Notice of Privacy Practices

IV. How We May Use or Disclose Your PHI

STRIDE Community Health Center collects health information about you and stores it in an electronic health record (EHR). This is your medical record. The EHR is the property of this medical practice, but the information in it belongs to you. The law permits us to use or disclose your health information for the following purposes, with or without authorization:

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1. Treatment. Treatment refers to the provision, coordination, or management of health care (including mental health and substance use disorder treatment, and reproductive health care) and related services by one or more health care providers. We use and share your PHI to provide you with health care and related services. For example, we may share your health information with other doctors, nurses, or hospital staff who help provide care for you.

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2. Payment. Payment refers to the activities undertaken by a healthcare provider (including a behavioral health provider or reproductive health care provider) to obtain or provide reimbursement for the provision of health care. The information provided to insurers and other third-party payers may include information that identifies you, your diagnosis, type and date of service, provider name/identifier, and other information about your condition and treatment. If you are covered by Medicaid, this information will be provided to the State of Colorado's Medicaid program.

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3. Health Care Operations. Health Care Operations refers to activities undertaken by STRIDE Community Health Center that are regular functions of management and administrative activities. Such activities include coordination of care and case management services provided to you. This may include disclosure to social service agencies, community-based organizations, home and community-based service, providers, or other third-parties that provide or coordinate health- related services that are needed for your care.

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4. Contacting the Client. STRIDE Community Health Center may contact you to remind you of appointments and to tell you about treatments or other services that might benefit you.

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5. When Required by Law. We may disclose your information when the law requires it. For example, we may disclose your information to a person who has authority under the law to act on your behalf; to report suspected victims of abuse, neglect, or domestic violence; for judicial and administrative proceedings; and to law enforcement officials to assist them in their law enforcement duties to the extent permitted by law subject to the further restrictions specified in this Notice below.

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6. For Health Oversight Activities. We may disclose your information to a health oversight agency for oversight activities authorized by law including audits; civil, administrative, or criminal proceedings or actions; or other activities necessary for oversight of the healthcare system and government benefit programs.

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7. For Specialized Government Functions. We may use or disclose your information as necessary for certain government functions including intelligence, national security, or security clearance activities.

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8. For Workers Compensation. We may disclose your information to workers compensation programs which provide benefits for work-related injuries.

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9. For Health Information Exchange. STRIDE Community Health Center endorses, supports, and participates in electronic Health Information Exchange (HIE) to improve the quality of your health and healthcare experience. HIE provides us with a way to share patients’ clinical information electronically securely and efficiently with other physicians and health care providers that participate in the HIE network. If you wish to opt-out of any HIE, you must submit an “Opt-Out” form to STRIDE. You can obtain an Opt-Out form by asking for this form at the front desk at any of our STRIDE clinic locations. If you have previously opted-out elsewhere and would like to opt back in, you can obtain an “Opt-In” form at the front desk at any of our STRIDE clinic locations. You may obtain information regarding the HIE at the front desk at any of our STRIDE clinic locations.

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10. To Business Associates. Some of the functions of STRIDE Community Health Center are provided by contracted business associates. In those situations, PHI will be provided to those contractors as needed to perform their contracted tasks. Business associates must enter into an agreement maintaining the privacy of the PHI released to them.

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11. For Marketing. Provided we do not receive any payment for making these communications, we may contact you to give you information about products or services related to your treatment, case management or care coordination, or to direct or recommend other treatments, therapies, health care providers or settings of care that may be of interest to you. STRIDE Community Health Center will not otherwise use or disclose your PHI for marketing purposes or accept any payment for other marketing communications without your prior written authorization. The authorization will disclose whether we receive any compensation for any marketing activity you authorize, and we will stop any future marketing activity to the extent you revoke that authorization.

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12. For Research. We may use or disclose your information for limited research purposes, but only if steps required by law are taken to protect your privacy and as otherwise in compliance with our research policies and practices.

