THIS NOTICE DESCRIBES HOW INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Commitment to You: We at Genesee County Mental Health Services (GCMHS) understand that the information we collect about you and your health is personal. Keeping your health information confidential and secure is one of our most important responsibilities. We keep a record of the care and services you receive at this facility. We need this record to provide you with quality care and to comply with certain legal requirements. We are committed to protecting your health information and to following all state and federal laws regarding the protection of your health information.
We are required by law to:
make sure that health information that identifies you is kept private
give you this notice of our privacy practices with respect to health information about you
follow the terms of the notice that is currently in effect
How we may use and disclose health information about you: For some activities, we must have your written authorization to use or disclose your health information. However, the law permits GCMHS to use or disclose your health information for the following purposes without your authorization:
For Treatment and Payment for Treatment
For Health Care Operations
For Other Government Agencies Providing Benefits or Services When Required by Law
To Avert a Serious Health or Safety Threat
For Public Health Risks
For Health Oversight Activities
In response to Lawsuits and Disputes
For Law Enforcement, Coroners, Medical Examiners and Funeral Directors
Organ Donation
For National Security and Protection of the President
For the Military
Your Health Information Rights: You have the following rights regarding health information we have about you:
RIGHT to request an opportunity to Inspect and Obtain Copies
RIGHT to request an opportunity to Amend your health information
RIGHT to receive a List of Disclosures we have made RIGHT to request Restrictions in the Disclosure of your health information
RIGHT to request Confidential Communications from us to you
RIGHT to a full and complete Paper Copy of this Notice If you would like to exercise one or more of these rights, ask the Receptionist or your Therapist, or contact the Clinical Director at 585-344-1421.
What is NOT Covered under this Notice
Confidential HIV Related Information: Under New York State Law, confidential HIV- related information (information concerning whether or not you have had an HIV- related test, or have HIV infection, HIV-related illness, or AIDS, or which could indicate that a person has been potentially exposed to HIV), cannot be disclosed except to those people you authorize in writing to have it.
Alcohol or Substance Abuse Treatment Information: If you have received alcohol or substance abuse treatment from an alcohol/substance abuse program that receives funds from the United States government, federal regulations may protect your treatment records from disclosure without your written authorization.
For More Information or to Report a Problem: If you have any questions about this notice or if you believe your privacy rights have been violated, you may request information or file a complaint with any or all of the agencies listed below. There will be no penalty or retaliation for filing a complaint:
Genesee County Mental Health Services
5130 East Main St. Rd. - Suite 2 Batavia, NY 14020
Phone: 585-344-1421
Fax: 585-344-8554
Office for Civil Rights
Phone: 866-OCR-PRIV (866-627-7748) or TDD 877-521-2172 886-788-4989 TTY.
NYS Office of Mental Health Buffalo Field Office
737 Delaware Avenue - Suite 200 Buffalo, NY 14209
Phone: 716-885-4219
Fax: 716-885-4096
Secretary of Health and Human Services
200 Independence Avenue, SW Federal Center for Deaf and Hearing Washington, D.C. 20201
Impaired: 1-800-877-8339
Toll Free Phone: 877-696-6775