Mind Compass Counseling Notice of Privacy Practices

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This notice describes how your health information may be used and disclosed and how you can get access to this information. We ask that you review it carefully. This notice also describes your rights regarding your health information.  Protected Health Information (PHI) is health information (including identifying information about you) that we have collected from you or received from your health care providers, health plan, your employer or a health care clearinghouse. It may include information about your past, present, or future physical, mental health or substance use disorder.  Federal laws protect the confidentiality of PHI, including substance use disorder treatment. As such, Mind Compass Counseling is bound by both The Health Insurance Portability and Accountability Act (HIPAA), as well as 42 CFR Part 2, which are the federal protections for individuals in substance use disorder services.  If you have any questions or would like to discuss this information, please contact our Privacy/Compliance Officer at (781) 350-5055. 

There are potential situations where your information might be released; with or without your consent.   

If you have given us a valid, signed, dated written Release of Information (ROI), we can release information about you to the 3rd party the release addresses. You have the right to revoke your authorization at any time, and we will not make any further disclosures of your health information under that authorization. Mind Compass Counseling reserves the right to inform other providers when a release has been revoked.

Communication among staff that provides care to you is appropriate in order to ensure high quality and effective care.

In order to ensure that anyone receiving services receives quality care, there are some job responsibilities which require the release of PHI. These tasks include but not limited to quality assurance, licensing and accreditation, staff and student training, general administrative activities, compliance and auditing activities, and program management.

We will ask you to complete a fee agreement which gives us authorization to bill your health insurance. We will be required to disclose your health information (generally – a diagnosis), which enables your health plan to take certain actions before approving your services.

By way of example, some of these actions may include:

• Determining eligibility or coverage for health insurance;
• Determining if the services are medically necessary;
• Determining if the services are appropriately authorized or certified in advance of your care;
• Ensuring the appropriateness of your care or justifying the charges for your care (utilization review).

A medical or psychiatric emergency would be a situation that poses an immediate threat to your health and requires immediate intervention.

Any information provided may only be given to those who need to know to provide emergency interventions (paramedics, emergency room staff, etc.).

If you have provided us with an emergency contact person, we will notify that person as well.

We may disclose health information about you as necessary for public health activities including, by way of example, disclosures to:

• Report to public health authorities for the purpose of preventing or controlling disease, injury or disability;
• Report vital events such as birth or death;
• Conduct public health surveillance or investigations;
• Report child abuse or neglect;
• Report certain events to the Food and Drug Administration (FDA) by a person subject to jurisdiction of the FDA including information about defective products or problems with medications;
• Notify consumers about FDA-initiated product recalls;
• Notify a person who may have been exposed to a communicable disease or who is at risk of contracting or spreading a disease or condition.
• Notify the appropriate government agency if we believe an adult has been a victim of abuse, neglect or domestic.

Mind Compass Counseling will not release information based on a court subpoena unless you allow us to and sign a Release of Information form. Under some circumstances, a court order may override a person’s request not to release confidential information. In addition, Mind Compass Counseling reserves the right to defend itself in a malpractice case.

Note: Your clinician’s credentials and license status impact our ability to respond to court requests. Please speak with your clinician if you have any questions or concerns.

Mind Compass Counseling reserves the right to use information to protect programs and staff.

Oversight agencies include government agencies that oversee the health care systems, government benefits programs such as Medicare or Medicaid, and other government programs regulating health care. Mind Compass Counseling only conducts research that does not require release of PHI.

Mind Compass Counseling staff members are mandated reporters and therefore must abide by state requirements to report abuse/neglect of children, elders and disabled people.

Mind Compass Counseling contracts with other businesses to provide specialized services. These vendors must sign a confidentiality agreement.

Mind Compass Counseling may disclose PHI to maintain public safety. For example: Duty to warn identifiable victim(s) of a dangerous threat made against them.

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Records that are disclosed to a Part 2 program, covered entity, or business associate pursuant to the patient’s written consent for treatment, payment, and health care operations may be further disclosed by that Part 2 program, covered entity, or business associate, without the patient’s written consent, to the extent the HIPAA regulations permit such disclosure.

Mind Compass Counseling will only use and disclose your protected information as described in this notice, or with your written consent.

You may revoke your consent at any time, except to the extent that Mind Compass Counseling has acted in reliance upon it. If you wish to do so, please speak with your provider.

Records, or testimony relaying the content of such records, shall not be used or disclosed in any civil, administrative, criminal, or legislative proceedings against you unless based on your specific written consent, a court order, or otherwise required by law. Records shall only be used or disclosed based on a court order after notice and an opportunity to hear is provided to you (the patient) and/or the holder of the record, where required by 42 USC§290dd-2 and 42 CFR Part 2. A court order authorizing use or disclosure must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed.

• PHI is not disclosed in any fundraising, marketing or sales
• Names of participants are not listed in a Facility- Mind Compass Counseling does not maintain a patient facility directory.
• Mind Compass Counseling will not disclose PHI without authorization for any reason not described in this Notice of Privacy.

• You have the right to inspect and receive copies of your health record.
• You have the right to request restrictions of disclosures, for purposes of treatment, payment, and healthcare operations, including when you have previously provided written consent.
• You have the right to request and obtain restrictions of disclosures to your health plan for those services for which you have paid in
• You have the right to obtain a copy of this notice.
• You have the right to request a list of certain disclosures that have been made by our organization.
• You have the right to request that we communication with you in a specific manner or at a specific location.
• You have the right to discuss this notice with the contact person or office designated at the end of this notice.
• You have the right to request us to amend your health information. This request should be placed in writing and submitted to the Program Director. We may deny your request if:
  • The information was not created by Mind Compass Counseling;
  • The information is not part of deciding your care;
  • The information is not part of the health information you are permitted to inspect.
  • The information in the record is accurate.

If we deny your request to amend, we will send you a written notice stating the basis for the denial and offering you the opportunity to provide a written statement of disagreement. 

You may ask that your request for amendment and our denial notice be attached to all future disclosures of the health information that is the subject of your request.

If you choose to submit a written statement of disagreement, we have the right to prepare a written rebuttal to your statement of disagreement. In this case, we will attach your written statement of disagreement and our rebuttal, as well as your original request and our denial, to all future disclosures of the health information that is the subject of your request.

• Mind Compass Counseling is required by law: to maintain the privacy of records, to provide patients with notice of its legal duties and privacy practices with respect to records, and to notify affected patients following a breach of unsecured records.
• We are required to abide by the terms of this notice currently in
• We reserve the right to change the terms of its notice and to make the new notice provisions effective for records that it maintains. If amended, you will be provided an updated Notice of Privacy Practices at the time of your next service.