Notice Effective: 04/29/2025 Your Information. Your Rights. Our Responsibilities.

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.

LAYERED SUMMARY TEXT – 

Your Rights

You have the right to: 

• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

Per HIPPA policy, patients have choices in how medical practices use and share their information, including: 

• Sharing information with a patient’s family and friends about their condition
• Providing disaster relief
• Including patients in a hospital directory
• Providing mental health care
• Market services and selling of patient information
• Raising funds

Our Uses and Disclosures

We may use and share your information as we: 

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.

Get an electronic or paper copy of your medical record 

• You can ask to see or get an electronic or paper copy of your medical record 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 information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is 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.

Request confidential communications

• 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 say “yes” to all reasonable requests.

Ask us to limit what we use or 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.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared 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.

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.

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.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• 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.

Your Choices

For certain health information, you can 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:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory if applicable

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 sharing of psychotherapy notes

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information? 

We typically use or share your health information in the following ways.

Treat you

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

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services. 

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. 

Example: We give information about you to your health insurance plan so it will pay for your services. 

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/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

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

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

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.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

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

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

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

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

• 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 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, in our office, and on our web site.

USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION

Protected health information includes demographic and medical information that concerns the past, present, or future physical or mental health of an individual. Demographic information could include your name, address, telephone number, Social Security number and any other means of identifying you as a specific person.  Protected health information contains specific information that identifies a person or can be used to identify a person. 

Protected health information is health information created or received by a health care provider, health plan, employer, or health care clearinghouse. The Department of Health (Department) can act as each of the above business types. This medical information is used by the Department in many ways while performing normal business activities.    

Your protected health information may be used or disclosed by the Department for purposes of treatment, payment, and health care operations. Health care professionals use medical information in the clinics or hospital to take care of you. Your protected health information may be shared, with or without your consent, with another health care provider for purposes of your treatment.  The Department may use or disclose your health information for case management and services. The Department clinic or hospital may send the medical information to insurance companies, Medicaid, or community agencies to pay for the services provided to you.    

Your information may be used by certain Department personnel to improve the Department’s health care operations. The Department also may send you appointment reminders, information about treatment options or other health-related benefits and services. 

Some protected health information can be disclosed without your written authorization as allowed by law. Those circumstances include: x Reporting abuse of children, adults, or disabled persons. x Investigations related to a missing child.  x Internal investigations and audits by the Department’s divisions, bureaus, and offices. 

x Investigations and audits by the state’s Inspector General and Auditor General, and the Florida Legislature’s Office of Program Policy Analysis and Government Accountability. 

x Public health purposes, including vital statistics, disease reporting, public health surveillance, investigations, interventions, and regulation of health professionals. 

x District medical examiner investigations.  x Research approved by the Department. x Court orders, warrants, or subpoenas.  x Law enforcement purposes, administrative investigations, and judicial and administrative proceedings.    

Other uses and disclosures of your protected health information by the Department will require your written authorization. These uses and disclosures may be for marketing or research purposes, certain uses and disclosure of psychotherapist notes, and the sale of protected health information resulting in compensation to the Department,  

This authorization will have an expiration date that can be revoked by you in writing.   

INDIVIDUAL RIGHTS

You have the right to request that the Department restrict the use and disclosure of your protected health information to carry out treatment, payment, or health care operations.  You may also limit disclosures to individuals involved with your care. The Department is not required to agree to any restriction. 

You have the right to be assured that your information will be kept confidential. The Department will contact you in the manner and at the address or phone number you select.  You may be asked to put your request in writing. If you are responsible to pay for services, you may provide an address other than your residence where you can receive mail and where the Department may contact you.    

You have the right to inspect and receive a copy of your protected health information that is maintained by the Department within 30 days of the Department’s receipt of your request to obtain a copy of your protected health information. You must complete the Department’s Authorization to Disclose Confidential Information form and submit the request to the local county health department or Children’s Medical Services office. If there are delays in the Department’s ability to provide the information to you within 30 days, you will be told the reason for the delay and the anticipated date your request can be fulfilled.   

Your inspection of the information will be supervised at an appointed time and place. You may be denied access to some records as specified by federal or state law.    

If you choose to receive a copy of your protected health information, you have the right to receive the information in the form or format you request. If the Department cannot produce it in that form or format, you will be given the information in a readable hard copy form or another form or format that you and the Department agree to.   

The Department cannot give you access to psychotherapy notes or certain information being used in a legal proceeding. Records are maintained for specified periods of time in accordance with the law. If your request covers information beyond that time, the Department is not required to keep the record and the information may no longer be available. 

