Notice of Privacy Practices

Illuminate Healing LLC

3439 SE Hawthorne Blvd #1177

Portland, OR 97214

503.272.1482

This notice went into effect on 11/1/2023

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Privacy Practices

Illuminate Healing LLC is committed to adhering to the regulations set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and ORS 179.505 and 192.518 through 192.530. In the course of delivering its services and programs, DWC collects personal health information (PHI) from its clients. We understand that health information about you and your health care is personal. As a practice, we are committed to protecting health information about you.

We create a record of the care and services you receive from us. We never market or sell your personal information. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our practice. This notice will tell you about the ways in which we may use and disclose your health information. It also describes your rights to the health information we keep about you, and describes certain obligations we have regarding the use and disclosure of this information.

Illuminate Healing LLC collects, uses and shares PHI for the following purposes:

Providing quality programs and services to clients
Providing information to other people or organizations with client consent
Contacting clients, donors and members to evaluate service and work
Reviewing client files to ensure high quality of service and documentation

Illuminate Healing LLC may also collect, use and share personal information with consent or as permitted or required by law. We are committed to protecting the privacy of our clients and ensuring:

Personal information it receives from clients is kept safe, secure, confidential, accurate and up to date
We obtain client consent before collecting, using, sharing or releasing client information, except as set out in this policy or permitted or required by law
Only the personal information necessary for the purposes listed above is collected from clients, unless otherwise consented to by the client or permitted or required by law
Access to client information is limited to our employees, volunteers and students involved in delivering services to clients
Any external agents for whom you have provided a release of information have a need to know and only use and disclose client information for the purposes for which it was originally provided
Clients are able to withdraw their consent at any time to the collection, use and disclosure of their personal information
Complaints about our privacy policies and procedures are handled efficiently and effectively
All legal and regulatory requirements regarding client information are met and maintained
Notice of privacy practices are provided to every client and client’s representative, and are posted in office common areas

Limitations to Confidentiality

The session content and all relevant materials to the client’s treatment are protected by HIPAA and will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist include:

Reporting reasonable suspicion that a client or other named person is the perpetrator, observer of, or actual victim of physical, emotional, sexual abuse, or neglect of children under the age of 18 years and individuals 21 years of age and younger residing in or receiving care or services at a child-caring agency as that term is defined in ORS 418.205
Reporting imminent danger to client or others (ie- If a client threatens grave bodily harm or death to themselves or others, or otherwise conducts themselves in a manner in which there is a substantial risk of incurring serious bodily harm)
Reporting information required in court proceedings (eg- if a court of law issues a legitimate subpoena for information stated on the subpoena), or by client’s insurance company (submitting claims, in the event of an audit, etc), or other relevant agencies (criminal investigations, etc)

Certain Uses and Disclosures Require You To Have The Opportunity To Object

We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

You Have The Following Rights with Regard to your PHI

You have the right to request us to not use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree to your request, and may say “no” if we believe it would affect your health care.
You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
You have the right to ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and we will agree to all reasonable requests.
You have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request. We may charge a reasonable, cost based fee for doing so.
You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we may charge you a reasonable cost based fee.
If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. We may say “no” to your request but will tell you why in writing within 60 days.
You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by email.
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.
If you feel we have violated your rights, you can file a complaint with the U.S. Department of Health by visiting: https://www.hhs.gov/hipaa/filing-a- complaint/complaint-process/index.html. We will not retaliate against you for filing a complaint.

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 website.

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information.

You have the right to get a paper or electronic copy of this Notice.