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13. To Others Involved in Your Care. In some cases, we may disclose your information to a member of your family, a relative, a close friend, or other person you identify who is directly involved in your health care or payment of bills related to your health care. If you are seriously injured and unable to make a health care decision for yourself, we may disclose your information to a family member if we determine it is in your best interest.

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14. For Fundraising. STRIDE Community Health Center may contact you as a part of its resource development activities. You have the right to opt out of fundraising communications.

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15. To Avert a Serious Threat to Health or Safety. To the extent permitted by law and ethical conduct, we may disclose your information to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

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16. Prescription Drug Monitoring Program. If you are prescribed a controlled substance, STRIDE Community Health Center pharmacy workforce members will enter your identifying information into the Prescription Drug Monitoring Program database for certain healthcare providers to review.

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17. For the Sale of Health Information. We will not sell your health information without your prior written authorization, and we will stop any future sales of your information if you revoke that authorization.

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18. For Breach Notification. In the case of a breach of unsecured PHI, we will notify you as required by law. In some circumstances, our business associate may provide the notification.

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19. For Public Health Activities. We may disclose your information to a public health authority authorized by law to collect or receive information to prevent or control disease, injury, or disability,y or to report vital statistics; to a government authority authorized by law to receive reports or child neglect or abuse; and to the Food and Drug Administration for its reporting and tracking requirements.

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20. Confidentiality of Alcohol and Substance Use PHI. The confidentiality of alcohol and substance use client records is protected by Federal law. Generally, we may not communicate to a person outside the program that a client attends an identifiable alcohol or substance use program or disclose any information identifying a client as an alcohol or substance user, unless the client consents in writing, the disclosure is made to medical personnel in a medical emergency, or to qualified personnel for research, audit, or program evaluation. The protection does not apply to information regarding observed crimes, crimes in the facility, or releases of information required by law, such as a court order or child abuse reporting. Violation of the Federal law is a crime and may be reported to the appropriate authorities. 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.

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21. Additional Privacy for Reproductive Health Care PHI. Federal law prohibits us from using or disclosing your information when it is being sought to investigate or impose liability on you, health care providers, or others who seek, obtain, provide, or facilitate lawful reproductive health care, or to identify persons for such activities. This prohibition applies where we, or others acting on our behalf, have reasonably determined that:

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a. The reproductive health care is lawful under the law of the state in which it was provided under the circumstances in which it was provided, for example, if a resident of one state traveled to another state to receive reproductive health care, such as an abortion, that is lawful in the state where such health care is provided; or

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b. The reproductive health care is protected, required, or authorized by Federal law, including the U.S. Constitution, regardless of the state in which such health care is provided, for example, if the use of the reproductive health care, such as contraception, is protected by the Constitution; or

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c. The reproductive health care was not provided by us, but we presume it was lawful. However, if we receive a request for your information, and we have actual knowledge that the reproductive health care was not lawful under the circumstances under which it was provided to you, this presumption does not apply, for example, if you tell us you received reproductive health care from an unlicensed person and we know that the specific reproductive health care must be provided by a licensed health care provider.

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STRIDE Community Health Center may not use or disclose PHI in any other way without a signed release of information. When you sign a release of information, it may later be revoked, provided that the revocation is in writing. The revocation will apply, except to the extent STRIDE has already acted in reliance thereon. Any uses and disclosures not described in this Notice of Privacy Practices require an authorization by the individual. Most uses and disclosures of psychotherapy notes require authorization by the individual.

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When we receive a request for your information potentially related to reproductive health care, we must obtain a signed attestation from the requester that the use or disclosure is not for a prohibited purpose when the request relates to health oversight activities, judicial and administrative proceedings, law enforcement purposes, and disclosures to coroners and medical examiners. For example, if we receive a lawful subpoena for medical records that include information related to reproductive health care, we must obtain a signed attestation from the requester that states the request is not for a prohibited purpose.