Release of Personal Health Information
(Updated July 1, 2021)

Sagepoint IOP has a legal duty to protect and safeguard your personal health information, which includes past and present information obtained during your treatment stay. We must provide you with this notice about our privacy practices, in that it will explain how and why we use and disclose your personal health information. Sagepoint IOP is committed to protecting the confidentiality of information contained in your medical records, including your health and financial information, in accordance with applicable laws and regulations.

Sagepoint IOP is required by law to maintain the privacy of your health information; we are required to abide by the terms of this notice currently in effect and reserve the right to change the terms of its notice and to make new notice provisions effective for all protected health information that it maintains.

How we will use and disclose your health information. (Some uses and disclosures will require a specific authorization.):

 

Treatment: Your health information will be released for the purpose of treatment at our program, to include all members of your treatment team. Treatment team members include but are not limited to Sagepoint IOP therapists, counselors, case managers, medical records staff, intake personnel, and administrative/clinical personnel.

Limited access to your health information may include but is not limited to Sagepoint IOP business office personnel (admissions, collections), receptionists, and administrative/clinical assistants.

Family members participating in the Family Program will have limited knowledge regarding your health information, as revealed by you, the client, in the program groups.

While you are in treatment, your health information is released to an external laboratory facility that is utilized by Sagepoint IOP Inc for the purpose of lab diagnostics (i.e. urine analysis).

While in treatment, your private health information may be released to external physicians by Sagepoint IOP for the purpose of history and physicals and other medical concerns that may arise while you are in treatment.

While in treatment, you may require a medical service that is not provided by Sagepoint IOP; with your approval, your attending provider will recommend an external provider of care, and your health information will be released in order to provide care.

In the event that while in treatment you need to be either voluntarily transferred (for safety and further stabilization) or involuntarily transferred (due to danger to self, danger to others, refusing to remain on one-to-one evaluation, or if the need for a higher level of care is required), then an immediate response agency will be contacted. If they are not available, 911 will be contacted to transfer you to the appropriate facility.  Suicidal ideation or verbalization of intent or thought of self-harm, may result in disclosure of PHI for identified family contact and medical personnel with or without the client’s expressed consent for use or disclosure of protected health information (PHI).

 

Medical Emergencies:  We may use or disclose your protected health information in a medical emergency situation to medical personnel only.  Our staff will try to provide you a copy of this notice as soon as reasonably practicable after the resolution of the emergency.

Your health information will be released to referring professionals, therapists, medical providers, and extended care facilities for the purpose of continuity of care after discharge when you have given proper authorization.

 

Criminal Activity on Program Premises/Against Program Personnel:  We may disclose your protected health information to law enforcement officials if you have committed a crime on program premises or against program personnel.

 

Court Order:  We may disclose your protected health information if the court issues an appropriate order and follows required procedures.

Payment:  Your health information will be disclosed for the purpose of payment from your insurance carrier or third party for reimbursement purposes when proper authorization has been given. While in treatment and after you discharge, your health information will be released to process your insurance, to conduct third party reviews, and for other financial arrangements, as authorized by you, the patient. In the event that your bill for services rendered by Sagepoint IOP has not been resolved in a timely manner, the information in your financial record will be copied and sent to an external collection agency and/or attorney for collection services.

 

Healthcare Operations:  Your health information will be used and disclosed for the purpose of healthcare operations to include administrative functions such as evaluation of performance by your providers or evaluation of quality of services provided to you during your treatment stay. Your health information may be released for audit purposes to include (but not limited to) California Department of Healthcare Services, accounting for financial audits, and insurance auditors employed by your insurance carrier for comparing the claim to the medical record. Outcome studies are completed by Sagepoint IOP for the purpose of improving our patient care.

 

Internal Use:  Your first name and last initial will be posted on the white boards located in the  admissions office, and clinical team staffing room.Your first name and last initial may also be posted on group sign-in sheets, meeting sign-up sheets, and other locations pertinent to ensure client security, safety, and access to services.

Your picture will be taken upon admission and stored digitally within Sagepoint IOP of encrypted electronic medical record for the purpose of client identification.  Your photograph will also be printed on your medical record demographic face sheet, as well as on any utilization review notices used internally to document contact with your case coordinator at your insurance company.

Your first and last name, along with your medical record number, program, admission date, referral source and therapist is contained on the daily census, which is distributed to the treatment team and administrative staff daily.  Your medical record will be retained for up to seven years after your discharge. Once your record has reached the seven-year limit, it is destroyed (process of shredding or deletion from database).

A financial file will be created upon admission to Sagepoint IOP; this file will contain all documents signed during the admissions process relating to payment for services, as well as the claim form that is processed after your discharge. Some of these documents will have limited personal health information, so they will be safeguarded and secured just like your medical record. These files are kept on site for seven years and then destroyed (process of shredding).

