Notice of Privacy Practices at MHA - HIPAA

Under the privacy regulations associated with The Health Insurance Portability and Accountability Act of 1996 (HIPAA), The Mental Health Association of Westchester may use and/or disclose protected health information for the following purposes: (MHA has made every attempt to detail how PHI may be used or how information may be disclosed, although we may not have listed every potential use or disclosure that may occur with in the listed categories.)

Treatment

MHA may use or disclose your protected health information to better serve your treatment/services needs or in attempt to coordinate or manage your health care and any related services. Your treatment includes sharing information among mental health care providers who are involved in your treatment. For example we keep a record of each visit for mental health services. This record may include your test results, diagnoses, medication and your response to medication or other therapies. We disclose this information so that doctors, nurses and other staff members can meet your needs.

Payment

MHA may disclose protected health information about you in order to obtain payment for health care services. For example, we may need to give your health plan information about a service, your diagnosis, your name/address, or type of treatment received in an effort to secure payment from your insurance. We may also need to tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.

For Health Care Operations

We may use and disclose protected health information about you in order to run the office and make sure that you and other individuals involved with MHA receive quality care. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also share PHI with our attorneys, consultants and others in order to ensure that MHA is in compliance with applicable NYS Laws.

We may also share PHI about you in the following special situations:

• To notify or remind you about an upcoming or scheduled appointment for treatment.
• For purposes required by law. For example MHA may be required by law to use or disclose you PHI in response to a court order.
• For public health activities, such as reporting of disease, injury, birth and death and for public health investigations.
• With the proper authorities if we suspect child abuse or neglect or if we believe you to be a victim of abuse, neglect, or domestic violence.
• If authorized by law, your PHI may be given to a government oversight agency (e.g. Office of Mental Health) conducting audits, investigations,or civil or criminal proceedings.
• In response to a subpoena or discovery request to facilitate a judicial or administrative proceeding.
• To the proper authorities for Law Enforcement purposes.
• Upon death we may disclose PHI to coroners, medical examiners, and/or funeral directors consistent with law.
• For organ, tissue or eye donation.
• For research purposes, but only as permitted by law.
• To avoid a serious threat to health or safety.
• If you are a member of the military as required by armed forces services,
• For other specialized government functions such as national security or intelligence activities.
• To workers' compensation agencies and your employer if you are injured at work.
• To communicate with other providers, health plans or their related entities for their treatment or payment activities, or health care operations activities relating to quality assessment or licensing.
• To provide information to contractors, agents and other business associates who need the information in order to assist us with obtaining payment or carrying out business operations, such as medical record transcription services. Another example is that we may share your health information with an insurance company, a law firm or a risk management organization in order to obtain professional advice about how to manage risk and legal liability, including insurance or legal claims. However, you should know that in these situations, we require third parties to provide us with assurances that they will safeguard your information.

Emergencies

MHA may use or disclose your protected health information in an emergency treatment situation. If an emergency occurs and treatment is given, MHA will notify you and attempt to get your authorization as soon as possible. In case of a disaster we may be required to notify the appropriate disaster relief organizations or authorities or family/friends/care givers to keep them aware of your health status, condition or location.

Family/Friends Caregivers/Payment

If people such as family members, relatives, or close personal friends are helping care for you, we may release important health information about you to those people. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. You have the right to object to such disclosure, unless you are unable to function or there is an emergency. In addition, we may release your health information to organizations authorized to handle disaster relief efforts so those who care for you can receive information about your location or health status. We may allow you to agree or disagree orally to such release, unless there is an emergency.

We will, if required by law, release your PHI to the Secretary of the Department of Health and Human Services for enforcement of HIPAA.

In some cases, we are limited by state law from releasing certain categories of health information. For example, we would limit the disclosure of certain AIDS/HIV, mental health, substance abuse treatment and genetic testing information to certain parties without your permission.

Except for the above outlined areas, MHA would request your written Authorization to release protected health information (PHI). At any time during your treatment or care with MHA you may revoke your Authorization, in writing. If you would like to withdraw your Authorization please contact Kelly Darrow who will provide you with the necessary paperwork to complete this withdrawal of authorization. Once completed, all written paperwork requests should be mailed to:

Kelly Darrow, LCSW, Privacy Officer
MHA of Westchester
2269 Saw Mill River Road, Building 1A
Elmsford, NY 10523

Your Rights

You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy

You have the right to inspect and copy your health information, such as medical and billing records, that we use to make decisions about your care. If you request a copy of the information, MHA may charge a fee for the costs of copying, mailing or other associated supplies. We may also deny your request to inspect and/or copy in certain limited circumstances. If you are denied access to your health information, you may ask that the denial be reviewed. Please contact MHA's Privacy Officer, Kelly Darrow, if you have any questions about how to access your records.

Right to Make Changes

If you believe MHA has health information about you that is incorrect or incomplete, you may ask MHA to make changes to correct the information. We ask that you contact MHA's privacy officer in writing and provide as much detail as possible as to what information needs to be changed and why. We may deny your request if you ask us to amend information that MHA did not create, or if MHA believes the information is complete and accurate.

Right to Accounting

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of PHI for certain purposes, which do not include treatment, payment and health care operations. To obtain this list, you must submit your request in writing to MHA's Privacy Officer. Please include time frames, which may not be longer than six years and may not include dates before April 14, 2003. MHA will review all requests individually and will comply with your request within 60 days, unless circumstances require additional time. MHA may charge a nominal fee for this list if a request is made more than one time annually. You will be notified of all charges prior to completion of your request.

Right to Request Restrictions

You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy.

Complaints

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your protected health information or in response to a request you made to amend or restrict the use or disclosure of your protected health information or to have us communicate with you in confidence by alternative means or at an alternative location, you may contact us. If you would like to file a complaint, please contact MHA's Privacy Officer, Kelly Darrow at 914-345-5900 extension 233.

If you feel that your complaint has not been sufficiently resolved, you may also contact:

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
212-264-3039

If you have any questions or concerns about your privacy rights, please contact: