This privacy notice discloses the privacy practices for www.7summitpathways.com. This privacy notice applies solely to information collected by this web site. It will notify you of the following:
- What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.
- What choices are available to you regarding the use of your data.
- The security procedures in place to protect the misuse of your information.
- How you can correct any inaccuracies in the information.
Information Collection, Use, and Sharing
Multiple Innovation to Recovery LLC, DBA 7 Summit Pathways are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.
We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.
Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website:
- See what data we have about you, if any.
- Change/correct any data we have about you.
- Have us delete any data we have about you.
- Express any concern you have about our use of your data.
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:
- To be treated with respect and dignity.
- To receive timely treatment by qualified professionals.
- Every effort will be made to use the least restrictive, most appropriate treatment available, based on Client needs.
- Each Client shall be afforded the opportunity to participate in activities designed to enhance self-image.
- An individualized treatment plan shall be developed for each Client in accordance with the provisions established for each program component.
- 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.
- To express by signature an informed consent of the right to release information for communication purposes with other agencies.
- To receive communication and correspondence from individuals.
- To privacy for interview/counseling sessions.
- To practice your religious practices.
- To be provided humane care and protection from harm.
- To contract and consult with legal counsel and private practitioners of your choice at your expense.
- To exercise your constitutional, statutory, and civil rights.
- To be free of physical restraint or seclusion.
- 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.
- To be provided information on an ongoing basis regarding your treatment or rehabilitation.
- 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.
- 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:
- The limited circumstances of release of Client information includes, crimes on program premises or against program personnel, medical emergencies, mandated reports of child abuse or neglect, elderly abuse, threats to harm self or others, research, audit and evaluations, or court orders.
- 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:
- The Client consents in writing
- The disclosure is allowed by a court order; or
- The disclosure is made to medical personnel
- The disclosure to a qualified person for research, audit or program evaluation; or
- The disclosure is made to protect self or others or a crime has been committed; or
- The disclosure in the event of threats of harm to self or others (Duty To Warn).
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,)
Acknowledgment of client grievance process
As a client, or parents and/or legal guardian of a client participating in one of 7 Summit Pathways (7SP) treatment programs, you have the right to file a complaint through the following grievance procedure without fear of discharge or reprisal.
- Grievance means any written complaint about treatment, including assessment, intervention, and decisions about placement and discharge as well as any complaint concerning staff or operations. Whenever such a complaint is filed, the Clinical Director and Chief Executive Officer are notified via the designated management structure.
- The grievance procedure is considered part of the treatment process. Every attempt will be made to resolve the grievance.
- A client filing a grievance may choose other people (staff) to accompany him/her through the grievance process.
- The grievance process includes the following steps:
The client is directed to talk about the complaint with the staff member involved or responsible for the area of concern. Together they try to solve the matter informally. The Therapist or Clinical Director will assure the person served the grievance will not result in discharge or reprisal and if the person served requests help in preparing the written grievance, will arrange staff assistance.
If an informal approach does not resolve the grievance, the persons served will present the grievance to the Clinical Director in written form. The Therapist, or Clinical Director, will conduct a meeting with the aggrieved person(s) served within five (5) working days of the written grievance being received and provide an opportunity for the client to discuss all concerns. Thereafter, the Therapist or Clinical Director will furnish to the client, a written response within five (5) working days after the meeting.
B. Client/Therapist/Clinical Director:
If the grievance is not resolved, the client may request a meeting with the Clinical Director and all parties involved in Step A. The Clinical Director will schedule and hold the meeting within five (5) working days of the client’s request and provide an opportunity to discuss all concerns. Thereafter, the Clinical Director will furnish to the client a written response within five (5) working days after the meeting.
C. All parties & President/CEO:
If the grievance is still not resolved, the client may request a meeting with the President/CEO and all parties involved in Step B. The President/CEO will schedule and hold the meeting within ten (10) working days. Thereafter, the President/CEO will furnish to the client a written response within two (2) days of the meeting. The President/CEO may include other appropriate management staff in the meeting in order to expedite resolution of the complaint. The decision of the President/CEO is final.
