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.

Our Privacy Commitment to You

AT HARC, "we" understand that information about you and your family is personal. We are committed to protecting your privacy and sharing information only with those who need to know and are allowed to see the information. This notice tells you about the responsibilities we have in regards to your information, your information rights, and how we may use and disclose information about you.

Responsibilities of HARC Required by Law

Maintain the privacy of your information in accordance with federal and state laws.
Provide you this notice of our legal duties and practices concerning the information we have about you.
Follow the rules in this notice.
Tell you if we make changes to this notice in the future and post new notices at the HARC facilities. If there are significant changes we will provide you with a new notice within a reasonable time frame. Effective Date of This Notice: April 14, 2003

Who Will Follow This Notice

All members of the HARC workforce, including employees, volunteers, contractors, and interns from any and all departments of this agency.

What is Protected Health Information?

All information HARC creates or keeps that relates to your health or care, and treatment. This includes your name, address, birth date, social security number, medical or clinical information, individualized service plan, and other information about the services we provide for or to you. The word "information" in this notice refers to your protected health information.

Your Health Information Rights

You have the following rights concerning your information. The word "you" in this notice may also refer to your personal representative. Depending on your circumstances and in accordance with New York State law this may be your guardian, health care proxy, or your involved parent, spouse, or adult child.

You have the right to:

See or inspect and obtain a copy of your information. Some exceptions apply, such as psychotherapy notes, records regarding incident reports and investigations, and information compiled for use in court or administrative procedures.
Request a review of denial if we have denied your request to see your information. Professionals chosen by us who were not involved in denying your request will review the request and decide if you may have access to the information.
Request restrictions on certain uses and disclosures of your information related to treatment, payment, and health care operations and disclosures to involved family. We are not required to agree to the restriction that you requested.
Request communications with you are done in a reasonable way to keep your information confidential.
Request that we change or amend your information that you believe is incorrect or incomplete. We are not required to change your information in some cases, for example, if the information was not created by us or if after reviewing your request we believe the record to be accurate and complete. We will provide you with information about the denial, and how you can disagree with the denial.
Request a list of disclosures HARC has made of your information. We do not have to keep or provide certain disclosures. For example, disclosures made for treatment, payment, health care operations, or disclosures made to you or others with your permission.
A paper copy of this Notice of Privacy Practices. You may request another copy or obtain one from our website at www.herkimerarc.org.

HARC may need you to ask for any of these rights in writing. If you have any questions about our privacy practices or to ask for any of the rights listed above, contact this organization at the address and phone number listed at the bottom of this form.

How HARC May Use or Disclose Your Health Information

HARC collects health information about you and stores it in a paper record and on a computer. These records are the property of, and are protected by, HARC, but the information in these records belongs to you. The law permits HARC to use or disclose your health information without your permission for the following purposes:

