Notice of Privacy Practices

1. How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose your Protected Health Information without your written authorization:

Treatment

We may use your PHI to provide, coordinate, or manage your healthcare and related services. This includes sharing information with other healthcare providers involved in your care, such as physicians, therapists, pharmacists, and other treatment professionals. For example, your treating physician may share information about your condition with your therapist to coordinate your treatment plan.

Payment

We may use and disclose your PHI to bill and collect payment for the treatment and services we provide. For example, we may contact your insurance company to verify coverage, submit claims, or obtain prior authorization for treatment services.

Healthcare Operations

We may use and disclose your PHI for our healthcare operations, which include quality assessment and improvement activities, reviewing the competence of our staff, conducting training programs, accreditation activities, and other business operations necessary to run our facility.

Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your authorization in the following situations:

• As Required by Law: We will disclose your PHI when required to do so by federal, state, or local law
• Public Health Activities: To public health authorities for purposes of preventing or controlling disease, injury, or disability
• Abuse or Neglect: To appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence
• Health Oversight Activities: To health oversight agencies for activities authorized by law, such as audits, investigations, and inspections
• Judicial and Administrative Proceedings: In response to a court order or administrative tribunal, or in response to a subpoena or discovery request
• Law Enforcement: For certain law enforcement purposes, including reporting certain types of wounds, or in response to a court order or warrant
• To Avert a Serious Threat: To prevent or lessen a serious and imminent threat to the health or safety of a person or the public
• Coroners, Medical Examiners, and Funeral Directors: To coroners, medical examiners, and funeral directors as necessary for them to carry out their duties
• Workers' Compensation: As authorized by and to the extent necessary to comply with workers' compensation laws

2. Special Protections for Substance Use Disorder Records

As a substance use disorder treatment program, your records are subject to additional federal protections under 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records). These regulations provide stricter protections than HIPAA in many circumstances:

• We generally cannot disclose that you are or were a patient at our facility, or any information that would identify you as having a substance use disorder, without your specific written consent
• Your consent must meet specific requirements under 42 CFR Part 2, including naming the recipient, the purpose of the disclosure, and an expiration date
• Limited exceptions exist for medical emergencies, qualified audits and evaluations, court orders meeting specific legal criteria, and communications within our program
• Information disclosed with your consent may be accompanied by a prohibition on re-disclosure by the recipient
• Violations of 42 CFR Part 2 are subject to criminal penalties under federal law

3. Uses and Disclosures Requiring Your Written Authorization

Except as described above, we will not use or disclose your PHI without your written authorization. Uses and disclosures that require your authorization include:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures for marketing purposes
• Disclosures that constitute a sale of PHI
• Any other uses and disclosures not described in this Notice

You may revoke your authorization at any time by submitting a written request to our Privacy Officer. Revocation will not affect any uses or disclosures made in reliance on your authorization before we received your revocation.

4. Your Rights Regarding Your Health Information

You have the following rights with respect to your PHI:

Right to Access

You have the right to inspect and obtain a copy of your PHI maintained in our records. To request access, submit a written request to our Privacy Officer. We may charge a reasonable fee for copying and mailing costs. We may deny your request in limited circumstances; if we do, you have the right to request a review of the denial.

Right to Amend

You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. Submit your request in writing to our Privacy Officer, including the reason for the amendment. We may deny your request in certain circumstances and will provide you with a written explanation.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we have made of your PHI. This accounting will not include disclosures made for treatment, payment, or healthcare operations, or disclosures made with your authorization. Submit your request in writing to our Privacy Officer.

Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. While we are not required to agree to all restrictions, we must agree to restrict disclosures to a health plan for services you have paid for in full out of pocket.

Right to Request Confidential Communications

You have the right to request that we communicate with you about your health information in a specific way or at a specific location. For example, you may request that we contact you only at a certain phone number or address.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this Notice at any time, even if you have previously agreed to receive this Notice electronically. Contact our Privacy Officer to request a paper copy.

Right to Be Notified of a Breach

You have the right to be notified in the event of a breach of your unsecured PHI. We will notify you as required by law.

5. Our Responsibilities

• We are required by law to maintain the privacy and security of your PHI
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your PHI
• We must follow the duties and privacy practices described in this Notice and give you a copy of it
• We will not use or share your information other than as described here unless you tell us we can in writing
• If you tell us we can share your information, you may change your mind at any time by letting us know in writing

6. Changes to This Notice

We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI that we maintain, including PHI created or received before the changes. When we make a significant change to this Notice, we will post the revised Notice on our website and make copies available at our facility. The effective date of the current Notice is listed at the top of this page.

7. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

8. Contact Information

For questions about this Notice or to exercise any of your rights described above, contact our Privacy Officer: