THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION INCLUDING MENTAL HEALTH AND DRUG AND ALCOHOL-RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

East House has adopted the following policies and procedures for protection of the privacy of the people we serve.

Our Obligation to You
We at East House respect your privacy. This is part of our professional standards. We are required by federal and/or state laws to maintain the privacy of "protected health information" about you, to notify you of our legal duties and your legal rights, and to follow the privacy policies described in this notice. "Protected health information" means any information that we create or receive that identifies you and relates to your health or payment for services to you.

Use and Disclosure of Information about You
Use and disclosure for treatment, payment and health care operation.
East House may use and/or disclose protected health information about you for these purposes:

Treatment. In order to provide and coordinate your treatment, East House staff who are involved in your care may use information in your record. We may also need to provide information about you to other health and rehabilitation professionals to arrange for services that will benefit you.

Payment. If East House services for you are being paid by a health insurance plan, including Medicaid, information about you such as your diagnosis and the services we render may need to be included in the bills that we submit to your health insurance plan.

Health Care Operations. In order for East House to operate in accordance with applicable laws and insurance requirements and to provide quality and efficient care, it may be necessary for East House to compile, use and/or disclose your protected health information. For example, our quality assurance staff may review your record to be sure we are delivering appropriate services of high quality.

Our Policy
It is East House policy to obtain specific written permission from you to disclose your protected health information to others for treatment purposes and to another health care organization that has requested information about you for their health care operations. We will not obtain your permission to disclose protected health information to secure payment for services that we provide to you unless this is required by law. For example, if you are a client of our Crossroads Program we will obtain your permission to disclose information if we need to bill an insurance company to pay for services that we provide to you. We will secure your written permission by asking you to sign an Authorization form for disclosure to each person or organization that receives the information. Federal law permits East House to disclose personal health information without your permission in certain circumstances as described here.

Emergencies. If there is an emergency, we will disclose your protected health information as needed to enable people to care for you.

Disclosures to child protection agencies. We will disclose protected health information as needed to comply with state law requiring reports of suspected incidents of child abuse or neglect.

Disclosure to health oversight agencies. We are legally obligated to disclose protected health information to certain government agencies, including the federal Department of Health and Human Services.

Disclosures to a Business Associate. For example, we will disclose protected health information to obtain legal services as long as there is a business associate agreement in place.

Other disclosures without written permission that are normally allowed.

Pursuant to court order;
To public health authorities;
To law enforcement officials in some circumstances;
To correctional institutions regarding inmates;
To federal officials for lawful military or intelligence activities;
To coroners, medical examiners and funeral directors;
To researchers involved in approved research projects; and
As otherwise required by law.

If it applies to you, a federal law pertaining to alcohol and drug client records may place further restriction on what we can disclose without your written permission.

Your Legal Rights
Right to request confidential communications. You may request that communications to you, such as appointment reminders, bills, or explanations of health benefits be made in a confidential manner. We will accommodate any such request, as long as you provide a means for us to process payment transactions.

Right to request restrictions on use and disclosure of your information. You have the right to request restrictions on our use of your protected health information for particular purposes, or our disclosure of that information to certain third parties. We are not obligated to agree to a requested restriction, but we will consider your request.

Right to revoke an Authorization. You may revoke a written Authorization for us to use or disclose your protected health information. The revocation will not affect any previous use or disclosure of your information.

Right to review and copy record. You have the right to see records used to make decisions about you. We will allow you to review your record unless a clinical professional determines that it would create a substantial risk of physical harm to you or someone else. If another person provided information about you to our clinical staff in confidence, that information may be removed from the record before it is shared with you. We will also delete any protected health information about other people.

At your request, we will make a copy of your record for you. We will charge a reasonable fee for this service.

Right to "amend" record. If you believe your record contains an error, you may ask us to amend it. If there is a mistake, a note will be entered in the record to correct the error. If not, you will be told and allowed the opportunity to add a short statement to the record explaining why you believe the record is inaccurate. This information will be included as part of the total record and shared with others if it might affect decisions they make about you.

Right to an accounting. You have the right to an accounting of some disclosures of your protected health information to third parties. This does not include disclosures that you authorize or disclosure that occur in the context of treatment, payment or health care operations. We will provide an accounting of other disclosures made in the preceding six years. If requested by law enforcement authorities that are conducting a criminal investigation, we will suspend accounting of disclosures made to them.

Right to a paper copy of this Notice. You have the right to a paper copy of this Notice of Privacy Practices. 

How to Exercise Your Rights
Questions about our policies and procedures, requests to exercise individual rights, and complaints should be directed to our Contact Person.

Our Contact Person is the Vice President of East House. The Vice President can be reached at 585-256-3800.

Complaints
If you have any complaints or concerns about our privacy policies or practices, please submit a Complaint to our Contact Person. If you wish, the Contact Person will give you a form that you can use to submit a Complaint.

You can also submit a complaint to the United States Department of Health and Human Services. Send your complaint to:

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
Voice Phone (212) 264-3313
FAX (212) 264-3039, TDD (212) 264-2355

We will never retaliate against you for filing a complaint.

Effective Date
These policies and procedures were approved by our Board of Directors on March 28, 2003. They are effective as of April 14, 2003. East House reserves the right to revise the terms of this Notice and will post revisions on our website and at all agency facilities.

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