This Notice of Privacy Practices (“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.
This Notice applies to Sacred Journey Recovery Solutions LLC and the services provided through Sacred Journey Recovery, a men’s addiction treatment program in California.
In this Notice, “we”, “us”, and “our” refer to Sacred Journey Recovery Solutions LLC and the members of its workforce who are involved in your care or in related operations.
“Protected Health Information” or “PHI” means information that:
PHI can be in any form, including paper records, electronic records, and spoken information.
We are required by law to:
Because we provide substance use disorder treatment services, some of your records may be protected by additional confidentiality laws, including federal regulations at 42 C.F.R. Part 2. These rules provide extra protection for information that identifies you as having or having had a substance use disorder or as someone who has received substance use disorder treatment services.
In many situations, we cannot disclose information protected by 42 C.F.R. Part 2 without your written consent, a court order, or another specific exception under those regulations.
In some situations, we use or disclose your PHI without a separate written authorization from you, as allowed or required by law.
We may use and disclose your PHI to provide, coordinate, or manage your care and related services. This can include:
We may use and disclose your PHI for activities related to payment for your care, such as:
When 42 C.F.R. Part 2 applies, we follow its requirements before disclosing information for payment purposes.
We may use and disclose your PHI for healthcare operations, which are activities that support the running of our program and help us improve quality, such as:
We may use your contact information to:
We may use or disclose your PHI when a law requires us to do so. In that case, we only disclose what the law requires.
We may use or disclose your PHI in limited circumstances to help prevent or reduce a serious and imminent threat to your health or safety or the health or safety of another person, consistent with applicable law and professional standards.
We may disclose PHI to health oversight agencies for activities authorized by law, such as inspections, audits, or investigations related to healthcare systems, government benefit programs, or regulatory compliance.
We may disclose PHI in response to a valid court or administrative order, subpoena, discovery request, or other lawful process, consistent with HIPAA, 42 C.F.R. Part 2, and state law.
In general, we may not disclose information that identifies you as a substance use disorder patient to law enforcement unless a specific legal exception applies.
We may disclose PHI to coroners, medical examiners, or funeral directors as necessary for them to carry out their duties, consistent with applicable law and 42 C.F.R. Part 2 when it applies.
We may use or disclose PHI for research purposes in limited situations and only when certain privacy protections are in place or when you provide written consent, if required by law.
With your verbal permission or when allowed by law, we may share limited information with a family member, close friend, or other person you identify as being involved in your care or payment for your care.
When 42 C.F.R. Part 2 applies, we will generally obtain your written consent before sharing substance use disorder information with family or others, unless an exception applies.
For most uses and disclosures of PHI that are not described in this Notice, we will obtain your written authorization. Examples include:
If you provide written authorization, you may revoke it at any time in writing, except to the extent that we have already acted based on your authorization.
You have several rights with respect to your PHI. Some rights may be limited in certain situations under HIPAA, 42 C.F.R. Part 2, or state law.
You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations, or to individuals involved in your care.
We are not required to agree to every request, but if we agree, we will follow the restriction except in an emergency or when the law allows or requires a disclosure.
You have the right to request that we communicate with you in a specific way or at a specific location. For example, you may ask us to contact you at a certain phone number or mailing address.
We will accommodate reasonable requests when they are practical.
You have the right to request access to inspect and obtain a copy of certain PHI that we maintain about you. This usually includes medical and billing records.
We may charge a reasonable fee to cover the cost of copying, mailing, or other supplies associated with your request. In some cases, we may deny your request, but you may have the right to have the denial reviewed.
If you believe that information in your record is incorrect or incomplete, you may request that we amend it.
We may deny your request in some situations, for example when the information was not created by us, is already accurate and complete, or is part of a record that we are not allowed to change. If we deny your request, we will provide a written explanation. You have the right to submit a statement of disagreement that we will include with your record.
You have the right to request a list (an “accounting”) of certain disclosures of your PHI that we have made in a specific time period, up to six years before the date of your request. This list will not include disclosures made for treatment, payment, or healthcare operations, and some other types of disclosures.
You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically. You can request a copy by contacting us using the information below.
If a breach of your unsecured PHI occurs, we will notify you as required by law.
To exercise any of the rights described in this Notice or to ask questions about your rights, contact us at:
Some requests must be in writing. We will tell you if a written request is required and will explain any forms or steps needed.
We reserve the right to change this Notice at any time, as permitted by law. Any revised Notice will apply to PHI that we already have, as well as PHI we receive in the future.
When we change this Notice, we will update the effective date at the top of the page and post the new Notice on our website. We will also make copies available at our facility upon request.
If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services (HHS).
To file a complaint with us:
To file a complaint with HHS:
You can file a complaint with the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services. Visit the OCR website for current instructions.
You will not be retaliated against for filing a complaint or for exercising any of your privacy rights.
If you have questions about this Notice or our privacy practices, contact:
Sacred Journey Recovery Solutions LLC
