 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
General Information
Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), 42 U.S.C. § 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2. Under these laws, Albany Citizens Council on Alcoholism and Other Chemical Dependencies, Inc. (ACCA) may not say to a person outside ACCA that you attend the program, nor may ACCA disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law.
ACCA must obtain your written consent before it can disclose information about you for payment purposes. For example, ACCA must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before ACCA can share information for treatment purposes or for health care operations. However, federal law permits ACCA to disclose information without your written permission:
1.
To program staff for the purposes of providing treatment and maintaining
the clinical record;
2. Pursuant to an agreement
with a business associate (e.g. accounting services);
3. For research, audit or evaluations
(e.g. state licensing review, accreditation, program data reporting as
required by the State
and/or Federal government);
4. To report a crime committed
on ACCA's premises or against ACCA personnel;
5. To medical personnel in a
medical/psychiatric emergency;
6. To appropriate authorities
to report suspected child abuse or neglect;
7. To report certain infectious
illnesses as required by state law;
8. As allowed by a court order
For example, ACCA can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, as long as there is a business associate agreement in place.
Before
ACCA can use or disclose any information about your health in a manner
that is not described above, it must first obtain your specific written
consent allowing it to make the disclosure. Any such written consent may
be revoked by you in writing. [NOTE: Revoking a consent to disclose information
to a court, probation department, parole office, etc. may violate an agreement
that you have with that organization. Such a violation may result in legal
consequences for you.]
Your Rights
Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. ACCA is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency. You have the right to request that we communicate with you by alternative means or at an alternative location. ACCA will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by ACCA, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances. Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in ACCA's records, and to request and receive an accounting of disclosures of your health related information made by ACCA during the six years prior to your request. You also have the right to receive a paper copy of this notice. You may also obtain a copy of this notice at our website, www.albanycitizenscouncil.org.
Use of Your Information at the Program
In
order to provide you with the best care, ACCA will use your health and
treatment information for communication among program staff (including
interns) for the purposes of treatment needs, treatment planning, progress
reporting and review, staff supervision, incident reporting, medication
administration, billing operations, medical record maintenance, discharge
planning, and other treatment related processes. Also, for communication
with Business Associates such as clinical laboratories (urinalysis), food
service (special dietary needs), agencies that provide on-site services
(GED) and reporting data to the NYS OASAS Client Data System.
ACCA's Duties
ACCA is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. ACCA is required by law to abide by the terms of this notice. ACCA reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains. ACCA will provide individuals with a revised notice upon request.
Complaints and Reporting Violations
You may file a complaint with the ACCA or with the Secretary of the United States Department of Health and Human Services if you believe that your privacy right have been violated under HIPAA. To file a complaint with the ACCA, contact our Compliance Officer. All complaints must be submitted in writing. You will not be retaliated against for filing such a complaint.
Violation
of the Confidentiality Law by a program is a crime. Suspected violations
of the Confidentiality Law may be reported to the United States Attorney
in the district where the violation occurs.
Contact
If you have any questions about this notice or wish to initiate any of your rights as they pertain to HIPAA, please contact our Compliance Officer, by
·
Calling the ACCA at (518) 465-5470 and asking for the HIPAA Compliance
Officer or the Compliance Department;
or
· Writing to the ACCA
HIPAA Compliance Officer at P.O. Box 4007, Albany, NY 12204.
Effective Date
August
28, 2003