HIPAA Notice of Privacy Practices

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.

It is my legal duty to safeguard your protected health information (PHI). Privacy is very important in the therapeutic relationship. By law I am required to ensure that your PHI is kept private. PHI constitutes information created/noted by me used to identify you. It contains data about your past, present, or future health condition, the healthcare services delivered to you, or the payment for healthcare. I am required to provide this Notice about my privacy procedures.

This Notice explains when, why, and how I would use and/or disclose your PHI. Use of PHI means when I share, apply, utilize, examine, or analyze information within my practice; PHI is disclosed when I release, transfer, or give to a third party outside my practice. With some exceptions, I may not use or disclose more of your PHI than is necessary; however, I am always legally required to follow the privacy practices described in this Notice. I can change the terms of this Notice/privacy policies at any time as permitted by law. Any changes to this notice will be posted in my office. You may request a copy of this Notice, view a copy in my office, or at my website, www.jillbaumgartnerlcsw.com.

How I will use/disclose your PHI. Some uses/disclosures will require your prior written authorization; others will not.  Uses and Disclosures related to treatment, payment, or healthcare operations do not require your written consent.  1. For treatment I can use your PHI within my practice to provide you with mental health treatment. 2. For health care operations. I may disclose your PHI to facilitate the efficient and correct operation of my practice. 3. To obtain payment for treatment. I may use and disclose your PHI to bill and collect payment for the treatment and services I provided you. 4.Other E.g. If there is an emergency and I believe it will benefit you to disclose PHI. If I do so, I will tell you as soon as possible. I will stop if you object, as long as it isn’t against the law.

Uses and Disclosures that Do Not Require Your Consent (Federal and CA laws). Possible PHI disclosures without your consent or authorization for the following reasons:

·         Disclosure required by federal/state/local law; judicial/board/administrative proceedings; or law enforcement. E.g. I may make a disclosure to appropriate officials when a law requires me to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.

·         If disclosure is compelled by a party to a proceeding before a court of an administrative agency pursuant to its lawful authority.

·         If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.

·         If disclosure is compelled by the client or client’s representative pursuant to CA Health & Safety Codes or to corresponding federal statutes of regulations, such as the Privacy Rule that requires this Notice.

·         To avoid harm. E.g. PHI to law enforcement to prevent a serious threat to health/safety of a person/the public.

·         If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or a person, or if disclosure is necessary to prevent threatened danger.

·         If disclosure is mandated by the California Child Abuse and Neglect Reporting law.

·         If disclosure is mandated by the California Elder/Dependent Adult Abuse Reporting law.

·         If disclosure is compelled or permitted by the fact that you tell me of a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.

·         For health oversight activities. E.g. PHI to assist in inspection of a health care organization or provider.

·         For Workers' Compensation purposes. E.g. PHI in order to comply with Workers' Compensation laws.

·         Appointment reminders and health related benefits or services.

·         If an arbitrator/arbitration panel requires disclosure, when arbitration is lawfully requested by either party, (a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding.

·         If disclosure is required/permitted to a health oversight agency for oversight activities authorized by law.  E.g. U.S. Secretary of Health and Human Services to investigate/assess my compliance with HIPAA.

·         If disclosure is otherwise specifically required by law.

Certain Uses and Disclosures Require You to Have the Opportunity to Object.

Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part.  Retroactive consent may be obtained in emergency situations.

Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described above, I will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may revoke that authorization in writing at any time.

Your rights regarding PHI: Right to See and Get Copies of Your PHI. You have the right to see or get copies of your PHI, but must it request it in writing. You will receive a response from me within 30 days of my receiving your written request. Under certain circumstances, I may feel I must deny your request, and will provide the reasons for the denial in writing. I will explain your right to have my denial reviewed. If you ask for copies of your PHI, I will charge you no more than $.25 per page. I provide you with a summary or explanation of the PHI only if you agree to it and the cost in advance. Right to Request Limits on Uses/Disclosures of Your PHI. You have the right to ask that I limit how I use and disclose your PHI. While I will consider your request, I am not legally bound to agree. If I do agree, I will put those limits in writing and abide by them except in emergencies. Right to Choose How I Send Your PHI to You. Your PHI can be sent to you at an alternate address (E.g. work versus home address) or alternate method (e-mail versus regular mail). Right to a List of the Disclosures I Have Made. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I give will include disclosures made in the previous six years unless you indicate a shorter period. The list will include the date of disclosure, to whom PHI was disclosed (their address, if known), description of information disclosed, the reason for the disclosure. I will provide the list to you at no cost, unless you make more than one request in the same year, in which case I will charge you a reasonable sum based on a set fee for each additional request. Right to Amend Your PHI. If you believe an error or important information is omitted from your PHI, you can request I correct existing information/add missing information. Your request and reason must be made in writing. You will receive a response within 60 days of my receipt of  request. I may deny your request if I find that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of my records, or (d) written by someone other than me. My denial must be in writing stating reasons for the denial. It must also explain your right to file a written statement objecting the denial. If you do not file a written objection, you still have the right to ask that your request and my denial be attached to any future disclosures of your PHI. If I approve your request, I will make the change(s) to your PHI. I will tell you the changes have been made and advise all others who need to know about the change. Right to This Notice by Email. You can request this Notice by email and paper.

PHI after death Generally, PHI excludes any health information of a person who has been deceased for more than 50 years after the date of death. Jill Baumgartner, LCSW, may disclose deceased individuals' PHI to non-family members, as well as family members, who were involved in the care or payment for healthcare of the decedent prior to death; however, the disclosure must be limited to PHI relevant to such care or payment and cannot be inconsistent with any prior expressed preference of the deceased individual.

Individuals’ right to restrict disclosures/right of access To implement the 2013 HITECH Act, the Privacy Rule is amended. Jill Baumgartner, LCSW, is required to restrict the disclosure of PHI about you, the patient, to a health plan, upon request, if the disclosure is for the purpose of carrying out payment or healthcare operations and is not otherwise required by law. The PHI must pertain solely to a healthcare item or service for which you have paid the covered entity in full. The 2013 Amendments also adopt the proposal in the interim rule requiring Jill Baumgartner, LCSW, to provide you, the patient, a copy of PHI if you, the patient, requests it in electronic form. The electronic format must be provided to you if it is readily producible. OCR clarifies that Jill Baumgartner, LCSW, must provide you only with an electronic copy of PHI, not direct access to their electronic health record systems. The 2013 Amendments also give you the right to direct Jill Baumgartner, LCSW, to transmit an electronic copy of PHI to an entity or person designated by you. The amendments restrict the fees that Jill Baumgartner, LCSW, may charge you for handling and reproduction of PHI, which must be reasonable, cost-based and identify separately the labor for copying PHI (if any). The 2013 Amendments modify the timeliness requirement for right of access, from up to 90 days currently permitted to 30 days, with a one-time extension of 30 additional days.

Notification of breaches In the case of a breach, Jill Baumgartner, LCSW, is required to notify individuals whose PHI has been compromised.

Complaints If you believe your privacy rights have been violated, you may file a complaint in writing with privacy officer, Jill Baumgartner, LCSW, or with the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W. Washington, D.C. 20201 or (202) 619-0257. I will take no retaliatory action against you if you file a complaint about my privacy practices.