Employee Health Service

Effective Date: 8/28/13

EMPLOYEE HEALTH SERVICE

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

Who Will Follow This Notice:

This notice describes the Department of Civil Service's (DCS) Employee Health Service (EHS) practices and that of:

If you have any questions about this Notice, please contact the Employee Health Service Administrator at (518) 233-3100. All correspondence directed to EHS should be sent to the following address:

Employee Health Service
New York State Department of Civil Service
55 Mohawk Street - Suite 201
Cohoes, NY 12047

Our Pledge Regarding Medical Information:

EHS understands that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the services you receive at all EHS nursing stations and medical clinics. We need this record to provide you with quality services and to comply with certain legal requirements. This notice applies to all of the records of your medical status and services maintained by EHS, whether generated by EHS personnel, by staff where you were work who referred you to EHS, or by your personal doctor.

This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

How We May Use and Disclose Medical Information About You:

The following categories describe different ways that EHS uses and discloses medical information. For each category of uses and disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Your Rights Regarding Medical Information About You:

You have the following rights regarding medical information we maintain about you:

Other Uses Of Medical Information

Other uses and disclosure of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.

Access Limitation

Copyrighted psychological testing documents, including testing booklets and questions, test-scoring keys, and interpretive reports, that if released would result in disclosure of trade secrets or undermine the integrity and validity of test results, will not be released to you or your representative. These documents will only be released to a licensed psychologist able to interpret the information.

Changes To This Notice

EHS reserves the right to change this Notice and make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in the waiting area of the EHS Medical Clinic and all EHS nursing stations. In addition, when you register at or request services at an EHS location, we will offer you a copy of the current notice in effect.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Department of Civil Service or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the Department of Civil Service, contact the Department's HIPAA Privacy Officer's office at (518) 473-1841 to request a form. All complaints must be submitted in writing and should be filed within 180 days of when you learned of the problem.

You will not be penalized for filing a complaint.