Notice of Privacy Practices

Your Rights

When it comes to your health information, you have important 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 inspect or receive a copy of health information we maintain about you in a designated record set, including an electronic copy when applicable.
• We generally will provide access within the time required by law. In limited circumstances, we may deny access to some information, and some denials may be reviewed.
• Psychotherapy notes are not part of the HIPAA designated record set and are subject to special protections. Other Virginia or federal rules may also limit access to particular information.
• We may charge only fees permitted by applicable law. We will not deny access merely because you have an unpaid balance.

Ask us to correct your health record

You may ask us to amend health information you believe is incorrect or incomplete. We may deny the request in certain circumstances, but we will explain a denial in writing and tell you about your right to submit a statement of disagreement when applicable.

Request confidential communications

You may ask us to contact you in a particular way or at a particular location—for example, at a specific telephone number or mailing address. We will accommodate reasonable requests as required by law.

Ask us to limit what we use or share

• You may ask us not to use or share certain information for treatment, payment, or our health care operations. We generally are not required to agree, except where the law requires us to do so.
• If you pay for a health care item or service out of pocket in full, you may ask us not to disclose information about that item or service to your health plan for payment or health care operations. We will honor the request when HIPAA requires it.

Get a list of certain disclosures

You may ask for an accounting of certain disclosures of your health information made during the period allowed by law. The accounting does not include every disclosure; for example, many disclosures for treatment, payment, and health care operations are excluded under HIPAA.

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.

Choose someone to act for you

If you have given someone medical power of attorney, if someone is your legal guardian or personal representative, or if another person otherwise has legal authority to act for you, that person may exercise your privacy rights to the extent permitted by law. We may ask for documentation of that authority.

File a privacy complaint

You may complain if you believe your privacy rights have been violated. You may contact Family Guidance Centers using the information at the end of this notice or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint or exercising a privacy right.

Your Choices

For certain health information, you may tell us your preferences about what we share. If you have a clear preference, tell us what you want us to do and we will follow your instructions when the law requires or permits us to do so.

Family, friends, and others involved in your care

You may tell us that we may share relevant information with a family member, friend, caregiver, or other person involved in your care or payment for your care. When you are present and able to make decisions, we generally will ask for your agreement or give you an opportunity to object before sharing information, unless another law permits or requires the disclosure.

Family Guidance Centers uses a more protective administrative practice for routine telephone and administrative disclosures: administrative staff generally require a valid written Release of Information before sharing appointment, billing, or other PHI with a friend or family member. We also verify identity before releasing information.

If you are unable to tell us your preference

If you are not present or cannot make health care decisions, a clinician may use professional judgment to share limited information with someone involved in your care when permitted by law and believed to be in your best interest.

Marketing, sale of information, and fundraising

• We will obtain your written authorization for marketing or the sale of your PHI when HIPAA requires authorization.
• If we conduct fundraising communications permitted by HIPAA, you will have the right to opt out of future fundraising communications.
• If fundraising communications would use Part 2-protected information, we will provide the advance notice and opportunity to opt out required by Part 2.

How We May Use and Share Your Information

HIPAA and other laws permit or require us to use and disclose health information in a number of situations. Virginia law may provide additional protection for behavioral health records. We will apply the law that governs the particular information and disclosure.

Treat you

We may use and share your health information with professionals who are treating you. For example, your clinician may consult with another health care provider involved in your treatment when permitted by law.

Run our organization

We may use and share health information for health care operations such as quality improvement, care coordination, training, compliance, auditing, credentialing, business administration, and evaluating our services.

Bill for your services

We may use and share health information to bill and obtain payment from health plans or other responsible payers, determine eligibility or coverage, and conduct other payment activities permitted by law.

Business associates

We may share health information with vendors and service providers that perform functions for us when permitted by HIPAA. When HIPAA requires it, those business associates must sign agreements requiring them to safeguard your information.

Public health, safety, oversight, and legal requirements

We may use or disclose health information when permitted or required by law, including for certain public health activities, health oversight, reporting abuse or neglect, workers’ compensation, judicial or administrative proceedings, law-enforcement purposes, or other legally authorized activities. We disclose only the information permitted or required by the applicable law.

