THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL–RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Information regarding your health care, including payment for health care services, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C. §1320d et seq., 45 C.F.R. Parts 160 & 164, and the federal Confidentiality Law governing substance use disorder treatment records, 42 U.S.C. §290dd-2, 42 C.F.R. Part 2.
Under these laws, Detox California at Cliffside Capistrano may not disclose to any person outside of Detox California at Cliffside Capistrano that you attend or have attended the program, nor may it disclose any information identifying you as a patient, except as permitted by federal law.
Detox California at Cliffside Capistrano must obtain your written consent before disclosing information about you for payment purposes. For example, written consent is required before information may be shared with your health insurance provider to obtain payment for services. In most circumstances, written consent is also required before information may be shared for treatment purposes or health care operations.
However, federal law permits Detox California at Cliffside Capistrano to disclose information without your written consent in the following limited circumstances:
Pursuant to an agreement with a Qualified Service Organization (QSO);
For research, audit, or evaluation purposes;
To report a crime committed on the premises of Detox California at Cliffside Capistrano or against its personnel;
To medical personnel in the event of a medical emergency;
To appropriate authorities to report suspected child abuse or neglect;
As permitted or required by a valid court order.
For example, Detox California at Cliffside Capistrano may disclose information without your consent to obtain legal, accounting, billing, or financial services, or to another medical facility to provide health care to you, provided a Qualified Service Organization Agreement is in place.
Before Detox California at Cliffside Capistrano may use or disclose your health information in any manner not described above, it must obtain your specific written authorization. You may revoke such authorization at any time by submitting a written request.
Under HIPAA, you have the right to request restrictions on certain uses and disclosures of your health information. Detox California at Cliffside Capistrano is not required to agree to requested restrictions; however, if it does agree, it will comply with those restrictions except as necessary in a medical emergency.
You have the right to request that communications with you be conducted by alternative means or at an alternative location. Reasonable requests will be accommodated, and no explanation will be required.
You also have the right to inspect and obtain a copy of your health information maintained by Detox California at Cliffside Capistrano, except where such information includes psychotherapy notes or information compiled for use in legal, criminal, or administrative proceedings, or as otherwise limited by law.
Additionally, you have the right—subject to certain exceptions—to request amendments to your health records and to receive an accounting of disclosures of your health information made by Detox California at Cliffside Capistrano during the six (6) years prior to your request.
You have the right to receive a paper copy of this notice upon request.
Detox California at Cliffside Capistrano is required by law to maintain the privacy of your protected health information and to provide you with notice of its legal duties and privacy practices. It is required to comply with the terms of this notice.
Detox California at Cliffside Capistrano reserves the right to revise this notice and to make revised or updated provisions effective for all protected health information it maintains.
You may file a complaint with Detox California at Cliffside Capistrano and/or with the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.
Violation of the federal Confidentiality Law is a crime. Suspected violations may be reported to the United States Attorney in the district where the violation occurs.
