Hollywood Hills Recovery
Thank you for choosing to be part of our community at Hollywood Hills Recovery ("Company", "we", "us", "our"). We are committed to protecting your personal information and your right to privacy. If you have any questions or concerns about this privacy notice, or our practices with regards to your personal information, please contact us at info@hollywoodhillsrecovery.com.
When you visit our website hollywoodhillsrecovery.com (the "Website"), and more generally, use any of our services (the "Services", which include the Website), we appreciate that you are trusting us with your personal information. We take your privacy very seriously. In this privacy notice, we seek to explain to you in the clearest way possible what information we collect, how we use it and what rights you have in relation to it. We hope you take some time to read through it carefully, as it is important. If there are any terms in this privacy notice that you do not agree with, please discontinue use of our Services immediately.
This privacy notice applies to all information collected through our Services (which, as described above, includes our Website), as well as, any related services, sales, marketing or events.
Please read this privacy notice carefully as it will help you understand what we do with the information that we collect.
TABLE OF CONTENTS
1. WHAT INFORMATION DO WE COLLECT?
2. HOW DO WE USE YOUR INFORMATION?
3. WILL YOUR INFORMATION BE SHARED WITH ANYONE?
4. DO WE USE COOKIES AND OTHER TRACKING TECHNOLOGIES?
5. IS YOUR INFORMATION TRANSFERRED INTERNATIONALLY?
6. HOW LONG DO WE KEEP YOUR INFORMATION?
7. HOW DO WE KEEP YOUR INFORMATION SAFE?
8. WHAT ARE YOUR PRIVACY RIGHTS?
9. CONTROLS FOR DO-NOT-TRACK FEATURES
10. DO CALIFORNIA RESIDENTS HAVE SPECIFIC PRIVACY RIGHTS?
11. DO WE MAKE UPDATES TO THIS NOTICE?
12. HOW CAN YOU CONTACT US ABOUT THIS NOTICE?
13. HOW CAN YOU REVIEW, UPDATE OR DELETE THE DATA WE COLLECT FROM YOU?
Information automatically collected
In Short: Some information — such as your Internet Protocol (IP) address and/or browser and device characteristics — is collected automatically when you visit our Website.
We automatically collect certain information when you visit, use or navigate the Website. This information does not reveal your specific identity (like your name or contact information) but may include device and usage information, such as your IP address, browser and device characteristics, operating system, language preferences, referring URLs, device name, country, location, information about how and when you use our Website and other technical information. This information is primarily needed to maintain the security and operation of our Website, and for our internal analytics and reporting purposes.
Like many businesses, we also collect information through cookies and similar technologies.
The information we collect includes:
Log and Usage Data. Log and usage data is service-related, diagnostic, usage and performance information our servers automatically collect when you access or use our Website and which we record in log files. Depending on how you interact with us, this log data may include your IP address, device information, browser type and settings and information about your activity in the Website (such as the date/time stamps associated with your usage, pages and files viewed, searches and other actions you take such as which features you use), device event information (such as system activity, error reports (sometimes called 'crash dumps') and hardware settings).
Device Data. We collect device data such as information about your computer, phone, tablet or other device you use to access the Website. Depending on the device used, this device data may include information such as your IP address (or proxy server), device and application identification numbers, location, browser type, hardware model Internet service provider and/or mobile carrier, operating system and system configuration information.
Location Data. We collect location data such as information about your device's location, which can be either precise or imprecise. How much information we collect depends on the type and settings of the device you use to access the Website. For example, we may use GPS and other technologies to collect geolocation data that tells us your current location (based on your IP address). You can opt out of allowing us to collect this information either by refusing access to the information or by disabling your Location setting on your device. Note however, if you choose to opt out, you may not be able to use certain aspects of the Services.
Information collected from other sources
In Short: We may collect limited data from public databases, marketing partners, and other outside sources.
