HIPAA Notice of Privacy Practices
Effective Date: 02/05/2025
Introduction
At Silver State Adolescent Treatment Center (“Silver State ATC,” “we,” “our,” or “us”), we are committed to protecting your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA). This HIPAA Notice of Privacy Practices explains how we may use and disclose your health information and outlines your rights regarding your PHI.
1. Your Rights Under HIPAA
As a patient, you have several rights regarding your Protected Health Information (PHI):
1.1 Right to Access Your Records
•You have the right to inspect and obtain a copy of your medical and billing records.
•You may request electronic or paper copies of your records.
•Requests must be made in writing, and fees may apply for copies.
1.2 Right to Request Corrections
•If you believe your health information is inaccurate or incomplete, you may request corrections.
•We may deny requests in certain cases but will provide an explanation in writing.
1.3 Right to Request Restrictions
•You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations.
•We are not required to agree to all restrictions unless legally mandated.
1.4 Right to Request Confidential Communications
•You can request that we contact you in a specific way or location (e.g., only by mail or phone).
•We will accommodate reasonable requests.
1.5 Right to an Accounting of Disclosures
•You may request a list of disclosures we have made of your PHI, excluding those made for treatment, payment, and healthcare operations.
1.6 Right to Revoke Authorization
•If you previously gave written consent for a use or disclosure of your PHI, you may revoke your authorization at any time in writing.
1.7 Right to a Copy of This Notice
• You may request a paper copy of this HIPAA Notice of Privacy Practices at any time.
2. How We May Use & Disclose Your PHI
We may use or disclose your Protected Health Information (PHI) in the following ways:
2.1 For Treatment
• We may use your PHI to provide medical treatment and services.
•This may include sharing your PHI with doctors, nurses, therapists, and other healthcare providers involved in your care.
2.2 For Payment
•We may use and disclose your PHI to bill and collect payment from you, your insurance provider, or a third-party payer.
2.3 For Healthcare Operations
•We may use and disclose your PHI to run our facility efficiently, improve care, and comply with regulations.
• This may include staff evaluations, training programs, and quality control reviews.
2.4 When Required by Law
We may disclose your PHI when required by federal, state, or local laws, including:
•Public health reporting (e.g., reporting communicable diseases, child abuse, or neglect).
•Legal proceedings (e.g., court orders, subpoenas).
•Law enforcement requests (e.g., locating missing persons, investigating crimes).
2.5 For Health Oversight Activities
We may share your PHI with government agencies that oversee healthcare facilities for:
•Audits
•Inspections
•Investigations
2.6 For Workers’ Compensation
We may release PHI to comply with workers’ compensation laws or similar programs.
2.7 For Research Purposes
We may use or disclose your PHI for medical research in compliance with HIPAA guidelines.
2.8 In the Event of Death
We may disclose PHI to a coroner, medical examiner, or funeral director as necessary.
3. When We Need Your Authorization
We will not use or disclose your PHI for:
• Marketing purposes
• Sale of PHI
• Sharing psychotherapy notes
Unless you provide written authorization, which you may revoke at any time.
4. How We Protect Your PHI
We implement administrative, technical, and physical safeguards to protect your PHI, including:
✔ Encryption of electronic records
✔ Secure physical storage for paper records
✔ Access controls & staff training to ensure PHI confidentiality
5. Complaints & Filing a Report
If you believe your privacy rights have been violated, you may file a complaint:
5.1 File a Complaint with Silver State ATC
📍 Privacy Officer: Christina Wallis
📧 Email: christina@silverstateatc.com
📞 Phone: 818 928-0026
5.2 File a Complaint with the Office for Civil Rights (OCR)
You may also file a complaint with the U.S. Department of Health & Human Services (HHS):
🔗 HIPAA Complaint Filing – U.S. Department of Health & Human Services
🚨 Filing a complaint will not affect your treatment or services.
6. Changes to This Notice
We reserve the right to change this HIPAA Notice of Privacy Practices at any time. Changes will be:
✅ Posted on our website
✅ Available upon request
The latest version of this notice will always reflect the most current effective date.
7. Contact Information
If you have any questions about this HIPAA Notice of Privacy Practices, contact:
📍 Privacy Officer: Christina Wallis
📧 Email: christina@silverstateatc.com
📞 Phone: 818 928-0026
🏢 Silver State Adolescent Treatment Center