 

Substance Use Disorder Health Information:  The release of medical information concerning substance use disorders may be subject to and released in compliance with the requirements of Federal Law and regulations.

 

HIV Information:  All medical information regarding substance use is kept strictly confidential and released only in conformance with the requirements of federal and state laws.  Disclosure of any medical information referencing HIV status may only be made with your written authorization. A general authorization for the release of medical or other information is not sufficient for this purpose.

 

Public Health:  As required by state law, public health agencies will be contacted and your health information will be disclosed for the following reasons:

• Child abuse or neglect

• Elder abuse or neglect

• An attempted suicide or a self-injury

• Death of a client

• Prevent or control diseases, injury, or disability

• Adverse reactions to medications

• Adverse events 

• Avert a serious threat to the health or safety of a person or the public

 

Litigation:  Your personal health information cannot be released to any entities involved in a litigation suit without authorization from you. If you are involved in litigation after you have discharged from Sagepoint IOP, your personal health information will be released to Sagepoint IOP’s corporate attorney to oversee the litigation process. Otherwise, your personal health information may be released in accordance with applicable state or federal law. Subpoenas served upon Sagepoint IOP will be followed according to federal and state law.

 

National Security & Intelligence Activities:  We may be required to release your medical information to authorized federal officials for intelligence, counterintelligence, and other national security activities as authorized or required by law.

 

Business Associates:  We may disclose protected health information to a business associate and may allow a business associate to create, receive, or use protected health information on its behalf pursuant to a written contract or other written arrangements.  A business associate performs a function on behalf of the treatment center.  For example, vendors to perform billing services, accountants to perform audits, and agencies to provide accreditation.

Coroners, Medical Examiners, and Funeral Directors:  We may release medical information to a coroner or medical examiner for the purpose of identifying a deceased person or to find out the cause of death, or for other legal duties.  We may release medical information about treatment center clients to funeral directors so they may carry out their duties.

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Written Authorizations: All other uses and disclosures (i.e., verbal, written, Internet, and fax) of personal health information will be made only with the written authorization made by you, the client. Sagepoint IOP will only accept the original signed authorization; no photocopies will be accepted. Any information that Sagepoint IOP obtained from another healthcare facility will not be released.

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Right to Request Confidential Communications:  You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.  You must submit your request for confidential communication in writing.  Your request must specify how and where we should contact you.  We will try to accommodate all reasonable requests.

 

Other Uses of Medical Information: Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will only be made with your written permission and after you have had an opportunity to agree or object.  You may revoke that permission in writing at any time.

Revocation of Authorization: You have the right to revoke this authorization at any time; however, the revocation will not apply to your personal health information that was disclosed before the revocation. If you choose to revoke authorization while in treatment, you need to notify your primary therapist. If you choose to revoke authorization after you have discharged, you will need to contact Sagepoint IOP.

 

Request for Restriction of Use & Disclosure: You have the right to request restrictions concerning certain uses and disclosures of your protected health information as it relates to treatment, payment, and healthcare operations. However, Sagepoint IOP is not required to agree to this request. Sagepoint IOP will document the decision to accept or deny your request.

 

Request to Access: You have the right, which may be restricted in certain circumstances, to inspect and copy medical information that may be used to make decisions about your care. To receive a copy of your health information, you need to contact Sagepoint IOP. A nominal fee will be assessed for labor, supplies, and postage costs.

 

Request to Amend: You have the right to request an amendment to your health information. It is your right to append a statement or counter-opinion. It is not, however, your right to obliterate or totally remove documentation from your record. In addition, Sagepoint IOP is not required to agree with this request.  Amendments that are made and accepted will be transmitted to those who need to know. These requests will be handled by the Sagepoint IOP Program Director.

 

Request for Accounting of Disclosures: You have the right to receive an accounting of any disclosures of your health information. A nominal fee may be assessed for labor, supplies, and postage costs.

 

Copy of Privacy Notice: You have a right to request a copy of this notice from us.  Any questions should be directed to our Program Director.

 

Complaints: If you believe that your privacy has been violated, you have the option of submitting your written complaint to the Program Director of Sagepoint IOP.  We will not retaliate against you for filing a complaint.  The Program Director of Sagepoint IOP is Caroline Bentley and can be contacted at 8788 Elk Grove Blvd, Suite O, Elk Grove, CA 95624, or by calling 916-896-1061.. If Sagepoint IOP cannot resolve your concern, you have the right to file a written complaint to the United States Secretary of the Department of Health and Human Services at Office for Civil Rights 61 Forsyth Street, SW – Suite 3B70, Atlanta, Georgia 30323, (404) 562-7886.