Privacy Notice Effective Date: 4/14/2003 — Revised: July 5, 2017 

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. 
Your Privacy is Important to Us:  Horizon is required by law to protect the privacy of health information, to provide this notice to you, and to abide by the terms of this notice. Horizon reserves the right to change this privacy notice and must notify you if this notice is changed. Individuals served by Horizon will be notified of material changes to the notice during regular updates of the Orientation Guide, via service contact visits, or by mail. By signing the Orientation Checklist upon admission and during regular updates, you acknowledge that this notice was shared with you and that you were provided a copy.
Our Uses and Disclosures
Documentation:  Each time you receive services from Horizon, we make a record of the contact. Types of information kept in your record may include written assessments, individual service plans (ISP), progress notes, diagnoses, treatment records, correspondence, and transition or discharge plans.
Minimum Necessary Rule: Horizon and its business associates use the minimum amount of health care information necessary when responding to appropriate needs for information.
To Treat You: Upon signing the agency’s Consent to Treatment form, you are allowing Horizon to use or share your medical information to provide you with treatment or medical services. For example, we will share medical information about you with doctors, nurses, therapists, and other people who are taking care of you. We may contact you to communicate treatment options and other related benefits or services.
For Healthcare Operations: We can use and share your health information to run our practice, improve your care, and contact you when necessary. We may use your health information to review our treatment and services, to perform business planning activities, and to evaluate and improve our staff and the quality of care you receive.
Billing and Payment Use of Your Health Information: To receive payment of services, your health information may be sent to companies or other organizations responsible for payment coverage. A monthly bill from Horizon is sent to the responsible party you have identified.
Email and Text Messages: You may elect to have appointment reminders and other limited service information sent to you by email or text message. Email and text messages could be inadvertently or intentionally intercepted, read, and/or copied by unintended recipients.
Sign In: We may have you sign in when you arrive at one of our facilities. We may also call out your name when we are ready to see you.
Other Ways Horizon May Use Your Health Information
Consultation: In order to effectively provide services, our staff may consult with various service providers within the agency. During consultation health information about you may be shared. Horizon is a Virginia Community Services Board and if you receive regionally based services and more than one Community Service Board (CSB) is involved in your care, your health information may be shared among participating providers. In our day-to-day business practices, our administrative staff may handle and use your health information for business operations, facilitate services, process insurance information, perform billing functions, or assure that your information is current and readily accessible to our clinical staff.
Specific Circumstances for Disclosure: Horizon is allowed by federal and state law in certain circumstances to disclose specific health information about you. Communication or sharing of information may occur for the following:
· As required by law such as court-ordered warrant, Virginia Health Information laws
· Public Health concerns such as communicable diseases
· Judicial and Administrative proceedings including an order from a court, administrative tribunal, legal counsel to the agency, or the Inspector General
· Law Enforcement purposes such as reporting of gun-shot wounds, limited information requested about criminal suspects, fugitives, material witnesses, missing persons, or criminal conduct on agency premises
· Health Oversight Agencies for the purpose of audits, inspections, credentialing, or licensure
· To avert a serious threat to health and safety such as a response to a statement made by a client to harm self or another person, or substantial property damage
· To protect children or incapacitated adults who are victims of abuse, neglect or exploitation by reporting suspected abuse to the Department of Social Services.
Specialized Government Functions: Horizon may communicate with state and federal government in certain situations and for certain purposes. These include: Military Services (ex: in response to appropriate military command to assure the proper execution of the military mission); National Security and Intelligence activities (ex: in relation to protective services to the President of the United States); State Department (ex: medical suitability for the purpose of security clearance); Correctional Facilities (ex: to correctional facility about an inmate); Workers Compensation to facilitate processing and payment; Coroners and Medical Examiners for identification of a deceased person or to determine cause of death.
Business Associates: Some services are provided by Horizon business associates. For example, Horizon may contract with outside companies to provide nursing services. We may disclose your health information to these companies so that they can perform the contract with each of these business associates that require them and their subcontractors to protect the confidentiality and security of your protected health information.
Other Providers: We may disclose health information to health care professionals who have cared or currently caring for you, such as hospitals for their use in your treatment, obtaining payment, or their health care operations.
Individuals Involved in Your Care: We may share or contact a family member, a personal representative, or another person responsible for your care to tell them where you are unless you object
Fundraising and Marketing: If you are contacted to raise funds for Horizon programs you can tell us not to contact you again. We will not condition treatment or payment on your choice. Unless you give us written permission, we will never sell your information and we will not share it for marketing purposes other than Horizon internal marketing efforts.
