Seneca Cayuga ARC Privacy Notice

Summary of Privacy Notice

This notice briefly describes Seneca Cayuga ARC privacy practices and the privacy rights of people we serve. A longer Privacy Notice required by HIPAA is attached.

The HIPAA Privacy rule DOES NOT CHANGE the way you get services from Seneca Cayuga ARC, or the privacy rights you have always had under New York State Mental Hygiene law. The Privacy rule adds some details about how you can exercise your rights.

This notice becomes effective on April 14, 2003. If you have any questions about this notice; please contact your Service Coordinator or the Privacy Officer at (315) 539-5067.

Our Privacy Commitment to You

At Seneca Cayuga ARC, we are committed to protecting your privacy and sharing information about you only with those who need to know and are allowed to see the information, to assure that you get quality services.

Your Clinical Information Rights

You have a right to look at your clinical or health records to get a copy.
If we deny your request to see your clinical or health records, you may ask for a review of that denial.
You may ask Seneca Cayuga ARC to change or amend your clinical or health record if you believe it is incorrect or incomplete.
In certain cases, you may ask for a list of the people who have received clinical or health information about you from Seneca Cayuga ARC.
You may ask Seneca Cayuga ARC not to use or share your clinical or health records in some cases.
You may ask Seneca Cayuga ARC to communicate with you in a way that keeps your information confidential.
You may ask for a paper copy of this notice.

How Seneca Cayuga ARC Will Use and Disclose Clinical/Health Information About You

Treatment:To provide you with treatment services. We may disclose health/clinical information about you to: doctors, nurses, psychologists, social workers, qualified mental retardation professionals (QMRPs), direct care service workers, your service coordinator, other Seneca Cayuga personnel, volunteers or interns who provide you with care, to other providers outside of Seneca Cayuga ARC who provide you with services identified in your Individualized Services Plan, or to other providers to obtain new services for you.
Payment: To bill and collect payment from either: you, a third party, an insurance company, Medicare or Medicaid or other government agencies.
Health Care Operations: For Seneca Cayuga ARC administrative operations such as: for quality improvements to review our treatment and services; to obtain legal services through Seneca Cayuga ARC and NYSARC's Counsel's Office; to conduct fiscal audits; and for fraud abuse and detection.
Other reasons allowed by law. Besides disclosures for treatment, payment and health care operations, Seneca Cayuga ARC may also use clinical or health information about you without your permission when allowed by law. Some examples are: when we are required to do so by federal or state law; for health oversight activities (including audits, investigations, surveys and inspections); for law enforcement purposes; and to prevent or lessen a serious and imminent threat to your health and safety or to someone else's health and safety.

Uses and Disclosures that Require Your Agreement or Authorization

If you have no objections, Seneca Cayuga ARC may disclose clinical/health information about you to family members and friends who are involved in your care, if the information is relevant to their involvement.

Your Authorization Is Required For All Other Uses and Disclosures

For all other types of uses and disclosures, Seneca Cayuga ARC will use or disclose clinical/health information about you only with a written authorization signed by you.

Changes to this Notice

We may change this notice in the future. If we do, we will provide you with a copy and ask you to acknowledge the receipt of the copy.

Complaints

If you believe your privacy rights have been violated you can file a complaint with:

Seneca Cayuga ARC's Privacy Officer, 1083 Waterloo-Geneva Road, Waterloo, New York, 13165 or by calling (315) 539-5067.
The Secretary of the Federal Department of Health and Human Services, 200 Independence Ave. S.W., Washington, D.C. 20210, phone (877) 696-6775.
The Federal Office for Civil Rights, 200 Independence Ave. S.W., Room 509F, HHH Building, Washington, D.C. 20201, phone (866) 627-7748; TTY (886-4989 or by email www.hhs.gov/ocr).