- Depending upon the nature and/or severity of the complaint, the Chief Executive Officer may recommend eliminating one or more steps in order to resolve the complaint more quickly.
- Each step of the grievance process must be documentéd by the staff member hearing the complaint or a designated agency recorder.
- Client advocate: During the Grievance process, if the client desires, a client advocate may assist the client with understanding and going through the process of filing the grievance. The client advocate may be a case manager, a direct care staff member, or another 7 Summit Pathways staff member.
- The problem and its resolution will be documented in writing and included in the clients clinical record. The staff member will be notified of the outcome of the grievance in writing.
- Clients will be free of interference, coercion, discriminations or reprisal when filing a grievance.
- A copy of the grievance procedure is posted at all facilities and forms readily available 24 hours a day in every building of the facility. The forms and postings will be kept in an open area and will include the name, address, phone number of an external review entity:
State of Florida
Department of Children & Families
District Alcohol, Drug Abuse, and Mental Health Program Office
Pinellas County, FL Programs:
Suncoast Region — (727) 588-6834
State of Florida
Department of Children & Families
District Alcohol, Drug Abuse, and Mental Health Program Office
9393 North Florida Avenue
Tampa, FL 33612-7907
558-5500 (automated line)
The following information is provided to assist you in your counseling experience at 7 Summit Pathways.
Counseling and treatment is a personal and confidential relationship between a clinician and individual, group or family.
We work from a team approach at 7 Summit Pathways. Therefore, there may be times when it is necessary for us to consult with other professional staff either individually or at our clinical team meetings in an effort to provide you with the highest consideration and quality. Our clinicians are all Mastered prepared and professionally licensed, graduate student interns, or clinicians working toward certification in substance abuse counseling.
No information will be released from 7 Summit Pathways regarding counseling or consultation sessions without your expressed written consent. If you wish for information to be released to anyone, it will be necessary for you to complete a Release of Information form, stipulating the professional to whom the information is being sent. The law stipulates that in the event of imminent danger to yourself or others, we must breach confidentiality. We must also act in accordance with any applicable State laws regarding mandatory disclosure of child, elder, or other abuse.
Your satisfaction is the key to our success. We want you to tell us what is good about our services and where we need to improve. Periodically we will distribute a satisfaction survey to you to be filled out. Your signature is optional.
Multiple Innovations to Recovery, LLC DBA 7 Summit Pathways
Limits of Confidentiality
Contents of all therapy sessions are considered confidential, and protected by state and federal regulations. Both verbal information and written records about a client cannot be shared with another party without the written consent of the client or the client’s legal guardian. Noted exceptions are as follows:
Duty to Warn and Protect
When a client discloses intentions or plan to harm another person, the mental health professional is required to warn the intended victim and report this information to legal authorities. In cases in which the client discloses or implies a plan for suicide, the health care professional is required to notify legal authorities and make reasonable attempts to notify the family of the client.
Abuse of Children and Vulnerable Adults
If a client states or suggests that he or she is abusing a child (or vulnerable adult) or has recently abused a child (or vulnerable adult), or a child (or vulnerable adult) is in danger of abuse, the mental health professional is required to report this information to the appropriated social service and/ or legal authorities.
Prenatal Exposure to Controlled Substances
Mental Health care professionals are required to report admitted prenatal exposure to controlled substances that are potentially harmful.
Parents or legal of non-emancipated minor clients have the right to access the client’s records.
Insurance Providers (when applicable)
Insurance companies and other third-party payers are given information that they request regarding services to clients. Information that may be requested includes type of services, date/time of services, diagnosis, treatment plan, and description of impairment, progress of therapy, case notes, and summaries.
Notice of Privacy Practices
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.
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 an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record 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 information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different
- 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 to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
- We will say “yes” unless a law requires us to share that information.
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 page 1.
- You can file a complaint with the U.S. Department of Health and Human Services Offi e 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.
