronic or paper copy at any time.

Revisions to the Notice

TIERS may update this Notice at any time. Material changes will be posted in our facilities and on our website (if maintained). You may request the current version from our Privacy Officer.

Complaints

You have the right to file a complaint with TIERS or the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint. Questions or complaints should be directed to the TIERS Privacy Officer.

TIERS Privacy Officer Contact Information:

Timothy R. Farrell Jr., EMT-P

Executive Director
Thousand Islands Emergency Rescue Service, Inc
885 Graves St., PO Box 524
Clayton, New York 13624
Phone: (315) 686-4333 ext. 302 -- email: tfarrell@tirescue.org

Effective Date: February 25, 2026