Notice of Privacy Policy

This is a notice that demonstrates how medical, drug and alcohol related information about you may be utilized and disclosed. A paper copy of this notice is available upon request at any New Life Wellness office location.

This notice fulfills two requirements of federal law: The Health Insurance Portability and Accountability Act (HIPAA) 42 U.S.C. §1320d et seq., 45 C.F.R. Parts 160 & 164, and 42 U.S.C. § 290dd-2, 42 CFR Part 2 (“Part 2”) regarding Confidentiality of Alcohol and Drug Abuse Patient Records. In addition, this notice includes amendments made in order to fulfill section 3221 of the Covid Relief, and Economic Security (CARES) Act set forth at 89 FR 12472, effective April 16, 2024, which amended Part 2, and in particular, 42 CFR section 2.22.

Under these federal regulations, New Life Wellness, PLLC "New Life Wellness" may not disclose to any person or entity outside New Life Wellness that you are a patient of New Life Wellness, that you may be suffering from a Substance Use condition or any medical condition, nor may New Life Wellness disclose to any outside person or entity any other Protected Health Information (“PHI”) about you except as permitted by federal law. Your PHI means any written or oral health information about you, including demographic data that may be used to identify you. This is health information that is created or received by your healthcare provider, and that relates to your past, present or future physical or mental health or condition. This Notice describes how New Life Wellness may use and disclose your protected health information to carry out treatment, payment and health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI.

In this notice:

How your health information may be used and disclosed
Your rights with respect to your protected health information
How to file a complaint concerning any violation regarding the privacy or security of your protected health Information, or of your rights regarding your protected information

As a client/patient of New Life Wellness, you have a right to a copy of this notice, be it in paper or electronic format. Any inquires or concerns can be directed to:

Randall Kelly, Chief Executive Officer, New Life Wellness PLLC.

Phone: 541-303-3558.

Email: randall@nlwellness.org

I. Uses of PHI and Disclosures

New Life Wellness is required to obtain your written consent before it may disclose information about you, be it for treatment, payment, or health care operations purposes. New Life Wellness must obtain your written consent before it may disclose information to your health insurer in order to be paid for services. In addition, you are required to sign a written consent before New Life Wellness may share information outside of New Life Wellness for treatment purposes or for health care operations purposes. Federal law does permits New Life Wellness to obtain your written consent for such purposes. If the judgement of New Life Wellness that disclosure is required for such purposed in order to effectively provide treatment, be paid for services, and perform business operations, and you elect not to consent, which is your right, New Life Wellness may not be able to effectively provide treatment to you.

Below are a list of instances where federal law permits New Life Wellness to disclose information without your written permission:

Pursuant to an agreement with a person, entity, or agency (i.e. a qualified service organization/business associate) that provides services to New Life Wellness. For example, New Life Wellness may disclose information without your consent to obtain data management or financial services as long as a compliant qualified service organization/business associate agreement is in place limiting redisclosure.
For research, audit or program evaluation purposes.
To report a crime committed on New Life Wellness premises or against New Life Wellness personnel.
To medical personnel in a medical emergency.
To appropriate authorities to report suspected child abuse or neglect.
As authorized by a court order.
Within New Life Wellness and any administrative entity having control over New Life Wellness to the extent needed to provide patient care and conduct business.
To a public health authority, as long as the information has been de-identified.
To a parent, guardian, or other authorized representative if you are a minor and New Life Wellness determines that you lack the capacity to make a rational choice as to consent.

Prior to New Life Wellness. using or disclosing any information about your health in a way which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. You may revoke any such written consent in writing, except to the extent that New Life Wellness has already acted upon it. You are permitted to provide a single consent for all future uses or disclosures for treatment, payment, and health care operations purposes.

Patient records, or testimony relaying the content of such records, may not be used or disclosed in any civil, administrative, criminal, or legislative proceedings against you as a patient unless based on specific written consent or a court order. Records will only be used or disclosed based on a court order after any appropriate notice and an opportunity to be heard is provided to you or the holder of the record, where required by law. Any court order authorizing use or disclosure must be accompanied by any applicable and required legal mandate before the record is used or disclosed.

Records that are disclosed to a part 2 program, covered entity, or other qualified service organization or business associate pursuant to your written consent for treatment, payment, and health care operations purposes may be further disclosed by that part 2 program, covered entity, or business associate, without your further consent, to the extent the permitted by law.

New Life Wellness may not use or disclose records to fundraise unless you are first provided with a clear and conspicuous opportunity to elect not to receive fundraising communications.

II. Patient Rights

You have the following rights regarding your protected health information:

-The right to inspect and copy your protected health information.