In order to enhance our ability to provide relevant marketing, offers and services to you and update our records, we may obtain information about you from other sources, such as public databases, joint marketing partners, affiliate programs, data providers, as well as from other third parties. This information includes mailing addresses, job titles, email addresses, phone numbers, intent data (or user behavior data), Internet Protocol (IP) addresses, social media profiles, social media URLs and custom profiles, for purposes of targeted advertising and event promotion.
In Short: We process your information for purposes based on legitimate business interests, the fulfillment of our contract with you, compliance with our legal obligations, and/or your consent.
We use personal information collected via our Website for a variety of business purposes described below. We process your personal information for these purposes in reliance on our legitimate business interests, in order to enter into or perform a contract with you, with your consent, and/or for compliance with our legal obligations. We indicate the specific processing grounds we rely on next to each purpose listed below.
We use the information we collect or receive:
To facilitate account creation and logon process. If you choose to link your account with us to a third-party account (such as your Google or Facebook account), we use the information you allowed us to collect from those third parties to facilitate account creation and logon process for the performance of the contract.
To post testimonials. We post testimonials on our Website that may contain personal information. Prior to posting a testimonial, we will obtain your consent to use your name and the content of the testimonial. If you wish to update, or delete your testimonial, please contact us at info@hollywoodhillsrecovery.com and be sure to include your name, testimonial location, and contact information.
Request feedback. We may use your information to request feedback and to contact you about your use of our Website.
To enable user-to-user communications. We may use your information in order to enable user-to-user communications with each user's consent.
To manage user accounts. We may use your information for the purposes of managing our account and keeping it in working order.
To send administrative information to you. We may use your personal information to send you product, service and new feature information and/or information about changes to our terms, conditions, and policies.
To protect our Services. We may use your information as part of our efforts to keep our Website safe and secure (for example, for fraud monitoring and prevention).
To enforce our terms, conditions and policies for business purposes, to comply with legal and regulatory requirements or in connection with our contract.
To respond to legal requests and prevent harm. If we receive a subpoena or other legal request, we may need to inspect the data we hold to determine how to respond.
Fulfill and manage your orders. We may use your information to fulfill and manage your orders, payments, returns, and exchanges made through the Website.
Administer prize draws and competitions. We may use your information to administer prize draws and competitions when you elect to participate in our competitions.
To deliver and facilitate delivery of services to the user. We may use your information to provide you with the requested service.
To respond to user inquiries/offer support to users. We may use your information to respond to your inquiries and solve any potential issues you might have with the use of our Services.
To send you marketing and promotional communications. We and/or our third-party marketing partners may use the personal information you send to us for our marketing purposes, if this is in accordance with your marketing preferences. For example, when expressing an interest in obtaining information about us or our Website, subscribing to marketing or otherwise contacting us, we will collect personal information from you. You can opt-out of our marketing emails at any time (see the "WHAT ARE YOUR PRIVACY RIGHTS?" below).
Deliver targeted advertising to you. We may use your information to develop and display personalized content and advertising (and work with third parties who do so) tailored to your interests and/or location and to measure its effectiveness.
For other business purposes. We may use your information for other business purposes, such as data analysis, identifying usage trends, determining the effectiveness of our promotional campaigns and to evaluate and improve our Website, products, marketing and your experience. We may use and store this information in aggregated and anonymized form so that it is not associated with individual end users and does not include personal information. We will not use identifiable personal information without your consent.
In Short: We only share information with your consent, to comply with laws, to provide you with services, to protect your rights, or to fulfill business obligations.
We may process or share your data that we hold based on the following legal basis:
Consent: We may process your data if you have given us specific consent to use your personal information for a specific purpose.
Legitimate Interests: We may process your data when it is reasonably necessary to achieve our legitimate business interests.
Performance of a Contract: Where we have entered into a contract with you, we may process your personal information to fulfill the terms of our contract.
