“I learned there is more to recovery than not using. Club Recovery helped me make some choices about my life. I'm back in school now, and I have a future.”
- SS, Minneapolis
(952) 926-2526
Free initial consultations
PRIVACY PRACTICES NOTICE
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.
I. Who We Are
This notice describes the privacy practices notices of Club Recovery, LLC, 6550 York Avenue South, Edina, Minnesota.
II. Our Privacy and Confidentiality Obligations
We understand that health information about you is personal. We are committed to protecting the privacy of your health information by following all applicable federal and state privacy and confidentiality requirements. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice tells you about how we use and disclose health information about you. It also describes your rights to access your health information and certain obligations we have regarding the use and disclosure of your health information.
We are required by law to maintain the privacy and confidentiality of health information about you and to provide you with this notice of our legal duties and privacy practices with respect to your information. When we use or disclose this information, we are required to abide by the terms of this notice (or other notice in effect at the time of the use or disclosure).
Club Recovery’s uses and disclosures of information about you are protected by federal law and regulations on Confidentiality of Alcohol and Drug Abuse Patient Records, by federal law and standards protecting the privacy of individually identifiable information under the Health Insurance Portability and Accountability Act (HIPAA), and by Club Recovery’s own privacy policies and procedures, which may extend to programs and information not covered by either of these laws.
III. Uses of Protected Health Information
A. Uses and Disclosures Without Your Authorization
Club Recovery uses your protected health information for treatment and health care operations and other uses allowable by law. Not every use or disclosure is listed below, but all of the ways we use and disclose information will fall into one of the categories.
For Treatment. Treatment includes diagnosis, treatment, and other services such as discharge planning. For example, counselors may disclose your health information to each other to coordinate individual and group therapy sessions for your treatment or to gain information about treatment alternatives or other health-related benefits and services that are necessary or may be of interest to you.
Health Care Operations. This includes internal administration and planning and various activities that improve the quality and effectiveness of care. For example, we may use information about your care to evaluate the quality of care provided for you. We may disclose information to qualified personnel for outcome evaluation, management audits, financial audits, or program evaluation; however, such personnel may not identify, directly or indirectly, an individual client in any report of such audit or otherwise disclose client identities in any manner. We may disclose your information as needed within Club Recovery in order to resolve any complaints or issues regarding your care. We may also disclose your protected health information to an agent or agency, which provides services to Club Recovery under a qualified service organization agreement, in which they agree to abide by 42 CFR Part 2 and HIPAA. Health Care Operations may also include use of your protected health information for programs offered by Club Recovery, such as sending you invitations to events sponsored by Club Recovery. This list of examples is for illustration only and is not an exclusive list of all the potential uses and disclosures, which may be made for health care operations.
Other allowable uses and disclosures besides treatment and health care operations include:
1. Appointment Reminders. We may contact you to send you reminder notices of future appointments for your treatment.
2. Medical Emergencies. We may disclose your protected health information to medical personnel to the extent necessary to meet a medical emergency (as defined by 42 DFR Part 2).
3. Minors. We may disclose facts relevant to reducing a threat to the life or physical well being of the applicant or any other individual to a parent, guardian, or other person authorized under state law to act in the minor’s behalf if the program director judges that the minor applicant lacks capacity to make a rational decision and the applicant’s situation poses a substantial threat to the life or physical well being of the applicant or any other individual, which may be reduced by communicating relevant facts to such person.
4. Incompetent and Deceased Clients. In such cases authorization of a personal representative, guardian, or other substituted decision maker may be given in accordance with 42 CFR Part 2.
5. Decedents. We may disclose protected health information to a coroner or medical examiner as authorized by law.
6. Duty to Warn. Where the program learns that a patient has made a specific threat of serious physical harm to another specific person or the public, and disclosure is otherwise required under statute and/or common law, the program will carefully consider appropriate options which would permit disclosure subject to 45 CFR 164.512(i).
7. Judicial and Administrative Proceedings. We may disclose your protected health information in response to a court order that meets the requirements of federal regulations, 42 CFR Part 2 concerning Confidentiality of Alcohol and Drug Abuse Patient Records. Note also that if your records are not actually client records with the meaning of 42 CFR Part 2 (e.g. if your records are created as a result of your participation in a family program or another non-treatment setting), your records may not be subject to the protections of 42CFR Part 2.
