Privacy Practices


About Us
About Us	Programs & Services	News	Calendar & Events	Special Projects	Email List

NOTICE OF PRIVACY PRACTICES

Effective April 14, 2003

THIS NOTICE DESCRIBES HOW IDENTIFIABLE MEDICAL* INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET 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.

If you have any questions about this notice or would like further information,

please contact the Learning Disabilities Association (LDA) Privacy Officer at

1 (888) 250-5031 (Toll Free), or (716) 679-1601 or at qualityassurance@ldaofwny.org

Our Privacy Commitment to You

At LDA of WNY, 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 to assure quality services for you. This notice tells you how LDA of WNY uses and discloses information about you. It describes your rights and what LDA of WNY responsibilities are concerning information about you.

Who will follow this notice:

All people who work for LDA of WNY in our residences, in all of our other (non-residential) programs, and in our LDA of WNY administrative offices will follow this notice. This includes employees, persons LDA of WNY contracts with (contractors) who are authorized to enter information in your clinical record or need to review your record to provide services to you, and volunteers that LDA of WNY allows to assist you.

What information* is protected:

All information we create or keep that relates to your health or care and treatment. In this Notice, we refer to protected information as "clinical information." Some examples of protected clinical information are:

the fact that you are a participant at, or receiving services from, our agency;

information about your condition;

information about health care products or services you have received or may receive in the future (such as a medication or equipment); 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, or ethnicity);

unique numbers that may identify you (such as your social security number, your phone number, or your Medicaid number); and

other types of information that may identify who you are, including photographs and other images.

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

WHAT RIGHTS DO YOU HAVE

You have the following rights concerning your clinical information. When we use the word "you" in this section of the notice we also mean your personal representative. Depending on your circumstances and in accordance with state law, this may be your guardian, your health care proxy, or your involved parent, spouse, or adult child.

To Access Your Clinical Information: You generally have the right to inspect and copy your clinical information. For more information, please see later in this notice. See (1) under the section below titled "How You Can Exercise Your Rights".

To Correct Your Clinical Information: You have the right to request that we amend your clinical information if you believe it is inaccurate or incomplete. For more information, please see later in this notice. See (2) under the section below titled "How You Can Exercise Your Rights".

To Keep Track Of The Ways Your Health Information Has Been Shared With Others: You have the right to receive a list from us, called an "accounting list," which provides information about when and how we have disclosed clinical information about you to outside persons or organizations. Many routine disclosures we make will not be included on this accounting list, but the accounting list will identify non-routine disclosures of your information. For more information, please see later in this notice. See (3) under the section below titled "How You Can Exercise Your Rights".

To Request Additional Privacy Protections: You have the right to request further restrictions on the way we use clinical information about you or share it with others. We are not required to agree to the restriction you request, but if we do, we will be bound by our agreement. For more information, please see later in this notice. See (4) under the section below titled "How You Can Exercise Your Rights".

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 home instead of at work. We will try to accommodate all reasonable requests. For more information, please see later in this notice. See (5) under the section below titled "How You Can Exercise Your Rights".

To Have Someone 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 clinical information. Parents and guardians will generally have the right to control the privacy of clinical information about minors unless the minors are permitted by law to act on their own behalf.

To Learn About Special Protections For HIV, Alcohol and Substance Abuse, And Genetic Information: Special privacy protections apply to HIV-related information, alcohol and substance abuse treatment information, and genetic information. Some parts of this general Notice of Privacy Practices may not apply to these types of information. If your clinical records include this type of 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 the LDA Privacy Officer at 1-888-250-5031 (Toll Free), or 716-679-1601.

To Obtain A Copy Of This Notice: You have the right to a paper copy of this notice. You may request a paper copy at any time, even if you have previously agreed to receive this notice electronically.

A copy of our current notice will always be posted in our reception area. You will also always be able to obtain a copy by accessing our website, calling our office Toll Free at 1-888-250-5031, 716-874-7200 in Erie County, 716-679-1601 in Chautauqua County, or by asking for one at the time of your next visit.

HOW YOU CAN EXERCISE YOUR RIGHTS

We want you to know that you have the following rights to access and control your clinical information. These rights are important because they will help you make sure that the clinical information we have about you is accurate. They may also help you control the way we use your information and share it with others, or the way we communicate with you about your medical matters.

Right To Inspect And Copy Records

You have the right to inspect and obtain a copy of any of any clinical 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 clinical information, please submit your request in writing to the LDA Privacy Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your request.