Legal Obligations: We may disclose your information where we are legally required to do so in order to comply with applicable law, governmental requests, a judicial proceeding, court order, or legal process, such as in response to a court order or a subpoena (including in response to public authorities to meet national security or law enforcement requirements).
Vital Interests: We may disclose your information where we believe it is necessary to investigate, prevent, or take action regarding potential violations of our policies, suspected fraud, situations involving potential threats to the safety of any person and illegal activities, or as evidence in litigation in which we are involved.
More specifically, we may need to process your data or share your personal information in the following situations:
Business Transfers. We may share or transfer your information in connection with, or during negotiations of, any merger, sale of company assets, financing, or acquisition of all or a portion of our business to another company.
Google Maps Platform APIs. We may share your information with certain Google Maps Platform APIs (e.g., Google Maps API, Place API). To find out more about Google’s Privacy Policy, please refer to this link.
In Short: We may use cookies and other tracking technologies to collect and store your information.
We may use cookies and similar tracking technologies (like web beacons and pixels) to access or store information. Specific information about how we use such technologies and how you can refuse certain cookies is set out in our Cookie Notice.
In Short: We may transfer, store, and process your information in countries other than your own.
Our servers are located in. If you are accessing our Website from outside, please be aware that your information may be transferred to, stored, and processed by us in our facilities and by those third parties with whom we may share your personal information (see "WILL YOUR INFORMATION BE SHARED WITH ANYONE?" above), in and other countries.
If you are a resident in the European Economic Area (EEA) or United Kingdom (UK), then these countries may not necessarily have data protection laws or other similar laws as comprehensive as those in your country. We will however take all necessary measures to protect your personal information in accordance with this privacy notice and applicable law.
In Short: We keep your information for as long as necessary to fulfill the purposes outlined in this privacy notice unless otherwise required by law.
We will only keep your personal information for as long as it is necessary for the purposes set out in this privacy notice, unless a longer retention period is required or permitted by law (such as tax, accounting or other legal requirements).
When we have no ongoing legitimate business need to process your personal information, we will either delete or anonymize such information, or, if this is not possible (for example, because your personal information has been stored in backup archives), then we will securely store your personal information and isolate it from any further processing until deletion is possible.
In Short: We aim to protect your personal information through a system of organizational and technical security measures.
We have implemented appropriate technical and organizational security measures designed to protect the security of any personal information we process. However, despite our safeguards and efforts to secure your information, no electronic transmission over the Internet or information storage technology can be guaranteed to be 100% secure, so we cannot promise or guarantee that hackers, cybercriminals, or other unauthorized third parties will not be able to defeat our security, and improperly collect, access, steal, or modify your information. Although we will do our best to protect your personal information, transmission of personal information to and from our Website is at your own risk. You should only access the Website within a secure environment.
In Short: You may review, change, or terminate your account at any time.
If you are a resident in the EEA or UK and you believe we are unlawfully processing your personal information, you also have the right to complain to your local data protection supervisory authority. You can find their contact details here: http://ec.europa.eu/justice/data-protection/bodies/authorities/index_en.htm.
If you are a resident in Switzerland, the contact details for the data protection authorities are available here: https://www.edoeb.admin.ch/edoeb/en/home.html.
Cookies and similar technologies: Most Web browsers are set to accept cookies by default. If you prefer, you can usually choose to set your browser to remove cookies and to reject cookies. If you choose to remove cookies or reject cookies, this could affect certain features or services of our Website. To opt-out of interest-based advertising by advertisers on our Website visit http://www.aboutads.info/choices/.
Most web browsers and some mobile operating systems and mobile applications include a Do-Not-Track ("DNT") feature or setting you can activate to signal your privacy preference not to have data about your online browsing activities monitored and collected. At this stage no uniform technology standard for recognizing and implementing DNT signals has been finalized. As such, we do not currently respond to DNT browser signals or any other mechanism that automatically communicates your choice not to be tracked online. If a standard for online tracking is adopted that we must follow in the future, we will inform you about that practice in a revised version of this privacy notice.
