New Leaf Detox and Treatment
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
Your health record contains personal information about you and your health. State and federal laws protect the confidentiality of this information. “Protected Health Information” (PHI) includes information about you, including demographic details, that may identify you and relates to your past, present, or future physical or mental health condition and related health care services.
The confidentiality of alcohol and drug use disorder treatment records is specifically protected by federal law and regulations. New Leaf Detox and Treatment complies with these requirements. Except in limited circumstances, we may not disclose that you are a patient here or any information identifying you as someone receiving substance use disorder services. Violations of these federal laws and regulations are crimes and may be reported to the appropriate authorities.
Treatment
We may use and disclose your medical and clinical information to provide, coordinate, or manage your care and related services (for example, consulting with or referring to another provider, laboratory, or specialist involved in your treatment).
Payment
We will not use or disclose your PHI to obtain payment for services without your written authorization (e.g., eligibility checks, claims processing, medical necessity reviews, or utilization review).
Health Care Operations
We may use or disclose your PHI for operations such as quality assessment, staff training, licensing, accreditation, and other business activities. For example, we may use a sign-in sheet at reception or call you by name in the waiting area. We may share PHI with contracted service providers (e.g., billing) under agreements requiring them to safeguard your information and prohibiting re-disclosure.
Other Contacts
We may contact you with appointment reminders or information about treatment alternatives or other health-related benefits and services.
Without Authorization
In limited situations allowed by law (such as a valid court order), we may disclose information without your authorization. These situations are described below.
With Authorization
Any other use or disclosure of your PHI requires your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
Right to Inspect and Copy
You may inspect and obtain copies of PHI used to make decisions about your care (designated record set) while we maintain it. We may charge a reasonable, cost-based fee for copies. In certain cases, access may be limited, with a right to appeal.
Right to Amend
If you believe your PHI is incorrect or incomplete, you may request an amendment. If we deny your request, you may submit a statement of disagreement, and we may provide a rebuttal.
Right to an Accounting of Disclosures
You may request an accounting of certain disclosures made in the past six years, excluding disclosures to you, for treatment, or those made pursuant to your authorization. A reasonable fee may apply for more than one request in a 12-month period.
Right to Request Restrictions
You may request restrictions on our use or disclosure of your PHI for treatment, payment, health care operations, or to family members involved in your care. We are not required to agree, but if we do, we will comply (except in emergencies or as otherwise permitted by law).
Right to Request Confidential Communications
You may request that we communicate with you in a specific way or at an alternate location. We will accommodate reasonable written requests and may ask how payment will be handled or request an alternate address.
Right to a Copy of This Notice
You may obtain a paper or electronic copy of this Notice upon request.
We will not retaliate against you for exercising your rights or for filing a complaint.
Required by Law
Disclosures mandated by federal or state law, limited to the relevant requirements. We must also disclose PHI to you upon request and to the U.S. Department of Health and Human Services for compliance investigations.
Health Oversight
Disclosures to oversight agencies for activities authorized by law (e.g., audits, inspections, investigations, licensing). Agreements will require recipients to safeguard your PHI.
Medical Emergencies
Limited disclosures to medical personnel in a bona fide medical emergency. We will provide this Notice as soon as reasonably practicable after the emergency.
Child Abuse or Neglect
Disclosures to authorized agencies as required by law, limited to what is necessary to make the mandated report.
Deceased Patients
Disclosures as permitted for determining cause of death or as required by laws regarding vital statistics.
Research
Disclosures to researchers with Institutional Review Board approval and appropriate privacy safeguards, including commitments to maintain security and to limit re-disclosure.
Crimes on Premises or Against Personnel
Limited disclosures to law enforcement if you commit or threaten to commit a crime on program premises or against program personnel.
Court Order
Disclosures made pursuant to a valid court order following required procedures.
We are required by law to maintain the privacy of your PHI and to provide you with this Notice. We reserve the right to change this Notice and our privacy practices at any time. The revised Notice will apply to all PHI we maintain and will be made available by posting at our facility and/or on our website, by mail upon request, or at your next appointment.
If you have questions, want to exercise your rights, or wish to file a complaint, please contact our Privacy Officer:
Joshua Hamburg, Director of Compliance
📧 jhamburg@nldetox.com
📞 +1 (949) 945-8391
You may also file a complaint with the U.S. Secretary of Health and Human Services:
200 Independence Avenue, S.W.
Washington, D.C. 20201
📞 (855) 977-6335
We will not retaliate against you for filing a complaint.
