Stirling Behavioral Health Institute

  Mental Health Services Provider

  6931 Van Nuys Blvd. #102 

  Phone (818) 376-0134 
  Fax (818) 376-1437



Patient Privacy



Notice of Privacy Practices / HIPAA


I. 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.



II. IT IS OUR LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI)

  

By law, Stirling Behavioral Health Institute (SBHI) is required to keep your PHI private. SBHI is required to provide you with this Notice about our privacy procedures.


The PHI constitutes information created or noted by SBHI staff that can be used to identify you. It contains data about:

  • your past, present, or future health or condition, 
  • the provision of health care services to you, and 
  • the payment for such health care 


The Notice must explain when, why, and how SBHI would use and/or disclose your PHI. Use of PHI means when SBHI shares, applies, utilizes, examines, or analyzes information within the practice. PHI is disclosed when SBHI releases, transfers, gives or otherwise reveals it to a third party outside SBHI. With some exceptions, SBHI may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. SBHI is always legally required to follow the privacy practices described in this Notice.


SBHI reserves the right to change the terms of this Notice and our privacy policies at any time as permitted by law. Any changes will apply to PHI already on file with SBHI. Before SBHI makes any important changes to these policies, SBHI will immediately change this Notice and post a new copy of it in our offices and on our website. You may also request a copy of this Notice from our staff, or you can view a copy of it in our office or on the website at www.stirlingbhi.org.



III. HOW SBHI WILL USE AND DISCLOSE YOUR PHI.

 
SBHI will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others will not. Below you will find the different ways we may use and disclosure PHI with some examples.


A. Uses and Disclosures Related to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. SBHI may use and disclose your PHI without your consent for the following reasons:


1. For Treatment: SBHI can use your PHI within our practice to provide you with mental health treatment, including discussing or sharing your PHI with my trainees and interns. SBHI may disclose your PHI to physicians, psychiatrists, psychologists and other licensed health care providers who provide you with health care services or are otherwise involved in your care. Example: If a psychiatrist is treating you, SBHI may disclose your PHI to her/him in order to coordinate your care.


2. For Health care operations: SBHI may disclose your PHI to facilitate the efficient and correct operation of the practice. Examples: Quality control – SBHI might use your PHI in the evaluation of the quality of health care services that you have received or to evaluate the performance of the health care professionals who provided you with these services. SBHI may also provide your PHI to our attorneys, Los Angeles County Department of Mental Health (LACDMH) staff, accountants, consultants and others to make sure that SBHI is in compliance with applicable laws.


3. To obtain payment for treatment: SBHI may use and disclose your PHI to bill and collect payment for the treatment and services SBHI provided you. Example: SBHI will send your PHI to LACDMH in order to receive payment for services rendered.


4. Other disclosures: Examples: Your consent isn’t required if you need emergency treatment provided that SBHI attempts to get your consent after treatment is rendered. In the event that SBHI tries to get your consent but you are unable to communicate with SBHI (for example, if you are unconscious or in severe pain) but we think that you would consent to such treatment if you could, SBHI may disclose your PHI.


B. Certain Other Uses and Disclosures Do Not Require Your Consent. SBHI may use and/or disclose your PHI without your consent or authorization for the following reasons:


1. When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or law enforcement. Example: SBHI may make a disclosure to the appropriate officials when a law requires me to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.


2. If disclosure is compelled by a party to a proceeding before a court of an administrative agency pursuant to its lawful authority.


3. If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.


4. If disclosure is compelled by the patient of the patient’s representative pursuant to California Health and Safety Codes or to corresponding federal statutes or regulations, such as the Privacy Rule that requires this Notice.


5. To avoid harm, SBHI may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public (i.e. adverse reaction to meds.).


6. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others and if SBHI determines that disclosure is necessary to prevent the threatened danger.


7. If disclosure is mandated by the California Child Abuse and Neglect Reporting law For example, if SBHI has a reasonable suspicion of child abuse or neglect.


8. If disclosure is mandated by the California Elder/Dependent Adult Abuse Reporting law For example, if SBHI has a reasonable suspicion of elder abuse or dependent adult abuse.


9. If disclosure is compelled or permitted by the fact that you tell us of a serious/imminent threat of physical violence by you against a reasonable identifiable victim or victims.


10. For public health activities Example: In the event of your death, if a disclosure is permitted or compelled, SBHI may need to give the county coroner information about you.


11. For health oversight activities: Example: SBHI may be required to provide information to assist the government in the course of an investigation or inspection of a health care organization or provider.


12. For specific government functions: Examples: SBHI may disclose PHI of military personnel and veterans under certain circumstances. Also, SBHI may disclose PHI in the interest of national security such as protecting the President of the United States or assisting with intelligence operations.


