Privacy Practices for Individuals Served by AHRC New York City

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT THE INDIVIDUALS WE SERVE MAY BE USED AND DISCLOSED, AND HOW THE INDIVIDUALS, THEIR GUARDIANS AND/OR THEIR PERSONAL REPRESENTATIVES, CAN GET ACCESS TO THIS INFORMATION.  GUARDIANS AND PERSONAL REPRESENTATIVES SHOULD BE AWARE THAT THE WORD “YOU” IN THIS NOTICE REFERS TO THE INDIVIDUALS WE SERVE, NOT TO THE GUARDIAN.  PLEASE REVIEW IT CAREFULLY.

We are committed to protecting the privacy of you and your family and sharing information about you only with those who need to know and who are permitted by law to receive this information.  We are required by law to protect the privacy of health information that may reveal your identity, and to provide you with a copy of this notice which describes the health information privacy practices of our agency, its staff, and affiliated health care providers that jointly provide treatment, and perform payment activities and business operations, with our agency.  A copy of our current notice will always be posted in our reception area at our administrative offices. You will also be able to obtain a copy by accessing our website at www.ahrcnyc.org, calling our office at 212 780-2500, or asking for one at the time of your next visit.

If you have any questions about this notice or would like further information, please contact our Privacy Officer at 212 780-2500, or write to: Privacy Officer, AHRC New York City, 83 Maiden Lane, New York, N.Y. 10038.

Requirement For Written Authorization. 

We will generally obtain your written authorization before using your health information or sharing it with others outside the agency.  You may also initiate the transfer of your records to another person by completing an authorization form.  If you provide us with written authorization, you may revoke that authorization at any time, except to the extent that we have already relied upon it.  To revoke an authorization, please write to the Privacy Officer.

Exceptions To Authorization Requirement. 

There are some situations when we do not need your written authorization before using your health information or sharing it with others.  They are:

  • Exception For Treatment, Payment, And Agency Operations.  We may use your health information to treat your condition, collect payment for that treatment, and run our agency’s normal business operations.  We also may disclose your health information to another provider or a payor for its payment activities, and for certain of its business operations, if it also has, or had, a treatment or payment relationship with you and the information pertains to that relationship.  (If you are a patient of our Licensed Home Care Services Agency, we will ask for your general consent for these purposes.)
  • Exception In Emergencies Or Public Need.  We may use or disclose your health information in an emergency or for important public needs.  For example, we may share your information with public health officials at the New York State or City health departments who are authorized to investigate and control the spread of diseases.
  • Exception If Information Does Not Identify You.  We may use or disclose your health information if we have removed any information that might reveal who you are.

How To Access Your Health Information.

You generally have the right to inspect and copy your health information.

How To Correct Your Health Information.

You have the right to request that we amend your health information if you believe it is inaccurate or incomplete.

How 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 your health information 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.

How To Request Additional Privacy Protections.

You have the right to request further restrictions on the way we use your health information 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.

How 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 work instead of at home.  We will try to accommodate all reasonable requests.  For more information, please see page 14 of this notice.

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

How to Learn About Special Protections For HIV, Alcohol and Substance Abuse, And Genetic Information.

There are higher standards for privacy protections of HIV-related information, alcohol and substance abuse treatment information, psychotherapy notes, and genetic information.  Therefore, some parts of this general Notice of Privacy Practices may not apply to these types of information. Please contact the AHRC Privacy Officer at 212 780-2500 if you want more information on these special protections.

How 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.  To do so, please call the Privacy Officer at 212 780-2500.  You may also obtain a copy of this notice from our website at www.ahrcnyc.org, or by requesting a copy at your next visit.

How to Obtain a Copy Of Revised Notice.

We may change our privacy practices from time to time.  If we do, we will revise this notice so you will have an accurate summary of our practices.  The revised notice will apply to all of your health information, and we will be required by law to abide by its terms.  We will post any revised notice in our agency administrative office reception area. You will also be able to obtain your own copy of the revised notice by accessing our website at www.ahrcnyc.org, calling our office at 212 780-2500, or asking for one at the time of your next visit. The effective date of the notice will always be noted in the top right corner of the first page.

How to File A Complaint.

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services.  To file a complaint with us, please contact the Privacy Officer at (212) 780-2500.  No one will retaliate or take action against you for filing a complaint. Or, if you wish to make an anonymous complaint, you may call the AHRC New York City privacy hotline at (212) 780- 4485.

We are committed to protecting the privacy of information we gather about you while providing health-related services.  Some examples of protected health information are:

  • the fact that you are a participant at, or receiving treatment or health-related services from, our agency; information about your health condition (such as a disease you may have); information about health care products or services you have received or may receive in the future (such as a medication or treatment); or information about your health care benefits under an insurance plan (such as whether a prescription is covered); especially when combined with: geographic information (such as where you live or work); demographic information (such as your race, gender, ethnicity or marital status); unique numbers that may identify you (such as your social security number, your phone number, or your driver’s license number); and other types of information that may identify who you are.

1.  Treatment, Payment And Agency Business Operations 

The agency and its staff may use your health information or share it with others in order to treat your condition, obtain payment for that treatment, and run the agency’