We will respond to your request for inspection of records within 10 days. We ordinarily will respond to requests for copies within 30 days if the information is located in our facility, and within 60 days if it is located off-site at another facility. If we need additional time to respond to a request for copies, we will notify you in writing within the time frame above to explain the reason for the delay and when you can expect to have a final answer to your request.

Under certain very limited circumstances, we may deny your request to inspect or obtain a copy of your information. 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. If we have reason to deny only part of your request, we will provide complete access to the remaining parts after excluding the information we cannot let you inspect or copy.

Right To Request Amendment of Records

If you believe that the clinical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept in our records. To request an amendment, please write to the LDA Privacy Officer. Your request should include the reasons why you think we should make the amendment. Ordinarily we will respond to your request within 60 days. If we need additional time to respond, we will notify you in writing within 60 days to explain the reason for the delay and when you can expect to have a final answer to your request.

If we deny part or all of your request, we will provide a written notice that explains our reasons for doing so. You will have the right to have certain information related to your requested amendment included in your records. For example, if you disagree with our decision, you will have an opportunity to submit a statement explaining your disagreement which we will include in your records. We will also include information on how to file a complaint with us or with the Secretary of the Department of Health and Human Services. These procedures will be explained in more detail in any written denial notice we send you.

Right To An Accounting Of Disclosures

After April 14, 2003, you have a right to request an "accounting of disclosures" which is a list that contains certain information about how we have shared your information with others. An accounting list, however, 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 in the facility directory;

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 clinical information;

Disclosures for purposes of research, public health or our normal business operations of limited portions of your clinical information that do not directly identify you;

Disclosures about inmates to correctional institutions or law enforcement officers;

Disclosures made before April 14, 2003.

To request this accounting list, please write to the LDA 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. You have a right to receive one accounting list within every 12 month period for free. However, we may charge you for the cost of providing any additional accounting list in that same 12 month period. We will always notify you of any cost involved so that you may choose to withdraw or modify your request before any costs are incurred.

Ordinarily we will respond to your request for an accounting list within 60 days. If we need additional time to prepare the accounting list you have requested, we will notify you in writing about the reason for the delay and the date when you can expect to receive the accounting list. In rare cases, we may have to delay providing you with the accounting list without notifying you because a law enforcement official or government agency has asked us to do so.

Right To Request Additional Privacy Protections

You have the right to request that we further restrict the way we use and disclose your clinical information to treat your condition, collect payment for that treatment, or run our agency’s normal business operations. You may also request that we 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 LDA Privacy Officer. Your request should include (1) what information you want to limit; (2) whether you want to limit how we use the information, how we share it with others, or both; and (3) 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. However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law. Once we have agreed to a restriction, you have the right to revoke the restriction at any time. Under some circumstances, we will also have the right to revoke the restriction as long as we notify you before doing so; in other cases, we will need your permission before we can revoke the restriction.

Right To Request Confidential Communications

You have the right to request that we communicate with you about your medical matters in a more confidential way by requesting that we communicated with you by alternative means or at alternative locations. For example, you may ask that we contact you by fax instead of by mail, or at work instead of at home. To request more confidential communications, please write to the LDA Privacy Officer. We will not ask you the reason for your request, and we will try to accommodate all reasonable requests. 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.

*To request access to your clinical information or to request any of the rights listed here, you may contact LDA Privacy Officer at 1-888-250-5031 or 716-672-1601.

LDA of WNY's Responsibilities For Your Clinical Information

LDA of WNY is required to:

Maintain the privacy of your information in accordance with federal and state laws.

Provide you with a copy of this notice of our legal duties and practices concerning the clinical information we have about you.

Follow the rules in this notice. LDA of WNY will use or share information about you only with your permission except for the reasons explained in this notice.

Tell you if we make changes to our privacy practices in the future. If significant changes are made, LDA of WNY will give you a new notice and post a new notice on our website and at all of our sites. The effective date of the notice will always be noted in the top of the first page.

How LDA of WNY Uses and Discloses Clinical Information

LDA of WNY will not disclose clinical information about you without your consent or written authorization, except for the following purposes:

When we are communicating with other mr/dd and/or health care agencies which are currently providing services to you, or working with us to plan for services for you, if this communication is about treatment, payment, or agency operations.

"treatment" means that we may share clinical information about you inside our agency, or with another agency, to plan for and provide services for you. If you agree, we may also share information about you with others outside the mr/dd or health care service system when necessary to provide other services; for example, we may disclose certain information about you to a prospective employer in connection with a job placement or training program.
"payment" means that we may use clinical information about you, or share it with others, so that we obtain payment for your services"operations" means that we may use clinical information about you, or share it with others, in order to conduct our normal business operations. For example, we may use clinical information about you to evaluate the performance of our staff in providing services to you, or to educate our staff on how to improve the care they provide for you.

