Notice of Privacy Practice

Effective Date: 12/15/2025

Notice of Privacy Practices

This notice describes:

• How medical information about you may be used and disclosed.
• Your rights with respect to your health information.
• How to file a complaint concerning a violation of the privacy or security of your health information, or of your rights concerning your information.

Please review this notice carefully.

This Notice describes the privacy practices of NorthCare, (all locations) and the privacy practices of:

• all of our doctors, nurses, and other heath care professionals authorized to enter information about you into your medical chart.
• all of our departments, including, e.g., our medical records and billing departments.
• all of our NorthCare sites.
• all of our employees, staff, volunteers and other personnel who work for us or on our behalf.

Our Pledge:  NorthCare acknowledges that all mental health and drug or alcohol abuse treatment services whether recorded or not and all communication between a physician or psychotherapist and a consumer are both privileged and confidential and will not be released without written consent or as authorized by law. The requirements for confidentiality apply to all individuals who have received services at NorthCare at any time, whether active or discharged.

This notice applies to all of our records about your care, whether made by our health care professionals or others working in this office, and tells you about the ways in which we may use and disclose your personal health information. This notice also describes your rights with respect to the health information that we keep about you and the obligations that we have when we use and disclose your health information.

For More Information, Contact Us:

Privacy Officer
NorthCare
3000 N. Grand Blvd, Oklahoma City, OK 73107
405-858-2836

We are required by law to:

• make sure that health information that identifies you is kept private in accordance with relevant law.
• give you this notice of our legal duties and privacy practices with respect to your personal health information.
• follow the terms of the notice that is currently in effect for all of your personal health information.
• Notify affected consumers following a breach of unsecured records.

How We May Use and Disclose Your Health Information:

For Treatment. We may use health information about you to provide you with health care treatment or services. We may disclose health information about you to the doctors, nurses, technicians, medical students and others who are involved in your care. They may work at NorthCare, or other health care provider to whom we may refer you for treatment or other health care service. They may also include doctors and other health care professionals who work at NorthCare, or elsewhere, whom we consult about your care. For example, we may disclose to an emergency room doctor regarding your medications and condition.

For Payment. We may use and disclose health information about you to bill and collect payment from you, your insurance company, including Medicaid and Medicare, or other third party that may be available to reimburse us for some or all of your health care. We may also disclose health information about you to other health care providers or to your health plan so that they can arrange for payment relating to your care. For example, if you have health insurance, we may need to share information about your office visit with your health plan in order for your health plan to pay us or reimburse you for the visit. We may also tell your health plan about treatment that you need to obtain your health plan’s prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations. We may use and disclose health information about you for our day-to-day operations and may disclose information about you to other health care providers involved in your care or to your health plan for use in their day-to-day operations. These uses and disclosures are necessary to run NorthCare and to make sure that individuals receive quality care, and to assist other providers and health plans in doing so as well. For example, we may use health information to review the services that we provide and to evaluate the performance of our staff in caring for you.

Appointment Reminders. We may use and disclose health information about you to contact you as a reminder that you have an appointment at NorthCare.

Individuals Involved in Your Care or Payment for Your Care. We may release health information about you to a friend or family member who is involved in your health care or the person who helps pay for your care.

Research. Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all consumers who received one medication to those who received another for the same condition. We will almost always ask for your specific permission if the researcher will have access to your name, address, or other information that reveals who you are or will be involved in your care.

Organ and Tissue Donation. If you are an organ donor, we may disclose health information about you to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety. We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Military and Veterans. If you are a member of the armed forces or separated/ discharged from military services, we may release health information about you as required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities.