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 your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
- Contact you for fundraising efforts
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
- Most sharing of psychotherapy notes
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
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.
- We can use your health information and share it with other professionals who are treating you.
- Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
- We can use and share your health information to run our practice, improve your care, and contact you when necessary.
- Example: We use health information about you to manage your treatment and services.
Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
- Example: We give information about you to your health insurance plan so it will pay for your services.
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 have to 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
- 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
- We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
- 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
- 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/oct/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, in our office, and on our web site.
Effective Date: October 11, 2013
This Notice of Privacy Practices applies to the following organizations: 7 Summit Pathways
Uses and Disclosure of Health Information
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
This notice is effective as of April 15, 2003
USES AND DISCLOSURE OF HEALTH INFORMATION
7 Summit Pathways is committed to protecting the privacy of the personal and health information we collect or create as part of providing health care services to our clients, known as “Protected Health Information” or “PHI”. PHI typically includes your name, address, date of birth, billing arrangements, care, and other information that relates to your health, health care provided to you, or payment for health care provided to you. PHI DOES NOT include information that is de-identified or cannot be linked to you.
This notice of Health Information Privacy Practices (the “Notice”) describes 7 Summit Pathways’s duties with respect to the privacy of PHI, 7 Summit Pathways’s use of and disclosure of PHI, client rights and contact information for comments, questions, and complaints.
7 Summit Pathways’ PRIVACY PROCEDURES AND LEGAL OBLIGATIONS
7 Summit Pathways obtains most of its PHI directly from you, through care applications, assessments and direct questions. We may collect additional personal information depending upon the nature of your needs and consent to make additional referrals and inquiries. We may also obtain PHI from community health care agencies, other governmental agencies or health care providers as we set up your service arrangements.
7 Summit Pathways is required by law to provide you with this notice and to abide by the terms of the Notice currently in effect. 7 Summit Pathways reserves the right to amend this Notice at any time to reflect changes in our privacy practices. Any such changes will be applicable to and effective for all PHI that we maintain including PHI we created or received prior to the effective date of the revised notice. Any revised notice will be mailed to you or provided upon request.
7 Summit Pathways is required by law to maintain the privacy of PHI. 7 Summit Pathways will comply with federal law and will comply with any state law that further limits or restricts the uses and disclosures discussed below. In order to comply with these state and federal laws, 7 Summit Pathways has adopted policies and procedures that require its employees to obtain, maintain, use and disclose PHI in a manner that protects client privacy.
USES AND DISCLOSURES WITH YOUR AUTHORIZATION
Except as outlined below, 7 Summit Pathways will not use or disclose your PHI without your written authorization. The authorization form is available from 7 Summit Pathways (at the address and phone number below). You have the right to revoke your authorization at any time, except to the extent that 7 Summit Pathways has taken action in reliance on the authorization.
The law permits 7 Summit Pathways to use and disclose your PHI for the following reasons without your authorization:
For Your Treatment: We may use or disclose your PHI to physicians, psychologists, nurses and other authorized healthcare professionals who need your PHI in order to conduct an examination, prescribe medication or otherwise provide health care services to you.
To Obtain Payment: We may use or disclose your PHI to insurance companies, government agencies or health plans to assist us in getting paid for our services. For example, we may release information such as dates of treatment to an insurance company in order to obtain payment.
For Our Health Care Operations: We may use or disclose your PHI in the course of activities necessary to support our health care operations such as performing quality checks on your employee services. We may also disclose PHI to other persons not in 7 Summit Pathways’s workforce or to companies who help us perform our health services (referred to as “Business Associates”) we require these business associates to appropriately protect the privacy of your information .
As Permitted or Required By The Law: In some cases we are required by law to disclose PHI. Such as disclosers may be required by statute, regulation court order, government agency, we reasonably believe an individual to be a victim of abuse, neglect or domestic violence: for judicial and administrative proceedings and enforcement purposes.
For Public Health Activities: We may disclose your PHI for public health purposes such as reporting communicable disease results to public health departments as required by law or when required for law enforcement purposes.
