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HIPAA StatementNotice of Privacy
Practices
THIS
NOTICE DESCRIBES HOW IDENTIFIABLE HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
If
you have any questions about this notice, please contact Christine Hough at
218-0000 extension #4309. At
Living Resources, we understand that information about you and your family is
personal. We are committed to
protecting your privacy and sharing information only with those persons who need
to know and are allowed to see the information. This notice tells you how Living Resources uses and discloses
information about you. It describes
your rights and what our responsibilities are concerning information about you.
All people who work for Living Resources in our
residences, in our non-residential service programs and in our administrative
offices will follow this notice. This
includes employees and contractors who are
authorized to enter information in your clinical record or need to review your
record in order to provide services to you, and volunteers or interns
that we allow to assist you. 2. What
information is protected? All information that we create or keep that relates
to your health or care and treatment, including your name, address, birth date,
social security number, your medical information, your individualized service
plan and other information about your care in our programs. You
have the following rights concerning your clinical information.
When we use the word “you” in this notice we also mean your personal
representative. Depending on your
circumstances and in accordance with state law, this may be your guardian, your
health care proxy, or your involved parent, spouse or adult child. v
You have
a right to see or inspect your clinical information and obtain a copy.
Some exceptions apply, such as records regarding incident reports and
investigations, and information compiled for use in court or administration
proceedings. NOTE: Living
Resources may require you to make your request for records in writing. v
If we
deny your request to see your clinical information, you have the right to
request a review of that denial. Professionals
chosen by Living Resources who were not involved in denying your request will
review the record and decide if you may have access to the record. v
You have
the right to ask Living Resources to change or amend clinical information that
you believe is incorrect or incomplete. We
may deny your request in some cases, for example, if the record was not created
by Living Resources or if after reviewing your request, we believe the record is
accurate and complete. v
You have
a right to request a list of disclosures that Living Resources has made of your
clinical information. The list,
however, does not include certain disclosures such as those made to you or made
to others with your permission. v
You have
the right to request a restriction on uses or disclosures of your health
information related to treatment, payment, health care operations and
disclosures to involved family. Living
Resources, however, is not required to agree to your request v
You have
the right to request that Living Resources communicates with you in a way that
will help keep your information confidential. v
You have
the right to receive a paper copy of this notice.
You may ask Living Resources staff to give you another copy or you may
obtain one from our website at www.livingresources.org v
To
request access to your clinical information or to request any of the rights
listed here, you may contact Chris Hough at 346-8888 ext. 3309
Living
Resources is required to: v
Maintain
the privacy of your information in accordance with federal and state laws. v
Give you
this notice of our legal duties and practices concerning the clinical
information we have about you. v
Follow
the rules in this notice. Living
Resources will use or share information about you only with your permission
except for the reasons explained in this notice. v
Tell you
if we make changes to our privacy practices in the future.
If changes are made that affect the use and disclosure of your protected
health information, your rights, our duties, or our privacy practices, Living
Resources will notify you and post a new notice on our website at www.livingresources.org
How Living
Resources Uses & Discloses Clinical Information
Living
Resources may use and disclose clinical information without your permission for
the purposes described below. For
each of the categories of uses and disclosures, we explain what we mean and
offer an example. Not every use or
disclosure is described, but all of the ways we will use or disclose information
will fall within these categories. v
Treatment: Living
Resources will use your clinical information to provide you with treatment and
services. We may disclose clinical
information to doctors, nurses, psychologists, social workers, qualified mental
retardation professionals (QMRP), developmental specialist, and other Living
Resources personnel, volunteers or interns who are involved in providing your
care. For example, involved staff
may discuss your clinical information to develop and carry out your
individualized service plan (ISP). Other
agency staff may share your clinical information to coordinate different
services you need, such as medical tests, respite care, transportation, etc. We may also need to disclose your clinical information to
your service coordinator and other providers outside of Living Resources who are
responsible for providing you with the services identified in your ISP or to
obtain new services for you. v Payment: Living Resources will use your clinical information so that we can bill and collect payment from you, a third party, an insurance company, Medicare or Medicaid or other government agencies. For example, we may need to provide the NYS Department of Health (Medicaid) with information about the services you received in our facility or through one of our HCBS waiver programs so they will pay us foe the services. In addition, we may disclose your clinical information to receive prior approval for payment for services you may need. Also, we may disclose your clinical information to the US Social Security Administration, or the department of health to determine your eligibility for coverage or your ability to pay for services. v
Health Care Operations:
Living Resources will use clinical information for health care
operations. These uses and
disclosures are necessary to operate agency programs and residences and to make
sure all consumers receive appropriate, quality care.
For example, we may use clinical information for quality improvement to
review our treatment and services and to evaluate the performance of our staff
in caring for you. We may also
disclose information to clinicians and other personnel for on-the-job training.
We will share your clinical information with other Living Resources staff
for the purposes of obtaining legal services through our Counsel’s office,
conducting fiscal audits, and for fraud and abuse detection and compliance
through our department of Quality Assurance.
We will also share your clinical information with Living Resources staff
to resolve complaints or objections to your services.