Workers’ Compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Activities. We may disclose health information about you for public health activities. These activities generally include the following:

• to prevent or control disease, injury or disability.
• to report births and deaths.
• to report child abuse or neglect.
• to report reactions to medications or problems with products.
• to notify people of recalls of products.
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
• to notify the appropriate government authority if we believe a consumer has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities. We may disclose health information about you to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Lawsuits and Disputes. We may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request or other lawful process that is not accompanied by a court or administrative order, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release health information about you if asked to do so by a law enforcement official:

• in response to a court order, subpoena, warrant, summons or similar process.
• to identify or locate a suspect, fugitive, material witness or missing person.
• under certain limited circumstances, about the victim of a crime.
• about a death we believe may be the result of criminal conduct.
• about criminal conduct at NorthCare
• in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Coroners, Health Examiners and Funeral Directors. We may release health information about our consumers to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information to funeral directors as may be necessary for them to carry out their duties.

National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

Protective Services for the President and Others. We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the corrections institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care, (2) to protect your health and safety or the health and safety of others, or (3) for the safety and security of the correctional institution.

Confidentiality of Alcohol and Drug Abuse Records

The confidentiality of alcohol and drug abuse client records maintained by NorthCare is protected by Federal law and regulations. Generally, we may not say to a person outside NorthCare that a client attends an alcohol or drug treatment program or disclose any information identifying a client as an alcohol or drug user.

Exceptions to disclosures related to alcohol and drug abuse records may be made when:

1. The client consents in writing
2. The disclosure is allowed or required by a court order; or
3. The disclosure is made to healthcare personnel in a healthcare emergency or to qualified personnel for research, audit, or program evaluation.

Records that are disclosed to NorthCare based on your written consent for treatment, payment, and health care operations may be further disclosed by NorthCare without your written consent to the extent allowed under the privacy law.

Records or testimony relaying the content of such records shall not be used or disclosed in any civil, administrative, criminal or legislative proceedings against you unless based on your specific written consent or a court order.  Records shall only be used or disclosed based on a court order after notice and an opportunity to hear is provided to you and/or the holder of the record.  A court order authorizing the use or disclosure must be accompanied by a subpoena or other similar legal mandate compelling disclosure before the record is used or disclosed.

Federal law and regulations do not protect any information about a crime committed by a client either at NorthCare or against any person who works for NorthCare or about any threat to commit such a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.

You may sign a single consent for all future uses or disclosures for treatment, payment, and health care operations purposes.

YOUR RIGHTS

You have certain rights with respect to your personal health information. This section of our notice describes your rights and how to exercise them:

Right to Inspect and Copy: You have the right to inspect and copy the personal health information in your medical and billing records, or in any other group of records that we maintain and use to make health care decisions about you. This right does not include the right to inspect and copy psychotherapy notes, although we may, at your request and on payment of the applicable fee, provide you with a summary of these notes.

To inspect and copy your personal health information, you must submit your request in writing to our privacy contact person identified on the first page of this notice. If you request a copy of the information, we may charge a fee for the copying and mailing costs, and for any other costs associated with your request.

We may deny your request to inspect and copy in certain very limited circumstances. If your request is denied, you may request that the denial be reviewed. We will designate a licensed health care professional to review our decision to deny your request. The person conducting the review will not be the same person who denied your request. We will comply with the outcome of this review. Certain denials, such as those relating to psychotherapy notes, however, will not be reviewed.

Right to Amend: If you feel that the health information we maintain about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for any information that we maintain about you. To request an amendment, your request must be made in writing, submitted to our privacy contact person identified on the first page of this notice, and must be contained on one piece of paper legibly handwritten or typed. In addition, you must provide a reason that supports your request for an amendment.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• was not created by us, unless the person or organization that created the information is no longer available to make the amendment,
• is not part of the health information kept by or for the NorthCare
• is not part of the information which you would be permitted to inspect and copy, or
• is accurate and complete.

Any amendment we make to your health information will be disclosed to the health care professionals involved in your care and to others to carry out payment and health care operations, as previously described in this notice.

Right to Receive an Accounting of Disclosures. You have the right to receive an accounting of certain disclosures of your health information that we have made. Any accounting will not include all disclosures that we make. For example, an accounting will not include disclosures:

• to carry out treatment, payment and health care operations as previously described in this notice pursuant to your written authorization.
• to a family member, other relative, or personal friend involved in your care or payment for your care when you have given us permission to do so.
• to law enforcement officials.

