Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

This Notice describes how health information about you may be used and disclosed, how you can obtain access to this information, and the rights you have regarding your health information.

Please review it carefully.

This Notice applies to protected health information maintained by Weave Mental Health in connection with the mental health services we provide.

Your Rights

When it comes to your health information, you have certain rights. Weave Mental Health is responsible for helping you exercise these rights as required by applicable law.

Get an Electronic or Paper Copy of Your Health Record

You may ask to see or receive an electronic or paper copy of your health record and other health information that we maintain about you.

We will provide access, a copy, or a summary of your health information as required by law.

A reasonable, cost-based fee may apply when permitted by law.

Ask Us to Correct Your Health Record

You may ask us to correct health information about you that you believe is incorrect or incomplete.

We may deny certain requests when permitted by law. If we deny your request, we will explain the reason in writing within the timeframe required by law.

Request Confidential Communications

You may ask us to contact you in a specific way.

For example, you may request that we:

• Call a particular telephone number
• Use a particular email address
• Contact you at home or work
• Send mail to a different address

We will accommodate reasonable requests as required by law.

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.

We are generally not required to agree to every requested restriction.

However, if you pay for a health care service or item completely out-of-pocket, you may ask us not to disclose information about that service to your health insurer for payment or health care operations. We will honor that request unless disclosure is required by law.

If we agree to a restriction, we may still disclose information when necessary to provide emergency treatment or when otherwise permitted or required by law.

Get a List of Certain Disclosures

You may request an accounting of certain disclosures of your health information.

This generally includes certain disclosures made during the six years before the date of your request.

The accounting will not necessarily include every disclosure, including certain disclosures made for treatment, payment, health care operations, or disclosures you specifically authorized.

We will provide one accounting within a 12-month period without charge. A reasonable, cost-based fee may apply to additional requests when permitted by law.

Get a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

A current copy is also available on our website.

Choose Someone to Act for You

If another person has legal authority to act on your behalf, such as a legal guardian, personal representative, or person holding an appropriate health care power of attorney, that person may exercise applicable privacy rights on your behalf.

We may verify that person’s legal authority before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint directly with Weave Mental Health.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

We will not retaliate against you for filing a privacy complaint or exercising your privacy rights.

Your Choices

For certain health information, you may tell us how you would like your information shared.

Where applicable, you may tell us whether you want us to:

• Share information with family members
• Share information with close friends
• Share information with others involved in your care
• Share information with individuals involved in payment for your care
• Share information during disaster-relief situations

If you are unable to communicate your preference—for example, during an emergency—we may disclose information when permitted by law and when we reasonably believe doing so is in your best interest.

We may also disclose information when necessary to prevent or lessen a serious and imminent threat to health or safety as permitted by law.

Uses Requiring Written Authorization

Except where otherwise permitted or required by law, we will obtain your written authorization before using or disclosing your health information for purposes not described in this Notice.

Written authorization is generally required for:

• Most uses and disclosures of psychotherapy notes
• Certain marketing activities
• The sale of protected health information
• Other uses and disclosures requiring authorization under applicable law

If you provide written authorization, you may generally revoke that authorization in writing at any time, subject to applicable legal limitations.

How We Typically Use and Share Your Information

Treatment

We may use and disclose your health information to provide, coordinate, or manage your treatment.

For example, when appropriate and legally permitted, we may communicate with another health care professional involved in your care.

Running Our Practice

We may use and disclose health information as necessary to operate Weave Mental Health and improve the quality of services we provide.

Examples may include:

• Treatment coordination
• Quality assessment
• Administrative activities
• Practice management
• Compliance activities
• Staff training
• Reviewing the effectiveness of services

Billing and Payment

We may use and disclose health information when necessary to bill and receive payment for services. For example, if you use health insurance, certain information may be provided to your insurance company or another payer to determine eligibility, obtain authorization, submit claims, or receive payment.

Other Situations Where Information May Be Used or Shared

Federal and state law may allow or require us to disclose health information in certain circumstances. These may include:

Public Health and Safety

We may disclose health information when permitted or required for activities such as:

• Preventing disease
• Reporting suspected abuse or neglect
• Preventing or reducing a serious threat to someone’s health or safety
• Other legally authorized public-health activities

Health Oversight

We may disclose information to health oversight agencies for activities authorized by law, including audits, investigations, inspections, licensing activities, or other oversight functions.

