P r i v a c y   P o l i c y

Abilities First, Inc.

70 OVEROCKER ROAD

POUGHKEEPSIE, NEW YORK 12603

TEL:  845-485-9803

FAX: 845-473-1270

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL / CLINICAL INFORMATION ABOUT OUR CONSUMERS MAY BE USED AND DISCLOSED, AND HOW OUR CONSUMERS, THEIR PARENTS, GUARDIANS AND/OR THEIR PERSONAL REPRESENTATIVES, CAN GAIN ACCESS TO THIS INFORMATION. GUARDIANS AND PERSONAL REPRESENTATIVES SHOULD BE AWARE THAT THE WORD "YOU" IN THIS NOTICE REFERS TO THE CONSUMER, NOT TO THE GUARDIAN. PLEASE REVIEW IT CAREFULLY.

WHAT HEALTH INFORMATION IS PROTECTED:

We are committed to protecting the privacy of information we gather about you while providing health-related services. Some examples of protected health information (commonly referred to as PHI) are:

• the fact that you are a participant at, or receiving treatment or health-related services from our agency;
• information about your health condition (such as a disease you may have);
• information about health care products or services you have received or may receive in the future (such as a medication or treatment); or
• information about your health care benefits under an insurance plan (such as whether a prescription is covered);
• when combined with:
• geographic information (such as where you live or work);
• demographic information (such as your race, gender, ethnicity or marital status);
• unique numbers that may identify you (such as your social security number, phone number or drivers license number) and
• other types of information that may identify who you are.

HOW WE MAY USE AND DISCLOSE YOUR PHI WITHOUT AUTHORIZATION:

We may use your health information or share it with others in order to treat your condition, obtain payment for that treatment, and run the agency’s normal business operations.

Treatment: (45 C.F.R. ¤¤164.506(1)&(2)) We may share your health information with doctors, nurses, therapists, aides and other health care professionals at the agency who are involved in providing services to you, and they may in turn use that information to diagnose or treat you, or to develop a plan of services for you.  A health care professional at our agency may share your health information with another health care professional inside our agency, or with a health care professional at another agency, to determine how to diagnose or treat you, to expedite linkage and referral by your case manager/service coordinator, or as necessary to carry out your treatment plan. For example, we may disclose certain information about your health to a prospective employer in connection with a job placement or training program or to a transportation provider.

Payment: We may use your health information or share it with others so that we obtain payment for your health care services. For example, we may share information about you with your health insurance company or other funding source, such as VESID, OMRDD, SSA, and/or your school district in order to obtain reimbursement after we have provided services to you. In some cases, we may share information about you with your health insurance company or funding source to determine whether it will cover your services. We may also need to inform your health insurance company or funding source about your health condition in order to obtain pre-approval for your services, such as care provided at a residential treatment facility. Finally, we may share your health information with other providers and payors for their payment activities.

Business Operations:  We may use your health information or share it with others in order to conduct our normal business operations and to ensure that our clients receive quality care. For example, we may use your health information to evaluate the performance of our staff in caring for you, or to educate our staff on how to improve the care they provide for you, to decide what additional services the agency should offer, what services are not required, and whether certain services are effective. We may also share your health information with another company that performs business services for us, such as billing companies. If so, we will have a written contract to ensure that this company also protects the privacy of your health information. Finally, we may share your health information with other providers and payors for certain of their business operations if that other party also has or had a treatment or payment relationship with you, and in that event, we will only share information that pertains to that relationship.

Appointment Reminders, Treatment Alternatives, Benefits And Services: We may use your health information when we contact you with a reminder that you have an appointment for treatment or services at our facility. We may also use your health information in order to recommend possible treatment alternatives or health-related benefits and services.

Fundraising: We may use demographic information about you, including information about your age and gender, where you live or work, and the dates that you received treatment, in order to contact you to raise money to help us operate. We may also share this information with a charitable 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 Director of Development, Abilities First, Inc., 70 Overocker Road, Poughkeepsie, NY 12603. Contributions to Abilities First is tax-deductible to the fullest extent allowed by law. Donations are generally non-refundable. Please call the Abilities First development office for more details.

Friends And Family: We may share your health information with a family member, relative or close personal friend who is involved in your care or payment for that care or to notify a family member, personal representative, or another person responsible for your care, about your location and general condition at our facility, or in the of your death. In some cases, we may need to share your information with a disaster relief organization that will help us notify these persons.