Serious and immediate threats

Virginia law imposes a duty on certain mental health service providers to take protective action when a patient communicates a specific and immediate threat of serious bodily injury or death to an identified or readily identifiable person and the legal conditions are met. Protective actions may include warning a potential victim, contacting law enforcement, seeking involuntary admission, or other actions authorized by Virginia law.

Required reporting

Clinicians and other mandated reporters may be required by Virginia law to report suspected child abuse or neglect and certain abuse, neglect, or exploitation of adults. When a report is required, we may disclose information necessary to make the report.

Legal proceedings and subpoenas

Behavioral health communications and records may be protected by Virginia confidentiality and privilege laws. A subpoena, court order, law-enforcement request, or other legal demand does not automatically mean that every requested record may be released. We review legal requests and disclose information only as permitted or required by applicable federal and Virginia law.

Disaster relief

We may share limited information with an organization assisting in a disaster-relief effort when permitted by law so that family or others responsible for your care can be notified about your location, condition, or death.

Research

We may use or share health information for research when the research satisfies the requirements of HIPAA and any other law that applies, including required authorization or an approved waiver when applicable.

Organ and tissue donation

We may share health information with organ procurement organizations or other entities involved in organ, eye, or tissue donation and transplantation when permitted by law.

Medical examiners, coroners, and funeral directors

We may share health information with a coroner, medical examiner, or funeral director as permitted or required by law.

Special government functions

We may use or share health information for special government functions permitted by HIPAA, such as certain military, national-security, protective-service, correctional, or custodial functions, subject to applicable behavioral-health confidentiality restrictions.

Special Protections for Behavioral Health Information

Psychotherapy notes

Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the contents of a counseling conversation and maintained separately from the rest of the medical record, as defined by HIPAA. We generally need your written authorization to use or disclose psychotherapy notes, except for limited circumstances permitted by law.

Virginia confidentiality protections

Virginia recognizes an individual’s right of privacy in health records and restricts disclosure except as permitted or required by law. Virginia law also provides privilege protections for certain confidential communications between clients and licensed professional counselors, clinical social workers, psychologists, and marriage and family therapists, subject to legal exceptions.

Minors and behavioral health services

Parents and guardians generally have rights involving a minor’s health information, but those rights are not unlimited. Under Virginia law, a minor is treated as an adult for consenting to certain services, including outpatient treatment or rehabilitation for mental illness, emotional disturbance, and substance use, and the minor controls access to and authorization for disclosure of records related to those services. Other exceptions may apply based on custody, court orders, emancipation, or safety considerations.

Substance use disorder records—42 CFR Part 2

Some substance use disorder (SUD) patient records are protected by 42 CFR Part 2. When Family Guidance Centers creates, receives, or maintains Part 2-protected records, we follow the additional Part 2 requirements that apply to those records. A patient may provide a single consent for future uses and disclosures for treatment, payment, and health care operations as permitted by Part 2. SUD counseling notes that are maintained separately from the rest of the SUD treatment and medical record require a separate consent.

• Part 2 records generally may be used or disclosed only as Part 2 permits, including pursuant to a valid patient consent or a specific Part 2 exception.
• Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your specific consent or a Part 2-compliant court order and subpoena or other legal mandate.
• If Part 2 applies to your records, you may file a Part 2 complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights.
• If Family Guidance Centers is a Part 2 program for your care, this notice is intended to function with the additional Part 2 patient-notice requirements applicable to that program.

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 that is 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 share your information other than as described in this notice unless you authorize us in writing or another law permits or requires the use or disclosure.
• If you give us a written authorization, you may revoke it in writing. A revocation does not undo actions already taken in reliance on the authorization.
• We use administrative, physical, and technical safeguards to protect health information, including electronic health information.

Changes to This Notice

We may change the terms of this notice, and the changes may apply to all health information we maintain, including information created or received before the change. When we make a material change, the revised notice will be available upon request, at our office, and on any website we maintain that provides information about our services, as required by law.

Questions, Requests, or Complaints

Contact our Privacy Officer if you have questions about this notice, want to exercise a privacy right, or wish to make a complaint.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, or by calling 1-877-696-6775. Family Guidance Centers will not retaliate against you for filing a complaint.