Notice of Privacy Policies

This notice describes how your medical information may be used, disclosed and safeguarded, and how you can get access to this information. Please review it carefully. 

Provider Responsibilities

The confidentiality of your personal health information is very important to us. Your health information includes both clinical (symptoms, diagnoses, treatments) and administrative (billing, dates) material. Generally speaking, providers are required to: 
**Maintain the privacy of your health information as required by law; 
**Provide you with this Notice of provider duties and privacy practices regarding the health information about you that your provider collects and 
**Follow the terms of this Notice currently in effect. 

Uses and Disclosures of Information

Under federal law, your provider is permitted to use and disclose personal health information for treatment, payment, and health care operations without authorization. Whenever possible, I will obtain your consent before disclosing any such information. Here are some examples to clarify these terms: 
**Treatment: Your provider consults with your therapist or family doctor about your condition. 
**Payment: Your health information is disclosed to your insurer to obtain reimbursement. In these situations, your provider will disclose only the minimum amount of information necessary. 
**Health Care Operations: This refers to administrative activities such as services or audits that relate to the operation of this practice. 

Other Uses and Disclosures

In the following situations your provider may be ethically or legally obligated to use or disclose your personal information without authorization: 
**Serious Threat to Health or Safety 
Your provider may disclose your health information to protect you or others from a serious threat of harm by you. 
**Abuse, Neglect, or Domestic Violence 
If you give your provider information which leads her to suspect child abuse, neglect, or death due to maltreatment of a child; or that a disabled adult is in 
need of protective services, she must report such information to the county Department of Social Services. If asked by the Director of Social Services to turn over information relevant to a child protective services investigation, she must do so. 
If you are an unemancipated minor under North Carolina law, there may be circumstances in which your provider discloses health information about you to a parent, guardian, or other person acting in loco parentis, in accordance with your provider’s legal and ethical responsibilities. 
If you are a parent of an unemancipated minor, and are acting as the minor’s personal representative, your child’s provider may disclose health information about your child to you under certain circumstances. For example, if the provider is legally required to obtain your consent as your child’s personal representative in order for your child to receive care from this practice, the provider may disclose health information about your child to you. In some circumstances, a provider may not disclose health information about an unemancipated minor to you. For example, if your child is legally authorized to consent to treatment (without separate consent from you), consents to such treatment, and does not request that you be treated as his or her personal representative, the provider may not disclose health information about your child to you without your child’s written authorization. 
**Judicial or Administrative Proceedings 
In cases where you are involved in a court proceeding and a request is made for your personal health information, this information is privileged under state law and your provider will not release it without your consent or a court order. 
**Workers’ Compensation 
Your provider may disclose health information about you for purposes related to workers’ compensation, as required and authorized by law. 
**Health Care Oversight 
Your provider may disclose health information about you for oversight activities authorized by law or to an authorized health oversight agency to facilitate auditing, inspection, or investigation related to your provider’s provision of health care, or to the health care system. 
**Food and Drug Administration (FDA) 
Your provider may disclose health information about you to the FDA, or to an entity regulated by the FDA, in order, for example, to report an adverse event or a defect related to a drug or medical device. 
**Required By Law 
Your provider may disclose health information about you as required by federal, state, or other applicable law. You will be notified, as required and when allowed by law, of any such disclosures.

Psychotherapy Notes

In the course of your care with this practice, your provider may keep separate notes about your conversations. These notes, known as “psychotherapy notes”, are kept apart from the rest of your medical record and their confidentiality is subject to greater protection. They do not include basic medical information about your diagnosis or treatment. 

Psychotherapy notes may be disclosed only after you have given written authorization to do so. (Limited exceptions exist, e.g. in order for your provider to prevent harm to yourself or others, and to report child abuse/neglect). You cannot be required to authorize the release of your psychotherapy notes in order to obtain health-insurance benefits for your treatment, or enroll in a health plan. Psychotherapy notes are also not among the records that you may request to review or copy (see discussion of your rights the next section below). If you have any questions, feel free to discuss this subject with your provider. 

Your Health Information Rights

Under the law, you have certain rights regarding the health information that collected and maintained about you by this practice. This includes the right to: 
**Request that your provider restricts certain uses and disclosures of your health information; your provider is not, however, required to agree to a requested restriction. 
**Request that your provider communicates with you by alternative means. Your provider will accommodate reasonable requests for such confidential communications; for example, if you do not want a family member to know you are receiving treatment at this practice, your provider can send correspondence to an alternate address. 
**Request to review, or to receive a copy of, the health information about you that is maintained by this practice. If your provider is unable to satisfy your request, she will tell you in writing the reason for the denial and your right, if any, to request a review of the decision. 
**Request that your provider amend the health information about you that is maintained in her files and the files of other members of your Developing Minds treatment team (if applicable). Your request must explain why you believe the records about you are incorrect, or otherwise require amendment. If your provider is unable to satisfy your request, she will tell you in writing the reason for the denial and tell you how you may contest the decision, including your right to submit a statement (of reasonable length) disagreeing with the decision. This statement will be added to your records. 
**Request a list of your provider’s disclosures of your health information. This list, known as an “accounting” of disclosures, will not include certain disclosures, such as those made for treatment, payment, or health care operations. 
**Request a paper copy of this Notice. 
In order to exercise any of your rights described above, you must submit your request in writing to your provider. If you have questions about your rights, please speak with your provider in person or by phone during normal office hours.

For More Information or to Report a Problem 

If you need further information or want to contact your provider for any reason regarding the handling of your health information, please direct any communications to: 

Developing Minds of North Carolina, P.L.L.C. 
813 Broad Street 
Durham, NC 27705 
(919) 794-3919 

If you believe your privacy rights have been violated, you may file a written complaint by mailing it or delivering it to your provider. You may complain to the Secretary of Health and Human Services (HHS) at: 

Office for Civil Rights 
U.S. Department of Health and Human Services 
200 Independence Avenue, S.W. 
Room 509F, HHH Building 
Washington, D.C. 20201 

Your provider cannot, and will not, make you waive your right to file a complaint with HHS as a condition of receiving care at Developing Minds, or penalize you for filing a complaint with HHS. 

Revisions to this Notice

The providers at Developing Minds reserve the right to amend the terms of this Notice. If this Notice is revised, the amended terms shall apply to all health information that your provider maintains, including information about you collected or obtained before the effective date of the revised Notice. If the revisions reflect a material change to the use and disclosure of your information, your rights regarding such information, your provider’s legal duties, or other privacy practices described in the Notice, your provider will promptly distribute the revised Notice, post it in the waiting area of the office, make copies available to Developing Minds’ patients and others, and post it at
Effective Date: August 1, 2008