Incidental Disclosures: While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information. For example, during the course of a program/treatment session, other consumers in the treatment area may see, or overhear discussion of, your health information.

Public Need:  We may use your health information, and share it with others, in order to meet important public needs, in which case we are not required to obtain your written authorization, consent or other type of permission.

As Required By Law: We may use or disclose your health information if we are required by law to do so. We also will notify you of these uses and disclosures if notice is required by law.

Public Health Activities: We may disclose your health information to authorized public health officials so they may carry out their public health activities. For example, we may share your health information with:

• government officials that are responsible for controlling disease, injury or disability.
• to a person who may have been exposed to a communicable disease or be at risk for contracting or spreading the disease if a law permits us to do so.
• to your employer if your employer hires us to provide you with a physical exam and we discover that you have a work-related injury or disease that your employer must know about in order to comply with employment laws.
• to a public health authority that is authorized to receive reports of abuse, neglect or domestic violence. For example, we may report your information to government officials if we reasonably believe that you have been a victim of abuse, neglect or domestic violence.
• to a person or company that is required by the Food and Drug Administration to report reactions to medications or problems with products
• to government agencies authorized to conduct audits, investigations, and inspections of our facility. These government agencies monitor the operation of the health care system, government benefit programs such as Medicare and Medicaid, and compliance with government regulatory programs and civil rights laws.

Lawsuits And Disputes: If you are involved in a lawsuit or a dispute, we may disclose protected health information about you in response to a court or administrative order. We may also disclose protected health information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.

Law Enforcement: We may disclose your health information to law enforcement officials for the following reasons:

• To comply with court orders or laws that we are required to follow;
• To assist law enforcement officers with identifying or locating a suspect, fugitive, witness, or missing person;
• If you have been the victim of a crime and we determine that: (1) we have been unable to obtain your consent because of an emergency or your incapacity; (2) law enforcement officials need this information immediately to carry out their law enforcement duties; and (3) in our professional judgment disclosure to these officers is in your best interest;
• If we suspect that your death resulted from criminal conduct;
• If necessary to report a crime that occurred on our property; or
• If necessary to report a crime discovered during an offsite medical emergency (for example, by emergency medical technicians at the scene of a crime).

To Avert A Serious Threat To Health Or Safety: We may use your health information or share it with others when necessary to prevent a serious threat to your health or safety, or the health or safety of another person or the public. In such cases, we will only share your information with someone able to help prevent the threat.

Inmates And Correctional Institutions: If you are an inmate or you are detained by a law enforcement officer, we may disclose your health information to the prison officers or law enforcement officers if necessary to provide you with health care, or to maintain safety, security and good order at the place where you are confined. This includes sharing information that is necessary to protect the health and safety of other inmates or persons involved in supervising or transporting inmates.

Workers Compensation: We may disclose your health information for workers compensation or similar programs that provide benefits for work-related injuries.

Coroners, Medical Examiners And Funeral Directors: In the unfortunate event of your death, we may disclose your health information to a coroner or medical examiner. This may be necessary, for example, to determine the cause of death. We may also release this information to funeral directors as necessary to carry out their duties.

Organ And Tissue Donation: In the unfortunate event of your death, we may disclose your health information to organizations that procure or store organs, eyes or other tissues so that these organizations may investigate whether donation or transplantation is possible under applicable laws.

Research: In most cases, we will ask for your written authorization before using your health information or sharing it with others in order to conduct research. However, under some circumstances, we may use and disclose your health information without your authorization if we obtain approval through a special process to ensure that research without your authorization poses minimal risk to your privacy. Under no circumstances, however, would we allow researchers to use your name or identity publicly.

YOUR RIGHTS:

Requirements for Written Authorization: In instances that do not involve any of the above, we will generally obtain your written authorization before using your health information or sharing it with others outside the agency. You may also initiate the transfer of your records to another person by completing an authorization form. If you provide us with written authorization, you may revoke that authorization at any time, except to the extent that we have already relied upon it. To revoke an authorization, please write to the Program Director where you receive services.  In the parts of the agency regulated by mental hygiene law, i.e., Office of Mental Retardation and Developmental Disabilities (OMRDD), Office of Mental Health (OMH) and Office of Alcoholism and Substance Abuse Services (OASAS) we may communicate with other MRDD agencies which are currently providing services to you or working with us to plan services for you.

