NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW IDENTIFIABLE HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice is effective as of 1/20/2017. If you have any questions about this notice, please contact our Corporate Compliance/Privacy Officer at 585-426-4120, ext. 3099.
Our Privacy Commitment to You.
At Lifetime Assistance, Inc. 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 about you. This notice tells you how Lifetime Assistance, Inc. uses and discloses information about you. It describes your rights and what our responsibilities are concerning information about you.
Who will follow this notice:
All people who work for Lifetime Assistance, Inc. will follow this notice. This includes employees, persons we contract with (contractors) who are authorized to enter information in your clinical record or need to review your record to provide services to you or Lifetime Assistance, and volunteers that we allow to assist you.
What information is protected?
All information we create or keep that relates to your health care and treatment, or the billing or payment for such services, including your name, address, birth date, social security number, your medical information, your individualized service plan, and other information about your care in our programs.
Your Health/Clinical Information Rights.
You have the following rights concerning your health/clinical information. When we use the word “you” in this notice, we also mean your personal representative. Depending on your circumstances and in accordance with state law, this may be your guardian, involved parent, spouse, or adult child, or your advocate.
You have a right to see or inspect your health/clinical information and obtain a copy. Some exceptions apply.
If we deny your request to see your health/clinical information, you have the right to request a review of that denial. A professional chosen by Lifetime Assistance, Inc. who was not involved in denying your request, will review the record and decide if you may have access to the record. You may also have an opportunity for further review at the State level.
You have the right to ask Lifetime Assistance, Inc. to change or amend your health/clinical information that you believe is incorrect or incomplete. We may deny your request in some cases, for example, if the record was not created by Lifetime Assistance, Inc. of if after reviewing your request, we believe the record is accurate and complete.
You have the right to request a list of the disclosures Lifetime Assistance, Inc. has made of your health/clinical information with certain exceptions and depending upon how the information is maintained.
You have the right to request a restriction on uses or disclosures of your health information related to treatment, payment, health care operations and disclosures to involved family. Lifetime Assistance, Inc., however, is not required to agree to your request, except we must agree to your request to restrict the information we provide to your health plan if the disclosure is not required by law and the information relates to health care being paid in full by someone other than the health plan.
You have the right to request that Lifetime Assistance, Inc. communicates with you in a way that will help keep your information confidential.
You have the right to receive a paper copy of this notice. You may ask Lifetime Assistance, Inc. staff to give you another copy. To request access to your health/clinical information or to request any of the rights listed here, you may contact our Corporate Compliance Officer at 585-426-4120, extension 3116.
Lifetime Assistance, Inc.’s Responsibilities for Your Health Information.
Lifetime Assistance, Inc. is required by law to:
- Maintain the privacy of your information.
- Notify you following a breach of unsecured health information.
- Give you this notice regarding our legal duties and practices concerning the health information we have about you.
Follow the rules in this notice. Lifetime Assistance, Inc. will use or share information about you only with your permission except for the reasons explained in this notice. Any new notice will be posted on our website at www.lifetimeassistance.org and in our facilities.
How Lifetime Assistance, Inc. Uses and Discloses Health Care Information.
Lifetime Assistance, Inc. may use and disclose health/clinical information without your permission for the purposes described below. For each of the categories of uses and disclosures, we explain what we mean and offer an example. Not every use of disclosure is described, but all of the ways we will use or disclose information will fall within these categories.
Lifetime Assistance, Inc. will use your health/clinical information to provide you with treatment and services. We may disclose health/clinical information to doctors, nurses, psychologists, social workers, qualified intellectual disability professionals (QIDPs), developmental aides, and other Lifetime Assistance, Inc. personnel, volunteers or interns who are involved in providing you care. For example, involved staff may discuss your health/clinical information to develop and carry out your individualized service plan (ISP). Other Lifetime Assistance, Inc. staff may share your health/clinical information to coordinate different services you need, such as medical tests, respite care, transportation, etc. We may also need to disclose your health/clinical information to your service coordinator and other providers outside of Lifetime Assistance, Inc. who are responsible for providing you with the services identified in your ISP or to obtain new services for you.
Lifetime Assistance, Inc. may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or services at one of our programs.
