privacy practices
AMBULANCE SERVICE NOTICE OF PRIVACY PRACTICES
This Notice describes how confidential information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
Emergent Health Partners | Huron Valley Ambulance | Jackson Community Ambulance | LifeCare Ambulance | Monroe Community Ambulance Lenawee Community Ambulance | Albion Community Ambulance
Emergent Health Partners and its affiliates (“Emergent Health”) are required by law to maintain the privacy of certain health information, known as Protected Health Information (PHI), and to provide you with notice of our legal duties and privacy practices with respect to your PHI. Emergent Health is required to abide by the terms of the version of the Notice that is currently in effect.
Emergent Health makes a significant effort to protect your privacy. The federal government requires that you be given this Notice of Privacy Practices. If you have questions about this Notice, your rights with respect to PHI, or if you wish to file a complaint, please contact the Emergent Health Privacy Officer at [email protected].
Emergent Health Privacy Officer
Phone: 734-302-3100
Email: [email protected]
Mail: 1200 State Circle, Ann Arbor, MI 48108
Uses and Disclosures of PHI – Without Your Authorization or Opportunity to Object
Emergent Health is permitted or required to use your PHI without your written authorization, or an opportunity to object, in certain circumstances, including:
For Treatment: This includes such things as obtaining verbal and written information about your medical condition and treatment from you, as well as others, such as doctors and nurses who give us treatment orders. Emergent Health may give your PHI to other health care providers involved in your treatment.
For Payment: This includes any activities Emergent Health must undertake in order to get reimbursed for the services we provide to you, including such things as submitting bills to insurance companies, making medical necessity determinations, and collecting outstanding accounts.
For Health Care Operations: This includes quality assurance activities, licensing, and training programs to ensure that personnel meet our standards of care and follow established policies, procedures, and certain other management functions.
Health Information Exchanges: Emergent Health electronically records and transmits health information, including prescription information. Emergent Health participates in Health Information Exchange (HIN) information networks. HINs have rules regarding how health information can be accessed, and limits on use or disclosures of that information. Only providers with a treatment relationship with you are permitted to access your health information through HINs. You have the right to opt out of having your information shared through HINs. For more information about HINs and your rights associated with the transmission of your information, or to opt out of sharing your information, please contact the Emergent Health Privacy Officer at [email protected].
For Health Care Oversight and legal compliance activities, including audits or government investigations, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or contractors) by law.
To Public Health Authorities in certain situations, as required by law (such as to report abuse, neglect, or domestic violence).
For Judicial and Administrative Proceedings as required by a court or administrative order, or in response to a subpoena or other legal process.
For Law Enforcement: In certain limited circumstances, such as with warrants or where information is needed to locate or respond to a crime or to apprehend an individual who participated in a violent crime or escapee from lawful custody.
Serious Threat to Health or Safety: To prevent or lessen the imminent threat of a person or the public in accordance with federal or state law.
Military Activity/National Security: For certain limited functions or other special government functions.
Organ Donation: To organizations that handle organ procurement/transplantation as necessary to facilitate organ donation and transplantation, if you are an organ donor.
Medical Examiner and Funeral Directors: For identifying a deceased person, determining cause of death, or for funeral home activities.
Research: Emergent Health may use and disclose your PHI to researchers when an institutional review board has reviewed the research proposal and protocols to ensure the privacy of your PHI, and has approved the research.
Workers Compensation: To comply with workers compensation laws and other similar legally established programs.
De-Identified Information: Emergent Health may use and disclose your PHI if it does not personally identify you or reveal who you are.
Fundraising Activities: Emergent Health is a nonprofit organization, and we may ask you to support our organization. Emergent Health may use your name and address to contact you for a donation for fundraising purposes. You have the right to elect to opt out of future fundraising or donation requests. If you do not want to be contacted for our fundraising efforts, you can submit a written request to the Emergent Health Privacy Officer at [email protected]. In no event will the provision of medical care be conditioned on your willingness to receive fundraising communications.
Uses and Disclosures of PHI – After you have an Opportunity to Agree or Object
Any use or disclosure of PHI not described in this Notice will only be made with your written authorization, which you may revoke at any time, in writing, except to the extent that Emergent Health has already used or disclosed PHI in reliance on that authorization.
