Home Aide Service of the Central Adirondacks, Inc

114 S. Shore Rd.    PO Box 25    Old Forge, NY 13420
Phone/Fax   315 369-6183 

NOTICE OF PRIVACY PRACTICE

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

HASCA is required by law to maintain the privacy of your Protected Health Information and provide to you a copy of this detailed Notice of Privacy Practice including our legal duties and privacy practices relating to your Protected Health Information; and abide by the terms of this Notice that are currently in effect.  HASCA reserves the right to change the terms of this Notice, and will notify you or your personal representative by letter if any material changes are made to this Notice.

HASCA is committed to maintaining your confidentiality and protecting your health information.  Your Protected Health Information may be used for treatment, payment arrangements, and for operational purposes, such as improving the quality of care and services we provide you.

This Notice applies to all information and records related to your care that our agency personnel and Business Associates have received or created.  It also applies to health care professionals such as physicians and organizations that provide care to you from HASCA.  It informs you about the possible uses and disclosures of your Protected Health Information and describes your rights and our obligations at HASCA regarding your Protected Health Information.

I.            WITH YOUR CONSENT WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS

Our agency is required by New York State law to obtain a signed Consent allowing us to use and disclose your Protected Health Information or Private Information know also as ‘PHI’ to others for purposes of providing your home care services, obtaining payment for our services, and our health care operations.  Instances in which HASCA may use and disclose your health information are for;

§         Treatment.  Our staff and affiliated health care professionals may review and record information in your record about your treatment and care.  We will use and disclose this health information to health care professions such as your physicians or therapists in order to best treat and care for you.

 

§         Payment.  HASCA may use or disclose your Protected Health Information to others when applicable for purposes of billing for your home care services.  We may also, if necessary, disclose your health information to other health care providers so that they can receive payment for your services. 

 

§         Health Care Operations.  HASCA may use and disclose your Protected Health Information to conduct its general course of business, such as evaluation of our agency’s services, including the performance of our staff, education of staff, and quality improvement functions.

II.            WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION FOR OTHER SPECIFIED PURPOSES

§         Business Associates.  HASCA may share your Protected Health Information whenever applicable to our vendors and agents who create, receive, maintain or transmit PHI for certain functions on behalf of our agency.  These are called our “Business Associates” and include health care affiliates that create, receive, maintain, or transmit PHI on behalf of HASCA.  To protect and safeguard your health information, we require our Business Associates to appropriately safeguard your information. 

§         Family and Friends Involved in Your Care.  Unless you object, we may disclose your Protected Health Information to a family member or close personal friend, including clergy, who is involved in your care or payment for that care.

 

§         Personal Representative. If you have a personal representative, such as a legal guardian, we will treat that individual as if that person is you with respect to disclosures of your health information.  If you become deceased, we may disclose your health information to an executor or administrator of your estate to the extent that individual is acting as your personal representative or to your next of kin, as permitted under state and federal law.

§         Disaster Relief.  We may disclose your Protected Health Information to an organization assisting in a disaster relief effort.

§         Public Health Activities.  We may disclose your Protected Health Information for public health activities including the reporting of disease, injury, vital events, and the conduct of public health surveillance, investigation and/or intervention.  We may also disclose your information to notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition if a law permits us to do so.

§         Health Oversight Activities.  We may disclose your Protected Health Information to health oversight agencies authorized by law to conduct audits, investigations, inspections and licensure actions or other legal proceedings.

§         Reporting Victims of Abuse, Neglect or Domestic Violence.  If we have reason to believe that you have been a victim of abuse, neglect or domestic violence, we may use and disclose your Protected Health Information to notify a governmental authority if required or authorized by law, or if you agree to the report.

 

§         Law Enforcement.  We may disclose your Protected Health Information for certain law enforcement purposes or other specialized governmental functions;

 

§         Judicial and Administrative Proceedings.  We may disclose your Protected Health Information in the course of certain judicial or administrative proceedings.

 

§         Research.  HASCA will request that you sign a written authorization before using your Protected Health Information or disclosing it to others for research purposes. 

 

§         Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations.  We may release your health information to a coroner, medical examiners, and funeral director or, if you are an organ donor, to an organization involved in the donation of organs and tissue.

 

§         To Avert a Serious Threat to Health or Safety.  We may use and disclose your Protected Health Information when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person.  However, any disclosure would be made only to someone able to help prevent the threat.