Treatment: HARC will use your information to provide you with treatment and services. We may disclose information to doctors, nurses, psychologists, social workers, qualified mental retardation professionals (QMRPs), direct support professionals, and other personnel, volunteers or interns who are involved in providing you services. For example, involved staff may discuss your information to develop and carry out your individualized serve plan (ISP). Other members of the workforce may share your information to coordinate different services you need, such as medical attention, respite, transportation, etc. We may disclose your information to your service coordinator and other providers outside of the HARC who are responsible for providing you with the services identified in your ISP or to obtain new services. We may need to disclose information for volunteer and work opportunities that are identified in your ISP, or to make referrals for services outside the Herkimer Area Resource Center.
Payment: HARC will use your information to bill and collect payment for/from you, a third party, an insurance company, Medicare, Medicaid or other government agency. For example, we may need to provide the New York State Department of Health and Human Services (Medicaid) with information about the services you received in our facilities or through one of our other programs, to obtain payment. In addition, we may disclose your information to receive prior approval for payment for services you may need, or to the Social Security Administration, or the Department of Health to determine your eligibility for coverage or your ability to pay for services.
Health Care Operations: HARC will use or disclose your information for administrative operations. These uses and disclosures are necessary to operate all programs, including residential services, offered by the HARC, and to make sure all consumers receive appropriate, quality services. For example, we may use information for quality improvement to review treatment and services and to evaluate the performance of our workforce in providing you services. We may also disclose information to clinicians, interns, and other personnel for on-the-job training. We will share your health clinical information with other HARC staff, for purposes of obtaining legal services, conducting fiscal audits, and for fraud and abuse detection and compliance. We may use or disclose your information to resolve complaints or objections to your services. We may also disclose information to our business associates who need access to the information to perform administrative or professional services on our behalf.
Information provided to you
Required by Law: As required to do so by federal or state law.
Public Health Reasons: As required by law, including prevention or control of disease, injury or disability; reporting births or deaths, child abuse or neglect, problems with products and reactions to medications, report disease or infection exposure, and to report domestic violence and adult abuse or neglect to government agencies.
Health Oversight Activities: Activities which are necessary for the government to monitor the health care system, government programs, and compliance with civil right laws. This includes audits, investigations, surveys, inspections, licensure and other proceedings.
Judicial and Administrative Proceedings: In the course of any administrative or judicial proceeding, including hearings and disputes, if ordered to do so by the presiding officer or judge.
Law Enforcement: For purposes such as identifying or locating a suspect, fugitive, witness or missing person, in response to a court order or subpoena, in emergency circumstances to report a crime, to provide identifying data in connection with a criminal investigation, and to the district attorney in furtherance of a criminal investigation of client abuse, and other law enforcement purposes.
Deceased Person Information: To coroners or medical examiners for identification purposes and funeral directors in the course of their duties.
Organ Donation: To organ procurement organizations to accomplish cadaver, eye, tissue and organ donations in compliance with state law.
Research: For research purposes that you have agreed to participate in and have been approved by an Institutional Review Board or Privacy Committee to use the health information.
Public Safety: To prevent or lessen a serious and imminent threat to your health or safety or to that of someone else.
Specialized Government Functions: To authorized government officials for military, prisoner, or intelligence and other national securities authorized by law, or to provide protective services to the President and other officials.
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 facility.
Worker’s Compensation: As necessary to comply with worker’s compensation laws.
Marketing: We may contact you to provide or to give you information about other treatment services that may be of interest to you.
Appointment Reminders: We may contact you as a reminder that you have an appointment for treatment or to provide services to you.
Fundraising: We may contact you to participate in fund-raising activities for HARC.
Government Agencies Who Administer Public Benefits: If necessary to coordinate the covered functions of our programs.

Uses and Disclosures That Require Your Agreement or Authorization

HARC may disclose information to the following, if we inform you, and you agree or do not object:

Notice to and contact with family.
Notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
Disaster Relief Organizations: Notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death should a disaster occur.

Uses or Disclosures That Require Authorizations

Except as described in this Notice of Privacy Practices, HARC will not use or disclose your information without written authorization, signed by you or your personal representatvie, that states who may receive the information, what information is to be shared, the purpose for the use and disclosure, and when the authorization will expire.

If you or your personal representative are unable to provide authorization due to an emergency, HARC may disclose your information on your behalf and in your best interest. We are required to tell you or your personal representative as soon as possible.

You or your personal representative may cancel your authorization for uses and disclosures in writing and at any time. If you cancel your authorization in writing we will no longer use or disclose your health information for the reasons stated in your authorization. However, we cannot take back the disclosures we made before you cancelled the authorization, and we must keep information that indicates that we have provided services to you.

Changes to This Notice of Privacy Practices

HARC reserves the right to change this Notice of Privacy Practices at any time in the future, and to make the new notice terms in use for all information that we maintain, including information that was created or received prior to the date of such change. Until such change is made, HARC is required by law to comply with this Notice. We will post the new notice at all HARC sites and offer you a copy of the notice at your next scheduled annual meeting.

Complaints

You will not be punished for filing a complaint and all complaints must be submitted in writing. Complaints about this Notice of Privacy Practices or how HARC handles your protected health information should be directed to:

HARC Director for Corporate Compliance/QA
350 S. Washington Street, Box 271, Herkimer, NY 13350
Telephone: (315) 574-7564

If you are not satisfied with the manner in which this organization handles a complaint, you may submit a formal complaint to the

Region II, Office for Civil Rights, U.S. Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza-Suite 3312, New York, New York, 10278