Our strict standards of confidentiality meet all federal and state regulations and guidelines.
Our programs are licensed by:

The New York State Office of Mental Health
The New York State Office of Alcohol and Substance Abuse

NOTICE OF PRIVACY PRACTICES

PUTNAM FAMILY & COMMUNITY SERVICS, INC.

Putnam Family & Community Services, Inc. (PFCS) is dedicated to helping people enhance their potential, better manage their lives and improve the quality of family and community living. In order to fulfill this mission we must maintain a commitment to ensure that all individuals who are involved in our services are treated with respect and that all information is treated with the utmost confidentiality and privacy. As such this notice is designed to inform you about PFCS’s Privacy Practices. These privacy practices are followed by our employees, staff and all office personnel.

We are required by law to give you this notice. This notice will describe how we may use and disclose information that is called “protected health information” (PHI). PHI is any information oral, recorded, or demographic data that may identify you (i.e. name, address, diagnosis) or that may relate to your past, present or future physical, metal health or condition and related health care services. We will also outline your rights and our obligations regarding the use and disclosure of that information.

If you have any questions / issues in regards to this notice please contact:
PFCS’s Privacy Officer:
Suzzette Giordano
845.225.2700 ext. 108


YOUR RIGHTS:
PFCS needs your consent/permission to use protected health information for the following reasons. This consent must be in writing.

Treatment
We may use protected health information about you to better serve your treatment/services needs. We may disclose this information in an attempt to coordinate or manage your care and any related services. This may include sharing information with other mental health or community providers to better assist you in achieving your personal goals. For example you may ask for some assistance with securing housing, organizing your benefits or perhaps finding a new therapist or psychiatrist. With your permission we would share information in an attempt to assist you with securing the services you need. It is also important for you to be aware that at times your case record may be reviewed as part of an on-going process to ensure that PFCS is providing quality service and care. Specific agency staff are assigned to review records as part of Quality Management and they may have access to your record in an attempt to verify that agency standards are being met and that we are in compliance.

Payment
PFCS may disclose protected health information about you in order to obtain payment for health care services. For example, we may need to give your health plan information about a service, your diagnosis, your name/address, or type of treatment received in an effort to secure payment from your insurance. We may also need to tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.

For Health Care Operations
We may use and disclose health information about you in order to run the office and make sure that you and other individuals involved with PFCS receive quality care. For example, we may use your health information to evaluate the performance of our staff in caring for you. We may also share PHI with our attorneys, consultants and other in order to ensure that PFCS is in compliance with applicable NYS Laws.

PFCS may use PHI in an effort to notify you or remind you about an upcoming or scheduled appointment for treatment. In an effort to provide you with the most comprehensive treatment available we may discuss with you possible treatment options/alternatives or health related products or services that may be of interest to you. We may also use or disclose health information about you in a way that does not personally identify you or reveal who you are. In addition, we may use or disclose PHI about you without your permission in the following special situations.

Serious Threat to Health or Safety
We may use and disclose protected health 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.

Required By Law
We will disclose health information about you when required to do so by federal, or local law.

Workers' Compensation
We may release protected health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Matters
PFCS may be required to report your health information to authorities to help prevent or control disease, injury, or disability. This may require PFCS to report information about births, deaths, or suspected child/elder abuse or neglect.

Health Oversight Activities
We may disclose health information to individuals/agencies for the purpose of audits, investigations, inspections, or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor PFCS and ensure compliance with government and civil rights laws.

Research
Any research conducted at PFCS would first require approval from PFCS’s Board of Directors to ensure that it meets the mission and ethical standards of the agency and is in the best interest of the individuals we serve. Any research that may be conducted at PFCS shall not identify any individual patient in any report of that research or otherwise disclose patient identities.

Military, Veterans,National Security
If you are or were a member of the armed forces, or part of the national security we may be asked by military or government authorities to release protected health information about you.

Law Enforcement /Lawsuits Court Services
We may release protected health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements.

Victims of Abuse, Neglect or Domestic Violence
PFCS may notify the appropriate government authorities if we believe a client has been the victim of abuse, neglect or domestic violence. We will only make such disclosure if you agree or when required or authorized by law.

Death/Organ Donation
We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose your health information to people involved with obtaining, storing or transplanting organs or tissue donations.

Emergencies
PFCS may use or disclose your protected health information in an emergency treatment situation. If an emergency occurs and treatment is given by law your provider will notify you and attempt to get your authorization as soon as possible. In case of a disaster we may be required to notify the appropriate disaster relief organizations or authorities or family/friends/care givers to keep them aware of your health status, condition or location.

Family/Friends Caregivers/Payment
PFCS may disclose important health information about you to your family member, friend, caregiver, partner, relative, legal guardian or foster parent. We would make every attempt to gain your permission prior to disclosing information, but may need to notify any of the above persons responsible for your care in regards to your location, general condition, or death. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. You have the right to object to such disclosure at any point in your care/treatment with PFCS, again unless there is an emergency.

OTHER USES AND DISCLOSURES OF HEALTH INFORMATION
Except for the above outlined areas, PFCS would request your written Authorization to release protected health information (PHI). At any time during your treatment or care with PFCS you may revoke your Authorization, in writing. If you would like to withdraw your Authorization please contact our Privacy Officer who will provide you with the necessary paperwork to complete this withdrawal of authorization. Once completed, all written paperwork requests should be mailed to Louis D’Souza, MBA Privacy Officer at 1808 Route 6, Carmel, NY 10512.

YOUR RIGHTS
You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy
You have the right to inspect and copy your health information, such as medical and billing records, that we use to make decisions about your care. If you request a copy of the information, PFCS may charge a fee for the costs of copying, mailing or other associated supplies. We may also deny your request to inspect and/or copy in certain limited circumstances. If you are denied access to your health information, you may ask that the denial be reviewed. Please contact PFCS’s Privacy Officer, Louis D’Souza, MBA if you have any questions about how to access your records.

Right to Make Changes
If you believe PFCS has health information about you that is incorrect or incomplete, you may ask PFCS to make changes to correct the information. We ask that you contact PFCS’s privacy officer in writing and provide as much detail as possible as to what information needs to be changed and why. We may deny your request if you ask us to amend information that PFCS did not create, or if PFCS believes the information is complete and accurate.

Right to Accounting of Disclosures
You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment and health care operations. To obtain this list, you must submit your request in writing to PFCS’s Privacy Officer. Please include time frames, which may not be longer than six years and may not include dates before April 14, 2003. PFCS will review all requests individually and will comply with your request within 60 days, unless circumstances require additional time. PFCS may charge a nominal fee for this list if a request is made more than one time annually. You will be notified of all charges prior to completion of your request.

Right to Request Restrictions
You have the right to request a restriction or limitation on the protected health 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 health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend.

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.

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 work or by mail.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive it electronically, you are still entitled to a paper copy.

Family/Friends Caregivers/Payment
PFCS may disclose important health information about you to your family member, friend, caregiver, partner, relative, legal guardian or foster parent. We would make every attempt to gain your permission prior to disclosing information, but may need to notify any of the above persons responsible for your care in regards to your location, general condition, or death. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. You have the right to object to such disclosure at any point in your care/treatment with PFCS, again unless there is an emergency.


COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint. If you would like to file a complaint please contact PFCS’s Privacy Officer, Suzzette Giordano at 845.225-2700 ext. 108.


If you have any questions about this notice, please contact
Suzzette Giordano
Privacy Officer
1808 Route 6
Carmel, NY 10512
(845) 225-2700 ext 109
Fax# (845) 225-3207
sgiordano@pfcsinc.org