Ripple Recovery Ranch (“RRR”)

Notice of Privacy & Confidentiality

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

During your treatment at RRR, our caregivers may gather information about your medical history and current health. This Notice of Privacy Practices explains how that information may be used and shared with others. It also explains your privacy rights regarding this information.

RRR is required by law to abide by the terms of this Notice, to make sure that information that identifies you is kept private, and to give you this Notice of our legal duties and practices with respect to medical information about you. We are also required to notify you in the event there is a breach of your health information.

HIPAA Uses and Disclosures of your Health Information

  1. RRR may use health information to carry out treatment, payment and health care operations.
  2. Treatment is the provision, coordination or management of health care. For example, we may use and disclose your information to consult with a third party or to refer you to other health care providers.
  3. Payment includes the activities necessary to obtain reimbursement for the provision of health care. For example, we may need to give your health plan information about treatment you received at RRR so your health plan will pay us or reimburse you for the treatment.
  4. Health care operations include the activities necessary for RRR to run its business operations. For example, we may use your information to review treatment and services and to evaluate the performance of our staff.

We may use or disclose your health information:

  1. When required by federal, state, or local law.
  2. To support public health activities by reporting as required or authorized by state or federal law. These reports may include the reporting of exposure to a communicable disease or risk of spreading a disease or condition.
  3. To cooperate with law enforcement officials for certain law enforcement purposes as directed by a court order, warrant, criminal subpoena, or other lawful process.
  4. To report abuse or neglect.
  5. To support health oversight activities that are authorized by law, such as administrative or criminal investigations, inspections, licensure or disciplinary actions and other similar activities necessary for appropriate oversight of government benefit programs or functions.
  6. When required by a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death or other duties as required by law.
  7. When necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, as consistent with applicable law and standards.
  8. For judicial or administrative proceedings, in response to a valid court order, administrative order, a grand jury subpoena, or with your written consent.
  9. For research purposes, with your written authorization or as permitted by law.

10. To business associates to perform functions on RRR’s behalf, if the business associate has signed an agreement to protect the confidentiality of the information.

We may disclose your health information to a family member, other relatives, or a close friend or any other person you identify if the information relates to that person’s involvement in your health care if you consent to such a disclosure. If you are unable to agree or object to the use or disclosure, we may disclose such information as necessary if we determine that it is in your best interest.

 

We May Use or Disclose Your Health Information for Other Purposes Only With Your Authorization

Any uses and disclosures of your health information not described elsewhere in this Notice will be made only with your prior written authorization.

State laws may be more stringent and may prohibit certain uses and disclosures identified above. When state law is more protective of your privacy, we will follow that state law. For example, some state laws require additional protection for records related to mental health treatment, drug and alcohol treatment, and HIV-related information.

 

Patient Rights

You have the following rights regarding the use and disclosure of personal health information we maintain about you:

  1. Right to inspect and obtain a copy of your health information.
  2. Right to inspect and obtain a copy of your health information that is used to make decisions about your care for as long as RRR maintains the information. You may request an electronic copy of this health information that we maintain electronically. This right does not apply to certain health information, including information compiled in reasonable anticipation of or for litigation. Requests for access to health information should be made in writing to the RRR Privacy Office. You may also ask us to provide a copy of this health information to another person. In that case, your written request must be signed by you, must clearly identify the person to whom you want us to send the copy of your health information, and must state where the copy is to be sent. If access is denied, you will be provided with a written explanation that sets forth the basis for the denial, a description of how you may review those rights and a description of how you may complain.
  3. Right to request an amendment. You have the right to request that RRR amend your health information if it is incorrect or incomplete. Requests for amendment of information should be made in writing to RRR, Privacy Office, and you must provide a reason that supports your request to have the information changed. RRR may deny your request for an amendment if the request is not in writing and submitted to the Privacy Office. In addition, we may deny your request if you ask us to amend information that: (a) was not created by RRR (unless the person or entity that created the information is no longer available to make the amendment); (b) is not part of the medical information kept by RRR; (c) is not part of the information you would be permitted to inspect and copy; or (d) is accurate and complete.
  4. Right to request a general restriction. A general restriction is one that restricts or limits our use or disclosure of your health information. To request a general restriction, you must identify in this request: (i) what particular information you would like to limit, (ii) whether you want to limit use, disclosure, or both, and (iii) to whom you want the limits to apply. We will consider your request but are not required to agree. We have the right to terminate the restriction if: (i) you agree orally or in writing to terminate the restriction, or (ii) if we inform you of the termination, which becomes effective only for your health information created or received after we inform you of the termination.
  5. Right to request a plan restriction. A plan restriction is one that meets the following three conditions: (a) it is to restrict disclosure of your health information to a health plan for purposes of payment or health care operations; (b) the health information relates solely to a health care item or service for which you, or someone on your behalf, has paid us in full; and (c) the disclosure is not otherwise required by law.
  6. Right to obtain a copy of this Notice. To obtain a paper copy of this notice, contact the RRR Privacy Office.
  7. Exercise right through a personal representative. You may exercise your rights through a personal representative as permitted or required by applicable law. Your personal representative may be required to produce evidence of authority to act on your behalf before that person will be given access to your information or allowed to take any action for you.
  8. Complaints. If you believe your privacy rights have been violated you may complain to the RRR Privacy Office. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. All complaints should be submitted in writing: U.S. Department of Health and Human Services in writing at: U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201 or by telephone at (202)619-0257 or toll free (877)696-6775.. You will not be penalized in any way for filing a complaint.

 

Additional Rights and Requirements Governed by Confidentiality Law, 42 U.S.C. §290dd-2, 42 C.F.R. Part 2

 

We may use or disclose your private health information without your written permission in the following situations:

  1. Pursuant to an agreement with a qualified service organization / business associate that provides services to us;
  2. For research, audit, supervision, or program evaluation;
  3. To report a crime committed on our facility’s premises or against our personnel or any threat to commit such a crime;
  4. To medical personnel in a medical emergency;
  5. In connection with treatment, payment (insurance company), or health care operations;
  6. To appropriate authorities to report suspected child abuse and/or neglect; and
  7. As allowed by a court order.

 

We may not say to a person outside the program, nor disclose any information identifying you as an alcohol and/or drug user, or disclose any other protected information except as permitted by federal law or with your written consent.

 

We must obtain your written consent before we can disclose information about you for payment purposes (for example, health insurers).  Generally, you must also sign a written consent before we can share information for treatment purposes outside the program or for health care operations.

 

Complaints, Questions, and Requests

You may direct your questions about this Notice or RRR’s privacy practices, requests regarding your information, or other privacy or confidentiality concerns to:

 

RRR Privacy Office

2098 Texas Oaks

Spring Branch, TX 78070

 

Phone: 800-214-4038