Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY:
It is the policy of Cancer Support Team, Inc. (“CST”) to provide professional quality care while at the same time protecting patient privacy. Our use and disclosure of health information about you is essential to your treatment and to the effective operation of the agency. Such operations include administrative, financial, legal and quality improvement activities.
This Notice describes the practices of CST for protecting the privacy of individually identifiable information about you that relates to your physical or mental health condition, health care provided to you or payment for your health care.
Your personal doctor, hospital or other health care provider may have different policies or practices regarding use and disclosure of your health information. This Notice does not address the health information policies or practices of any entity other than CST.
HOW CST MAY USE AND DISCLOSE HEALTH INFORMATION
For Treatment. We may use health information to provide you with medical treatment or services, or to support your obtaining such treatment from others. We may disclose medical information about you to doctors, nurses, technicians, or other individuals who are involved in taking care of you. For example, health information about you may be shared with your primary care physician or oncologist.
For Payment. We may use and disclose health information to assist you in arranging payment for health care services and supplies received from other entities. (All of CST’s services are provided free of charge.) For example, we may disclose health information when we advocate on your behalf with insurance companies or other governmental or private agencies that may or should pay for services you receive from other entities.
For Health Care Operations. We may use and disclose health information for operations of CST. For example, we may use health information for case management or to make certain that patients receive appropriate CST services such as transportation to medical treatment by CST volunteers. Randomly chosen case files are routinely reviewed in their entirety for purposes of quality improvement. We also may use and disclose health information to contact you as a reminder about appointments for services.
Special Situations. We also may use or disclose health information for the following purposes:
Quality-of-Life Assistance. To advocate on your behalf with governmental or private entities to arrange assistance that might improve your quality of life. For example, we may seek financial assistance or medical supplies on your behalf, or may seek any manner of practical measures that may improve your comfort. At least a limited measure of health information is provided to our volunteers who provide transportation to medical treatment.
Alternative Care. To inform you about alternative treatments, therapies, healthcare providers, or settings of care.
Health-related Benefits, Products and Services. To inform you about case management or care coordination, or about a health-related product or services that may be of interest to you.
News and Fundraising. To send to patients and/or their families and associates newsletters, notices of events and fundraising materials.
Research. Under certain circumstances and subject to limitations and conditions imposed by law, for research purposes.
As Required by Law. When required by federal, state or local law. For example, the State Department of Health conducts periodic on-site reviews that include reviews of randomly selected case files, for the purpose of determining compliance with regulations.
To Avert Serious Threat to Health or Safety. As permitted under law, when necessary to prevent a serious threat to your health and safety, or that of another person, or the public.
Organ and Tissue Donation. To appropriate organizations as necessary to facilitate authorized organ or tissue donation and transplantation
Workers’ Compensation. To comply with laws relating to workers’ compensation or similar programs.
Health Oversight and Public Health Activities. To public health authorities for their authorized activities, including, for example, oversight, audits, inspections and licensure. Also, for public health activities, including to prevent or control disease, injury or disability; to report child abuse, neglect or domestic violence; or to notify people of recalls of products they may be using.
Lawsuits and Disputes. To respond to a subpoena, discovery request, summons, or other court or administrative order or other lawful process.
Others Involved in Your Care. Unless you object, to a family member or friend that you have identified as being involved in your health care. Also, to an entity assisting in a disaster relief effort, so that family members may be notified about your condition, status and location.
Coroners, Medical Examiners, and Funeral Directors. To a coroner or medical examiner for purposes of identifying a deceased person, determining the cause of death, or for other duties authorized by law. We also may release health information to funeral directors, as necessary.
Military and Veterans. As required by military command authorities, if you are a member of the United States armed forces.
National Security, Intelligence Activities, and Protective Services. To authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Law Enforcement. To law enforcement officials to provide information to identify or locate a missing person, suspect, fugitive, or material witness; about the victim of a crime under certain limited circumstances; about a death that may be the result of criminal conduct; about internal criminal conduct, or, in emergency circumstances, as necessary to report a crime or certain related information.