In Short: Yes, if you are a resident of California, you are granted specific rights regarding access to your personal information.
California Civil Code Section 1798.83, also known as the "Shine The Light" law, permits our users who are California residents to request and obtain from us, once a year and free of charge, information about categories of personal information (if any) we disclosed to third parties for direct marketing purposes and the names and addresses of all third parties with which we shared personal information in the immediately preceding calendar year. If you are a California resident and would like to make such a request, please submit your request in writing to us using the contact information provided below.
If you are under 18 years of age, reside in California, and have a registered account with the Website, you have the right to request removal of unwanted data that you publicly post on the Website. To request removal of such data, please contact us using the contact information provided below, and include the email address associated with your account and a statement that you reside in California. We will make sure the data is not publicly displayed on the Website, but please be aware that the data may not be completely or comprehensively removed from all our systems (e.g. backups, etc.).
In Short: Yes, we will update this notice as necessary to stay compliant with relevant laws.
We may update this privacy notice from time to time. The updated version will be indicated by an updated "Revised" date and the updated version will be effective as soon as it is accessible. If we make material changes to this privacy notice, we may notify you either by prominently posting a notice of such changes or by directly sending you a notification. We encourage you to review this privacy notice frequently to be informed of how we are protecting your information.
If you have questions or comments about this notice, you may email us at info@hollywoodhillsrecovery.com or by post to:
Hollywood Hills Recovery
6221 Holly Mont Dr, Los Angeles, CA 90068, USA
Los Angeles, CA 90068
United States
Handling of Resident Records
The primary purpose of the resident records review at Hollywood Hills Recovery is to maintain the quality and integrity of the resident’s chart. This is done through quality assurance audits. These audits are done per HIPPA Laws, The Joint Commission standards, California statute laws, and Hollywood Hills Recovery internal policies. The secondary purpose is to fulfill resident record requests made by external organizations. To complete the request in a timely manner and abide by all laws and regulations regarding authorizations to release information. It is the policy of Hollywood Hills Recovery to establish procedures for the practice of Resident records retention and distribution.
G. All charts must be thoroughly audited before being sent out. Please use discretion when sending out personal information to anyone.
H. All requests must be filed and a record of them should be kept on file. This is to ensure that all requests made were fulfilled and in a timely manner.
2. Internal Audits – Audits are completed as follows:
Resident Records Deficiency
It is the policy of Hollywood Hills Recovery that all resident record deficiencies shall be completed within 14 days of the resident’s discharge.
Correction of Resident Record Errors
It is the policy of Hollywood Hills Recovery that resident record documentation errors may be corrected only in a manner that preserves their integrity. The electronic resident record can be documented by adding a Note Update or Assessment Update to the form. In this update, the error will be noted, and the correct information will be documented.
The correction needs to be documented, including which entry the correction is replacing, and dated. In questionable situations, have the corrected notation witnessed by a colleague. Nothing may be removed or deleted from a resident record, and no irrelevant or facetious notations may be made in them.
Records Reviewed by Court Order
It is the policy of Hollywood Hills Recovery to review all resident records requested by a court order prior to release.
Confidentiality
It is the policy of Hollywood Hills Recovery to assure that the information in the resident’s healthcare records and any information pertaining to the identity of a resident, the resident’s diagnosis, prognosis, treatment, and condition are treated as confidential and disclosed only to authorized persons as stipulated by 42 Code of Federal Regulations, part 2 governing the alcohol and drug abuse treatment records. Hollywood Hills Recovery residents' records are also protected under standards for privacy of individuality, identifiable health information 45 Code of Federal Regulation part 160-164 (also referred to as HIPPA). When there is a conflict between regulations, the most restrictive will apply.
