Diversity Statement

Catholic Charities Community Services Diversity Committee is deeply committed to enhancing and strengthening the independence, inclusion, individuality and diversity of all people.

We promote advocacy and education to foster individual and community empowerment. In conjunction with those we serve, we promote the self worth of all individuals to live with dignity as people of God.

~ Diversity is not about how we differ. Diversity is
about embracing one another's uniqueness. ~

~ Ola Joseph ~

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 April 14, 2003. If you have any questions about this notice, please contact the Quality and Compliance Director at (315) 536-2749.

Our Privacy Commitment to You
At Catholic Charities Community Services (CCCS) 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 to assure quality services for you. This notice tells you we may use or release information about you. It describes your rights and what our responsibilities are concerning information about you. The HIPAA (Health Insurance Portability and Accountability Act) Privacy rule DOES NOT CHANGE the way you get services from Catholic Charities Community Services, or the privacy rights you have always had under New York State Mental Hygiene Law. The Privacy rule adds some details about how you can exercise your rights.

Who will follow this notice:
All people who work for Catholic Charities Community Services 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, and volunteers that we allow to assist you.
What information is protected:
All information we create or keep that relates to your health or care and treatment, including your name, address, birth date, social security number, medical information, individualized services 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, adult child, or health care proxy.

You have a right to see or inspect your health/clinical information and obtain a copy. Some exceptions apply, such as records regarding incident reports and investigations, and information compiled for use in court or administration proceedings. Note: Catholic Charities Community Services may require you to make your requests in writing to Quality and Compliance Director, and in some instances, may charge you for copies.
If we deny your request to see your health/clinical information, you have the right to request a review of that denial. Upon your request, the Executive Director of Catholic Charities Community Services will then appoint a licensed health care professional to review the denial.
You have the right to ask Catholic Charities Community Services 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 us 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 Catholic Charities Community Services has made of your health/clinical information. We will not, however, keep or provide you with a list of certain disclosures, for example, disclosures made for treatment, payment and health care operations, or disclosures made to you or made to others with your permission.
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. Catholic Charities Community Services, however, is not required to agree to your request.
You have the right to request that we communicate 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 Catholic Charities Community Services agency staff to give you another copy or you may obtain one from our website at www.cccsrochester.org and
To request access to your health/clinical information or to request any of the rights listed here, you may contact Catholic Charities Community Services Quality and Compliance Director at (315) 536-2749.
Note: Other regulations may restrict access to HIV/AIDS information and federally protected drug and alcohol information. See any special authorizations or consents forms which will specify what information may be released and when, or contact the quality and Compliance Director listed above.

Catholic Charities Community Services Responsibilities for Your Health Information
We are required by law to:

Maintain the privacy of your information
Give you this notice of our legal duties and practices concerning the health information we have about you
Follow the rules in this notice. Catholic Charities Community Services will use or share information about you only with your permission except for the reasons explained in this notice.
Tell you if we make changes to our privacy practices in the future. If significant changes are made you will be given a new notice and it will be posted on our website at www.cccsrochester.org

How Catholic Charities Community Services Uses and Discloses Health Care Information
Your health information may be used and released by Catholic Charities Community Services for the purposes of providing treatment and service to you, obtaining payment for services, for administrative and operational purposes and to evaluate the quality of the services that you receive. We provide a wide range and variety of services to individuals so for this reason, not all types of uses and disclosures can be described in this document. We have listed some common examples of permitted uses and disclosures below.

Treatment: Catholic Charities Community Services will use your health and clinical information to ensure that you receive appropriate treatment and services. Caregivers, such as doctors, nurses, psychologists, counselors and social workers may use this information to determine your plan of care. Individuals and programs within Catholic Charities Community Services may share health information about you in order to coordinate the services you may need, such as physical examinations, medical testing, medication therapy, hospitalization, counseling, follow-up care, housing and transportation. Involved staff may discuss your health/clinical information to develop and carry out your Service Plan/Education Plan. Additionally, we may also disclose this information to other providers outside of Catholic Charities Community Services who are responsible with providing you with the services identified in your service plan or to obtain new services for you.
Payment: Catholic Charities Community Services 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: Catholic Charities Community Services will use health/clinical information for administrative operations. These uses and disclosures are necessary to operate our programs and to make sure all consumers receive appropriated, 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 will share your health/clinical information with other Catholic Charities Community Services staff, for the purposes of obtaining legal services, conducting fiscal audits, and for fraud and abuse detection and compliance. We will share your health/clinical information with staff to resolve complaints or objections to your services. We will also share your clinical information with our regulatory oversight agencies such as OMRDD, NY State Commission on Quality of Care, Mental Hygiene Legal Services (MHLS), Child Protective Services, State Education Department and Department of Health to report serious incidents, fraud and abuse detection, fiscal audits, and program certification and compliance. We may also disclose health/clinical information to our business associates who need access to the information to perform administrative or professional services on our behalf.

Other Uses and Disclosures that Do Not Require Your Permission
In addition to treatment, payment and health care operations, Catholic Charities Community Services 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 of control of disease, injury or disability, reporting births and deaths, 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 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 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 or 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 the Quality/Compliance Committee of the Board has approved the use of the health/clinical information for the research purposes;
To prevent or lessen a serious imminent threat to your health and safety or someone else's;
To authorized federal officials for intelligence and other national security activities authorized by law or to provide protective services to the President and other officials.
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.
To governmental agencies that administer public benefits if necessary to coordinate the covered functions of the programs.
For marketing, we may use information about where you live to notify you of new services Catholic Charities Community Services provide.

Uses and Disclosures that Require Your Agreement or Authorization
Catholic Charities Community Services 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.
To charitable organizations that provide assistance with fundraising.

Authorization Required for All Other Uses and Disclosures

For all other types of uses and disclosures not described in this Notice, we 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 authorization is always required for marketing purposes such as Agency newsletters and press releases. Note: If you cannot give permission due to an emergency, Catholic Charities Community Services 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 indicate 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 Catholic Charities Community Services maintains. We will post the new notice with the effective date on our website at www.cccsrochester.org and in our facilities. In addition, we will offer you a copy of the revised notice at your next scheduled service-planning meeting.

Complaints
If you believe your privacy rights have been violated:

You may file a complaint at Catholic Charities Community Services with the Quality and Compliance Director at

1 Keuka Business Park, Suite 207
Penn Yan, NY 14527
Or call (315) 536-2749
You may contact the Federal Secretary of the Department of Health and Human Services.

200 Independence Ave. SW
Washington, DC 20201
Or call (877) 696-6775
You may file a grievance with the Federal Office of Civil Rights by calling 866-OCR-PRIV or (866) 627-7748, or (886) 788-4989 (TTY).
http://www.hhs.gov/ocr/regmail.html

All complaints must be submitted in writing. You will not be penalized for filing a complaint.