NOTICE OF PRIVACY PRACTICES

B. Less Common Uses and Disclosures

1. Disclosures Required by Law. We may use or disclose patient health information to the extent we are required by law to do so. 
   For example, we are required to disclose patient health information to the U.S. Department of Health and Human Services so that it can investigate complaints or determine our compliance with HIPAA.
2. Public Health Activities. We may disclose patient health information for public health activities and purposes, which include: preventing or controlling disease, injury or disability; reporting births or deaths; reporting child abuse or neglect; reporting adverse reactions to medications or foods; reporting product defects; enabling product recalls; and notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
3. Victims of Abuse, Neglect or Domestic Violence. We may disclose health information to the appropriate government authority about a patient whom we believe is a victim of abuse, neglect or domestic violence.
4. Health Oversight Activities. We may disclose patient health information to a health oversight agency for activities necessary for the government to provide appropriate oversight of the health care system, certain government benefit programs, and compliance with certain civil rights laws.
5. Lawsuits and Legal Actions. We may disclose patient health information in response to (i) a court or administrative order or (ii) a subpoena, discovery request, or other lawful process that is not ordered by a court if efforts have been made to notify the patient or to obtain an order protecting the information requested.
6. Law Enforcement Purposes. We may disclose your health information to a law enforcement official for law enforcement purposes, such as to identify or locate a suspect, material witness or missing person or to alert law enforcement of a crime.
7. Coroners, Medical Examiners and Funeral Directors. We may disclose your health information to a coroner, medical examiner or funeral director to allow them to carry out their duties.
8. Organ, Eye and Tissue Donation. We may use or disclose your health information to organ procurement organizations or others that obtain, bank or transplant cadaveric organs, eyes or tissue for donation and transplant.
9. Research Purposes. We may use or disclose your information for research purposes pursuant to patient authorization waiver approval by an Institutional Review Board or Privacy Board.
10. Serious Threat to Health or Safety. We may use or disclose your health information if we believe it is necessary to do so to prevent or lessen a serious threat to anyone’s health or safety.
11. Specialized Government Functions. We may disclose your health information to the military (domestic or foreign) about its members or veterans, for national security and protective services for the President or other heads of state, to the government for security clearance reviews, and to a jail or prison about its inmates.
12. Workers’ Compensation. We may disclose your health information to comply with workers’ compensation laws or similar programs that provide benefits for work-related injuries or illness.

Special Limitation for Substance Use Disorder Records. To the extent that we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, we will not use or disclose a Part 2 record, or testimony describing information contained in a Part 2 record, in a civil, criminal, administrative, or legislative investigation or proceeding against you without (1) your written consent or (2) a court order and subpoena as required by applicable federal law.

Most uses and disclosures of psychotherapy notes, uses and disclosures of protected health information for marketing purposes, and disclosures that constitute a sale of protected health information require your written authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization unless otherwise permitted or required by law. You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on the authorization.

V. Your Rights with Respect to Your Health Information 
You have the following rights with respect to certain health information that we have about you (information in a Designated Record Set as defined by HIPAA). To exercise any of these rights, you must submit a written request to our Privacy Official listed on the first page of this Notice. 

A. Right to Access and Review 
You may request to access and review a copy of your health information. We may deny your request under certain limited circumstances. If we deny your request, we will explain the reason in writing and, if the denial is subject to review, explain how you may request a review of the decision. We will provide a copy of your health information in a format you request if it is readily producible. If not readily producible, we will provide it in a hard copy format or other format that is mutually agreeable. If your health information is included in an Electronic Health Record, you have the right to obtain a copy of it in an electronic format and to direct us to send it to the person or entity you designate in an electronic format. We may charge a reasonable fee to cover our cost to provide you with copies of your health information. 

B. Right to Amend 
If you believe that your health information is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances. You will receive written notice of a denial and can file a statement of disagreement that will be included with your health information that you believe is incorrect or incomplete. 

C. Right to Restrict Use and Disclosure 
You may request that we restrict uses of your health information to carry out treatment, payment, or health care operations or to your family member or friend involved in your care or the payment for your care. We are not required to agree to your requested restriction, except as described below. If you pay out of pocket in full for a service and ask us not to disclose information about that service to your health plan for payment or health care operations, we will honor your request unless disclosure is required by law. 

D. Right to Confidential Communications, Alternative Means and Locations 
You may ask us to contact you in a specific way, such as at a particular phone number, or to send mail to a different address. We will accommodate reasonable requests.

E. Right to an Accounting of Disclosures 
You have a right to receive an accounting of disclosures of your health information for the six (6) years prior to the date that the accounting is requested except for disclosures to carry out treatment, payment, health care operations (and certain other exceptions as provided by HIPAA). The first accounting we provide in any 12-month period will be without charge to you. We may charge a reasonable fee to cover the cost for each subsequent request for an accounting within the same 12-month period. We will notify you in advance of this fee and you may choose to modify or withdraw your request at that time. 

F. Right to a Paper Copy of this Notice 
You have the right to a paper copy of this Notice. You may ask us to give you a paper copy of the Notice at any time (even if you have agreed to receive the Notice electronically). To obtain a paper copy, ask the Privacy Official. 

G. Right to Receive Notification of a Breach
We are required by law to notify you following a breach of your unsecured protected health information. We will notify you as required by applicable law if a breach occurs that may have compromised the privacy or security of your information.

H. Personal Representatives
If someone has legal authority to act on your behalf, such as a legal guardian or a person authorized under a health care power of attorney, that person may exercise your rights regarding your health information as permitted by law. We may require documentation establishing that person’s authority before taking action.

VI. Special Protections for Substance Use Disorder, HIV, Mental Health and Genetic Information 
Certain federal and state laws may provide additional privacy protections that restrict the use and disclosure of certain health information, including substance use disorder patient records, HIV-related information, mental health information, and genetic information.

Substance Use Disorder Records. To the extent that we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, we will use and disclose those records only as permitted by applicable law. A Part 2 record, or testimony describing information contained in a Part 2 record, may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you without (1) your written consent or (2) a court order and subpoena as required by applicable federal law.

Other federal or state laws may provide additional protections for HIV-related information, mental health information, genetic information, or other specially protected health information. To the extent such laws apply, we will comply with the more restrictive requirements.

VII. How to Make Privacy Complaints 
If you believe we have violated your privacy rights, you may file a complaint with us using the contact information listed on the first page of this Notice. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.