Other Uses and Disclosures that Do Not Require your Permission

In addition to treatment, payment and health care operations, LDA of WNY will use your clinical information without your permission for the following reasons:

When we are required to do so by federal or state law;

For public health reasons, including prevention and control of disease, injury or disability, reporting births and deaths, reporting child abuse or neglect, reporting reactions to medication or problems with products, and to notify people who may have been exposed to a disease or are at risk of spreading the disease;

To report domestic violence and adult abuse or neglect to government authorities if you agree or if necessary to prevent serious harm;

For health oversight activities, including audits, investigations, surveys and inspections, and licensure. These activities are necessary for government to monitor the health care system, government programs, and compliance with civil rights laws. Health oversight activities do not include investigations that are not related to the receipt of health care or receipt of government benefits in which you are the subject ;

For judicial and administrative proceedings, including hearings and disputes. If you are involved in a court or administrative proceeding we will disclose clinical information if the judge or presiding officer orders us to share the information;

For law enforcement purposes, in response to a court order or subpoena, to report a possible crime, to identify a suspect or witness or missing person, to provide identifying data in connection with a criminal investigation, and to the district attorney in furtherance of a criminal investigation of client abuse;

To prevent or lessen a serious and imminent threat to your health and safety or someone else’s;

To authorized federal officials for intelligence and other national security activities authorized by law or to provide protective services to the President and other officials;

To 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 institution;

To governmental agencies that administer public benefits if necessary to coordinate the covered functions of the programs;

In the event of your death, we may release this information to coroners and medical examiners for identification purposes or to determine cause of death, and to funeral directors as necessary to carry out their duties;

In the 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 appropriate and possible under applicable laws. Your organs and/or tissue would not be used for transplant without written consent by a legally authorized person.

Uses and Disclosures that Require Your Agreement

LDA of WNY may disclose clinical information to the following persons if we tell you we are going to use or disclose it and you agree or do not object:

To family members and personal representatives who are involved in your care if the information is relevant to their involvement and to notify them of your condition and location; or

To disaster relief organizations that need to notify your family about your condition and location should a disaster occur.

Special Situations

Fundraising: We may use demographic information about you (such as your age, gender, where you live or work, and the dates that you received services) 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 the LDA Privacy Officer, 1 Park Place, Suite 248, Fredonia, NY 14063.

Research: In most cases, we will ask for your written authorization before using clinical information about you or sharing it with others in order to conduct research. However, under some circumstances, we may use and disclose your clinical 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.

if we do not allow we allow researchers to use your name or identity publicly.

to people who are preparing a future research project, so long as any information identifying you does not leave our facility. In the unfortunate event of your death, we may share your clinical information with people who are conducting research using the information of deceased persons, as long as they agree not to remove from our facility any information that identifies you.

Authorization Required For All Other Uses and Disclosures

For all other types of uses and disclosures not described in this Notice, LDA of WNY will use or disclose clinical information only with a written authorization signed by you that states who may receive the information, what information is to be shared, the purpose of the use or disclosure and an expiration for the authorization. Written authorizations are always required for use and disclosure of psychotherapy notes and for marketing purposes.

Note: If you cannot give permission due to an emergency, LDA of WNY may release clinical information in your best interest. We must tell you as soon possible after releasing the information.

You may revoke your authorization at any time. If you revoke your authorization in writing we will no longer use or disclose your clinical information for the reasons stated in your authorization. We cannot, however, take back disclosures we made before you revoked and we must retain clinical information that indicates the services we have provided to you.

COMPLAINTS

If you believe your privacy rights have been violated, it is your right to file a complaint.

You may file a complaint with the LDA Privacy Officer at 1 Park Place, Suite 248, Fredonia, NY 14063, 1-888-250-5031 or 716-874-7200. Or, you may contact the Secretary of the Department of Health and Human Services. You may call them at (202) 619-0403 or write to them at 200 Independence Ave. S. W., HHH Building Room 509F, Washington DC, 20201.

You may file a grievance with the Office of Civil Rights by calling 866-OCR-PRIV or (866) 627-7748; or (TTY) (886) 788-4989; or by e-mail OCRComplaint@.hhs.gov
You can also open and print out, or download a Health Information Privacy Complaint Form by visiting http://hhs.gov/ocr/privacyhowtofile.htm

All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Home | Programs & Services | Calendar & Events | Special Projects | Contact Us

© 2007 Learning Disabilites Association of Western New York. All rights reserved.