A “Consent and authorization for release of information” form must be signed by the resident indicating to whom Hollywood Hills Recovery is authorized to release information. The resident confidentiality will be maintained, and information will not be divulged without prior approval. The residents may revoke consent at any time.
Prior to release, the administrator or his/her designee must approve all authorized releases made by Hollywood Hills Recovery. When answering the telephone, Hollywood Hills Recovery staff will never confirm or deny a resident is part of the program without express written consent of the resident. In addition, the program ensures confidentiality of closed files and their destruction, as outlined in the resident file's privacy.
Federal and state confidentiality regulations authorize disclosure of information regarding the identity, diagnosis, prognosis, or treatment of alcohol and/or other drug program resident/residents under specific guidelines. Hollywood Hills Recovery shall adhere to the regulations stipulated in the code of federal regulations (Titles 42, Sections 2.1 through 2.67- 1), the state of California Welfare and Institutions Code (section 5326 through 5330) and other provisions.
Any information, recorded or not, related to a resident of Hollywood Hills Recovery, is to be afforded full confidentiality as outlined in the above regulations. Exceptions to confidentiality are as follows:
Violation of the Federal and State Laws and Regulations by a program is a crime. Suspected violations may be reported to the United States Attorney in the district where the violation occurs. Federal regulations allow information sharing among programs with Qualified Service Organization Agreements (QSOA’s), as follows:
Staff who fail to abide by Hollywood Hills Recovery's program’s Confidentiality Policy are subject to termination of employment. Hollywood Hills Recovery has a lawful duty to safeguard confidential information concerning clients, alumni, staff members and agency business. Unauthorized accessing and/or disclosure of confidential information by agency employees are prohibited and may result in disciplinary sanctions.
Hollywood Hills Recovery acknowledges that prospective, current, and former clients and staff members have the right to privacy and protection against release of personal information to sources that have no legitimate need for such data. Hollywood Hills Recovery clients and staff members alike shall receive maximum protection against invasion of their privacy.
Restrictions and Violations
There are state laws, federal guidelines, and agency policies that govern the release of confidential information:
Staff members are responsible for knowing the confidentiality laws, policies and guidelines that pertain to their location. Staff members sign a client confidentiality acknowledgement upon hire. In addition, supervisors are responsible for informing staff members about restrictions on confidential information. All employees must strictly comply with this policy. When in doubt, they should assume information is confidential and not disclose it until if/when they are authorized to do so.
Hollywood Hills Recovery staff members shall maintain client confidentiality in all communications in accordance with Federal Guidelines (42 CFR Part 2) and HIPAA Regulations (45 CFR). In addition to a Confidential Information Release Authorization, the following disclosure will accompany all electronic transmissions of confidential client information in compliance with Federal Guidelines and HIPAA Regulations on confidentiality:
“Protected Health Information (PHI) is personal and sensitive information related to a person’s health care. It is being faxed to you after appropriate authorization from the
resident or under circumstances that do not require resident authorization. You, the recipient, are obligated to maintain it in a safe, secure, and confidential manner.
Re-disclosure without additional resident consent or as permitted by law is prohibited. Unauthorized disclosure or failure to maintain confidentiality could subject you to
penalties described in federal and state laws. This transmission is intended only for those to which it is addressed and may contain information that is privileged,
confidential, or protected by law. All others are hereby notified that receipt of this message does not waive any applicable privilege or exemption from disclosure and that
any dissemination, distribution, or copying of this communication is prohibited. If you have received this communication in error, please notify us immediately and shred this
documentation.”
Client Notification of Confidentiality Requirements
At the time of the client’s initial assessment, staff shall inform the client of California and federal laws and regulations that protect the confidentiality of their treatment episode along with records thereof.
Upon intake the client shall be given a written summary of the laws and regulations governing confidentiality. The client will read, acknowledge, and sign the summary. A copy of this acknowledgement is to be kept in the client record.