Lifetime Assistance, Inc. will use your health/clinical information so that we can bill and collect payment from you, a third party, an insurance company, Medicare or Medicaid or other government agencies. For example, we may need to provide the NYS Department of Health (Medicaid) with information about the services you received in our facility or through one of our HCBS waiver programs so they will pay us for the services. In addition, we may disclose your health/clinical information to receive prior approval for payment for services you may need. Also, we may disclose your health/clinical information to the US Social Security Administration, or the Department of Health to determine your eligibility for coverage or your ability to pay for services.
Health Care Operations:
Lifetime Assistance, Inc. will use health/clinical information for administrative operations. These uses and disclosures are necessary to operate our programs and residences and to make sure all consumers receive appropriate, quality care. For example, we may use health/clinical information for quality improvement to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also disclose information to clinicians and other personnel for on-the-job training. We will share your health/clinical information with other Lifetime Assistance, Inc. staff, for the purposes of obtaining legal services through our agency attorney, conducting fiscal audits, and for fraud and abuse detection and compliance. We will also share your health/clinical information with Lifetime Assistance, Inc. staff to resolve complaints and to our business associates who need access to the information to perform administrative or professional services on our behalf.
To support our business operations, we may use certain information about you when deciding whether to contact you or your personal representative to raise money to help us operate. We may also share this information with a charitable foundation that will contact you or your personal representative to raise money on our behalf. You have a right to opt out of receiving such communications by contacting the Privacy Officer.
We may disclose your health information to contractors, agents and other business associates who need the information in order to assist us with obtaining payment or carrying out our business operations. For example, we may share your health information with an accounting firm or law firm that provides professional advice to us about how to improve our health care services and comply with the law. If we do disclose your health information to a business associate, we will have a written contract to ensure that our business associate also protects the privacy of your health information.
Other Uses and Disclosures That Do Not Require Your Permission.
In addition to the above, Lifetime Assistance, Inc. will use your health/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 the 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 health/clinical information if the judge or presiding officer orders us to share the information;
For law enforcement purposes in response to a subpoena, or other legal process, to identify a suspect or witness or missing person, regarding a victim of a crime, a death, criminal conduct at the facility, and in emergency circumstances to report a crime;
Upon your death, to coroners or medical examiners for identification purposes or to determine cause of death, and to funeral directors to allow them to carry out their duties;
To organ procurement organizations to accomplish cadaver, eye, tissue, or organ donations in compliance with state law;
For research purposes, when you have agreed to participate in the research and an Institutional Review Board or Privacy Committee has approved the use of the health/clinical information for the research purposes;
To prevent or lessen a serious and imminent threat to your health and safety or someone else’s;
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; and
To governmental agencies that administer public benefits if necessary to coordinate the covered functions of the programs.
Uses and Disclosures That Require Your Agreement or Authorization.
Lifetime Assistance, Inc. may disclose health/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 locations should a disaster occur.
Authorization Required for All Other Uses and Disclosures.
For all other types of uses and disclosures not described in this Notice, Lifetime Assistance, Inc. will use or disclose health/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 for marketing purposes and involving the sale of protected health information. Note: If you cannot give permission due to an emergency, Lifetime Assistance, Inc. may release health/clinical information in your best interest. We must tell you as soon as 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 health/clinical information for the reasons stated in your authorization. We cannot, however, take back disclosures we made before you revoked and we must retain health/clinical information that indicates the services we have provided to you.
Changes to This Notice.
We reserve the right to change this notice. We reserve the right to make changes to terms described in this notice and to make the new notice terms effective to all health/clinical information that Lifetime Assistance, Inc. maintains. We will post the new notice with the effective date on our website at www.lifetimeassistance.org and in our facilities.
If you believe your privacy rights have been violated:
You may file a complaint with our Corporate Compliance/Privacy Officer at 425 Paul Rd., Rochester N.Y. 14624, 585-426-4120, ext. 3116. Or, you may contact the Office of Civil Rights, US Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza, Suite 3312, New York, New York 10279. Phone number: (800) 368-1019. TDD: (800) 537-7697. Fax: (212) 264-3039.
You may file a grievance with the Office of Civil Rights by calling (866) OCR PRIV or (866) 627-7748 or (886) 788-4989 (TTY).
All complaints must be submitted in writing. You will not be penalized for filing a complaint.