Pioneering a New Approach to Behavioral Health—Together

Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

Effective Date of Notice: 1/1/2014 (revised 7/15/2019)

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.

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Your Rights

When it comes to your health information, you have certain rights.
This section explains your rights and some of our responsibilities to help you.

You have the right to:

  1. Get a copy of your health and claims records
    • You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this.
    • We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
  2. Ask us to correct health and claims records
    • You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this.
    • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  3. Request confidential communication
    • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
    • We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.
  4. Ask us to limit the information we share
    • You can ask us not to use or share certain health information for treatment, payment, or our operations.
    • We are not required to agree to your request, and we may say “no” if it would affect your care.
  5. Get a list of those with whom we’ve shared your information
    • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
    • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  6. Get a copy of this privacy notice

    You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
  7. Choose someone to act for you
    • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
    • We will make sure the person has this authority and can act for you before we take any action.
  8. File a complaint if you believe your privacy rights have been violated
    • You can complain if you feel we have violated your rights by contacting us in writing at New Directions Behavioral Health, Privacy Officer, P.O. Box 6729, Leawood, KS 66206-0729, by calling (816) 994-1449 or by sending an email to jpatten@ndbh.com
    • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-(877)-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/
    • We will not retaliate against you for filing a complaint.
Obtain Copies of Your Medical Records
  1. Consent to Release Information
  2. Consent to Release Information – Authorization to Disclose PHI Form - Form Instruction
Your Choices

For certain health information, tell us your choices about what we share.
If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  1. Answer coverage questions from your family and friends

    Share information with your family, close friends, or others involved in payment for your care.
  2. Provide disaster relief

    Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most uses and disclosures of psychotherapy notes
  • Any other uses and disclosures not addressed in this Notice
Name an Authorized Delegate
  1. If you wish to give access to your information to someone else (spouse, family member, your child's guardian, your employer, parent, etc.), you can complete the Authorized Delegate Form, which allows New Directions to share information about your healthcare account with whomever you designate.
  2. Authorized Delegate Instruction Form
  3. Authorized Delegate Form
  4. Spanish Authorized Delegate Form
Our Uses and Disclosures

How do we typically use or share your health information?

We may use and share your information as we:

  1. Help manage the health care treatment you receive

    We can use your health information and share it with professionals who are treating you.

    Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

  2. Run our organization
    1. We can use and disclose your information to run our organization and contact you.
    2. We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.

    Example: We use health information about you to develop better services for you.

  3. Pay for your health services

    We can use and disclose your health information as we pay for your health services.

    Example: We share information about you with your health plan to coordinate payment for your behavioral health or EAP services.

  4. Administer your health plan

    We may disclose your health information to your health plan sponsor for plan administration.

    Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html.

  1. Help with public health and safety issues

    We can share health information about you for certain situations such as:

    1. Preventing disease
    2. Helping with product recalls
    3. Reporting adverse reactions to medications
    4. Reporting suspected abuse, neglect, or domestic violence
    5. Preventing or reducing a serious threat to anyone’s health or safety
  2. Respond to requests from a medical examiner

    We can share health information with a coroner or medical examiner when an individual dies.

  3. Do research

    We can use or share your information for health research.

  4. Comply with the law

    We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

  5. Address workers’ compensation, law enforcement, and other government requests

    We can use or share health information about you:

    1. For workers’ compensation claims
    2. For law enforcement purposes or with a law enforcement official
    3. With health oversight agencies for activities authorized by law
    4. For special government functions such as military, national security, and presidential protective services
  6. Respond to lawsuits and legal actions

    We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities
  1. We are required by law to maintain the privacy and security of your protected health information.
  2. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  3. We must follow the duties and privacy practices described in this notice and give you a copy of it.
  4. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

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, on our web site, and we will mail a copy to you.

Other Instructions for Notice
  1. If you have any questions/concerns or complaints, please contact New Directions’ Privacy Officer Jarod Patten via telephone at (816) 994-1449, via email at jpatten@ndbh.com, or via postal mail at P.O. Box 6729, Leawood, KS 66206-0729.
  2. Certain states place heightened restrictions upon how we are able to use and access your info, and what info we are allowed to share. New Directions will comply with all state laws and will help you understand those requirements if you ask us.
  3. Although New Directions does not typically conduct fundraising activities, in the event that we do, you will be allowed to opt out.
  4. New Directions may decide to contact you to provide you appointment reminders. If we do so, you will be allowed to opt out of those reminders.