We may also disclose clinical information to our business associates who
need access to the information in order to perform administrative or
professional services on our behalf. (example:
agency attorney or independent auditors)
Other Uses and
Disclosures that Do Not Require Your Permission
In addition to treatment, payment and health care operations, Living
Resources may use your clinical information without your permission for the
following reasons: v
To tell
you directly about possible alternatives or health-related benefits or services
that may be of interest to you. v
When we
are required to do so by federal or state law. v
For public
health reasons, including prevention and control of disease, injury or
disability, reporting births and deaths, reporting child abuse or neglect,
reporting reactions to medication or problems with medical devices or products,
and to notify people who may have been exposed to a disease or are at risk of
spreading the disease. v
To report
domestic violence and adult abuse or neglect to government
authorities if you agree or if necessary to prevent serious harm in accordance
with the law. v
For health
oversight activities, including audits, investigations, surveys and
inspections, and licensure. These
activities are necessary for government to monitor the health care system,
government programs, and compliance with civil rights laws.
Health oversight activities do not include investigations that are not
related to the receipt of health care or receipt of government benefits in which
you are the subject. v
For judicial
and administrative proceedings, including hearings and disputes.
If you are involved in a court or administrative proceeding we will
disclose clinical information if the judge or presiding officer orders us to
share the information. v
For law
enforcement purposes, in response to a court order or subpoena, to
report a possible crime, to identify a suspect or witness or missing person, to
provide identifying data in connection with a criminal investigation and to the
district attorney in furtherance of a criminal investigation of client abuse. v
In the
event of your death, to coroners or medical examiners for
identification purposes or to determine cause of death, and to funeral directors
to allow them to carry out their duties. v
To organ
procurement organizations to accomplish cadaver, eye, tissue, or organ
donations in compliance with state law. v
For research
purposes when you have agreed to participate in the research an
Institutional Review Board or Privacy Committee has approved the use of the
clinical information for the research purposes. v
To prevent
or lesson a serious imminent threat to your health and safety or someone
else’s where permitted by law. v
To
authorized federal officials for intelligence and other national security
activities authorized by law or to provide protective services to the president
and other officials. v
To correctional
institutions or law enforcement officials if you are an inmate and the
information is necessary to provide you with health care, protect your health
and safety or that of others, or for the safety of the correctional institution. v
To government
agencies that administer public benefits if necessary to coordinate the
covered functions of the programs. v Fundraising. We may use your name and address, or the name of your involved family members, in order to make contact as part of a fund-raising effort. We may also share this information with only our Living Resources Foundation that will contact you to raise money on our behalf. If you do not want to be contacted for these fundraising efforts, please write to: Ms. Joan Meyer, Director of Public Affairs at 300 Washington Ave. Ext., Albany, NY 12203, or you can call her at (518)218-0000 x5330. v
Appointment
reminders and follow-up calls. We
may use and disclose protected health information to contact you with a reminder
that you have an appointment for treatment or medical care.
We may also call to follow-up on care you received with us, to tell you
of test results, or to confirm an appointment with us or another health care
provider.
Living
Resources may disclose clinical information to the following persons if we tell
you we are going to use or disclose it and you agree or do not object: v
To family
members and personal representatives who are involved in your care if
the information is relevant to their involvement and to notify them of your
condition and location; or v
To disaster
relief organizations that need to notify your family about your
condition and location should a disaster occur. Authorization Required For All Other Uses and Disclosures: For
all other types of uses and disclosures not described in this notice, Living
Resources will use or disclose clinical information only with a written
authorization signed by you that states who may receive the information, what
information is to be shared, the purpose of the use or disclosure and an
expiration for the authorization. Written
authorizations are always required for use and disclosure of psychotherapy notes
and for certain marketing purposes. NOTE: If you cannot give permission due to an emergency, Living
Resources may release clinical information in your best interest.
We must tell you as soon as possible after releasing the information. You
may revoke your authorization at any time.
If you revoke your authorization in writing, we will no longer use or
disclose your clinical information for the reasons stated in your authorization.
We cannot, however, take back disclosures we made before you revoked and
we must retain clinical information that indicates the services we have provided
to you. Changes to this Notice: We
reserve the right to change this notice. We
reserve the right to make changes to terms described in this notice and to make
the new notice terms effective to all clinical information that Living Resources
maintains. We will post the new
notice with the effective date on our website at www.livingresources.org
and will also have a copy at each program site immediately available.
In addition, we will offer you a copy of the revised notice at your next
scheduled service planning meeting. Complaints: If
you believe your privacy rights have been violated: v
You may file a complaint with the agency’s Privacy Officer at
300 Washington Avenue Extension, Albany, NY
12203, or call 218-0000 ext. 4309. Or, v
You may
contact the Secretary of the Department of Health and Human Services.
You may call them at (877) 696-6775 or write them at 200 Independence Ave
S.W., HHH Building, Room 509H, Washington DC, 20201. v
You may
file a grievance with the Office of Civil Rights by calling 866-OCR-PRIV or (866)
627-7748, or (TTY)(886)788-4989, or by e-mail at www.hhs.gov.ocr All complaints must be submitted in writing.
You will not be penalized for filing a complaint. |
