NOTICE OF PRIVACY PRACTICES (HIPAA)
OUR LEGAL RESPONSIBILITIES
We are required by federal and state law to give you this Notice of Privacy Practices. It explains how we may use and disclose your protected health information (“PHI”) and describes your rights and our obligations regarding that information. We are committed to maintaining the privacy of your PHI and to providing you with this notice of our legal duties and privacy practices.
We reserve the right to change our privacy policies at any time, as permitted by law. If changes are made, the updated notice will apply to all PHI we maintain, including information created or received before the policy change. You may request a copy of our current Notice at any time by contacting:
Golden Thread Psychiatry, PLLC 800 Roosevelt Rd, Suite E220 Glen Ellyn, IL 60137
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
The following categories describe ways we may use and disclose your PHI. Not every use or disclosure in a category is listed, but all fall within these permitted purposes.
Treatment
We may use and disclose your PHI to provide, coordinate, or manage your care. This includes sharing information with other healthcare providers, trainees, therapists, medical staff, or office personnel involved in your treatment. For example, we may consult with another provider about your care or contact your pharmacy to fill a prescription.
Payment
We may use and disclose your PHI to obtain payment for services. This may include providing information to your insurance company for authorization, billing, or reimbursement purposes.
Healthcare Operations
We may use and disclose your PHI for activities necessary to operate our practice, such as: • Training students • Reviewing cases with staff • Improving quality of care • Contacting you by phone, email, or text for appointment reminders
If we share PHI with third‑party business associates (e.g., billing services), we will have a written contract requiring them to protect your information.
Marketing
We may use or disclose PHI for limited marketing activities, such as sending you a thank‑you card or information about services or products that may interest you. You may opt out of receiving marketing communications at any time.
Authorization
We will not use or disclose your PHI for purposes outside those described in this Notice unless you provide written authorization. You may revoke your authorization at any time, except for information already used or disclosed while the authorization was in effect.
Appointment Reminders
We may contact you by phone, text, or email to remind you of appointments or lab work.
Individuals Involved in Your Care
We may disclose PHI to family members or friends involved in your care if you verbally agree or are given the opportunity to object and do not do so. If you are unable to agree or object due to an emergency, we may disclose PHI if we determine it is in your best interest.
Research
We will not use or disclose your PHI for research without your written authorization.
Organ Donation
If you are an organ donor, we may disclose PHI to organizations involved in organ, eye, or tissue procurement as necessary.
Public Health Activities
We may disclose PHI for public health purposes, such as: • Preventing or controlling disease • Reporting adverse events • Reporting medication or product issues to the FDA
Health Oversight
We may disclose PHI to oversight agencies for audits, investigations, inspections, or licensing.
Required by Law
We will disclose PHI when required by federal, state, or local law.
Workers’ Compensation
We may disclose PHI to workers’ compensation programs as authorized by law.
Legal Proceedings
We may disclose PHI in response to a court order, administrative order, or subpoena.
Law Enforcement
We may disclose PHI to law enforcement officials in response to a court order, warrant, subpoena, or as otherwise required by law.
MINORS AND PROTECTED HEALTH INFORMATION (ILLINOIS)
Illinois law provides specific rights to minors regarding mental health treatment and the confidentiality of their records. These laws may affect how we use or disclose protected health information (“PHI”) for clients under the age of 18.
Minors Ages 12 and Older
Under Illinois law, minors 12 years of age or older may consent to up to five (5) outpatient mental health sessions without the permission or involvement of a parent or legal guardian. When a minor consents to their own treatment: • The minor controls access to their mental health records for those sessions. • We may not disclose PHI to a parent or guardian without the minor’s written permission, unless an exception applies. • After five sessions, we must make a reasonable attempt to involve a parent or guardian unless doing so would be clinically inappropriate or harmful to the minor.
Exceptions Requiring Disclosure
We may disclose PHI to a parent or guardian without the minor’s permission if: • The minor is at risk of harming themselves or others. • There is suspected abuse or neglect. • Disclosure is required by law. • The minor is unable to meaningfully participate in treatment decisions.
We will share only the minimum necessary information to ensure safety or comply with legal requirements.
Medication and Medical Treatment
Illinois law does not allow minors to independently consent to psychiatric medication or other medical interventions. A parent or legal guardian must provide consent for: • Psychiatric medication • Laboratory testing • Medical evaluations • Any treatment considered medical rather than therapeutic
If medication is recommended, we will discuss this with both the minor and the parent or guardian.
TELEHEALTH AND PROTECTED HEALTH INFORMATION
Telehealth services involve the use of electronic communication technologies to provide clinical care. While telehealth can increase access and convenience, it also introduces unique privacy considerations.
Use and Disclosure of PHI During Telehealth
We may use or disclose PHI during telehealth sessions in the same ways permitted for in‑person care. This may include: • Sharing information with other providers involved in your care • Coordinating treatment • Obtaining payment • Conducting healthcare operations
Technology and Privacy Risks
Although we use secure, HIPAA‑compliant telehealth platforms, electronic communication carries inherent risks, including: • Internet or connection failures • Unauthorized access to your device or network • Potential exposure of PHI if others can overhear or view your screen
We encourage you to: • Participate from a private location • Use a secure internet connection • Avoid recording sessions unless specifically authorized • Inform us if you are not at your usual location before beginning a session
Emergency Situations
Telehealth may limit our ability to respond immediately to emergencies. Before beginning telehealth services, we will: • Identify your physical location at each session • Obtain emergency contact information • Develop a crisis plan appropriate to your location
If an emergency occurs during a telehealth session, we may disclose PHI to emergency responders, crisis services, or other individuals necessary to ensure your safety.
Minors and Telehealth
For minors receiving telehealth services: • We must follow all Illinois minor consent laws described above. • A parent or guardian may need to be present or available depending on the minor’s age, treatment needs, and legal requirements. • If a minor consents to their own treatment under Illinois law, telehealth confidentiality protections apply in the same way as in‑person care.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
Access
You have the right to inspect and obtain copies of your PHI. Requests must be submitted in writing. We may charge a reasonable fee for copying and administrative time.
Amendment
If you believe your PHI is incorrect or incomplete, you may request an amendment in writing. We may deny your request if: • You do not provide a written reason • The information is accurate and complete • The information was not created by us
If denied, you will receive a written explanation.
Accounting of Disclosures
You may request a list of disclosures of your PHI made in the past 10 years, except for disclosures related to treatment, payment, healthcare operations, or those made with your authorization. Requests must be submitted in writing. A reasonable fee may apply.
Restrictions
You may request restrictions on how we use or disclose your PHI for treatment, payment, or healthcare operations. We will honor your request unless the disclosure is required by law.
Confidential Communications
You may request that we communicate with you in a specific way or at a specific location. We will accommodate reasonable requests that allow us to continue billing and receiving payment.
Paper Copy
If you signed this Notice electronically, you may request a paper copy at any time.
OUR RESPONSIBILITIES
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.goldenthreadpsychiatry.com.
• The Practice will inform you if PHI is compromised in a breach.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. We will provide the appropriate contact information upon request. We will not retaliate against you for filing a complaint.
Contact Person
Marie Zahorick, APRN
Golden Thread Psychiatry, PLLC 800 Roosevelt Rd, Suite E220 Glen Ellyn, IL 60137