How your health information is used and protected

This notice applies to Goldenturas, A Nursing Corporation and to the clinicians and staff working within it. Your care is provided by Shannon Enochs, DNP, APRN, PMHNP-BC, and by any clinician who joins the practice.

We are required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and share your health information

For treatment

We use your health information to provide and coordinate your care. For example, a clinician reviewing your history, prior medications and current symptoms to decide what to prescribe, or sending a prescription to a pharmacy so it can be dispensed to you.

For payment

We use your information to bill you and to document what you paid for. For example, preparing a superbill at your request so that you can submit it to your own insurer. Goldenturas does not bill insurance companies directly.

For health care operations

We use your information to run the practice safely and lawfully. For example, reviewing our own care quality, keeping records as required by law, or consulting our professional advisers.

Uses and disclosures that need your written authorization

Some uses always require your written permission first:

• Psychotherapy notes, where they are kept separately from the rest of your record, with narrow exceptions the law specifies.
• Marketing. We do not use your health information for marketing. California law separately prohibits it.
• Any sale of your health information. We do not sell it and would not.
• Most other uses not described in this notice.

You can take that permission back at any time, in writing, and we will stop. We cannot undo something already done in reliance on it.

Other situations where the law permits or requires disclosure

The law allows or requires us to share information without your authorization in limited circumstances. These are the ones most likely to be relevant to a psychiatric practice:

• To prevent a serious and imminent threat to your health or safety or to that of another person.
• Where we are required to report suspected abuse or neglect of a child, an elder or a dependent adult, as California law requires of us.
• For public health activities, such as reporting required by a public health authority.
• In response to a court order, subpoena or other lawful process, subject to the additional protections California gives mental health records.
• To coroners, medical examiners and funeral directors, as the law allows.
• For workers' compensation, where the law requires it.
• To health oversight agencies for audits and investigations.
• For research, only where an ethics board has approved it and appropriate protections are in place.

Where you are present and able to agree, we will ask before sharing information with family or a friend involved in your care. Where you are not able to agree, we use professional judgment about what is in your best interest.

Records about substance use treatment

If we receive records about substance use disorder treatment from a program covered by the federal rules at 42 CFR Part 2, those records keep their special protection in our hands. The law requires us to tell you the following:

In plain terms: those records cannot be used against you in a legal proceeding without your written consent or a court order, and a court order on its own is not enough without an accompanying demand.

Your rights over your health information

To see and get a copy of your record

You can inspect and obtain a copy of your health information, including electronically where we hold it that way.

California sets shorter deadlines than federal law, and we follow the shorter ones. You can inspect your records within five working days of a written request, and receive copies within fifteen days. Copying charges are capped by California law.

There is one limit specific to mental health records. If we judge that seeing a particular record would create a substantial risk of significant harm to you, we may decline to hand it to you directly. If that happens we must put the reason in writing, and you can name a licensed professional of your own choosing to inspect the record on your behalf. We will tell you that option exists rather than leaving you with a refusal.

To ask us to correct it

If you believe something is wrong or incomplete, you can ask us to amend it. If we decline, we will tell you why in writing and you can file a statement of disagreement to be kept with the record.

To get a list of disclosures

You can ask for an accounting of certain disclosures we have made, going back up to six years.

To ask us to limit what we use or share

You can request a restriction. We are not required to agree to every request, with one important exception below.

To choose how we contact you

You can ask us to reach you at a particular number or address, or by a particular method. We will accommodate reasonable requests and will not ask you to explain why.

To a paper copy of this notice

You can ask for one at any time, even if you agreed to receive it electronically.

To be told if your information is breached

If there is a breach that compromises the privacy or security of your information, we will notify you as the law requires.

California gives you additional protection

California's Confidentiality of Medical Information Act (Civil Code sections 56 and following) applies to health care providers in this state. Among other things it bars disclosing your medical information without authorization, and it specifically prohibits using it for marketing.

Where California law is stricter than federal law, we follow the stricter rule.

Information about psychotherapy is protected more strongly here

Federal law protects a narrow category of separately kept process notes. California goes further. Where a request concerns your participation in outpatient treatment with a psychotherapist, the person asking must make a separate written request to you as well as to us, saying exactly what they want, what they will use it for, how long they will keep it, that they will not use it for anything else, and that they will return or destroy it afterwards.

In practice that means information about your being in psychiatric treatment here is harder for an outside party to obtain than an ordinary medical record, and that is deliberate.

Younger patients and their parents

Integrative psychiatric care is available from age 5, so this matters to families and the rules are not obvious.

• Under 12. A parent or guardian generally consents to care and generally has access to the record.
• 12 and older. California allows a young person of 12 or over to consent to their own outpatient mental health treatment where the clinician judges them mature enough to take part in it knowingly. Where they have consented for themselves, California may limit what we can share with a parent without the young person's permission, and a parent cannot authorize the release of information about that care.
• Medication is different. A young person's own consent does not extend to psychiatric medication. A parent or guardian consents to that, whatever the young person's age.

We also have to involve a parent or guardian in a young person's care unless, having talked with the young person, we judge that involving them would be inappropriate.

Separately, we may decline to give a parent access to a young person's record where the law allows it, including where we judge that access would harm our professional relationship with the young person or their safety or wellbeing.

None of this is left for a family to work out from a web page. We explain how it applies to your situation at the start of care.

Our duties

• We are required by law to keep your health information private and secure.
• We must give you this notice and follow the version currently in effect.
• We must tell you if a breach affects your information.
• We cannot use or share your information other than as described here, unless you tell us in writing that we may.

We may change this notice. A change applies to information we already hold as well as to information we receive later. The current version is always posted on this page with its effective date, and a paper copy is available on request.

If you think your privacy has been violated

Tell us first if you are willing to. Email care@goldenturas.com and say what happened. We would rather know and put it right.

You can also complain directly to the federal government, and you do not need our permission or involvement to do so. Contact the U.S. Department of Health and Human Services, Office for Civil Rights:

• Online at hhs.gov/ocr/complaints
• By post to 200 Independence Avenue SW, Washington, D.C. 20201
• By phone on 1-800-368-1019

In California you may also raise concerns with the California Department of Public Health or the California Attorney General's office.

Questions, and who to ask

The person responsible for privacy at this practice is the Privacy Officer, Goldenturas, A Nursing Corporation.

Questions about this notice, or about anything to do with your health information, go to care@goldenturas.com, marked for the Privacy Officer. You can also ask for a paper copy of this notice at any time, and we will give you one.

For what this website collects, which is a separate matter, see the Privacy Policy.