You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as New Life Wellness maintains the PHI. A “designated record set” contains medical and billing records and any other records that your practitioner and the facility uses for making decisions about you. You may request an electronic copy in a “designated record set” if maintained electronically, in the format of your choice that is readily producible. If not readily reproducible, a readable copy will be provided to you.

Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; and PHI that is subject to a law that prohibits access to PHI.

New Life Wellness, in its professional judgement, may deny your request to inspect or copy your PHI if, if New Life Wellness determines that the access requested is likely to endanger your life or safety or that of another person, or that it is likely to cause substantial harm to another person referenced within the information. You have the right to request a review of this decision.

To inspect or copy your medical information, you must submit a written request to the Privacy Officer whose contact information is listed on the last page of this Notice. If you request a copy of your information, New Life Wellness may charge you a fee for the costs of copying, mailing or other costs incurred by New Life Wellness in complying with your request.

Please contact New Life Wellness Privacy Officer if you have questions about access to your medical record.

-The right to request a restriction on uses and disclosures of your protected health information.

Under federal law, you may request New Life Wellness not to use or disclose certain parts of your PHI for the purposes of treatment, payment or health care operations, including in instances where you have already consented to such use. Your request must state the specific restriction that you are requesting and to whom you want the restriction to apply.

If New Life Wellness denies a restriction, you will be informed. New Life Wellness is not required to agree to a restriction that's requested, except in the limited instance where your request pertains solely to notification to a health plan and involves a health care item or service for which you have already paid in full. New Life Wellness. If the restriction is approved, New Life Wellness may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstances, New Life Wellness may terminate its agreement to a restriction. You may request a restriction by contacting the New Life Wellness Privacy Officer.

-The right to request to receive confidential communications from New Life Wellness by alternative means or at an alternative location.

You have the right to request that New Life Wellness communicate with you in variable ways. New Life Wellness will accommodate reasonable requests. New Life Wellness will not require you to provide an explanation for your request. Requests must be made in writing to the Privacy Officer.

-The right to request amendments to your protected health information.

You may request an amendment of protected health information in a designated record set for as long as New Life Wellness maintains this information. In certain cases, New Life Wellness may deny your request for an amendment. If New Life Wellness denies your request for amendment, you have the right to file a statement of disagreement with New Life Wellness and New Life Wellness may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Requests for amendment must be in writing and must be directed to New Life Wellness Privacy Officer. In this written request, you must also provide a reason to support the requested amendments.

-The right to receive an accounting.

You have the right to request an accounting of all disclosures made by New Life Wellness to which you have consented within the preceding 3-year period, to include disclosures for purposes of treatment, payment, and health care operations . New Life Wellness is not required to account for disclosures that New Life Wellness is permitted to make without your authorization. This request for an accounting must be made in writing to the Privacy Officer. New Life Wellness will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee. You have the further right to request an accounting of any disclosures made by an intermediary, which means any person, other than part of a Part 2 program, covered entity, or business associate, who has received such records pursuant to consent and a general description in order to be disclosed to one or more member participants who have a treating provider relationship with the patient, for any such disclosures within the past 3 years.

-The right to obtain a paper copy of this notice.

Upon request, New Life Wellness will provide a paper or electronic copy of this notice even if you have already received a copy of the notice or have agreed to accept this notice electronically.

III. Our Duties

New Life Wellness is required by law to maintain the privacy of your protected health information and report to you any breach of unsecured PHI. This obligation continues even after you are no longer a patient of New Life Wellness. New Life Wellness is also required to provide you with this Notice of the duties of New Life Wellness and privacy practices and shall abide by terms of this Notice as may be amended from time to time. New Life Wellness reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all future PHI that New Life Wellness maintains. In such event, New Life Wellness will notify the patient in a timely manner. The patient will sign their understanding in writing.

IV. Complaints and/or Concerns

You have the right to articulate complaints to New Life Wellness and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. Your complaints or concerns can be directed to New Life Wellness by contacting the Privacy Officer verbally or in writing, using the contact information below. New Life Wellness encourages you to articulate any concerns you may have regarding the privacy of your information. You will not be retaliated or discriminated against in any way for filing a complaint. Violation of Part 2 by a program such as New Life Wellness may be a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations.

V. Privacy Officer Contact Information

For all issues regarding patient privacy and your rights under the federal privacy standards, is directed to the Privacy Officer. Information regarding matters covered by this Notice may be requested by contacting the Privacy Officer. If you feel that your privacy rights have been violated by New Life Wellness, you may submit a complaint to the Privacy Officer by sending it to:

Randall Kelly DMSc MHS PAC

256 E Hurlburt Ave Suite 117

Hermiston, OR 97838

Phone: 541-303-3558

Email: randall@nlwellness.org

VI. Effective Date

The effective date of this notice is 12/31/2024