Employee Health Service Notice of Privacy Practices

This notice describes now medical information about you may be used and disclosed and how you can get access to this information.

Who Will Follow This Notice?

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

• Any health care professional authorized by EHS to enter information into your medical and/or nursing record.
• All EHS employees, staff and other medical personnel.
• All divisions and personnel of the Department.
• All medical service vendors who perform functions under contract for the Department.

If you have any questions about this Privacy Notice, please contact the EHS 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:

• Make sure that medical information that identifies you is kept private;
• Give you this notice of our legal duties and privacy practice with respect to medical information about you;
• Follow the terms of the notice that is currently in effect;
• Maintain the privacy of your medical information. If any of your medical information is ever released without your permission, we will notify you and advise you of the risks.

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.

• For Treatment. EHS may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, medical test assistants, paramedics, or other emergency medical personnel who are involved in taking care of you at your work site or at an EHS clinic location. For example, if you are diabetic, become ill while at work, and require transport to a hospital for treatment, the EHS nurse would tell the paramedics that you have diabetes so that this information could be passed along to the emergency room staff. We may also tell your designated contact person if you require transfer to a hospital.
• For Payment. We may use and disclose medical information about you so that the services you receive at EHS may be billed to and payment may be collected from the New York State department or agency where you are employed. For example, we may need to give the NYS agency where you are employed a listing of the services that you received from EHS so that your agency will pay us.
• For EHS Operations. We may use and disclose medical information about you for EHS operations. These uses and disclosures are necessary to run the Department and/or EHS. For example, when we schedule an appointment for you at one of our medical services contractors, we will provide them with information about you.
• Appointment Scheduling. We may use and disclose medical information to contact you concerning an appointment for services or in response to questions you may have asked regarding a specific program.
• Individuals Requesting Services for You or Involved in Payment for Your Services. We may release medical information about you to the individual in the Personnel Office at the New York State department or agency where you are employed. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
• Research. Under certain circumstances, we may use and disclose medical information about you for research purposes. Before we use or disclose medical information for research, the project will have been approved through a stringent approval process. We will ask for your specific permission if the researcher will be collecting your name, address, or other information that reveals who you are.
• As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
• To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
• Military and Veterans. If you are a member of the armed forces or reserves, we may release medical information about you as required by military command authorities.
• Workers' Compensation. We may release medical information about you for workers' compensation or similar programs.
• Public Health Risks. We may provide medical information about you to prevent or control disease, injury or disability, such as to report reactions to medications.
• Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure.
• Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
• Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
• In response to a court order, subpoena, warrant, summons or similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;
• About a death we believe may be the result of criminal conduct;
• About criminal conduct at the Department or associated with EHS; and
• In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
• National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
• Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Your Rights Regarding Medical Information About You:

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

• Right to Inspect and Copy. You have the right to inspect and copy medical information we maintain about you. For instructions on how to inspect and/or obtain a copy of your personal medical information, refer to the EHS web page at www.cs.ny.gov/ehs/, ask the EHS Nurse in your building, or call the EHS Medical Records Clerk at (518) 233-3100. All requests must be in writing. If you request a copy of the information, we may charge a fee for the costs of retrieving, copying, and mailing your records. We may deny your request to inspect and/or obtain a copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. The Department will assign a person to review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
• Right to an Accounting of Disclosures. You have the right to request a list of the disclosures we made of medical information about you. To request this list, you must submit your request in writing to the EHS Medical Records Clerk. You may ask for information about any disclosures made back six years from the date of your letter, but not before April 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list.
• Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for EHS. For instructions on how to request an amendment, ask the EHS Nurse in your building or call the EHS Medical Records Clerk at (518) 233-3100. All requests to amend or correct information in your health records must be made in writing. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
• Was not created by us;
• Is not part of the medical information kept by EHS;
• Is not part of the information which you would be permitted to inspect and copy; or
• Is accurate and complete.
• Right to Request Restriction. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who requested services for you or who is involved in the payment for your services, such as a friend, family member or a person at the NYS department or agency where you are employed. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
  
  For instructions on how to request restrictions, ask the EHS Nurse in your building or call the EHS Medical Records Clerk at (518) 233-3100. All requests to restrict or limit disclosure of your personal health information must be made in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
• Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at home or by mail. To request confidential communications, you must make your request in writing to the EHS Nurse in your building or EHS Medical Records Clerk. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
• Right to a Paper Copy of This Notice. You have the right to receive a copy of this notice upon request by calling the EHS Administrator at (518) 233-3100.

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 or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the Department, 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.