Posted May 2, 2003

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.

Columbia 9-1-1 Communications District (the "District") may have access to individually identifiable health information of certain individuals in the normal course of the District's operations. Federal and/or state law may protect such health information from certain uses and further disclosures. For example, the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its implementing regulations require covered entities to maintain the privacy of protected health information ("PHI") and to provide individuals with notice of its legal duties and privacy practices.

On April 25, 2003, the District adopted privacy policies and procedures (the "Policies") and intends to comply fully with all legal requirements regarding the use and disclosure of PHI. To obtain a copy of the District's Policies or if you have any questions about this notice, please contact:

Susan Reedy, Data Specialist/Privacy Officer
Columbia 9-1-1 Communications District
P.O. Box 998
St. Helens, OR 97051
Phone:(503) 397-7255 ext. 2224
Fax:(503) 366-7196
Email:sreedy@columbia911.com

The District's Policies are not intended to create any third party rights (including but not limited the District's participants, those individuals who invoke or facilitate the District's services on behalf of others or the District's business associates). The District reserves the right to amend or change its Policies and/or this notice at any time and to make any new provisions effective to any and all protected health information that it maintains. Changes to the Policies or this notice will be posted on the District's web site currently located at www.columbia911.com. To the extent that its Policies exceed those legally required, they are merely guidelines and are not binding upon the District.

The remainder of this notice describes how information about you may be used and disclosed and how you can obtain access to this information.

1. Permitted uses and disclosures.

While PHI will generally be kept confidential, PHI may be used by the District to facilitate its functions as an emergency dispatch center and for related administrative purposes. PHI may be disclosed to other entities for treatment and payment purposes and for certain health care operations if that entity has (or had) a relationship with the individual and the PHI requested pertains to that relationship. For example, PHI may be disclosed to various emergency response agencies, such as ambulance services, paramedics or fire and rescue districts for treatment purposes.

Certain PHI may also be disclosed to other entities in the following situations without an individual's authorization:

• When required by law;
• For certain public health activities;
• Reports of abuse, neglect or domestic violence;
• For certain health oversight activities;
• For judicial and administrative proceedings;
• For certain law enforcement purposes;
• In certain circumstances relating to decedents;
• For cadaver organ, eye or tissue donation purposes;
• For certain limited research purposes;
• To avert a serious threat to health or safety;
• For certain specialized government functions; and
• Administration of workers' compensation programs.

Other uses and disclosures generally will be made only with the individual's written authorization, which may be revoked at any time (except to the extent that it has already been acted upon).

2. Individual rights.

• With respect to their own PHI, individuals may:
• Inspect and obtain copies of their PHI that the District (or its business associates) maintains;
• Request in writing to have their PHI amended;
• Obtain an accounting of certain disclosures of his or her own PHI;
• Request to receive communications regarding their PHI by alternative means or at alternative locations;
• Obtain a paper copy of this notice and/or the District's Privacy Policies upon request;
• Request reasonable restrictions on the use and disclosure of the participant's PHI. While the District is not required to agree to a requested restriction, its policy is to attempt to accommodate reasonable requests. The District retains the sole discretion to determine whether a particular request is reasonable under the circumstances; and
• Complain to the District or to the federal Secretary of the Department of Health and Human Services if they believe their privacy rights have been violated. To file a complaint with the District, please contact the Privacy Officer identified above. No individual will be retaliated against for filing such a complaint.

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