Notice of Privacy Practices

EFFECTIVE DATE: September 13, 2020

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.

Drew Linsalata (“me“, “I” ) is committed to protecting the privacy and confidentiality of your personal information and mental health information.

OUR RESPONSIBILITY

As of September 2020 there appears to be ambiguity regarding my obligation to follow guidelines and rules set forth by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Out of an abundance of caution and concern for your privacy and rights, I am choosing to abide by these rules and guidelines and to follow them wherever possible. This Notice describes the ways in which I may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of that information.

HOW I MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

Your Protected Health Information may be used and disclosed for treatment, payment, healthcare operations and other purposes permitted or required by law. I may use and disclose your Protected Health Information for the following purposes:

TREATMENT

I may use or disclose your protected health information to provide coaching services as part my service offerings. I may disclose information to doctors, therapists, or other healthcare providers who are involved in taking care of you and your health.

HEALTHCARE OPERATIONS

I may use and disclose health information about you for activities necessary to support, operate, and improve my services. For example, I may use your Protected Health Information to monitor and/or improve the quality of my services, respond to client inquiries, and review the performance and appropriateness of my services. I may de-­identify your Protected Health Information to remove personal information that identifies you (for example your name and address) in order to develop new products and/or services, or to work with others who can develop such products and/or services, which I can use to better serve you.

BUSINESS ASSOCIATES

I may disclose your Protected Health Information to other companies or individuals, known as “Business Associates,” who provide services to me. Business Associates are required to protect the privacy and security of your Protected Health Information and notify me of any improper disclosure of information.

FAMILY AND FRIENDS

I may disclose health information about you to your family members or friends if I obtain your verbal or written agreement or if I can infer from the circumstances, based on my considered judgment that you would not object.

PERSONAL REPRESENTATIVES

I may disclose Protected Health Information about you to an authorized personal representative, such as a lawyer, administrator, executor, or other authorized person responsible for you or your estate.

THREAT TO HEALTH AND SAFETY

I may disclose Protected Health Information to prevent or reduce the risk of a serious and imminent threat to your health or to a third party or the general public.

COMMUNICATIONS ABOUT OUR PRODUCTS AND SERVICES

I may use and disclose your Protected Health Information to contact you about other products and services which I believe may be of interest to you.

LAW ENFORCEMENT

I may disclose your Protected Health Information to the police or other law enforcement officials as required by law or in compliance with a court order, warrant, subpoena, summons, or other legal process for locating a suspect, fugitive, witness, missing person, or victim of a crime.

AS REQUIRED BY LAW

I must disclose your Protected Health Information when required to do so by any applicable federal, state or local law.

JUDICIAL AND ADMINISTRATIVE PROCEEDINGS

Under certain circumstances, I may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a court order, subpoena, or other lawful process.

RESEARCH

Under certain circumstances, I may use or disclose your Protected Health Information for research purposes. All research projects are subject to review by team of ethical advisors responsible for ensuring the protection of individual research subjects, appropriate client authorization, and an adequate plan to safeguard Protect Health Information. In preparation for research, I may review limited Protected Health Information to draft research protocols, to identify prospective research participants, or for similar purposes.

HEALTH AND GOVERNMENT AGENCIES

As permitted by HIPAA, I may also disclose your PHI to:

  • Public Health Authorities
  • The Food and Drug Administration
  • Health Oversight Agencies
  • Military Command Authorities
  • National Security and Intelligence Organizations
  • Correctional Institutions
  • Organ and Tissue Donation Organizations
  • Coroners, Medical Examiners and Funeral Directors
  • Workers Compensation Agents

ALL OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION

I will ask for your written authorization before using or disclosing your Protected Health Information for any purpose not described above. You may revoke your authorization, in writing, at any time, except for disclosures that I have already acted upon or are required by law. I will never sell or give your identifying information to third­-party marketers unless you give us written permission for marketing purposes or sale of your identifying information.

I will never share coaching notes unless you give me written permission, or as required by law, health and safety, or a government agency.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the following rights with respect to your Protected Health Information. To exercise any of these rights, please contact me using the contact information provided at the end of this Notice.

RIGHT TO ACCESS PROTECTED HEALTH INFORMATION

You, or your authorized or designated personal representative, have the right to inspect or copy the Protected Health Information maintained by me. You must submit a written request via email to inspect and/or copy your health information records.

RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS

You have the right to request that I communicate with you about your Protected Health Information by alternative means or to an alternative address, email, or phone number. Your request must be in writing and must specify the alternative means or location.

RIGHT TO CORRECT OR UPDATE INFORMATION

If you believe the Protected Health Information I maintain about you contains an error, you may request that I correct or update your information. Your request must be in writing and must explain why the information should be corrected or updated. I may deny your request under certain circumstances and provide a written explanation.

RIGHT TO AN ACCOUNTING OF DISCLOSURES

You may request a list, or accounting, of certain disclosures of your Protected Health Information made by me or our business associates for purposes other than treatment, payment, healthcare operations and certain other activities. The request must be in writing and state a time period, which may not be longer than the prior six years.

RIGHT TO REQUEST RESTRICTIONS

You have the right to request restrictions on my use and disclosure of your Protected Health Information. While I will consider all requests for additional restrictions carefully, I am not required to agree to a requested restriction except for Payment or Operations restrictions where payment has been made “out-­of-­pocket” and “paid-­in-­full.”

RIGHT TO A COPY OF THIS NOTICE

Upon request, you may obtain a paper or electronic copy of this Notice.

INFORMATION BREACH NOTIFICATION

I am required to notify you following the discovery a breach of your unsecured Protected Health Information, unless there is a demonstration, based on a risk assessment, that there is a “low probability” that the Protected Health Information has been compromised. You will be notified in a timely fashion, no later than 60 days after discovery of the breach.

QUESTIONS AND COMPLAINTS

If you have questions or concerns about my privacy practices or would like a more detailed explanation about your privacy rights, please contact me using the contact information below.

If you believe that I may have violated your privacy rights, you may submit a complaint to me. You also may submit a written complaint to the U.S. Department of Health and Human Services. I will provide you with the address to file your complaint with the U.S. Department of Health and Human Services upon request. I will not take retaliatory action against you and you will not be penalized in any way if you choose to file a complaint with me or with the U.S. Department of Health and Human Services.

CHANGES TO THIS NOTICE

I reserve the right to change my privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. I will promptly post any changes to this Notice on my website or otherwise provide them to you.

CONTACT INFORMATION

When communicating with me regarding this Notice, my privacy practices, or your privacy rights, please contact me at [email protected]