Notice of Information Practices (abv.)

How Your Protected Healthcare Information can be used


Federal law ensures how your protected health information (PHI) is managed, the conditions under which it may be disclosed, and how you may access this information. Any questions concerning Auburn Behavioral Health's privacy practices should be addressed with your therapist. PHI is about you, including demographic information which may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. You will be advised anytime our Notice of Information Practices is revised. A copy of our privacy practices will be provided at intake and is available at any time on request. Auburn Behavioral Health, hereafter referred to as "ABH" is required by law to remain compliant with this Notice of Information Practices (NIP).


I. Uses and Disclosures of Protected Health Information

As a new patient, you will likely be asked to complete a new patient Personal Inventory Questionnaire. You will also be asked to sign that you have received this NIP. a copy of the signed NIP will be kept with all your other confidential information maintained by the practice. ABH is not required to ask for your consent to use or disclosure of your PHI for treatment, payment and/or health care operations; however, we are required to obtain your consent for the disclosure for other specific purposes or reasons described in this NIP.


II. Uses and Disclosures of Protected Health Information Based on Your Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization unless otherwise permitted or required by law You may revoke this authorization at any time, in writing, except to the extent that your provider has taken an action in reliance on the use or disclosure indicated in the authorization.

A.  Research

Auburn Behavioral Health will not allow your PHI collected by its staff, to be used in research projects without your written consent.

B.  Uses and Disclosures of Protected Health Information that Do Not require Your Consent or Authorization

  • When you are required by order of a Court of competent jurisdiction to receive an assessment or treatment following assessment. This disclosure may include release of PHI to third parties as a condition of the Court Order; e.g., Department of Human Resources, Probation or Parole Officers, or court Referral Officers. 
  • When there is a Court Order of competent jurisdiction to release your records to the Court. Your provider will not release your PH on the basis of a subpoena only.
  • When there is reason to believe that you are an imminent danger to yourself or others.
  • There is an emergency that requires treatment or intervention from emergency services providers; e.g., EMTs, paramedics, hospital staff, police or other law enforcement and/or fire department officials.
  • In the event of a psychiatric or behavioral emergency requiring third party intervention.
  • When there is known or suspected abuse of children, elderly adults, or adults with disabilities.

C.  Right to an Accounting of Disclosures

You have a right to an accounting of disclosures; i.e., a list of the disclosures made by ABH of your PHI.

D.  Right to Request Restrictions

You have a right to request a restriction or limitation on the PHI that ABH uses or discloses about you for treatment, payment and/or health care operations.

E.  Right to Confidential Communications

You have a right to privacy concerning your treatment with the exception of stipulations within this document.

F.  Right to a Paper Copy of This Notice


III.  Your Rights Regarding Health Information About You

A.  Right to Inspect and Copy

You have the right to inspect and receive a copy of your PHI.

B.  Right to Request an Amendment

If you feel that the PHI that ABH has about you is incorrect or incomplete, you may ask to have the information amended.

C.  Right to Complain if you Feel Your Privacy Rights Have Been Violated

If you feel your privacy rights have been violated we encourage you to talk with your therapist immediately. You may also file a complaint with the U.S. Department of Health and Human Services at www.hhs.gov/ocr/privacy/hipaa/complaints/.