NY A09406

Inmates receive an opportunity to complete a medical authorization form upon arrival at a reception facility and during any transfer-related orientation to disclose private medical and mental health information to designated next of kin or representatives.

Authorization remains in force until the inmate is transferred, dies, or revokes it in writing, and can be revised or revoked upon the inmate's request.

The Department of Corrections commissioner must provide a copy of the executed authorization to the inmate and send the original to the authorized representative at the address provided by the inmate.

A fully executed original authorization form must be maintained in the inmate's personal medical record.

Authorized representatives are granted access to protected health information as governed by HIPAA and New York Public Health Law, with healthcare providers authorized to disclose the inmate's health information to the designated representative.