Notice of Privacy Practices

Our commitment

Nova Mental Health Corp. ("Nova Mental Health," "we," "us") is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach occurs that may have compromised the privacy or security of your information. We will not use or share your information other than as described here unless you tell us we can in writing. If you give us permission, you may change your mind at any time by letting us know in writing.

California law, including the Confidentiality of Medical Information Act, may give you more protection than federal law. When state law is more protective, we follow it.

Your rights

When it comes to your health information, you have certain rights.

Get a copy of your records

You can ask to see or get an electronic or paper copy of your health records and other health information we have about you. We will provide a copy or a summary, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your records

You can ask us to correct health information that you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, a particular phone number or email address) or to send mail to a different address. We will say yes to all reasonable requests.

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 if it would affect your care. If you pay for a service in full out of pocket, you can ask us not to share information about that service with your health insurer, and we will say yes unless a law requires us to share it.

Get a list of those with whom we have shared information

You can ask for a list (accounting) of the times we have shared your health information for six years before the date you ask, who we shared it with, and why. It will include all disclosures except those for treatment, payment, and health care operations, and certain others (such as any you asked us to make). We will provide one list a year for free and may charge a reasonable, cost-based fee for additional lists within 12 months.

Get a copy of this notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

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 confirm the person has this authority 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 our Privacy Officer (see below). You can also 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.

You have both the right and the choice to tell us whether to share information with your family, close friends, or others involved in your care, and whether to 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 share your information if we believe it is in your best interest. We may also share information when needed to lessen a serious and imminent threat to health or safety.

We never share your information for these purposes unless you give us written permission: marketing, sale of your information, and most sharing of psychotherapy notes.

Our uses and disclosures

Treat you

We can use your health information and share it with other professionals who are treating you. Example: with your permission, sharing your evaluation report with your physician or psychiatrist.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: using secure systems to send you questionnaires before your evaluation and to prepare your report.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities, if applicable.

Other ways we may share your information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes:

• Help with public health and safety issues, such as reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
• Comply with the law, including sharing information with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
• Research, only under conditions the law allows.
• Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
• Address workers' compensation, law enforcement, and other government requests, such as for workers' compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security, and presidential protective services.
• Respond to lawsuits and legal actions, such as in response to a court or administrative order, or in response to a subpoena.

Special protections

Psychotherapy notes

Psychotherapy notes, if any are kept, receive extra protection. Most uses and disclosures of them require your written authorization.

Minors

When a minor receives services, a parent or guardian generally acts for the minor. Federal and California law may limit a parent's or guardian's access to some of a minor's information, for example when the minor was allowed by law to consent to their own care, or when sharing the information could harm the minor.

Online questionnaires and email

We may ask you to complete questionnaires through our secure online portal, which encrypts your information. Emails we send you contain only a link to the portal, not your health information. Please do not send health information to us by regular email.

Changes to 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 on request, in our office, and on our website.

Contact our Privacy Officer

If you have questions about this notice or want to exercise any of the rights above, contact:

Privacy Officer
Nova Mental Health Corp.
Yucaipa, CA 92399
Phone: (909) 235-6326
Email: connect@novamh.com