Map of district
District Boundaries
Approximately 80+ square miles starting at the Wisconsin state line
(excluding the City of South Beloit) and on the East by Boone County
line and on the West along Dorr Road continuing south along Old River
Road West between Roscoe Road and Gleasman Road and then it follows
the Rock River South to approximately Langley Road across East to Minns
Drive at Harlem-High School. North to Hwy 173 to I-90 and connects with
a line intersecting Carradale Road at the Boone County line. We also
provide protection to parts of Manchester Township Area (North Boone
District) under a contract agreement.
District Background
The Harlem-Roscoe Fire District consists of mainly a bedroom community,
sprinkled through the center area with commercial, retail, and light
manufacturing, serving approximately 25,000 residents. We have the I-90
Tollway, Route 173, Highway 251, a Railroad, and the Rock River running
through the district. The district has one High School (Harlem High
School) of over 2000 students, seven K-8 Grade Schools, and a number
of preschools located within our district. The district is made up of
parts of Machesney Park, Roscoe, Rockton, unincorporated Argyle, and
some rural unincorporated county areas. Most of the area east of I-90
(northwest Tollway) does not have a water supply including some of the
larger, higher priced, largely 2 story homes. West of the Rock River
a large multi-housing complex has started as has several large subdivisions.
Traffic is becoming a problem in the early morning hours and the later
evening hours. This puts the east-west roadways under pressure due to
heavy traffic congestion at these times. Our area has increased 200%
since the 1990 census was taken. There appears to be great expectations
for future development within our area, especially along Hwy 173 and
Rockton Rd. where they intersect I-90
HARLEM-ROSCOE FIRE PROTECTION
DISTRICT (HRFPD)
PROTECTED HEALTH INFORMATION (PHI) PRIVACY POLICY
PURSUANT TO THE HEALTH INSURANCE PORTABLITY AND ACCOUNTABLITY ACT.
1. No member of the HRFPD shall disclose any Patient's
Health Information in violation of the patient's privacy rights.
2. All patients shall be asked to sign the HRFPD Notice of Disclosure,
Release of Medical Information, and Notice of HRFPD Protected Health
Information (PHI) Privacy Police form, hereinafter referred to as the
PHI form. If a patient refuses to sign or is unable to sign the PHI
form, a witness should be obtained in writing to the request to sign
and refusal or inability to sign by the patient. If the patient is advised
of the PHI Notice and Policy and refuses to sign or is unable to sign
before a witness in writing, they still have received the PHI notice.
3. All signed or witnessed PHI documents must be retained for six years.
All PHI documents must be maintained in lockable and secure storage.
4. The parent of a minor child or guardian of a legally disabled patient
may sign the PHI form on behalf of the patient.
5. All disclosure of patient PHI shall be limited to persons and business
associates (BA) within HRFPD treatment, payment and healthcare operation
(TPO) and shall be based upon notice or consent obtained prior to providing
care, except for the following circumstances where disclosure of health
information may be made for TPO purposes prior to obtaining written
consent or notice:
A. In the case of an emergency as determined by the healthcare provider
on the scene, using his or her "professional judgment" as
defined and included in the Department of Health and Human Services
HIPAA Standards: "Healthcare providers must exercise professional
judgment to determine whether obtaining a written consent (or now a
signed notice) would interfere with the timely delivery of necessary
healthcare. If, based on professional judgment, a provider reasonably
believes at the time the patient presents for treatment that a delay
involved in obtaining the patient's written consent of use or disclosure
of information would compromise the patient's care, the provider may
use or disclose PHI that was obtained during the emergency treatment,
without prior consent, to carry out TPO."; or
B. When required by law, such as in the case of receipt of lawful subpoena
or court order of proper jurisdiction; or
C. When there are substantial communication barriers.
Notwithstanding the above exceptions to prior notice or consent, the
provider must attempt to obtain written acknowledgment of notice and
consent as soon as reasonably practicable after the provision of treatment.
6. HRFPD must secure prior authorization to disclose PHI to a patient's
employer or attorney before disclosure.
7. All disclosures, when made, are to disclose the least amount of PHI
necessary for the purpose.
8. Any PHI used for training purposes, or given as an example, must
be de-identified by removal of the patient's name, address, date of
birth, Social Security number, dates of treatment, telephone/fax numbers,
invoice/account number, health insurance number, driver's or vehicle
license numbers, codes, pictures, fingerprints, or any other identifying
features or information.
9. No disclosure to any business associate (BA) shall be made without
a prior written contract between HRFPD and the BA obligating that BA
to fully comply with the Privacy Policy and insure nondisclosure of
PHI except for purposes of compliance with the TPO and requiring the
BA to promptly notify the HRFPD of any violations of that Privacy Policy.
10. The Fire Chief shall appoint a Privacy Policy Compliance Officer
to implement, oversee and train as to the HRFPD Privacy Police. All
HRFPD personnel are to receive Privacy Policy training annually appropriate
to each person's function with the HRFPD. The Privacy Police Officer
shall insure that records of personal privacy training shall be maintained
and that PHI records maintained by HRFPD shall be kept secure against
unauthorized disclosure.
11. The Fire Chief shall appoint a Privacy Policy Complaint Officer
who shall be designated to receive, document, investigate and resolve
complaints alleging violation of patient privacy rights. All violations
of the Privacy Policy and resolutions therefore shall be reported in
writing to the Fire Chief as soon as practicably possible. Upon receipt
of such written report, the Fire Chief shall present said written report
to the Board of Trustees in such a form and manner as not to cause further
violation of the Privacy Policy.
12. Any HRFPD personnel found to have violated the Privacy Policy shall
be subject to disciplinary sanctions up to and including suspension
or discharge as appropriate to the circumstances of the unauthorized
disclosure. Such disciplinary action shall be by the majority vote of
the Board of Trustees upon recommendation of the Fire Chief.
13. All persons or entities acting as billing agents for HRFPD (Business
Associates) shall be provide a copy of this PHI privacy policy and shall
be required and expected to conform to the requirements hereof as well
as the requirements and spirit of all federal and state laws appertaining
to patient's privacy rights. Furthermore, said business associates shall
be required to notify HRFPD of any actual or suspected violation of
a patient's privacy rights and the privacy policy. Upon notice of violation
of patient's privacy rights, the HRFPD shall take action as reasonably
necessary and appropriate to avoid future violations.
14. A copy of this HRFPD Privacy Policy shall be given to each volunteer
and, in addition, be posted and kept posted in public view at all times
in the general personnel areas of the fire station as well as the HRFPD
website, if any.
15. This Privacy Police shall be in full force and effect immediately
upon approval of the HRFPD Board of Trustees.
Approved and adopted this 23rd day of February, 2004.
James L. Burdick - President
Jerold R. Ocker - Secretary
Barton C. Munger - Treasurer
PATIENT'S HEALTH INFORMATION PRIVACY
RIGHTS
1. Patients have the right to receive and review a copy
of HRFPD Health Information Privacy Policy.
2. Patients may request that certain information not be disclosed to
designated parties.
3. Patients may request that they be contacted only at a designated
alternative address other than their home address.
4. Patients may make reasonable request of HRFPD as to time and place
for a copy of their Protected Health Information (PHI), subject to a
copying and mailing expense fee.
5. Patients have the right to request a correction of actual errors
in the PHI.
6. Patients have the right, upon request, to be informed of disclosures
of PHI by court orders, investigations and subpoenas.
7. Patients have a right to revoke, in writing, prior consents to disclosure
of PHI.
8. Parents of minors or legal guardians can sign the release or acknowledgment
of Notice of Disclosure form for their children and/or legal wards.
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