THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU AND YOUR TREATMENT MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
ROTARY RECOVERY is required by law to maintain the privacy and confidentiality of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Please also respect the privacy of others you encounter in treatment.
ROTARY RECOVERY collects health information about you and stores it in an electronic health record. This is your medical record. The medical record is the property of ROTARY RECOVERY, but the information in the medical record belongs to you. The Health Insurance Portability and Accountability Act (HIPAA) requires ROTARY RECOVERY to maintain the privacy of your medical record. HIPAA generally requires that any uses or disclosures of information in your medical record be limited to the minimum necessary to the purposes of the uses or disclosures. HIPAA also provides you certain rights with respect to the information in your medical record which are described below.
Information relating to your treatment at ROTARY RECOVERY is protected by federal regulations specific to drug and alcohol treatment, which are known as 42 CFR Part 2. These regulations protect the confidentiality of information relating to the identity, diagnosis, prognosis, or treatment of any patient in a drug or alcohol treatment program. ROTARY RECOVERY may not disclose records relating to your treatment without your written consent, except in narrowly limited circumstances. Under 42 CFR Part 2, the terms of a written consent to disclose information must specify the scope and types of information to be disclosed, the parties to whom the information may be disclosed, the purpose of the disclosure and the timeframe of the consent. You may revoke a consent to disclose information relating to drug and alcohol verbally or in writing at any time.
ROTARY RECOVERY may ask for your written consent to disclose treatment information for certain purposes, including releasing treatment information to or obtaining information from your other medical providers, obtaining payment from insurance or other payors, contacting your family either for treatment purposes or in the case of a medical or other emergency. ROTARY RECOVERY will not disclose your treatment information for these purposes without your consent.
ROTARY RECOVERY may disclose treatment information without your written consent under certain narrow circumstances as permitted by 42 CFR Part 2. For treatment purposes, ROTARY RECOVERY is permitted to use and disclose treatment information internally and to entities with which it shares administrative control. ROTARY RECOVERY is permitted to share treatment information as necessary with qualified service organizations that agree to maintain the confidentiality of the information. ROTARY RECOVERY also may disclose treatment information to outside auditors, regulatory agencies, and evaluators and for certain research purposes.
ROTARY RECOVERY may disclose treatment information without your written consent when necessary in a life-threatening medical emergency and may disclose to report a crime on the premises or against ROTARY RECOVERY personnel. ROTARY RECOVERY also may disclose patient information without consent where the state mandates child abuse and neglect reporting; when cause of death is being reported; or when required by a valid court order that contains specific required findings. ROTARY RECOVERY may contact you to share information about ROTARY RECOVERY treatment services or to send you reminder notices of future appointments for your treatment.
1. Your Health Information Rights
In addition to protecting privacy and confidentiality, HIPAA and 42 CFR Part 2 afford you the following rights with respect to your medical record and drug or alcohol treatment information:
2. Changes to this Notice of Privacy Practices
ROTARY RECOVERY reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until amendment is made, ROTARY RECOVERY is required by law to comply with this Notice. Should our privacy practices change, we will provide all current and future patients with a copy of the revised Notice of Privacy Practices
Effective April 2023
III. Complaints Regarding Privacy Practices
Complaints about this Notice of Privacy Practices or how CLIENT NAME handles your health information should be directed to:
ROTARY RECOVERY
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to one of the following:
Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, SW Room 509F, HHH Building
Washington, DC 20201
Illinois Department of Human Services
Division of Substance Use Prevention and Recovery (SUPR)
401 S. Clinton Street, 2nd Floor
Chicago, IL 60607
You may also address your complaint to the regional U.S. Department of Health and Human Services Office for Civil Rights:
Office for Civil Rights – Chicago Regional Office
U.S. Department of Health and Human Services
233 N. Michigan Avenue, Suite 240
Chicago, IL 60601
Phone: (312) 886-2359
Fax: (312) 886-1807
TDD: (800) 537-7697
A list of additional regional offices can be found online at:
https://www.hhs.gov/ocr/about-us/contact-us/index.html
1. How Your Organization May Use and Disclose Protected Health Information (PHI) About an Individual:
ROTARY RECOVERY LLC may use and disclose protected health information (PHI) about an individual in various circumstances, including but not limited to:
2. The Individual’s Rights with Respect to the Information and How the Individual May Exercise These Rights:
As an individual, you have specific rights regarding your PHI:
3. Your Organization’s Legal Duties with Respect to the Information:
ROTARY RECOVERY LLC is committed to complying with the law and maintaining the privacy of protected health information. HIPAA mandates our legal duties in relation to PHI, and we are dedicated to upholding these duties, which include:
4. Whom Individuals Can Contact for Further Information About Your Company’s Privacy Policies:
If you have any questions, concerns, or need further information about ROTARY RECOVERY LLC's privacy policies, you can contact us today.
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