Company: Present Moments Recovery
Notice of Privacy Practices
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.
When it comes to your health information, you have certain rights. This section explains your rights and some of Present Moments responsibilities to help you.
Get an electronic or paper copy of your medical record
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications methods
You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.
Ask us to limit what we use or share and with whom we share it
Present Moments Recovery will ensure the confidentiality of the client and the client's files and information in accordance with Title 42, Code of Federal Regulations, Part 2, and the Health Insurance Portability and Accountability Act (HIPAA). Generally, the program is prohibited from disclosing to an individual, family member, agency, employer, law enforcement, or any other entity not employed or contracted by Present Moments Recovery and held accountable to confidentiality and non-disclosure guidelines, that a client attends the program or disclose any information identifying a client as an alcohol or drug abuser unless:
- The client consents in writing.
- The disclosure is allowed by a court order.
- The disclosure is made to medical personnel in a medical emergency or to designated and qualified staff for research, audit or program evaluation.
All appointments and the contents shared during individual counseling sessions and the content heard during group therapy/education sessions are held in confidence. This includes all file notes, personal information provided, and all data collected. No disclosures will be made without written permission of the client.
California state law limits confidentiality and mandates reporting to authorities in the following circumstances:
- Incidents that involve child or elder or dependent abuse (including but not limited to) neglect, sexual abuse, financial abuse, emotional and/or psychological abuse.
- Disclosures of intent to take harmful, dangerous or criminal action against another person or against oneself.
- Crimes committed on the premises or against a program staff member.
- All medical emergencies.
The confidentiality of medical and substance abuse information is protected by State and Federal Statutes, Rules and Regulations, including: California Confidentiality of Medical Information Act; California Administrative Code, Title 22; California Welfare and Institutions Code, Section 5328; and Title 42 of the Code of Federal Regulations. These statutes, rules and regulations require that the client or the client's authorized representative give informed consent before the release of any records or information, except as specifically provided for within the statutes, rules and regulations.
The client or authorized representative must state on a proper consent form:
- The name or general designation of the program(s) or persons making the disclosure,
- The name of the individual or organization that will receive the disclosure;
- The name of the client who is subject of the disclosure;
- The purpose or need for the disclosure;
- How much and what kind of information will be disclosed;
- The date, event or condition upon which the consent expires if not previously revoked, revocation may be verbal or in writing.
- The signature of the client and the date on which the consent is signed.
- The client may revoke the consent at any time
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act on your behalf and for your best interests
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
You can complain if you feel we have violated your rights by contacting us using the information on the back page.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue,
S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, we never share your information unless you give us written permission:
Sale of your information
Third parties are not affiliated with your care unless under court order
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
We can use your health information and share it with other healthcare professionals who are treating you.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see:
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
We will never share any substance abuse treatment records without your written permission or a court order.
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
This Notice of Privacy Practices applies to the following organizations
Present Moments Recovery, 1207 Carlsbad Village Drive, Suite Q, Carlsbad, CA 92008
PMR IOP, 2945 Harding Street, Suite 213, Carlsbad, CA 92008
EFFECTIVE DATE OF NOTICE: 08/30/2021