 

§         Military and Veterans.  If you are, or were, a member of the armed forces, we may use and disclose your Protected Health Information as required by military command authorities.  We may also use and disclose Protected Health Information about foreign military personnel as required by the appropriate foreign military authority.

 

§         Workers’ Compensation.  We may use or disclose you Protected Health Information to comply with laws relating to workers’ compensation or similar programs.

 

§         National Security and Intelligence Activities; Protective Services.  We may disclose Protected Health Information to authorized federal officials who are conducting national security and intelligence activities or as needed to provide protection to the President of the United States, or other important officials.

 

§         As Required By Law.  We will disclose your Protected Health Information when required by law to do so.

III.            YOUR AUTHORIZATION IS REQUIRED FOR OTHER USES OF YOUR PROTECTED HEALTH INFORMATION

HASCA will use and disclose your Protected Health Information other than as described in this Notice or required by law only with your written Authorization.  You may revoke your Authorization to use or disclose Protected Health Information in writing, at any time.  To revoke your Authorization, contact our Director or other Administrative staff.  If you revoke your Authorization, we will no longer use or disclose your Protected Health Information for the purposes covered by the Authorization, except where we have already relied on the Authorization.

§         Marketing/Fundraising.  HASCA is required by law to receive your written authorization before using any of your Protected Health Information or photo for purposes of marketing or fundraising.  Under no circumstances will we sell our client list or your Protected Health Information to a third party without your prior written authorization.  We may contact you for purposes of fundraising however you have the right to opt out of receiving such communication.

§         Psychotherapy Notes.  In most circumstances, HASCA is required by law to obtain your written authorization before we can use or disclose any psychotherapy notes. 

IV.            YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights with respect to your health information.   If you wish to exercise any of these rights, you should make a request to the HASCA Director (Privacy Officer).

§         Right of Access to Protected Health Information.  You have the right to request, either orally or in writing, to inspect and obtain a copy of your Protected Health Information, subject to some limited exceptions.  If available, you have the right to access your information in electronic format. We must allow you to inspect your records within 10 days of your request.  If you request copies of the records, we must provide you with copies within a reasonable time but not more than 30 days if the records are maintained onsite, or 60 days for if reason records are maintained at any location other than the agency office.  We may charge a reasonable fee for our costs of copying and mailing your requested information.

In certain limited circumstances, we may deny your request to inspect or receive copies.  If we deny access to your Protected Health Information, we will provide you with a summary of the information, and you have the right to request review of our denial and how to file a complaint with HASCA or the Secretary of the Department of Health and Human Services.

§         Right to Request Restrictions.  You have the right to request restrictions on the way we use and disclose your Protected Health Information for treatment and services, collection of payment for treatment and services, or for purposes of agency operations.  You have the right to restrict your Protected Health Information that we disclose to a family member, friend or other person who is involved in your care or the payment of your care.

HASCA may not be required to agree to your requested restrictions, and in some cases, the law may not permit us to accept your restrictions.  However, if we do agree to accept your restriction, we will comply with your restriction EXCEPT IF:  you are being transferred to another health care institution, the release of records is required by law, or the release of information is needed to provide you emergency treatment.  If your restriction applies to the disclosure of information to a health plan for payment or health care operations purposes and is not otherwise required by law, and where you paid out of pocket in full for services rendered, we are required to honor that request.

§         Right to Receive Notice of a Breach.  We will notify you by first class mail or by e-mail (if you have indicated a preference), of any breaches of Unsecured Protected Health Information as soon as possible, but in any event, no later than 60 days following the discovery of a breach.  A “Breach” is defined as the unauthorized access, acquisition, use, or disclosure of Protected Health Information which compromises the security or privacy of Protected Health Information, except:  (1) an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information; (2) any unintentional acquisition, access, or use of PHI by an employee or individual acting under the authority of a covered entity or business associate (a) was made in good faith and within the course and scope of the employment or other professional relationship of such employee, or individual, respectively, with the covered entity or business associate; and (b) such information is not further acquired, accessed, or used or disclosed by any person; or (3) any inadvertent disclosure from an individual who is otherwise authorized to access your PHI at HASCA or by a covered entity or business associate to another similarly situated individual, provided that any such information received as a result of disclosure in not further acquired, accessed, used, or disclosed without authorization.  HASCA must notify you of any breach unless our agency can demonstrate, based on a risk assessment, that there is a low probability that the PHI has been compromised. 