To request an accounting of disclosures, you must submit your request in writing to our privacy contact person identified on the first page of this notice. Your request must state a time period which may not be more than six (6) years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We will mail you a list of disclosures in paper form within 30 days of your request or notify you if we are unable to supply the list within that time period and by what date we can supply the list; this date will not exceed 60 days from the date you made the request.

Right to Request Your Records. You can access your records maintained by or for NorthCare. This includes the right to inspect or obtain a copy, or both as well as to direct NorthCare to transmit a copy to a designated person or entity.

Oklahoma law requires that we inform you that your health information used or disclosed as described in this Notice of Privacy Practices may include records which may indicate the presence of a communicable or venereal disease which may include, but are not limited to, diseases such as hepatitis, syphilis, gonorrhea and the human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS).

Right to Revoke.  You may revoke your consent at any time.  You may revoke your consent by submitting a request in writing.  You may request a reasonable accommodation for an alternative revocation process by contacting NorthCare medical records personnel or a member of your treatment team at 405-858-2700.

If you revoke your authorization, we will no longer use or disclose your personal health information for the reasons covered by your written authorization. You understand that we are unable to take back any uses and disclosures that we have already made with your authorization, and that we are required to retain our records of the care that we have provided to you.

If you were mandated to treatment or testing through the criminal legal system (including drug court, probation or parole) and you sign a consent authorizing disclosures to elements of the criminal justice system such as the court, probation officers, parole officers, prosecutors, or other law enforcement, your right to revoke consent may be more limited and should be clearly explained when you sign the consent.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you may request that we not disclose information about you to a certain doctor or other health care professional, or that we not disclose information to your spouse about certain care that you received.

We are not required to agree to your request for restrictions if it is not feasible for us to comply with your request or if we believe that it will negatively impact our ability to care for you. If we do agree, however, we will comply with your request unless the information is needed to provide emergency treatment. To request a restriction, you must make your request in writing to our privacy contact person identified on the first page of this notice. In your request, you must tell us what information you want to limit and to whom you want the limits to apply.

Right to Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you at work or by mail to a specified address.

To request that we communicate with you in a certain way, you must make your request in writing to our privacy contact person identified on the first page of this notice. We will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.

Right to a Paper Copy of this Notice. You have the right to receive a paper copy of this notice at any time. To receive a copy, please request it from front desk personnel. You may also obtain a copy of this notice at our website, at www.northare.com.

Right to Discuss This Notice. You have a right to discuss this notice with the NorthCare Privacy Officer listed at the end of this notice.

Right Not to Receive Communication Related to Fundraising. You have the right to elect not to receive communication from NorthCare related to fundraising.

Complaints or Questions:

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing or e-mailing us a written description of your complaint or by telling us about your complaint in person or over the telephone:

Privacy Officer, NorthCare
3000 N. Grand Blvd, Oklahoma City  73107
405-858-2836

Please describe what happened and give us the dates and names of anyone involved. Please also let us know how to contact you so that we can respond to your complaint. You will not be penalized for filing a complaint.

If you are not satisfied with the manner in which this office handles a complaint, you may submit a complaint to:

Department, Health & Human Services

Office of Civil Rights
Herbert H. Humphrey Building
Room 509F
200 Independence Avenue, SW
Washington, D.D. 20201

You will not be penalized for filing a complaint.

Other Uses and Disclosures of Your Protected Health Information:

Other uses and disclosures of personal health information not covered by this notice or applicable law will be made only with your written authorization.

 Changes to this Notice:

We reserve the right to change this notice and to make the changed notice effective for all of the health information that we maintain about you, whether it is information that we previously received about you or information we may receive about you in the future. We will post a copy of our current notice in our facility Our notice will indicate the effective date on the first page, in the top right-hand corner. We will also give you a copy of our current notice upon request. Copies of current notice will be available at each office.