Notice of Privacy Practices (NPP) and Information Regarding Confidentiality of Information

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address.

We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. You have this same right with respect to your substance use disorder records protected by 42 C.F.R. part 2 (“Part 2”).

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). For substance use disorder records protected by 42 C.F.R. part 2, the accounting will also include disclosures made for treatment, payment, and health care operations pursuant to your written consent, for the three years prior to the date of your request. 42 C.F.R. § 2.25. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting our Privacy Representative at (858) 258-9883 or contact@mhcsandiego.com. You may also contact that person with any question about this notice.

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint/index.html.

We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

To the extent records or information is subject to Part 2, we cannot share them with your family, close friends, or anyone else involved in your care without your written consent, and in an emergency we may share them only with medical personnel to the extent necessary to meet a bona fide medical emergency.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes, and any sharing of substance use disorder counseling notes

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

To the extent that we have your substance use disorder patient records, and to the extent those records are subject to 42 CFR part 2, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information.

Our Uses and Disclosures

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you. If that information consists of substance use disorder records protected by 42 C.F.R. part 2, we will do so only as permitted by your written consent or as otherwise allowed by Part 2, such as a medical emergency under 42 C.F.R. § 2.51.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our facility, improve your care, and contact you when necessary, as necessary and appropriate under these terms. If that information consists of substance use disorder records protected by 42 C.F.R. part 2, we will do so only as permitted by your written consent or as otherwise allowed by Part 2.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. If that information consists of substance use disorder records protected by 42 C.F.R. part 2, we will do so only as permitted by your written consent or as otherwise allowed by Part 2.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways—usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information, see here.

In all cases, including those listed below, special rules apply to any substance use disorder patient records we have about you that are subject to 42 C.F.R. part 2. We will make the disclosures described below from those records only where Part 2 independently permits the disclosure — generally, only with your written consent, under a qualifying court order, or under one of the limited exceptions in Part 2. In addition, we cannot use or share information in those records in any civil, criminal, administrative, or legislative investigation or proceeding against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence — for substance use disorder records protected by 42 C.F.R. part 2, this is limited to reports of suspected child abuse and neglect under 42 C.F.R. § 2.12(c)(6); reports of elder abuse or domestic violence from those records require your consent or a court order.
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research. Disclosure of substance use disorder records for research is subject to the additional conditions in 42 C.F.R. § 2.52.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. A general state or federal reporting law does not by itself authorize disclosure of substance use disorder records protected by 42 C.F.R. part 2; those disclosures also require your written consent, a qualifying court order, or a specific Part 2 exception.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations. Part 2 contains no exception for these disclosures, so we will not disclose substance use disorder records to an organ procurement organization without your written consent or a court order.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies. Disclosure of substance use disorder records regarding a deceased patient is governed by 42 C.F.R. § 2.15(b) and is more limited.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you for the purposes below. We will not disclose substance use disorder records protected by 42 C.F.R. part 2 for any of these purposes without your written consent or a qualifying court order; Part 2 permits reporting to law enforcement only in connection with a crime on our premises or against our personnel, 42 C.F.R. § 2.12(c)(5). Subject to that limitation, we can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena. A subpoena alone is never sufficient to obtain substance use disorder records protected by 42 C.F.R. part 2. Those records may be disclosed in litigation only with your written consent or under a court order that meets the requirements of 42 C.F.R. §§ 2.61–2.67.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. Breaches of substance use disorder records protected by 42 C.F.R. part 2 are subject to the HIPAA Breach Notification Rule, 45 C.F.R. part 164, subpart D.
• 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, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see here.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Substance Use Disorder Records Subject to 42 C.F.R. Part 2

To the extent that we have your substance use disorder (SUD) patient records, and to the extent those records are subject to Part 2, we will not use or disclose that information in any civil, criminal, administrative, or legislative investigation or proceeding against you without (1) your written consent that expressly permits that use or disclosure or (2) a court order issued after notice and an opportunity to be heard, together with a subpoena or other lawful process. 42 C.F.R. §§ 2.12(a)(2), 2.64–2.67.

Redisclosure of your Part 2 records

If you give us written consent to use or disclose your Part 2 records for treatment, payment, or health care operations, and we disclose those records to a person or entity covered by HIPAA, that recipient may redisclose them in accordance with the HIPAA Privacy Rule. The records still may not be used or disclosed in any civil, criminal, administrative, or legislative proceeding against you without your specific written consent or a court order. 42 C.F.R. § 2.33(b).

Your right to revoke consent

You may revoke any consent you give us to use or disclose your Part 2 records at any time, in writing, except to the extent we have already acted in reliance on that consent. 42 C.F.R. § 2.31(a)(6).

Prohibition on discrimination

Federal law prohibits the use of your Part 2 records to discriminate against you in admission to or treatment by a health care provider or health plan, in employment, in housing (including the rental or sale of real property), in access to the courts, and in access to social services and benefits funded in whole or in part by federal, state, or local government. 42 U.S.C. § 290dd-2(i).

California Addendum

This notice is used in more than one state. If you receive services from us in California, the following additional protections apply. California law that is more protective of your health information is not preempted by HIPAA.

• Alcohol and drug program records. To the extent your records are maintained in connection with a program regulated, funded, or licensed or certified by the California Department of Health Care Services, your identity and those records are confidential under Health and Safety Code section 11845.5, which permits disclosure only with your written consent or under one of five narrow exceptions. Those records may not be used to initiate or substantiate criminal charges against you, or to conduct any investigation of you, except under a court order issued on a showing of probable cause. We will not confirm or deny to anyone that you are or were a client.
• HIV test results. The results of an HIV test may not be disclosed except as permitted by Health and Safety Code section 120980.
• Reproductive and gender-affirming health care. California Civil Code sections 56.108 through 56.110 restrict our ability to disclose information related to gender-affirming care, or to a person seeking or obtaining an abortion or other reproductive health care, in response to a subpoena, warrant, or other request originating outside California.

Effective Date of this Notice 8.28.26.