Notice of Privacy Practices

Your rights

You have the right to:

• Get a copy of your health records. Ask us for a paper or electronic copy. We usually provide it within 30 days and may charge a reasonable, cost-based fee.
• Ask us to correct your records if you think they are incorrect or incomplete. If we say no, we will tell you why in writing within 60 days.
• Ask for confidential communications, such as contact at a different phone number or address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. We are not required to agree, and we may say no if it would affect care. If you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer, and we will say yes unless the law requires us to share it.
• Get a list of the times we shared your information in the six years before your request, with whom, and why. This leaves out treatment, payment, operations and some other disclosures. One list per year is free; we may charge a reasonable fee for more.
• Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. A parent or legal guardian, or someone with medical power of attorney, can exercise these rights. We confirm their authority first.
• File a complaint if you believe your privacy rights were violated. Contact our privacy officer (below) or the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

Children 12 and older. Under Illinois law, a child age 12 to 17 may ask to see their own mental health records. A parent or guardian may see the records of a child age 12 to 17 if the child is told and does not object, or if the therapist does not find compelling reasons to deny access. Even then, a parent or guardian may still receive basic information about the child's current condition, diagnosis, treatment needs, services, and medication.

How we use and share your health information

Treatment. We use and share information with the professionals treating you. Example: a therapist shares progress with the evaluating psychologist so the plan stays connected, including between Black Bear Academy and CCNC.

Running our organization. We use information to run our practice, improve care and contact you when needed. Example: reviewing services to train staff and graduate trainees.

Billing. We use and share information to bill and get payment from health plans or other entities. Example: we give your health plan information so it will pay for therapy or an evaluation.

Substance use disorder records. To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Other ways we may share information, as the law allows or requires. In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

• Public health and safety, including reporting suspected abuse or neglect and preventing a serious threat to health or safety.
• Research, under the conditions the law sets.
• Complying with federal and state law, including when the Department of Health and Human Services asks.
• Organ and tissue donation requests, and medical examiners or funeral directors.
• Workers' compensation, law enforcement, health oversight agencies and special government functions.
• Lawsuits and legal actions, in response to a court or administrative order or a subpoena.

Stricter Illinois law. Illinois law gives some information more protection than federal law, including mental health and developmental disability records under the Mental Health and Developmental Disabilities Confidentiality Act (740 ILCS 110). When Illinois law is stricter, we follow it.

Other uses need your written permission. Any use or sharing not described here requires your written permission. You can take that permission back in writing at any time, except for what we already did in reliance on it.