Release of Confidential Employee Information
The agency limits the authorized release of reference information on current/former employees to confirmation of dates of employment, position(s) held and salary verification. Requests for employment verification must be received via fax, email or postal mail and include an authorized signature for release of the information.
Any further information provided by residents is construed to be a personal reference for which the agency is not responsible.
Research
Hollywood Hills Recovery does not normally conduct research as a matter of practice; however, we reserve the right to initiate this process. If Hollywood Hills Recovery does conduct research using residents as subjects, we shall comply with all standards of the California Research Advisory Panel and the federal regulations for protection of human subjects (Title 45, Code of Federal Regulations, 46).
All individuals who apply for services, regardless of sex, race, age, color, creed, financial status, or national origin, are assured that their lawful rights as Clients shall be guaranteed and protected. While being served, you the Client are assured and guaranteed the following rights:
1. To be treated with respect and dignity.
2. To receive timely treatment by qualified professionals.
3. To receive quality treatment that is best suited to his/her needs and shall include appropriate services, whether they be medical, vocational, social, educational, and/or rehabilitative services.
4. To express by signature an informed consent of the right to release information for communication purposes with other agencies.
5. To receive communication and correspondence from individuals.
6. To privacy for interview/counseling sessions.
7. To practice your religious practices.
8. To be provided humane care and protection from harm.
9. To contract and consult with legal counsel and private practitioners of your choice at your expense.
10. To exercise your constitutional, statutory, and civil rights.
11. To be free of physical restraint or seclusion.
12. To be informed of the nature of treatment or rehabilitation, the known effects of receiving the treatment or rehabilitation, and alternative treatment or rehabilitation programs.
13. To be provided information on an ongoing basis regarding your treatment or rehabilitation.
14. To be provided services in accordance with standards of practice, appropriate to your needs, and designed to afford you a reasonable opportunity to improve your condition.
15. To confidentiality of the Client being in treatment and of the Client’s records. The Federal Rules restricts any use of information to criminally investigate or prosecute any alcohol or drug abuse Client. Federal regulations state any person who violates any provision of the law shall be fined not more the $500.00 in the case of the first offense and not more than $5,000.00 in the case of each subsequent offense, except where noted in the Federal Law of Confidentiality, 42 CFR, Part 2, Section 2.22, which includes the following:
16. To receive full information regarding the treatment process.
17. To refuse treatment.
18. To all other constitutional and legal rights, including the right to personal clothing and effects.
19. To be informed of the Client grievance procedure upon request.
Confidentiality of Alcohol and Drug Abuse Patient Records/Limits to Confidentiality:
The confidentiality of alcohol and drug abuse Client records maintained by this program is protected by Federal law and regulations. Generally, the program may not say to a person outside the program that Client attends the program or disclose any information identifying a Client as an alcohol or drug abuser unless:
Violation of the Federal law and regulations by a program is a crime. Suspected violation may be reported appropriate authorities in accordance with Federal regulations.
Federal law and regulations do not protect any information about a crime committed by Client either at the program or against any person who works for the program or about any threat to commit such a crime.
Federal laws and regulations do not protect any information about elderly abuse, suspected child abuse or neglect, threats to harm to self or others from being protected. These may be released under State law to appropriate State or local authorities beyond Federal CFR42-Regulations.
(See 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR Part 2 for Federal regulations,)
Grievance Procedure:
1. Any person(s) who believes that their rights have been violated or has a compliant or grievance may file a complaint pursuant to the procedures set forth below, on their behalf or on the behalf of another person. All persons are encouraged to file a grievance. By filing a complaint, the individual will not subject themselves to any form of adverse action, reprimand, retaliation, or otherwise negative treatment by Hollywood Hills Recovery. Client shall have immediate access to the grievance form; a posting of the grievance procedure will be in the group room with the levels of appeals, and in the Patient handbook.