“Unsecured Protected Health Information” is information that is not secured through the use of technology or methodology identified by the U.S. Department of Health and Human Services to the render the Protected Health Information unusable, unreadable and undecipherable to unauthorized users.  The notice is required to include the following information:

Ø       A brief description of the breach, including the date of the breach and the date of its discovery, if known;

Ø       A description of the type of Unsecured Protected Health Information involved in the breach;

Ø       Steps you should take to protect yourself from potential harm resulting from the breach;

Ø       A brief description of actions HASCA is taking to investigate the breach, mitigate losses, and protect against further breaches; and

Ø       Contact information, including a toll-free number, e-mail address, website, or postal address which permits you to ask questions or obtain additional information.

In the event the breach involves more than 10 clients whose contact information is out of date, we will post a notice of the breach in a major print or broadcast media.  The agency does not own domain to a website at this time.  If the breach involves more than 500 clients in the state or jurisdiction, we will send notices to prominent media outlets.  If the breach involves more than 500 clients, the agency is required to immediately notify the Secretary of Health and Human Services.  We are also required to submit an annual report to the Secretary of a breach that involved less than 500 clients during the year and will maintain a written log of breaches involving less than 500 clients.  Notification to the Secretary will occur within 60 days of the end of the calendar year in which the breach was discovered. 

§         Right to an Accounting of Disclosures.  You have the right to request an “accounting” of our disclosures of your Protected Health Information.  This is a listing of certain disclosures of your Protected Health Information made by the agency or by others on our behalf, but does not include disclosures made for treatment, payment and health care operations or certain other purposes unless the records are maintained in an Electronic Health Record.  Records maintained in an Electronic Health Record will include disclosures made for home care services, payment, health care operations and other purposes. 

You must submit a request in writing, stating a time period that is within six years from the date of your request. If an Electronic Health Record applies, we will provide you with an accounting of disclosures for a three year period. You are entitled to one free accounting within one 12-month period.  For additional requests, we may charge you our costs.

We will make every effort to respond to your request within 60 days.  Occasionally, we may need additional time to prepare the accounting.  If so, we will notify you of our delay, the reason for such delay and the date accounting statement can be expected.

§         Right to Request Amendment.  If you think that your Protected Health Information is not accurate or complete, you have the right to request that HASCA amend such information for as long as the information is kept in our records.  Your request must be in writing and state the reason for the requested amendment.  We will make every attempt to respond within 60 days, but will notify you within 60 days if we need additional time to respond, the reason for the delay and when you can expect our response.  We may deny your request for amendment, if we do so, we will provide you a written denial including the reasons for denial and an explanation of your right to submit a written statement disagreeing with the denial.

§         Right to a Paper Copy of This Notice.  It is the policy of HASCA to provide you with a paper copy of the notice.

 

§         Right to an Electronic Copy of This NoticeYou have a right to an electronic copy of the notice if you request.  We will forward this notice to you by email in Word document format. 

 

§         Right to Request Confidential Communications.  You have the right to request that we communicate with you concerning personal health matters in a certain manner or at a certain location.  For example, you can request that we speak to you only at a private location in your home.  We will accommodate all reasonable requests.

 

V.            COMPLAINTS

If you believe that your privacy rights have been violated, or you feel you have been discriminated against, you may file a complaint in writing with us or with the Office of Civil Rights in the U.S. Department of Health and Human Services at

1-800-368-1019.   To file a complaint with the agency, contact HASCA Privacy Officer Roberta Konecny at 315-369-6183.  No one will retaliate or take action against you for filing a complaint. 

VI.            CHANGES TO THIS NOTICE

We will promptly revise and distribute this Notice whenever there is a material change to the uses or disclosures, your individual rights, our legal duties, or other privacy practices stated in this Notice.  We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all Protected Health Information already received and maintained by the agency as well as for all Protected Health Information we receive in the future.  We will post a copy of the current Notice in our office.  In addition, we will provide a copy of the revised Notice to all clients/consumers.

VII.            FOR FURTHER INFORMATION

If you have any questions about the contents of this Notice or would like further information concerning your privacy rights, please contact HASCA Privacy Officer, Roberta Konecny at 315- 369-6183.

Effective date of this Notice:  September 23, 2013