Your Rights Regarding Your Health Information
Right to Inspect and Copy: You have the right to inspect and receive a copy of your health information. This right is not absolute. In certain situations, access may be denied if a physician or psychologist believes that reviewing your records would result in harm to self or others. Make this request by contacting your Primary Service Coordinator or the agency’s Health Information Department. If denied access, you will receive a timely, written notice of the decision and reason. A copy of this written notice becomes a part of your record. You have the right to gain a copy of any document that you have signed including your treatment plan. You have a right to have a copy sent to another person that you designate. You may request copies of records in an electronic format. If the records are available in electronic format, we will accommodate that request. Otherwise we will provide an alternative format. You have a right to obtain copies for a reasonable fee. Contact Health Information for details.
Right to Amend: You have the right to ask to amend your medical information if you believe our records are inaccurate or incomplete. You must make the request in writing and include a reason for the request. Horizon may deny your request. For example, we may deny a request to amend information that we did not create, or that is accurate and complete. If denied, we will provide you with a written reason for the denial.
Right to Receive an Accounting of Disclosures: You have the right to ask for an Accounting of Disclosures. This is a list of times we shared your information for reasons other than treatment, payment, or health care operations, and certain other reasons such as disclosure you asked us to make. You must submit your request in writing. Clients of Horizon are permitted one accounting of disclosure list free of charge in any 12-month period. Additional requests made in the same period may result in allowable administrative charges.
Right to Request Restrictions: You have the right to restrict disclosure of your health information to your health plan for services paid out of pocket in full prior to the services being provided. This restriction applies if the disclosure to the health plan is for purposes of payment or health care operations and the health information relates to the health care item or service for which we have been paid in full prior to the service. You have the right to request limits on how we share certain health information for treatment, payment, or health care operations. Horizon is not required to agree to your request. For example, we will not be able to meet requests that would interfere with your treatment or billing for services.
Right to Request Alternative Communication: You have the right to request that we communicate with you about medical matters in a particular manner or at a certain location. For example, you may ask that we contact you at home rather than at work. You must make requests for alternative communication in writing.
Breach Notification: Horizon will notify you in writing and take other steps required by law if there has been a breach of your unsecured health information.
Right to a Paper Copy of This Notice: You have the right to a printed copy of this Notice.
Right to Complain: You have the right to file a complaint with Horizon and/or the Secretary of the United States Department of Health and Human Services if you believe that we have violated your privacy rights. To complain to Horizon, contact our Client Privacy and Rights Officer at 434-455-3422. You will not be penalized for filling a complaint.
Disposition and Retention of Medical Records Upon Discharge: As directed by the Code of Virginia, Horizon Behavioral Health includes this information to inform you of how we handle medical records of persons who are no longer receiving services from our agency. You are welcome to contact us at the address or phone number listed below if you have any questions. Our standard procedure is to retain medical records for a period of at least six (6) years past the date of discharge. At that time, if there is no indication that the discharged individual is planning to return to our agency to receive services, then the medical records for that individual may be destroyed per Virginia (18VAC85-20-26) which state that practitioners must maintain a patient record for a minimum of six (6) years following the last patient encounter with the following exceptions:
1. Records of a minor child, including immunizations, must be maintained until the child reaches the age of 18 or becomes emancipated, with a minimum time for record retention of six (6) years from the last patient encounter regardless of the age of the child; (24 years of age)
2. Records that have previously been transferred to another practitioner or health care provider or provided to the patient or his personal representative; or
3. Records that are required by contractual obligation or federal law to be maintained for a longer period of time.
42 CFR Part 2-This regulation provides special protection of the confidentiality of substance use treatment information. All disclosures of this information will be subject to permission from the client or the exceptions allowed in the regulations. The exceptions are disclosures for research, child abuse and neglect reporting, internal communications, audits, crimes on program premises or against program personnel, medical emergencies, Qualified Service Organizations, and certain court orders. To report any suspected violations you may contact the United States Attorney’s Office at 255 West Main St., Room 130, Charlottesville, VA 22902 or call (434) 293-4283. For any violations by an opioid treatment program you may contact SAMHSA Center for Substance Abuse Treatment at (866)287-2728 or
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.
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 in this notice unless you tell us we can in writing. If you change your mind let us know in writing.
This Notice of Privacy Practices applies to the following organizations:
Horizon Behavioral Health and Horizon Opportunities, Inc.