13. For research purposes. In certain circumstances, SBHI may provide PHI in order to conduct medical research.


14. For Workers’ compensation purposes. SBHI may provide PHI in order to comply with Workers’ Compensation laws.


15. Appointment reminders and health related benefits or services. Examples: SBHI may use PHI to provide appointment reminders. SBHI may use PHI to give you information about alternative treatment options, or other health care services or benefits SBHI offers.


16. If an arbitrator or arbitration panel compels disclosures, when arbitration is lawfully requested by either party, pursuant to subpoena duces tectum (e.g. a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding before an arbitrator or arbitration panel.


17. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law. Example: When compelled by U.S. Secretary of health and Human Services to investigate or assess our compliance with HIPAA regulations.


18. If disclosure is otherwise specifically required by law.

 

C. Certain Uses and Disclosures Require You to Have the Opportunity to Object.


SBHI may provide your PHI to a family member, friend or other individual who you indicate is involved in your care unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.

 

D. Other Uses and Disclosure Require Your Prior Written Authorization. 


In any other situation not described in Sections IIIA, IIIB, and IIIC above, SBHI will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization in writing to stop any future use and disclosures of your PHI by us (assuming SBHI hasn’t provided PHI based on the original authorization).



IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI

 
These are your rights with respect to your PHI:

A. The Right to See and Get Copies of Your PHI


In general, you have the right to see your PHI that is in SBHI’s possession, or to get copies of it. The request must be in writing. It SBHI does not have your PHI, but we know who does, SBHI will advise you how you can get it. You will receive a response from SBHI within 30 days of our receiving your written request. Under certain circumstances, SBHI may feel we must deny your request, but if we do, we will give you, in writing, the reasons for the denial. SBHI will also explain your right to have the denial reviewed. If you ask for copies of your PHI, SBHI will charge you not more than $.25 per page. SBHI may see fit to provide you with a summary or explanation of the PHI, but only if you agree to it, as well as to the cost, in advance.

B. The Right to Request Limits on Uses and Disclosures of Your PHI


You have the right to ask that SBHI limit how we use and disclose your PHI. While SBHI considers your request, we are not legally bound to agree. If SBHI does agree to your request, we will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that SBHI is legally required or permitted to make.

C. The Right to Choose How SBHI Sends Your PHI to You It is your right to ask that your PHI be sent to you at an alternate address (for example, sending information to your work address rather than your home address) or by an alternate method (for example, via email instead of the regular mail.) SBHI is obliged to agree to your request providing that we can give you the PHI, in the format you requested, without undue inconvenience. SBHI may not require an explanation form you as to the basis of your request as a condition of providing communications on a confidential basis.

D. The Right to Get a List of the Disclosures SBHI Has Made


You are entitled to a list of disclosures of your PHI that SBHI has made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003. After April 15, 2003, disclosure records will be held for six years.

E. The Right to Amend/Change Your PHI


If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that SBHI correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of SBHI’s receipt of your request. SBHI may deny your request, in writing, if we find that: the PHI is (a) correct and complete (b) forbidden to be disclosed (c) not part of SBHI’s records or (d) written by someone other than SBHI staff. SBHI’s denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and SBHI’s denial be attached to any future disclosures of your PHI. If SBHI approves your request, we will make the change(s) to your PHI. Additionally, SBHI will tell you that the changes have been made, and we will advise all others who need to know about the change(s) to your PHI.

F. The Right to Get This Notice by Email You have the right to get this notice by email. You have the right to request a paper copy of it, as well. 



V. HOW TO COMPLAIN ABOUT SBHI’s PRIVACY PRACTICES


If you believe SBHI may have violated your privacy rights, or if you object to a decision SBHI has made about access to your PHI, you are entitled to file a complaint with the person listed in Section VI below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue, S.W., Washington, D.S., 20201. If you file a complaint about SBHI’s privacy practices, SBHI will take no retaliatory action against you.



VI. PERSON TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN ABOUT SBHI’S PRIVACY PRACTICES 


Stirling Behavioral Health Institute
Administrator
6931 Van Nuys Blvd. #102
Van Nuys, Ca. 91405
(818) 376-0134


Region IX, Office for Civil Rights
U.S. Department of Health and Human Services
50 United Nations Plaza –Room322
San Francisco, Ca. 94102
Voice Phone (415) 437-8310
FAX (415) 437-8329
TDD (415) 437-8311



VII. EFFECTIVE DATE OF THIS NOTICE


7/15/07



© Copyright 2011 ~ Stirling Behavioral Health Institute is funded by the Los Angeles County - Department of Mental Health.