2. The processing procedures for grievances and complaints are as follows:
3. The Clinical Director and the Director shall take steps to ensure an appropriate investigation of each complaint to determine its validity. These rules contemplate informal, but thorough, investigations affording all interested persons and their representatives, if any, an opportunity to submit evidence relevant to the complaint.
4. Any allegations of physical or sexual abuse by a therapist shall immediately be brought to the attention of the Clinical Director and the police shall be notified. The Client will be afforded the opportunity to contact the Police, state Abuse Hotline, state department of family services and the state disability rights department where applicable. The telephone numbers of the hotlines are posted on the Client Bulletin Board.
PERSONAL RIGHTS
ALCOHOL RECOVERY AND DRUG TREATMENT FACILITIES C-9
In accordance with Title 9, Chapter 4, Section 10569, of the California Code of Regulations, each person receiving services from a residential alcoholism or drug abuse recovery or treatment facility shall have rights which include, but are not limited to, the following:
1. The right to confidentiality as provided for in Title 42, Sections 2.1 through 2.67-1, Code of Federal Regulations. A copy is available upon your request.
2. No client will be discriminated against based on race, religion, age, sex, disability, handicaps, national ancestry, ethnic group identification, color, or sexual orientation. No client will be denied the opportunity to participate in the recovery program based on any form of discrimination.
3. To be treated with dignity and respect in personal relationships with staff, volunteers, Board Members, and other persons.
4. To be accorded safe, healthful, and comfortable accommodations to meet his or her needs.
5. To be free from verbal, intellectual, emotional and/or physical abuse and inappropriate sexual behavior.
6. To be informed by the licensee of the provisions of law regarding complaints including, but not limited to, the address and telephone number of the Department of Health Care Services. (See below)
7. To be informed by the program of the procedures to file a grievance or appeal discharge.
8. To be free to attend religious services or activities of his or her choice and to have visits from a spiritual advisor provided that these services or activities do not conflict with facility program requirements. Participation in religious services will be voluntary only.
9. To be accorded access to his or her file.
COMPLAINTS
In accordance with Title 9, Chapter 4, Section 10543(a), of the California Code of Regulations, any individual may request an inspection of an alcoholism or drug abuse recovery or treatment facility. Complaints should be directed to:
First Contact:
Darren Lipshitz, MD
Hollywood Hills Recovery
6221 Holly Mont Drive
Los Angeles, CA 90068
Tel: 323-798-4475
Email: info@hollywoodhillsrecovery.com
To report details of your complaint to the State:
Department of Health Care Services
Licensing and Certification Branch, MS 2600
P.O. Box 997413, MS 2600
Sacramento, CA 95899-7413
Attention: Complaint Coordinator
Tel: 916-322-2911 or 877-685-8333
Fax: 916-322-2658
Your Information.
Your Rights.
Our Responsibilities.
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
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get a copy of your health and claims records
• You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct health and claims records
• You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communication
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will consider all reasonable requests and must say “yes” if you tell us, you would be in danger if we do not.
Ask us to limit what we use or share
• You can ask us not to use or share certain health information for treatment, payment, or our operations.
• We are not required to agree to your request, and we may say “no” if it would affect your care.
Get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us using the information on the back page.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in payment for your care• Share information in a disaster relief situation
If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
Our Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways.
Help manage the health care treatment you receive
• We can use your health information and share it with professionals who are treating you.
Run our organization
• We can use and disclose your information to run our organization and contact you when necessary.
• We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.
Pay for your health services
• We can use and disclose your health information as we pay for your health services.
Administer your plan
• We may disclose your health information to your health plan sponsor for plan administration.
Our Uses and Disclosures
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
• We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety
Do research
• We can use or share your information for health research.
Comply with the law
• We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers compensation, law enforcement, and other government requests
• We can use or share health information about you:
• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
• We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our website, and we will mail a copy to you.
DHCS License: View license here
Expires 6/29/2025, 6:00 PM