The law also requires Emergent Health to obtain your written authorization before most uses or disclosures of: (i) psychotherapy notes, other than for the purpose of carrying out our treatment, payment, or health care operations purposes, (ii) any PHI for our marketing purposes, or (iii) any PHI as part of a sale of PHI.
You will be given an opportunity to agree or object before Emergent Health uses or discloses your PHI for the following purposes. However, in emergency circumstances or if you are incapacitated, our staff, in their professional judgement, will determine whether the use or disclosure is in your best interest. Our staff will then release only PHI directly relevant to that person’s involvement in your health care:
Family, relatives, and close friends: Emergent Health may disclose PHI to these individuals or any other person that you identify as being directly relevant to that person’s involvement in your health care.
Persons responsible for your care: Emergent Health may disclose PHI to these individuals of your location, general condition, or death.
Disaster relief efforts: Emergent Health may use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts.
Patient Rights
Access, Inspection, and Copying of your PHI: You have the right to inspect and receive copies of your PHI that is contained in a designated record set of medical and billing records for as long as Emergent Health maintains it. In certain circumstances, Emergent Health may deny your access to PHI, and you may appeal certain types of denials. You must complete a form to request access, andthe request will normally be responded to within 30 days. If you wish to inspect and/or receive a copy of your PHI, please submit a request on the Emergent Health website. You also have the right to receive confidential communications of your PHI.
Your Right to Amend your PHI: You have the right to ask Emergent Health to amend your PHI. Emergent Health has the right to deny your request if we believe the PHI is correct. If the request is denied for amendment, you have the right to file a statement of disagreement with Emergent Health, and we may file a rebuttal statement. You will need to complete a request form to amend your PHI, which is available from the Emergent Health Privacy Officer at [email protected]. Normally, your request to amend will be responded to within 60 days.
Right to Request a Restriction of the Use or Disclosure of your PHI: You have the right to ask Emergent Health to restrict the use and disclosure of your PHI for the purpose of treatment, payment, and health care operations. You may also request that your PHI not be disclosed to family members or friends who may be involved in your care. Emergent Health is not required to agree to your request; however, if we do agree, we will put our agreement in writing and will abide by that agreement exception to the extent the use or disclosure of such PHI is necessary to provide you treatment in an emergency. You will need to complete a form to request these restrictions, which is available from the Emergent Health Privacy Officer at [email protected]. Notwithstanding the foregoing, Emergent Health must agree to a restriction or disclosure of your PHI if: (i) the disclosure is for our payment or health care operations purposes and is not otherwise required by law, and (ii) you or another person acting on your behalf has paid for our services in full.
Right to Receive an Accounting of Disclosures Emergent Health has made of your PHI: You may ask for an accounting from Emergent Health of certain disclosures of your PHI that were made after April 14, 2003, within the last six years prior to your request. Emergent Health is not required by law to account for certain disclosures, such as for treatment, payment, or operations, or disclosures pursuant to your written authorization. If you wish to request an accounting of disclosures that are not exempted, please contact the Emergent Health Privacy Officer at [email protected].
Right to Obtain a Paper Copy of Notice of Privacy Practices: You have the right to obtain a paper copy of this Notice of Privacy Practices. A downloadable copy for print is available here, or you can contact the Emergent Health Privacy Officer at [email protected] to have a copy mailed to you.
Breach of Unsecured PHI: You have the right to be notified if a breach of unsecured PHI occurs. We will notify you if any of the information Emergent Health has obtained compromises your privacy due to a breach in our systems.
How to Make a Complaint
You have the right to complain to Emergent Health or to the Secretary of the US Department of Health and Human Services if you believe your privacy rights have been violated. Emergent Health will not retaliate against you in any way for filing a complaint with the government or our organization. You may file a complaint with the Emergent Health Privacy Officer at [email protected], who will give you further information about the complaint process.
Revisions to this Notice
Emergent Health reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all PHI that we maintain. Any material changes to the Notice will be promptly posted to Emergent Health’s website. You may obtain a copy of the latest version by contacting the Emergent Health Privacy Officer at [email protected].
This Notice first became effective on April 14, 2003
Revised March 19, 2026