How To Access Your Health Information: You generally have the right to inspect and copy your health information that may be used to make decisions about you and your treatment for as long as we maintain this information in our records. This includes medical and billing records. To inspect or obtain a copy of your health information, please submit your request in writing to the Program Director responsible for the records you are seeking or to the Privacy Officer. If you request a copy of the information, we may charge a fee for the associated costs. Under certain very limited circumstances, we may deny your request to inspect or obtain a copy of your information as allowed in regulations. If we do, we will provide you with a summary of the information instead. We will also provide a written notice that explains our reasons for providing only a summary, and a complete description of your rights to have that decision reviewed and how you can exercise those rights. The notice will also include information on how to file a complaint about these issues with us or with the Secretary of the Department of Health and Human Services

How To Correct Your Health Information. You have the right to request that we amend your health information. To request an amendment, please write to the Program Director responsible for the records you are seeking or to the Privacy Officer. Your request should include the reasons why you think we should make the amendment. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that was not created by us, unless the person or agency that created the information is no longer available to make the amendment, is not part of the health information kept by or for the agency, or is not part of the information which you would be permitted to inspect and copy, or is accurate and complete.

How To Keep Track Of The Ways Your Health Information Has Been Shared With Others: You have the right to receive an accounting list from us which provides information about when and how we have disclosed your health information to outside persons or organizations. Many routine disclosures we make are not included on this accounting list, but it does identify non-routine disclosures of your information. To request this accounting list, please write to our Privacy Officer.  Your request must state a time period within the past six years (but after April 14, 2003) for the disclosures you want us to include. For example, you may request a list of the disclosures that we made between January 1, 2004 and January 1, 2005. The first accounting you request within a twelve month period will be free. For additional accountings, we may charge you for the associated costs. Generally, an accounting list will not include any information about:

• Disclosures we made to you;
• Disclosures we made pursuant to your authorization;
• Disclosures we made for treatment, payment or health care operations;
• Disclosures made to your friends and family involved in your care or payment for your care;
• Disclosures made to federal officials for national security and intelligence activities;
• Disclosures that were incidental to permissible uses and disclosures of your health information;
• Disclosures for purposes of research, public health or our normal business operations of limited portions of your health information that do not directly identify you;
• Disclosures about inmates to correctional institutions or law enforcement officers.

How To Request Additional Privacy Protections: You have the right to request that we further restrict the way we use and disclose your health information to treat your condition, collect payment for that treatment, run our agency’s normal business operations or to limit how we disclose information about you to family or friends involved in your care. For example, you could request that we not disclose information about a surgery you had. To request restrictions, please write to the Program Director responsible for the records you are seeking or to the Privacy Officer. Your request should include what information you want to limit, whether you want to limit how we use the information, how we share it with others, or both; and to whom you want the limits to apply.  We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law.

How To Request More Confidential Communications: You have the right to request that we contact you in a way that is more confidential for you, such as at work instead of at home. We will try to accommodate all reasonable requests. To make your request, please write to our Privacy Officer. Please specify in your request how or where you wish to be contacted, and how payment for your health care will be handled if we communicate with you through this alternative method or location.

How Someone May Act On Your Behalf: You have the right to name a personal representative who may act on your behalf to control the privacy of your health information. Parents and guardians will generally have the right to control the privacy of health information about minors unless the minors are permitted by law to act on their own behalf.

How To Learn About Special Protections For HIV, Alcohol and Substance Abuse, Mental Health And Genetic Information: Special privacy protections apply to HIV-related information, alcohol and substance abuse treatment information, mental health information, and genetic information. Some parts of this general Notice of Privacy Practices may not apply to these types of information. If your treatment involves this information, you will be provided with separate notices explaining how the information will be protected. To request copies of these other notices now, please contact Manager of Waryas House (845) 452-1913 x103, for information on alcohol, substance abuse, and mental health and the Director of Nursing (845) 485-9803 x245, for information on HIV and genetic information.

How To Obtain A Copy Of This Notice: You have the right to a paper copy of this notice at any time, even if you have previously agreed to receive this notice electronically. To do so, please call our Privacy Officer at 845-485-9803. You may also obtain a copy of this notice from our website at Abilitiesfirstny.org, or by requesting a copy at your next visit. We may change our privacy practices from time to time and will post any revised notice in our agency reception area. 

How To File A Complaint. If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer, 70 Overocker Road, Poughkeepsie, NY 12603, 845-485-9803 x 299 or with the Secretary of the Department of Health and Human Services. No one will retaliate or take action against you for filing a complaint.

If you have any questions about this notice or would like further information, please contact our Privacy Officer at 485-9803.

Revised 4/08