THIS NOTICE IS EFFECTIVE AS OF JULY 1st 2021. PLEASE REVIEW THIS INFORMATION CAREFULLY. THIS NOTICE INTENDS TO DESCRIBE HEADLANDS PRIVACY PRACTICES ABOUT HOW MEDICAL INFORMATION MAY BE USED AND DISCLOSED, AND HOW PATIENTS CAN ACCESS THIS INFORMATION. A FULL COPY OF THIS POLICY IS AVAILABLE UPON REQUEST OR AT THE TIME OF ANY PATIENT ADMISSION.
HEADLANDS ADDICTION TREATMENT SERVICES is committed to protecting the privacy and personal health information, also known as “PROTECTED HEALTH INFORMATION” or “PHI” for all customers receiving our health services.
“Protected Health Information” or “PHI” typically includes demographic information such as the NAME, ADDRESS, DATE OF BIRTH, billing or insurance information, or any other information relative to you as the health service customer. Our organization may obtain or create information to provide health services to patients. This information is considered “PHI.”
“PHI” does not include information that cannot be linked to you. Any unidentifiable information that is not traced back to the patient is not considered protected health information or “PHI.”
This notice of Health Information Privacy Practices (the “Notice”) describes Headlands Addiction Treatment Services also known as HEADLANDS ATS or HATS use of and disclosure of PHI, client rights and protections as well as the state contact for filing complaints.
Headlands ATS is required by law to provide copies of this notice and must abide by these terms and conditions of this notice. Headlands ATS reserves the right to amend this notice at any time to reflect any changes made to the privacy practices. Headlands ATS will collect information or health data from you as the patient after a consent has been given to make additional referrals or to coordinate care. This information may derive from outside entities such as local health care centers, treatment facilities, hospitals, or government agencies. You as the patient have the right to limit consent to release information except for when Headlands ATS is mandated and required by law to provide release of information. Any changes made to this notice will be applicable to all PHI maintained by Headlands ATS maintain prior to the effective date of the revised notice. You as the patient will receive changes made to this policy upon request or via the system’s automatic notification process such as an email.
Headlands complies and abides by all federal and/or state laws to maintain a patient’s privacy. In order to comply with these stipulations, Headlands has developed standard policies and procedures that requires employees to obtain, use and disclose protected health information that ensures patient privacy is maintained. Disclosure is never made without your consent as the patient and Headlands will honor authenticated revocations made by the patient preventing PHI from being shared; except for when required by law.
You as the patient have the right to inspect and copy your PHI in a designated record set that contains information such as medical health services, care coordination and billing. Headlands will ensure that all steps are taken to honor this request, and if we do not have your PHI record set but know who does, we will inform you. If our PHI is a copy of the information maintained by another health care provider, we may direct you to request the recorded PHI from them. Headlands ATS charges an $8.00 clerical fee up and up to $0.25 per page. If Headlands deny the request, this denial can be appealed through Headlands’ denial appeal process.
You as the patient have the right to receive an accounting of your PHI disclosures that were made by Headlands ATS. The accounting of disclosures only includes disclosures that are outside of treatment purposes such as a court ordered responses to a subpoena or similar. You have the right to request that Headlands send your PHI to an alternative address or by alternative means as this becomes necessary.
You as the patient have the right to submit any complaints pertaining to the care or treatment you received when you believe your privacy rights have been violated. It is against the law for anyone to be retaliated against from making a complaint and Headlands will not retaliate against anyone who files a complaint or grievance. You can contact Headlands Risk & Privacy Office at:
Risk & Privacy Office, Department of Complaints & Investigations
Mail to: 215 South Hickory Street, Suite 114, Escondido CA, 92025
OR:
U.S Department of Health and Human Services
200 Independence Avenue, R.509, S.W. Washington D.C. 20201
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