This notice describes how your health information may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is important to us.
The agency is a Covered Entity as defined and regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The agency is required by law to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices related to your PHI, abide by the terms of the notice that is currently in effect and notify you in the event of a breach of your unsecured PHI. This notice describes how we may use and disclose your PHI. It also describes your rights to access, amend and manage your PHI and how to exercise those rights.
The agency reserves the right to change this notice. We reserve the right to make the revised or changed notice effective for your PHI we already have as well as any of your PHI we receive in the future. The agency will promptly revise and distribute this notice whenever there is a material change to the uses or disclosures, your rights, our legal duties, or other privacy practices stated in the notice. We will make any revised notices available on our website. We will also email or mail you a copy upon request.
Internal Protections of Oral, Written and Electronic PHI: We have privacy and security processes in place to protect PHI. These are some of the ways we protect your PHI.
- We train our staff to follow our privacy and security processes.
- We require our business associates to follow privacy and security processes.
- We keep our offices secure.
- We talk about your PHI only for a business reason with people who need to know.
- We keep your PHI secure when we send it or store it electronically.
- We use technology to keep the wrong people from accessing your PHI.
We May Use and Disclose Your Health Information for the Following Purposes:
- Treatment - We may use or disclose your PHI to a physician or other health care provider providing treatment to you or to coordinate your treatment among providers.
- Payment - We may use and disclose your health information to obtain payment for services we provide to you.
- Health Care Operations - We may use and disclose your health information in connection with our healthcare operations. Healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing, or credentialing activities. We may also disclose PHI to business associates with whom we have written agreements containing terms to protect the privacy of your PHI.
- Group Health Plan Disclosures – We may disclose your PHI to a sponsor of a group health plan, such as an employer or other entity that is providing a health care program to you. We can disclose your PHI to that entity if they have contracted with us to administer your health care program on their behalf.
- As Required by Law - We may disclose your health information when are required to do so by federal, state, and/or local law. If two or more laws or regulations governing the same use or disclosure conflict, we will comply with the more restrictive laws or regulations.
- Victims of Abuse and Neglect - We may disclose your PHI to a local, state, or federal government authority, including social services or a protective services agency authorized by law to receive such reports if we have a reasonable suspicion of abuse, neglect or domestic violence.
- Judicial and Administrative Proceedings - We may disclose your PHI in judicial and administrative proceedings, as well as in response to an order of a court, administrative tribunal, or in response to a subpoena, summons, warrant, discovery request, or similar legal request.
- Law Enforcement - We may disclose your relevant PHI to law enforcement when required to do so, such as in response to a court order, court-ordered warrant, subpoena or summons issued by a judicial officer, or a grand jury subpoena. We may also disclose your relevant PHI for the purpose of identifying or locating a suspect, fugitive, material witness, or missing person, or as needed for a correctional institution to provide care.
- Threats to Health and Safety - We may use or disclose your PHI if we believe, in good faith, that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
- Specialized Government Functions - If you are a member of U.S. Armed Forces, we may disclose your PHI as required by military command authorities. We may also disclose your PHI to authorized federal officials for national security and intelligence activities, the Department of State for medical suitability determinations and for protective services of the President or other authorized persons.
- Workers’ Compensation - We may disclose your PHI to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.
- Emergencies – We may disclose your PHI in an emergency, or if you are incapacitated or not present, to a family member, close friend, authorized disaster relief agency, or any other person previously identified by you. We will use professional judgment and experience to determine if the disclosure is in your best interest. If the disclosure is in your best interest, we will only disclose the PHI that is directly relevant to the person's involvement in your care.
- Research - Under certain circumstances, we may disclose your PHI to researchers when their clinical research study has been approved and where certain safeguards are in place to ensure the privacy and protection of your PHI.
Uses and Disclosures of Your PHI That Require Your Written Authorization:
Any other uses and disclosures not described previously will be made only with your written authorization. You may cancel this authorization at any time in writing. The agency cannot take back any uses or disclosures already made with your authorization.
Authorization is required to use and disclose psychotherapy notes, mental health and/or chemical dependency treatment records. Authorization is also required to use and disclose PHI for marketing purposes.
Individual Rights Concerning Your PHI:
- Right to Request Restrictions - You have the right to request limits to how your information is used or disclosed. You must make the request in writing and tell us what information you want to limit and to whom you want the limits to apply. We are not required to agree to the limit.
- Right to Confidential Communications - You have the right to request that we communicate with you about your PHI by alternative means or to alternative locations if you believe that a disclosure of your PHI could endanger you.
- Right to Access and Receive a Copy of your PHI – In most cases, you have the right to look at or get copies of your records. You must make the request in writing.
- Right to Amend your PHI - You have the right to request that we amend, or change, your PHI if you believe it contains incorrect information. You must make the request in writing, and provide a reason for your request.
- Right to Receive an Accounting of Disclosures - You have the right to receive a list of instances within the last 6-year period in which we or our business associates disclosed your PHI. This does not apply to disclosure for purposes of treatment, payment, health care operations, or disclosures you authorized and certain other activities.
- Right to File a Complaint - If you feel your privacy rights have been violated or that we have violated our own privacy practices, you can file a complaint with us in writing or by phone. You can also submit a written complaint to the U.S. Department of Health and Human Services. We will not take any action against you for filing a complaint.
- Right to Receive a Copy of this Notice - You may request a copy of our Notice at any time and may obtain a copy from our website.