5 Pine West Plaza, Suite 508
Albany, NY 12205
518.858.2330
asmadden@live.com


POLICIES ON PROTECTING PRIVACY AND DISCLOSING INFORMATION

 According to HIPAA (the Health Insurance Portability and Accountability Act), I am allowed to disclose information about you without your consent for the following purposes:

  • Medical treatment:  I may give medical information about you to a person who needs to provide you with medical care.
  • Payment:  I may give to insurance companies, or to billing services, only the information required to obtain payment for my services.
  • Legal requirement:  I may disclose medical information about you whenever required by federal, state, or local law.
  • Preventing a threat to health or safety, whether it be your own, another person’s, or that of the general public.  In these cases I am allowed to give information only to persons able to help prevent the threat.
  • Reporting child abuse to a child protective agency.


 The following are other, special situations in which I may disclose information about you:

  •  Public health risks, for example, to prevent or to control disease, to report reactions to medications, or to report problems with consumer products.
  • Workers’ Compensation issues.
  • Oversight activities, for example, audits and inspections of records by public agencies to ensure quality control.
  • Legal proceedings, for example, subpoenas, discovery requests, or other lawful requests.
  • Law enforcement activities, if I am requested to assist in, for example, identifying or locating a suspect or missing person; providing information about a victim of a crime; or reporting a death that may be the result of a crime.
  • Requests from military authorities, if you are a member of the military.
  • Deceased persons: requests from coroners or medical examiners to, for example, identify a deceased person or determine a cause of death; or from funeral directors to assist them in carrying out their duties.


The following are your rights as a client: 

  • Right to inspect and copy:  You have the right to inspect or to copy the information that may be used to make decisions about your care.  Your request should be sent in writing to A. Sydney Madden, LCSW-R, and should describe the information you are interested in.  If you request a copy, I am allowed to charge a reasonable fee for the costs of copying and mailing.
  • Right to amend:  If you feel that information about you is incorrect or incomplete, you may ask to amend it by sending me a request in writing.  In certain cases I am allowed to deny this request, but if so I must let you know in writing how you can have your objection to my denial included in your record.
  • Right to a list of disclosures:  You have the right to request a list of disclosures of information about you that are non-routine, i.e., that are not related to “treatment” or “payment” (as described above), and that were not authorized by you in writing.  To request this list, send a request in writing to A. Sydney Madden, LCSW-R.  Your request must state a time period no longer than six years.  The first list you request within a 12-month period will be free; for additional lists I may charge you for the costs of providing them.
  • Right to request restrictions on disclosures:  You have the right to ask for limits or restrictions on the information I disclose about you.  However, I am not obligated to agree to your request.
  • Right to request confidential communication with you:  You have the right to request that I communicate with you in a certain way or at a certain location, for example, only at work or only by mail.  Send your specific request in writing to A. Sydney Madden, LCSW-R.  I will not ask for the reason for your request.  It would be important for you to say if you believe it will protect you from danger; if you say this I will not ask why you believe that.  I will accommodate any reasonable request.
  • Right to copies of this notice:  You may ask for additional copies of this notice at any time. 


Disclosing information with your written permission:

  • Except as covered in the HIPAA law, summarized above, any disclosure of information about you requires your written permission.  If you do provide me with permission, you may revoke it, in writing, at any time.  I will be unable to take back disclosures that I have already made with your permission, and I will continue to be required to maintain my records of the services I provide to you. 


If you have a complaint or a concern:

  • If you have questions about this notice, disagree with a decision I make about access to your records, or have any other concern about your right to privacy, I would appreciate your telling me in person, by phone, or in writing, whichever way you are most comfortable with.

  
You may also file a complaint with:   Office of Civil Rights

                                                                 U.S. Dept. of Health and Human Services
                                                                 200 Independence Avenue SW, Room 509f
                                                                 Washington DC 20201

 I will not penalize you or retaliate against you for filing a complaint or for telling me your concerns.

 

A. Sydney Madden, LCSW-R

A. Sydney Madden, LCSW-R


HIPAA

A. Sydney Madden, LCSW-R

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