8. Law Enforcement Officials. We may disclose your protected health information to the police or other law enforcement officials for the purpose of seeking assistance of law enforcement agencies if you commit a crime on the premises or against program personnel, or threaten to commit such a crime.
9. Public Health Activities. We may disclose your protected health information for the following public health activities and purposes: 1) to report child abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports; and 2) to report deaths as required by law.
10. Health Oversight Activities. We may disclose protected health information to a health oversight agency, e.g., state licensure or certification agencies.
11. Marketing Communications. We may contact you with information about Club Recovery health related services and products that may be beneficial to you. Examples of these may be communications about or invitations to continuing care programs, events, and materials appropriate for recovery.
12. If Disclosure Is Otherwise Specifically Required by Law.
B. Use or Disclosure with Your Authorization or Consent.
Other than as described above, we may use or disclose your protected health information for other reasons, including communication with third parties regarding payment, only when you give your authorization to do so in writing on a form that specifically meets the requirements of laws and regulations cited in Section II. You may revoke your authorization by delivering a written statement to your counselor or therapist while you are in treatment at Club Recovery, or to the Director after you are discharged, except to the extent that Club Recovery has acted in reliance on the authorization. Please be aware that a court or other third party could request or compel you to sign an authorization.
IV. Your Individual Rights
A. Right to Receive Confidential Communications. You may request and we will accommodate any reasonable written request for you to receive protected health information by alternative means of communication or at alternative locations.
B. Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of protected health information for treatment, payment, and health care operations. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction. If you wish to request additional restrictions and you are currently receiving services, please contact your counselor or therapist. When you are no long receiving service, contact the Director in writing. We will send you a written response.
C. Right to Inspect and Copy Your Health Information. You may request access to your clinical file and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to a portion of your records. If you desire access to your records, and you are currently receiving services, please ask your counselor or therapist for the records. When you are no longer receiving services, contact the Director in writing. If you request copies, there will be a charge for each page copied, and you will be told the cost prior to the copies being made.
D. Right to Amend Your Records. You have the right to request that we amend protected health information maintained in your clinical file or billing records. If you desire to amend your records and you are currently receiving service, please contact your counselor or therapist. When you are no longer receiving services, contact the Director in writing. Under certain circumstances, Club Recovery has the right to deny your request to amend your records and will notify you of this denial as provided in the HIPAA regulations. If your requested amendment to your records is accepted, a copy of your amendment will become a permanent part of the medical record. Club Recovery is permitted to append information to the original record, as opposed to physically removing or changing the original record. If your requested amendment is denied, you will be informed of your right to have a brief statement of disagreement placed in your medical record.
E. Right to Receive an Accounting of Disclosures. Upon request, you may obtain an accounting of disclosures of your protected health information other than those for which you gave written authorization or those related to your treatment, payment for services, or our health care operations. The accounting will apply only to covered disclosures prior to the date of your request provided such period does not exceed six years and does not apply to disclosures that occurred prior to April 14, 2003. If you request an accounting more than once during a twelve-month period, there will be a charge. You will be told the cost prior to the request being filled.
F. For Further Information: Complaints. If you desire further information about your privacy and confidentially rights, are concerned that we have violated these rights, or disagree with a decision that we made about access to your protected health information, you may contact the Privacy Officer at 952-926-2526. You may also file a written complaint with the Secretary of the Department of Health and Human Services. Upon request, we will provide you with the correct address. We will not retaliate against you if you file a complaint.
G. Right to Receive a Copy of This Notice. Upon request, you may obtain a paper copy of this notice.
V. Effective Date and Duration of This Notice
A. Effective Date. This notice is effective on April 14, 2003.
B. Right to Change Terms of This Notice. We may change the terms of this notice at any time. If we change this notice, we may make the new notice terms effective to all protected health information that we maintain, including any information created or received prior to issuing the new notice. If we change this notice, we will post the new notice in public access areas of our facility. You may also obtain any new notice by contacting the Director.
C. Privacy Office. You may contact the Privacy Officer at 952-926-2526.