OTHER USES AND DISCLOSURES OF HEALTH INFORMATION
For uses and disclosures of health information not covered by this Notice or by law, CST usually will attempt to secure your written authorization. But this may not be done in all cases, and CST makes no guarantee that it will. Moreover, where you revoke any such authorization, such revocation will be effective only on a going-forward basis; we will be unable to take back any disclosures that already will have been made while the authorization was in effect.
BREACH NOTIFICATION
CST is required by law to notify you in the event of a breach of your unsecured protected health information. This notification will include a description of the breach, the types of information involved, steps you should take to protect yourself, and what we are doing to investigate the breach and mitigate harm.
OTHER POLICIES REGARDING HEALTH INFORMATION
Copying Information. With certain exceptions, you may submit a written request that you inspect and copy health information about you, except certain information including psychotherapy notes and information compiled for a civil, criminal or administrative action or proceeding. CST may provide a summary or explanation in lieu of the requested information, and may charge a fee for that or for any copying. Such fee will not exceed ten dollars.
Amending Information. If you believe that health information about you is incorrect or incomplete, you may submit a written request that it be amended. A request for amendment may be denied.
Requesting an Accounting of Disclosures. You may request a list of certain disclosures of your health information made by CST during the six years prior to the date of your request. This accounting will not include disclosures made for treatment, payment, or health care operations, or disclosures authorized by you in writing. To request an accounting, submit a written request to CST. The first request in a 12-month period is free. A fee may apply for additional requests.
Requesting Restrictions. You may submit a written request for restrictions on certain uses and disclosures of health information. You also may request a restriction on disclosures of health information about you to someone who is involved in your care or payment for your care, like a family member or close friend. CST is not required to agree to your request. Moreover, if we do agree, we will make reasonable efforts to respect requested restrictions, but do not guarantee their observance. CST may at any time terminate its agreement to comply with the restriction on a going forward-basis.
Requesting Confidential Communications. You may request that CST communicate with you about your health by alternative means or at alternative locations if you clearly state that disclosure of such information could endanger you. If we do agree, we will make reasonable efforts to respect the request, but do not guarantee its observance. We will not ask you the reason for your request, but only require that your request state that you believe that the information could endanger you if it were not communicated by the alternative means or to the alternative location you request.
Copies of this Notice. You may request a paper copy of this Notice at any time by contacting CST as directed at the end of this Notice.
Complaints. You may complain in writing to us if you believe the privacy of health information about you has been mishandled. Written complaints may be submitted to us as directed at the end of this notice. You also may file a complaint with the Secretary of the Department of Health and Human Services. You will not be retaliated against for complaining to us or to the Secretary of the Department of Health and Human Services or any other governmental authority.
EFFECTIVE DATE AND CHANGES TO THIS NOTICE
This Notice is effective as of the date shown in the header. CST reserves the right to change its privacy practices and this Notice at any time. CST further reserves the right to make the revised or changed practices and Notice effective for health information about you that CST already has about you, as well as to any such informatin we may receive in the future. Any revised Notice will state its effective date. CST will post on its website a copy of the current Notice.
Acknowledgment of Receipt:
You will be asked to acknowledge that you received this Notice. If you choose not to sign, we will still provide services, and your refusal will be documented.
For further information, please contact CST as follows:
Cancer Support Team
2900 Westchester Avenue, Suite 304
Purchase, New York 10577
914-777-2777
If you have concerns that your confidentiality has been breached and your concern has not been addressed by Cancer Support Team, you may contact the NYS Department of Health at 800-628-5972, or the Department of Health’s Office of Health Systems Management at 800-628-5972.
Under HIPAA 45 CFR §164.528, patients have the right to request an “accounting of disclosures” — i.e., a list of when, to whom, and why their PHI was disclosed without their authorization (e.g., for public health, law enforcement, etc.).
This right is separate from their right to access their medical records.