Notice of Privacy Practices (HIPAA)

Notice of Privacy Practices (HIPAA) - Short Form

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

Genesee County Mental Health Services (GCMHS) understands that information about you and your health is personal. Protecting the confidentiality and security of your health information is one of our most important responsibilities.

We maintain a record of the care and services you receive so we can provide quality care and comply with applicable legal requirements. We are committed to protecting your health information and following state and federal privacy laws.

We are required by law to:

  • Keep health information that identifies you private.
  • Provide you with this notice describing our privacy practices.
  • Follow the terms of the privacy notice currently in effect.

How We May Use and Disclose Your Health Information

Some uses and disclosures of your health information require your written authorization. However, GCMHS may use or disclose health information without your authorization when permitted or required by law, including for:

  • Treatment and payment for treatment
  • Health care operations
  • Other government agencies providing benefits or services when required by law
  • Preventing or reducing a serious threat to health or safety
  • Public health activities
  • Health oversight activities
  • Lawsuits and disputes
  • Law enforcement purposes
  • Coroners, medical examiners and funeral directors
  • Organ donation
  • National security and protection of the President
  • Military purposes

Your Health Information Rights

You have rights regarding the health information GCMHS maintains about you. These include the right to:

  • Request an opportunity to inspect and obtain copies of your health information.
  • Request an amendment to your health information.
  • Request a list, or accounting, of certain disclosures of your health information.
  • Request restrictions on certain uses or disclosures of your health information.
  • Request confidential communications from GCMHS.
  • Receive a complete paper copy of this Notice of Privacy Practices.

To exercise one or more of these rights, speak with the receptionist or your therapist, or contact the Clinical Director at 585-344-1421.

Information Subject to Additional Privacy Protections

Confidential HIV-Related Information

New York State law provides additional protections for confidential HIV-related information, including information about HIV testing, HIV infection, HIV-related illness, AIDS or possible exposure to HIV. Disclosure of this information is subject to specific legal requirements and may require written authorization.

Alcohol or Substance Use Disorder Treatment Information

Records related to alcohol or substance use disorder treatment may also be protected by additional federal confidentiality requirements. These requirements may limit disclosure without appropriate consent or other legal authorization.

Questions or Privacy Complaints

If you have questions about this notice or believe your privacy rights have been violated, you may request information or file a complaint. 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.

New York State 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
Washington, D.C. 20201

Impaired: 1-800-877-8339
Toll Free Phone: 877-696-6775