Patient rights & privacy
NOTICE OF PRIVACY PRACTICES
Lake Sacajawea Mind & Family
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.
This Notice applies to protected health information maintained by Lake Sacajawea Mind & Family in connection with services provided through the practice. “We,” “our,” and “the practice” refer to Lake Sacajawea Mind & Family when acting as a HIPAA covered health care provider.
OFFICE
1338 Commerce Ave #301Longview, WA 98632
In-person and telehealth services
Your Information. Your Rights. Our Responsibilities.
YOUR RIGHTS
- Get a copy of your record
- Ask us to correct your record
- Request confidential communications
- Ask us to limit certain uses or disclosures
- Get an accounting of certain disclosures
- Get a copy of this Notice
- Choose someone to act for you
- File a privacy complaint
YOUR CHOICES
You may have choices about sharing information with family, friends, or others involved in your care.
Most uses of psychotherapy notes, marketing uses, and sales of protected health information require written authorization.
HOW WE MAY USE OR SHARE INFORMATION
- Treatment
- Payment
- Health care operations
- Public health and safety when permitted by law
- Health oversight
- Certain legal requirements and proceedings
- Other uses specifically permitted or required by law
Your Rights
When it comes to your health information, you have certain rights. This section explains those rights and some of our responsibilities to help you exercise them.
Get an electronic or paper copy of your health record
- You may ask to see or receive an electronic or paper copy of your health record and other health information we maintain about you. Ask us how to do this.
- We will provide access, a copy, or a summary within the time required by law. We may charge a reasonable, cost-based fee as permitted by law.
- Certain records may be subject to additional protections or limitations under federal or Washington law. Information about other people may be limited when necessary to protect their confidentiality.
Ask us to correct your health record
- You may ask us to amend health information that you believe is incorrect or incomplete.
- We may deny the request in some circumstances. If we do, we will explain the reason in writing within the time required by law.
Request confidential communications
- You may ask us to contact you in a specific way, such as at a particular phone number or email address, or to send mail to a different address.
- We will accommodate reasonable requests.
Ask us to limit what we use or share
- You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are not generally required to agree, but if we do agree we will follow the restriction except as permitted by law, including when information is needed for emergency treatment.
- If you pay in full out of pocket for a service, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will honor that request unless disclosure is required by law.
Get a list of certain disclosures
- You may ask for an accounting of certain disclosures of your health information made during the six years before your request, including who received the information and why.
- The accounting does not include certain disclosures, such as many disclosures for treatment, payment, or health care operations and disclosures you specifically authorized. We will provide one accounting in a 12-month period without charge; additional requests may involve a reasonable, cost-based fee.
Get a copy of this Notice
You may ask for a paper copy of this Notice at any time, even if you agreed to receive it electronically. We will provide a copy promptly.
Choose someone to act for you
If a person has legal authority to act as your personal representative, that person may exercise applicable rights regarding your health information. We may verify that authority before acting. For minors, federal and Washington law may give a parent, guardian, or the minor different rights depending on the circumstances, and we will follow the law that applies.
File a complaint
If you believe your privacy rights have been violated, you may complain to us using the contact information on the first page. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or using the complaint information available at hhs.gov/hipaa. We will not retaliate against you for filing a complaint.
Your Choices
For some health information, you may tell us what you want us to do. When applicable, you may tell us whether you want us to share relevant information with family members, close friends, or others involved in your care or payment for your care, or in a disaster-relief situation.
If you are not able to tell us your preference, we may disclose limited information when permitted by law and when, using professional judgment, the disclosure is in your best interests. We may also disclose information when permitted by law to prevent or lessen a serious and imminent threat to health or safety.
Uses or disclosures that generally require your written authorization
- Most uses or disclosures of psychotherapy notes, if we maintain psychotherapy notes as HIPAA defines that term.
- Uses of protected health information for marketing when HIPAA requires authorization.
- The sale of protected health information.
- Other uses or disclosures not otherwise permitted or required by law.
If you give us written authorization, you may generally revoke it in writing at any time for future uses or disclosures. Revocation does not affect actions already taken in reliance on a valid authorization.
