Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL/EDUCATIONAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY. 

Steuben County Department of Special Children's Services' Early Intervention Program, Preschool Special Education Program, and Physically Handicapped Children's Program/Child with Special Health Care Needs Program records are property of the Department of Special Children's Services and shall be maintained and safeguarded against unauthorized access including, but not limited to: electronically stored, written, oral, original and copied information.  Steuben County Department of Special Children's Services is required by law to maintain the privacy of medical and/or educational information and to give notice of legal duties and privacy practices with respect to medical and/or educational information about your child. This notice may be revised at any time.  Any revisions will be effective for past, present or future medical information we have about your child.  The Department of Special Children's Services will follow the terms of the most current notice.  You will be able to request a copy at any time.   In addition, each time services are authorized or amended, you will receive a copy of the notice with your copy of the authorization. 

ALL EMPLOYED AND CONTRACT STAFF WILL FOLLOW THIS NOTICE

Uses and Disclosures of Health Information:
For Treatment/Services: To a doctor, dentist, orthodontist, therapist, and/or teacher providing program related services, and; for referrals, appointment reminders, and; coordination with individuals, agencies, and programs that may be involved in your child's care such as a designated friend or family member, labs, pharmacy, medical equipment provider, or hospital.  Some services provided in our Department are through contracts with Business Associates such as physical therapists or speech therapist.  To perform the services in the contract, medical/educational information may be disclosed to a Business Associate.  To protect your right to privacy, the Business Associates are required to appropriately safeguard your information in the same manner as the Department.
For Payment/Reimbursement: To the insurance company. Copies of notes related to treatment and services your child receives may be required to accompany the bill. 
For Health Care Operations: To run the Department and to assess your child's care such as reviewing our authorization for treatment and services and to evaluate the performance of staff and/or contracted providers working on your child's case

Special Situations – Protected Health Information may be released without your consent or authorization:
 As Required by Law and to avert serious threat to health and safety: In response to a court order, to identify or locate a suspect, fugitive material witness, or missing person; In emergency circumstances to report details of a crime, suspected crime, or about the victim of a crime if under certain limited circumstances, we are unable to obtain the person’s agreement; National Security, intelligence activities, and protective services of the President.
Public Health Risks - To prevent or control disease, injury or disability; to report child abuse or neglect or domestic violence when required or authorized by law; 
Oversight Activities – including audits, investigations, inspections, and licensure activities as required by State or Federal Mandate. 

(Exceptions to release without consent - We will follow the provisions of 42 CFR Part 2, which severely restricts the release of protected health information if the records are from substance abuse treatment.  There are also special rules about releasing HIV/AIDS/STD services.  The Department must make special efforts to protect the names of people who receive these services). 

Other Uses of Medical/Educational Information not covered by this notice or applicable law will be made only with your written permission.  Permission may be revoked by you in writing, at any time.  Please understand that we are unable to take back any disclosures we have already made with your permission. 

You have the right to:

  • Request a restriction on the medical/educational information we use or disclose about your child. We are not required to agree to your request.   A request for restrictions must be made in writing to the Privacy Official/designee and must specify the information to be restricted, if restriction is for use and/or disclosure, and who the restriction applies to. 
  • Request Confidential Communications-You have the right to request that we communicate with you about your child's medical/educational matters in a certain way or at a certain location.  Written request must be submitted to the Privacy Official/designee.  We will not ask you the reason for your request.  We will accommodate all requests.  Your request must specify how or where you wish to be contacted. 
  • Inspect and copy medical/educational information that may be used to make decisions about your child's care.  Request must be in writing to the attention of the Privacy Official.  A fee of 75 cents per page may be charged for the cost of copying, mailing or other supplies associated with your request.  We may deny your request to inspect and copy in certain limited circumstances.  A denial will be issued in writing with instructions on how to request a review of the denial. 
  • Request an amendment if you feel that medical/educational information we have about your child is incorrect or incomplete.  You have the right to request an amendment for as long as the information is kept by or for the Department.  The written request must be submitted to Privacy Official/designee with a reason that supports your request.  Your request for an amendment may be denied.  You will receive the denial in writing with an explanation and instructions on how to appeal the denial decision. 
  • Receive an accounting of disclosures for reasons other than treatment, payment or health care operations.  Requests must be in writing to the Privacy Official and state a time period, which may not be longer than six years or include dates prior to April 14, 2003.  The list will be a paper copy and the first list you request within a 12 month period will be free.  Additional lists may incur a cost. You will be notified of the amount involved to give you the opportunity to withdraw or modify your request before any costs are incurred. 
  • Receive a paper copy of this notice no later than the date of the first service delivery, upon request and a new copy whenever it is updated. 

Complaints:
 If you believe that your privacy rights have been violated, you have the right to complain without fear of reprisal or retaliation.  Complaints can be made to the Complaint Officer.   Written complaints can also be made directly to the Office of Civil Rights.  The Complaints Officer will provide you with the appropriate address upon request. 
 
 

Effective Date: April 14, 2003 
Complaint Officer - Diane Kiff – phone: (607) 664-2148 

Address:
Department of Special Children's Services
3 East Pulteney Square
Bath, New York 14810 

 
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