Notice of Privacy Practices

Section 1The short version

Below is everything on this page in brief. Each point is explained further down.

We may use or share your health information to:

• Treat you and coordinate your care
• Bill for services and work with your health plan
• Run the agency and check the quality of our work
• Comply with the law and respond to regulators
• Report to public health authorities where required
• Respond to court orders and lawful requests
• Work with a medical examiner or funeral director
• Handle workers' compensation and law enforcement requests

You get a say in whether we:

• Whether we tell your family and friends about your condition
• Whether we include you in disaster relief efforts
• Whether we contact you about our other services

You have the right to:

• See and get a copy of your records
• Ask us to correct something that is wrong
• Ask us to limit what we share
• Get a list of who we shared it with
• Ask us to contact you a particular way
• Get a paper copy of this notice
• Name someone to act for you
• Complain without it affecting your care

Section 2This is not our website policy

Two documents are easy to confuse. This one is about health information: the records we keep once someone becomes a client, and what we may do with them. Our Privacy Policy is about the website: what a form collects, which cookies run, what analytics we use.

Where the two overlap, this notice controls, because health information is governed by rules that a website policy cannot change.

Section 3What health information means here

Protected health information is anything about your health that could identify you, in any form we hold it: on paper, on a screen, or spoken between our nurses. It includes your name and contact details when they sit alongside health information, your past, present or future physical or mental condition, the care you receive, and how it is paid for.

We create a record of the care we provide because we need it to do the work and because the law requires us to keep it. This notice applies to all of it.

Section 4How we use and share it

When we use or share your information, we limit it to the minimum needed for the purpose at hand. Below are the situations where the law lets us act without asking you first.

To care for you

We share information with the people involved in your care: your aide, our nurses, your doctor, a hospital discharging you, a therapist working with you at home. For example, the nurse writing your plan of care needs to know what your physician ordered.

To get paid

We share what a payer needs to authorise and pay for your care, whether that is Medicaid, a managed long-term care plan, long-term care insurance, or you.

To run the agency

Scheduling, supervision, checking the quality of our own work, training our aides, responding to a complaint.

Companies that work for us

Some services we do not run ourselves: our electronic records system, billing support, legal and accounting advice. The law calls them business associates, requires them to protect your information exactly as we do, and we hold them to that in writing.

When the law requires or permits it

• Public health: reporting communicable disease, adverse reactions to a medication, births and deaths.
• Suspected abuse, neglect or domestic violence, including of a vulnerable adult.
• Health oversight: audits, inspections and investigations by federal or state agencies.
• Court orders, subpoenas and other lawful process.
• Law enforcement requests that meet the conditions set by law.
• Serious and immediate threats to someone's health or safety.
• Workers' compensation claims.
• Medical examiners, coroners and funeral directors after a death.
• Organ and tissue donation arrangements.
• Specialised government functions, including military and veterans' activities.
• Research, but only where an ethics board has approved it and the privacy risk is minimal.

Section 5Where you get a say

In these situations you tell us what you want, and we follow it. Call (718) 232-2777 and say so, at any time.

• Telling family and friends. Whether we may share your condition or location with a relative, a friend, or anyone else involved in your care.
• Disaster relief. Whether we may share with an organisation helping to locate or notify your family.
• Hearing from us about other services. Whether we may contact you about care we offer that you are not currently receiving.

If you cannot tell us what you want, because you are unconscious or otherwise unable, we may share what we judge to be in your best interest, or what is needed to prevent a serious and immediate threat.

Section 6What needs your written permission

We will not do any of the following without your signature:

• Sell your information. We do not do this at all.
• Use it for marketing that we are paid to send.
• Share psychotherapy notes, where any exist.
• Anything else this notice does not describe.

You can withdraw a permission you gave, in writing, at any time. Withdrawing it stops anything further; it cannot undo what was already shared while it was in force.

Section 7Your rights over your records

1. See your records and get a copy

   On paper or electronically, whichever you prefer, or a summary if that suits you better. Ask in writing. We answer within 30 days; if we cannot, we tell you why and when to expect it. There is no charge for the first request in a year. Beyond 25 pages we may charge a $25 processing fee, and we tell you before we do. If we ever refuse, we say why in writing and explain how to challenge it.

2. Correct something that is wrong

   Tell us what is inaccurate and why. We answer within 60 days, with one possible extension of 30 days that we explain in writing. If we say no, you may write a statement of disagreement, and we keep it with the record.

3. Ask us to limit what we share

   You can ask us not to share certain information for care, payment or operations. We do not have to agree, and we will say no if it would affect your care. But there is one case where we must agree: if you paid for a service in full yourself, we will not tell your health plan about it.

4. Get a list of who we shared it with

   For the six years before your request, excluding sharing for care, payment, operations and a few other categories. One list a year is free; we tell you the cost before preparing another, and you can withdraw the request at that point.

5. Ask us to contact you a particular way

   A different phone number, a different address, or only at certain times. We will not ask why, and we accommodate any reasonable request.

6. Get a paper copy of this notice

   Even if you agreed to receive it electronically. Ask and we will hand or post one to you.

7. Name someone to act for you

   A person with medical power of attorney, or a legal guardian, may exercise these rights on your behalf. We check that they hold that authority before acting.

8. Complain

   To us or to the federal government, described in the next section but one.

Section 8What we owe you

The law requires us to keep your health information private and secure, to give you this notice explaining our legal duties and privacy practices, and to follow what it says. We are also required to tell you promptly if a breach occurs that may have compromised the privacy or security of your information.

We will not use or share your information other than as described here, unless you tell us in writing that we may. Where New York law protects your information more strictly than federal law, we follow New York law.

Section 9If your information is exposed

If a breach affects your unsecured health information, we notify you without unreasonable delay and no later than 60 days after we discover it. Usually that is a letter by first-class post, or email if you have agreed to receive notices that way. Where a company working for us caused the breach, they may send the notice instead. If we do not have current contact details for you, the law allows other ways of reaching you and we use them.

Section 10How to complain

Start with us if you like. Call (718) 232-2777 and ask for the Privacy Officer, or write to us at the address below.

Or go straight to the federal government. You do not need our permission, and you do not need to tell us that you have.

• Online: ocrportal.hhs.gov/ocr/portal/lobby.jsf
• By mail: U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201
• By phone: 1-800-368-1019 · TDD: 1-800-537-7697

We will never retaliate against you for making a complaint. Your care will not change, your hours will not change, and your aide will not change because you complained.

If English is not your first language, we arrange an interpreter at no cost so that you can make a complaint in the language you speak. See our Notice of Availability of Language Assistance.

Section 11Changes to this notice

We may change this notice, and the changes will apply to information we already hold as well as to information we receive later. The current version is always on this page, and a copy is available in our office and on request. The effective date at the top tells you which version you are reading.