How We May Use and Disclose Your Health Information
HIPAA allows or requires certain uses and disclosures without a separate authorization. Because Washington law gives mental health information additional confidentiality protection, we will use or disclose information only when the applicable federal and Washington requirements are satisfied.
Treatment
We may use your health information to provide, coordinate, or manage your treatment. When permitted by law, we may share appropriate information with other health care professionals involved in your care. Example: with appropriate legal authority, we may coordinate with a medical provider about information relevant to your treatment.
Payment
We may use and disclose health information as needed to obtain payment for services. Example: if you use insurance, we may provide information needed for eligibility, claims processing, authorization, utilization review, or payment, subject to applicable confidentiality rules.
Health care operations
We may use and disclose health information as necessary to operate the practice and provide health care services. Examples include quality improvement, credentialing, compliance, billing administration, practice management, legal and accounting services, and other activities permitted by law.
Public health and safety
When permitted or required by law, we may disclose health information for certain public health or safety purposes, such as legally required reports of abuse or neglect, authorized public health activities, or preventing or reducing a serious and imminent threat to health or safety. Mental health information will be disclosed only to the extent permitted or required by applicable law.
Health oversight and compliance with law
We may disclose information to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, licensure, or disciplinary proceedings. We will also disclose information when state or federal law requires us to do so, including to the U.S. Department of Health and Human Services when necessary to determine our compliance with federal privacy law.
Workers’ compensation and certain government functions
We may use or disclose information for workers’ compensation matters and certain government functions when permitted or required by applicable law.
Medical examiners and funeral directors
When permitted by law, we may disclose information to a coroner, medical examiner, or funeral director following a person’s death.
Organ and tissue donation
When permitted by law, we may share health information with organ procurement organizations or other entities involved in organ, eye, or tissue donation and transplantation.
Research
Health information may be used or disclosed for research only when the requirements of applicable federal and state law have been satisfied.
Legal proceedings and law enforcement
Health information may sometimes be requested in connection with a court or administrative proceeding, subpoena, law-enforcement request, or other legal process. Mental health information receives additional protection under Washington law. We will disclose information only when the applicable legal requirements for the specific request have been met.
Additional Protection for Mental Health Information in Washington
Washington law generally provides additional confidentiality protections for information and records related to mental health services. We will not disclose mental health treatment information unless you authorize the disclosure or federal or Washington law otherwise permits or requires it. When a disclosure is permitted, we will limit the information disclosed as required by applicable law.
Psychotherapy notes
Psychotherapy notes are given special protection under HIPAA and Washington law. If we create and maintain psychotherapy notes as HIPAA defines that term, most uses or disclosures require your specific written authorization, subject to limited legal exceptions.
Substance Use Disorder Records
To the extent that we maintain substance use disorder patient records that are protected by 42 CFR Part 2, those records receive additional federal confidentiality protections. Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order and subpoena that meet federal requirements. Other Part 2 requirements may also apply to the use, disclosure, and redisclosure of those records.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We must follow the duties and privacy practices described in the Notice currently in effect.
- We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
- We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or the law otherwise permits or requires it.
Washington Notice of Information Practices
NOTICE
We keep a record of the health care services we provide you. You may ask us to see and copy that record. You may also ask us to correct that record. We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels us to do so. You may see your record or get more information about it by contacting Lake Sacajawea Mind & Family at 360-984-9018 or [email protected].
Changes to This Notice
We may change the terms of this Notice and make the revised Notice applicable to health information we already maintain as well as information we receive in the future. If we materially change the Notice, the current version will be available upon request, at our office, and on our website.
Questions or Privacy Concerns
Contact Lake Sacajawea Mind & Family at 360-732-8389 or [email protected] if you have questions about this Notice, want to exercise a privacy right, or want to make a privacy complaint.
This Notice is intended to describe the privacy practices of Lake Sacajawea Mind & Family under HIPAA and applicable Washington law. Where federal and Washington law differ, the practice will follow the law that provides the applicable protection or requirement.