For Health Oversight Activities: We may disclose your PHI in connection with governmental oversight, such as for licensure, auditing and for administration of government benefits.
To Avert Serious Threat to Health and Safety: We may disclose PHI if we believe in good faith that doing so will prevent or lessen a serious or imminent threat to the health and safety of a person or the public.
Disclosures of Health Related Benefits or Services: Sometimes we may want to contact you regarding service reminders, health related products or services that may be of interest to you, such as health care providers or settings of care or to tell you about other health related products or services offered at 7 Summit Pathways. You have the right not to accept such information.
Incidental Uses and Disclosures: Incidental uses and disclosures of PHI are those that cannot be reasonably prevented, are limited in nature and that occur as a by-product of a permitted use or disclosure. Such incidental used and disclosures are permitted as long as 7 Summit Pathways use reasonable safeguards and use or disclose only the minimum amount of PHI necessary.
To Personal Representatives: We may disclose PHI to a person designated by you to act on your behalf and make decisions about your care in accordance with state law. We will act according to your written instructions in your chart and our ability to verify the identity of anyone claiming to be your personal representative.
To Family and Friends: We may disclose PHI to persons that you indicate are involved in your care or the payment of care. These disclosures may occur when you are not present, as long as you agree and do not express an objection. These disclosures may also occur if you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest. We may also disclose limited PHI to public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other person that may be involved in caring for you. You have the right to limit or stop these disclosures.
YOUR RIGHTS CONCERNING PRIVACY
Access to Certain Records: You have the right to inspect and copy your PHI in a designated record set except where State law may prohibit client access. A designated record set contains medical and billing and case management information. If we do not have your PHI record set but know who does, we will inform you how to get it. If our PHI is a copy of information maintained by another health care provider, we may direct you to request the PHI from them. If 7 Summit Pathways produces copies for you, we may charge you up to $1.00 per page up to a maximum fee of $50.00. Should we deny your request for access to information contained in your designated record set, you have the right to ask for the denial to be reviewed by another healthcare professional designated by 7 Summit Pathways.
Amendments to Certain Records: You have the right to request certain amendments to your PHI if, for example, you
believe a mistake has been made or a vital piece of information is missing. 7 Summit Pathways is not required to make the requested amendments and will inform you in writing of our response to your request.
Accounting of Disclosures: You have the right to receive an accounting of disclosures of your PHI that were made by 7 Summit Pathways for a period of six (6) years prior to the date of your written request. This accounting does not include for purposes of treatment, payment, health care operations or certain other excluded purposes, but includes other types of disclosures, including disclosures for public health purposes or in response to a subpoena or court order.
Restrictions: You have the right to request that we agree to restrictions on certain uses and disclosures of your PHI, but we are not required to agree to your request. You cannot place limits on uses and disclosures that we are legally required or allowed to make.
Revoke Authorizations: You have the right to revoke any authorizations you have provided, except to the extent that 7 Summit Pathways has already relied upon the prior authorization,
Delivery by Alternate Means or Alternate Address: You have the right to request that we send your PHI by alternate means or to an alternate address.
Complaints & How to contact us: If you believe your privacy rights have been violated, you have the right to file a complaint by contacting 7 Summit Pathways at the address and/or phone number indicated below. You also have the right to file a complaint with the Secretary of the United States Department of Health and Human services in Washington, D.C. 7 Summit Pathways will not retaliate against you for filing a complaint.
If you believe your privacy rights have been violated, you may make a complaint by contacting “HIPAA PRIVACY OFFICER NAME”, HIPAA Privacy Officer at “PHONE NUMBER” or the Secretary for the Department of Health and Human Services. No individual will be retaliated against for filing a complaint.
The U.S.Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free: 1-877-696-6775
Please be aware that mail sent to the Washington D.C area offices takes an additional 3-4 days to process due to
changes in mail handling resulting from the Anthrax crisis of October 2001.
CLIENT TO BE GIVEN A COPY ALONG WITH A COPY TO FILED IN CLIENT CHART