VISTA HILL NOTICE OF PRIVACY PRACTICE
VH Form 03-01-2
Effective Date: 3/03
Review Date: 10/04, 3/06, 4/07, 5/17
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.
If you have any questions about this notice, please contact the Vista Hill Privacy Officer at 858.514.5100.
WHO WILL FOLLOW THIS NOTICE
This notice describes our organization’s practices and that of:
- Any health care professional authorized to enter information into your treatment record.
- All departments of the service program.
- All employees, staff and other personnel including volunteers.
Stein Education Centers (psychiatric consultation and counseling), Learning Assistance Center, GPS, ParentCare Family Recovery Center, Bridges Adult Intensive Outpatient Program, the Bridge Teen Recovery Center and other certain covered Vista Hill entities all follow the terms of this notice. In addition, these entities, sites and locations may share protected health information (PHI) with each other for treatment, payment or health care operations purposes described in this notice.
OUR PLEDGE REGARDING PROTECTED HEALTH INFORMATION (PHI)
We understand that health information about you and your health is personal. We are committed to protecting health information about you. We may create and maintain a record of the care and services you receive in our programs. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the clinical records of your care generated by the clinical staff.
This notice will tell you about the ways in which we may use and disclose protected health information (PHI) about you. We also describe your rights and certain obligations we have regarding the use and disclosure of PHI. We are required by law to:
- Make sure that PHI that identifies you is kept private (with certain exceptions);
- Inform you of our legal duties and privacy practices with respect to PHI about you; and
- Follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose protected health information (PHI). For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Disclosure at Your Request:
For Treatment. We may use PHI about you to provide you with clinical treatment or services. We may disclose PHI about you to internal clinical staff. For example a therapist or counselor may share information with his/her clinical supervisor regarding you for treatment planning purposes. We also may disclose information to another agency involved in your treatment.
For Payment. We may use and disclose PHI about you so that the treatment and services you receive at our programs may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about services you received so we may obtain reimbursement for the services.
For Health Care Operations. We may use and disclose PHI about you for health care operations. These uses and disclosures are necessary to operate our programs and make sure that all of our clients receive quality care. For example, we may use PHI to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine PHI about many clients/consumers to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to clinical and non-clinical personnel for review and learning purposes. We may also combine the PHI we have with information from other providers to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of PHI information so others may use it to study health care and health care delivery without learning who the specific clients/consumers are.
Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have and appointment for treatment or program services.
Treatment Alternatives. We may use and disclose PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
As Required By Law. We will disclose PHI about you when required to do so by federal, state or local law.
(HOW WE MAY USE AND DISCLOSE continued)
To Avert a Serious Threat to Health or Safety. We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
Public Health Risks. We may disclose PHI about you for public health activities. These activities generally include the following:
- to prevent or control disease, injury or disability;
- to report births and deaths;
- to report the abuse or neglect of children, elders and dependent adults;
- to report reactions to medications or problems with products;
- to notify people of recalls of products they may be using;
- to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- To notify emergency response employees regarding a possible exposure to HIV/AIDS to the extent necessary to comply with state and federal laws.
Health Oversight Activities. We may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discover request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request (which may include written notice to you) or to obtain an order protecting the information requested.
Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness, or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
- About the death we believe may be the result of criminal conduct;
- About criminal conduct at the program or facility; and
- In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. This may include private health information for the protection of federal and state elective constitutional officers and their families.
Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding protected health information (PHI) (includes medical, mental health or substance abuse) information we maintain about you:
Rights to Inspect and Copy. You have the right to inspect and obtain a copy of your protected health information (PHI) that may be used to make decisions about your care. Usually, this includes medical and billing records, but may not include some mental health and substance abuse information. To inspect and copy protected health information (PHI) that may be used to make decisions about you, you must submit your request in writing to your program director or manager (if a current client) or to the Vista Hill Privacy Officer (if a past client). If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to PHI records, you may request that the denial be reviewed.
Rights to Amend. If you feel that protected health information (PHI) we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the agency. To request an amendment, your request must be made in writing and submitted to the Vista Hill Privacy Officer. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the PHI kept by or for the organization;
- Is part of an electronic record system under ownership and control of a governmental agency;
- Is not part of information which you would be permitted to inspect and copy; or
- Is accurate and complete.
Even if we deny your request for amendment, you have the right to submit a written addendum, not to exceed 250 words, with respect to any item or statement in your record you believe is incomplete or incorrect. If you clearly indicate in writing that you want the addendum to be made part of your clinical record we will attach it to your records and include it whenever we make a disclosure of the item or statement you believe to be incomplete or incorrect.
Right to an Accounting of Disclosure. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of PHI about you other than our own uses for treatment, payment or health care operations, (as those functions are described above) and with other expectations pursuant to the law.
To request this list or accounting of disclosures, you must submit your request in writing to the Vista Hill Privacy Officer. Your request must state a time period which may not be longer than six (6) years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example on paper and mailed). The first list you request within a 12 month rolling period will be free of charge. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information (PHI) we use or disclose about you for treatment payment or health care operations. However, we are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to the Vista Hill Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosure to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about protected health information (PHI) matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications you must make your request in writing to your therapist/counselor or case manager. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice and may ask your program staff to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically or review in paper format, you are still entitled to a paper copy of this notice.
CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for protected health information (PHI) we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facilities. The notice will contain on the first page, in the lower left corner, the effective date. In addition, each time you register at or are admitted to our programs for treatment or health care services, we will offer you a copy of the current notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with the organization or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with the organization, submit it in written form addressed to: Vista Hill Privacy Officer, 8910 Clairemont Mesa Blvd., San Diego, CA 92123. You will not be penalized for filing a complaint. Violation of federal law and regulations for substance use disorder program records is a crime (42 CFR 2.22 (a)(2)(b)(2)).
OTHER USES OF PRIVATE HEALTH INFORMATION (INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT)
Other uses and disclosures of protected health or medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose protected health information (PHI) about you, you may revoke that permission, in writing, at any time. If you revoke your permission, this will stop any further use or disclosure of your protected health information (PHI) for the purposes covered by your written authorization, except if we have already acted in reliance on your permission. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
End of Vista Hill Notice of Privacy Practice