If access is denied, you have the right to request a review by a licensed health care professional who was not involved in the decision to deny access. This licensed health care professional will be designated by the Department. 

You have the right to correct your protected health information. A request to correct your protected health information must be in writing and provide a reason to support your requested correction.   

The Department may deny your request, in whole or part, if the protected health information: 

x Was not created by the Department. x Is not protected health information. x Is, by law, not available for your inspection. x Is accurate and complete.  

If your correction is accepted, the Department will make the correction and inform you and others who need to know about the correction. If your request is denied, you may send a letter detailing the reason you disagree with the decision. The Department may respond to your letter in writing. You also may file a complaint, as described below in the section titled Complaints.  

You have the right to receive a summary of certain disclosures the Department may have made of your protected health information.  This summary does not include: 

x Disclosures made to you.  

x Disclosures to individuals involved with your care.  x Disclosures authorized by you. 

x Disclosures made to carry out treatment, payment, and health care operations.  x Disclosures for public health. x Disclosures to health professional regulatory purposes. x Disclosures to report abuse of children, adults, or disabled persons.   x Disclosures prior to April 14, 2003. 

This summary does include disclosures made for: 

x Purposes of research, other than those you authorized in writing. 

x Responses to court orders, subpoenas, or warrants.  

You may request a summary for not more than a 6-year period from the date of your request. 

If you received this Notice of Privacy Practices electronically, you have the right to a paper copy upon request. 

The Department of Health may send health care appointment reminders to you by postal mail, or by a telephone text or call. 

PARTICIPATION IN THE HEALTH INFORMATION EXCHANGE NETWORK

Access to information about your health history and medical care is critical to help ensure that you receive high-quality care and gives your health care provider a more complete picture of your overall health. This can help your provider make informed decisions about your care. The information may also prevent you from having repeat tests, saving you time, money, and worry.  Recent advancements in technology now support the safe and secure electronic exchange of important clinical information from one health care provider to another through Health Information Exchange (HIE) networks. The Department and its county health departments participate in an HIE network and also participate in several HIE networks with trusted outside health care providers to quickly and securely share your health information electronically among a network of health care providers, including physicians, hospitals, laboratories and pharmacies.  

Your health information is transmitted securely and only authorized health care providers with a valid reason may access your information. By sharing information electronically through a secure system, the risk that your paper of faxed records may be misused or misplaced is reduced.   

Participation in HIE is completely your choice. 

Choice 1. YES to HIE participation. If you agree to have your medical information shared through HIE and you have a current Initiation of Services form on file, you need not do anything.  By signing that form, you have granted the Department permission to share your health information through the HIE. 

Choice 2. NO to HIE participation. You can choose to not have your information shared electronically through the HIE network (opt out) at any time, by completing the Health Information Exchange Opt-Out Form available at the county health department. If you decide to opt out of HIE, health care providers will not be able to access your health information through HIE. You should understand that if you opt out, the health care providers treating you are still permitted to contact the Department to ask that your health information be shared with them as stated in this Notice of Privacy Practices. Opting out does not prevent information from being shared between members of your care team. Please note, opting out does not affect health information that was disclosed through HIE prior to the time you opted out. 

Choice 3. You may change your mind at any time. 

You may consent today to the sharing of your information via HIE and change your mind later by following the instructions on the opt out form described under Choice 2. 

Alternatively, you may opt out of HIE today and change your mind later by submitting the Department’s Revocation of HIE Opt-Out Request Form.   

PERSONAL HEALTH RECORDS (PHR) MOBILE APPLICATION  SYNCHRONIZATION WITH USER DATA

As part of the services provided by the Department, you can download the companion PHR mobile application to access your personal health records. This application is the mobile version of the Florida Health Connect portal. 

The purpose of the PHR mobile application is to provide you with access to your health information through your mobile device. You can synchronize your Florida Health Connect account through the mobile application with your personal health information captured on your mobile device (Google Fit or Apple Health) to provide you with a 360-degree view of your health history and current health status. 

Your Google Fit or Apple Health information will not be disclosed to any third parties without your express written permission.   

DEPARTMENT OF HEALTH DUTIES

The Department is required by law to maintain the privacy of your protected health information. This Notice of Privacy Practices tells you how your protected health information may be used and how the Department keeps your information private and confidential. This notice explains the legal duties and practices relating to your protected health information. The Department has the responsibility to notify you following a breach of your unsecured protected health information.  

As part of the Department’s legal duties, this Notice of Privacy Practices must be given to you.  The Department is required to follow the terms of the Notice of Privacy Practices currently in effect. 

