ONTARIO COUNTY SUBSTANCE ABUSE SERVICES

Also known as

TURNINGS

NOTICE OF PRIVACY PRACTICES

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, Ontario County Substance Abuse Services (OCSAS) also known as Turnings may not say to a person outside OCSAS (Turnings) that you attend the program, nor may OCSAS (Turnings) disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by federal law.

OCSAS (Turnings) must obtain your written consent before it can disclose information about you for payment purposes. For example, OCSAS (Turnings) 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 OCSAS (Turnings) can share information for treatment purposes or for health care operations. However, federal law permits OCSAS (Turnings) to disclose information without your written permission:

• Pursuant to an agreement with a business associate;
• For research, audit or evaluations;
• To report a crime committed on OCSAS (Turnings) premises or against OCSAS (Turnings) personnel;
• To medical personnel in a medical emergency;
• To appropriate authorities to report suspected child abuse or neglect
• As allowed by a court order

For example, OCSAS (Turnings) 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 OCSAS (Turnings) can use or disclose any information about your health in a manner which 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.

Your Rights

Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. OCSAS (Turnings) 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. OCSAS (Turnings) 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 OCSAS (Turnings), 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 OCSAS (Turnings) records, and to request and receive an accounting of disclosures of your health related information made by OCSAS (Turnings) during the six years prior to your request. You also have the right to receive a paper copy of this notice.

OCSAS (Turnings) Duties

OCSAS (Turnings) 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 OCSAS (Turnings) is required by law to abide by the terms of this notice. OCSAS (Turnings) reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains. If practices are changed, we will tell you by sending you a new notice, or you may request one at your next visit. Notices will be posted on our website: www.co.ontario.ny.us/ turnings and in our offices at 3019 County Complex Drive Canandaigua, New York 14424 and 83 Seneca Street Geneva, New York 14456

Complaints and Reporting Violations

You may complain to OCSAS (Turnings) by contacting June E. Fisher, Director by phone at 585-396-4190 or mail at Ontario County Substance Abuse Services (Turnings) 3019 County Complex Drive Canandaigua, New York or the Secretary of the United States Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA. A complaint is filed with OCSAS (Turnings) through a written Complaint Form available at Turnings main office in Canandaigua.

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

For further information, contact June E. Fisher, Director by phone at 585-396-4190 or mail at Ontario County Substance Abuse Services (Turnings) 3019 County Complex Drive Canandaigua, New York.

Effective Date: April 14, 2003

Acknowledgment

I hereby acknowledge receiving a copy of this notice.

_____________________ __________________

Client's signature            Date

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