Complying With the Law

We may disclose information about you when federal or state law requires us to do so.

We may also disclose information to the U.S. Department of Health and Human Services when necessary to demonstrate our compliance with federal health-information privacy requirements.

Workers’ Compensation

We may disclose health information as authorized or required by workers’ compensation laws and similar programs.

Law Enforcement and Government Requests

We may disclose health information for certain legally authorized law-enforcement or governmental purposes. These may include:

• Law-enforcement requests permitted by law
• Health oversight activities
• Military or veterans’ activities
• National-security activities
• Other special government functions permitted by law

Medical Examiners and Funeral Directors

When permitted or required by law, we may disclose information to a coroner, medical examiner, or funeral director following an individual’s death.

Lawsuits and Legal Proceedings

We may disclose health information in response to certain court or administrative orders, subpoenas, discovery requests, or other lawful processes, subject to applicable federal and state confidentiality protections.

Mental health records, psychotherapy notes, and certain other records may receive additional protections.

Research

We may use or disclose health information for research only when permitted under applicable federal and state law and when required privacy protections have been satisfied.

Additional Protections for Mental Health Information

Psychotherapy Notes

Psychotherapy notes may receive protections beyond those applicable to other health information.

We generally will not use or disclose psychotherapy notes without your written authorization except where HIPAA or another applicable law specifically permits or requires the use or disclosure.

Mental Health Records

Because Weave Mental Health provides behavioral and mental health services, some of the information we maintain may be subject to confidentiality protections in addition to HIPAA.

We will comply with applicable federal and state laws governing mental health records and will apply additional restrictions when those laws provide greater privacy protection than HIPAA.

Substance Use Disorder Records

Certain substance use disorder treatment records may receive additional protection under federal law, including 42 CFR Part 2.

To the extent Weave Mental Health creates, receives, or maintains records subject to Part 2, those records will be handled according to applicable federal requirements.

Part 2-protected records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against an individual based on those records except as specifically permitted by federal law, including where appropriate written consent or a qualifying court order and subpoena have been obtained.

Additional restrictions may apply.

Our Responsibilities

Weave Mental Health is committed to protecting the privacy and security of your health information.

We are required by applicable law to:

• Maintain the privacy and security of protected health information.
• Provide you with this Notice explaining our legal duties and privacy practices.
• Follow the privacy practices described in the Notice currently in effect.
• Notify affected individuals when required following a breach of unsecured protected health information.
• Respect applicable restrictions on the use and disclosure of your information.
• Provide access to your health information as required by law.
• Honor your privacy rights as required by applicable federal and state law.

We will not use or disclose your information for purposes other than those described in this Notice unless the use or disclosure is otherwise permitted or required by law or you provide written authorization.

If you provide authorization, you may generally revoke it in writing at any time.

Electronic Communications and Telehealth

Weave Mental Health may provide services through telehealth and may use electronic systems for scheduling, communications, documentation, billing, and client portal access.

We use reasonable safeguards designed to protect health information transmitted or maintained electronically.

Clients may be provided with additional information regarding telehealth, electronic communications, and secure client portal use as appropriate.

Minors and Personal Representatives

When services are provided to minors, parents, guardians, and other legally authorized representatives may have rights regarding a minor’s health information.

Those rights may vary depending upon the minor’s age, the nature of the services provided, who consented to treatment, and applicable federal and state law.

Weave Mental Health will follow applicable law when determining whether a parent, guardian, minor, or other representative may access or control disclosure of health information.

Changes to This Notice

We reserve the right to change the terms of this Notice and our privacy practices as permitted by law.

Changes may apply to health information we already maintain as well as information we receive in the future.

When material changes are made, an updated Notice will be available:

• On our website
• Upon request
• At our physical office, when applicable

Questions or Privacy Complaints

If you have questions about this Notice, want to exercise your privacy rights, or believe your privacy rights have been violated, contact:

Weave Mental Health
Privacy Contact: Deanne Ford, LCSW
Phone: 208-969-0428
Email: Deanne@weavementalhealth.com
Twin Falls, Idaho

Federal Privacy Complaints

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

Filing a complaint will not affect your treatment, and Weave Mental Health will not retaliate against you for exercising your privacy rights.