The Department may change the terms of its notice.  The change, if made, will be effective for all protected health information maintained by the Department.  New or revised Notices of Privacy Practices and all forms referenced in this Notice of Privacy Practices may be accessed on the Department’s website at https://www.floridahealth.gov/about/patient-rights-andsafety/hipaa/index.html and will be available by email and at all Department of Health locations.  Also available are additional documents that further explain your rights to inspect, copy, or amend your protected health information. 

COMPLAINTS

If you believe your privacy health rights have been violated, you may file a complaint with the: 

Department of Health’s Inspector General at 4052 Bald Cypress Way, BIN A03/ Tallahassee, FL  32399-1704/ telephone 850-245-4141 and with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue, S.W./ Washington, D.C. 20201/ telephone 202-619-0257 or toll free 877-696-6775.   

The complaint must be in writing, describe the acts or omissions that you believe violate your privacy rights, and be filed within 180 days of when you knew or should have known that the act or omission occurred. The Department will not retaliate against you for filing a complaint. 

FOR FURTHER INFORMATION

Requests for further information about the matters covered by this notice may be directed to the person who gave you the notice, to the director or administrator of the Department of Health facility where you received the notice, or to the Department of Health’s Inspector General at 4052 Bald Cypress Way, BIN A03/ Tallahassee, FL  32399-1704/ telephone 850-245-4141. 

EFFECTIVE DATE

This Notice of Privacy Practices is effective beginning February 21, 2022, and shall remain in effect until a new Notice of Privacy Practices is approved and posted. 

REFERENCES

“Standards for the Privacy of Individually Identifiable Health Information; Final Rule.”  45 CFR Parts 160 through 164. Federal Register 65, no. 250 (December 28, 2000). 

“Standards for the Privacy of Individually Identifiable Health Information; Final Rule” 45 CFR Part 160 through 164. Federal Register, Volume 67 (August 14, 2002). 

HHS, Modifications to the HIPAA Privacy, Security, Enforcement, and Breach Notification 

Rules under the Health Information Technology for Economic and Clinical Health Act and the Genetic Information and Nondiscrimination Act; Other Modifications to the HIPAA Rules, 78 Fed. Reg. 5566 (Jan. 25, 2013). 

EFFECTIVE: JUNE 25 2024: 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.

This notice describes the privacy practices of the Department of Behavioral Health and Developmental Services (DBHDS) including Central Office and each of the psychiatric hospitals and training centers DBHDS operates.  DBHDS is required by law to provide you with this notice telling you about our legal duties and privacy practices with respect to health information.

If you have someone making decisions on your behalf because you are not able to make decisions yourself, we will give a copy of this notice to that person and we will work with that person in all matters relating to uses and disclosures of your health information.  

Summary of Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record
• Ask us to amend your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information

Our Uses and Disclosures

We may use and share your information for:

• Finding someone to make decisions on your behalf
• Treating you
• Healthcare Operations
• The Facility Directory
• Billing for your services
• Working with Business Associates
• Help with public health and safety issues
• Food and Drug Administration (FDA)
• Research
• Decedents
• Complying with the law
• Responding to organ and tissue donation requests
• Working with a medical examiner or funeral director
• Victims of Abuse and Neglect
• Addressing workers’ compensation, law enforcement and other government requests
• Judicial and Administrative proceedings
• Correctional Institutions and Other Law Enforcement Custodial Situations
• Student Disclosures (Immunizations)

Explanation of Your Rights

You have certain rights to your health information.  This section explains your rights and some of our responsibilities to help you.

Get a copy of your paper or electronic medical record

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you.
• We may deny your request in certain circumstances.  If you are denied access to your health information, you may request that the denial be reviewed.  A physician or licensed clinical psychologist not involved with your care will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review.  If you are denied access to any portion of your record, you have the right to ask that a psychiatrist, doctor, psychologist or lawyer of your choosing get a copy of wat has been denied to you.
• We will provide a copy or a summary of your health information, usually within 30 days of your request.  If we are unable to provide the summary to you within 30 days, we are permitted to request an extension in writing of an additional 30 days.  We may charge a reasonable, cost-based fee.

Ask us to correct your paper or electronic medical record

• You may request an amendment of your medical record in writing, if you think it is incorrect or incomplete.
• We may say “no” to your request, but we will tell you why in writing within 60 days.

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 say “yes” to all reasonable requests.

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.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we have shared your information

• You can ask for a list (accounting) of the times we have 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).

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.
• 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.

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 using the information on page 7.
• 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 HIPAA What to Expect | HHS.gov

You will not be retaliated against for filing a complaint