Notice of privacy practices.

This notice describes how medical and mental health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

CARE Mental Health Services is required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach of your unsecured PHI occurs.

Treatment

To provide, coordinate or manage your care, including consulting with other providers involved in your care.

Payment

To bill and receive payment from you, an insurance company or another third party.

Health care operations

To run our practice, improve quality of care, train staff and conduct audits and compliance activities.

Other uses permitted or required by law

• When required by federal, state or local law.
• To prevent or lessen a serious and imminent threat to the health or safety of you or others.
• To report suspected abuse, neglect or domestic violence as required by Virginia law.
• For public health activities and health oversight (such as licensing and audits).
• In response to a court order, subpoena or other lawful process, as permitted by law.
• To law enforcement, coroners, medical examiners and funeral directors as permitted by law.
• For specialized government functions, workers’ compensation and research as permitted by law.
• To business associates who perform services for us and agree in writing to protect your information.

Family and others involved in your care

Unless you object, we may share relevant information with a family member, friend or other person you identify who is involved in your care or payment for it.

We will obtain your written authorization before:

• Using or disclosing psychotherapy notes, except in limited circumstances permitted by law.
• Using or disclosing your information for marketing purposes.
• Selling your information.
• Any other use or disclosure not described in this notice.

You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Some information, such as substance use disorder treatment records, HIV-related information or other specially protected information, may receive additional protection under federal or Virginia law. We will follow the stricter law where it applies.

• Access. Inspect and get a copy of your health record, including in electronic form. We may charge a reasonable, cost-based fee.
• Amendment. Ask us to correct information you believe is incorrect or incomplete. We may deny your request in writing and explain why.
• Accounting of disclosures. Request a list of certain disclosures we made in the six years before your request.
• Restrictions. Ask us to limit what we use or share. We are not required to agree, except that we must agree not to share information with your health plan for services you paid for in full out of pocket, unless required by law.
• Confidential communications. Ask us to contact you in a specific way or at a specific location. We will accommodate reasonable requests.
• Paper copy. Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Personal representative. If someone is your legal guardian or has medical power of attorney, that person can exercise your rights.

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting hhs.gov/ocr/complaints.

We will not retaliate against you for filing a complaint.

Privacy Officer, CARE Mental Health Services, 348 S. Crater Rd, Suite B, Petersburg, VA 23803 · +1 (804) 203-4161 · [email protected]

We reserve the right to change this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office and on this website.