Notice of Privacy Practices: 

This Notice of Privacy Practices outlines how First Step Pediatric Therapy may use or disclose your child’s personal health information, how that information may be transmitted, and how that information is safeguarded in accordance with the Health Insurance Portability and Accountability Act (HIPAA) while your child is receiving care at First Step Pediatric Therapy. This notice also describes your rights to access or refuse the release of information outside of First Step Pediatric Therapy except when the release is required or authorized by law or regulation. All employees of First Step Pediatric Therapy, including therapists, office staff, and billing staff, are required to adhere to these privacy practices. 

You will be asked to sign an acknowledgement of receipt of this notice. The intent is to make you aware of the possible uses and disclosures of your child’s protected health information and your privacy rights. 

Protected health information is information that can be used to identify an individual and includes identifiers such as name, age, address, email, past or present health conditions and diagnoses and healthcare services. We are mandated to ensure that this information is kept secure and confidential, and to notify patients of our privacy practices and legal duties relating to how this information is used and transmitted. We are also required to notify affected individuals of any potential breach to this information. First Step Pediatric Therapy reserves the right to revise or change our privacy practice policies. 

Reasons why your child’s personal health information may be disclosed: 

• We will use and disclose your child’s personal health information when coordinating with other members of your child’s care team, such as their physician, other related medical providers, case managers, and any related services involved in your child’s healthcare. This information may also be used if a referral to another healthcare provider is required. 

• This information may be shared with schools and other providers/agencies upon receipt of written consent

• Your child’s personal health information may be shared with insurance or billing personnel for things such as verifying insurance, preparing and sending claims, and for collecting payment. Information may also be disclosed in financial or billing audits.

• Within our office for administrative purposes, supervision, peer review, business planning, and quality assessment. 

• Your information may be used to contact you to remind you about appointments.

First Step Pediatric Therapy may also be legally required to release personal health information if law or regulation requires the use or disclosure of the information. Examples of such disclosures may include: 

• State or federal law mandate that certain health information be reported for a specific purpose.

• For public health purposes, such as contagious disease reporting, investigation or surveillance.

• Therapists at First Step Pediatric Therapy are mandatory reporters of suspected abuse, neglect or domestic violence and will report victims to the appropriate government agencies.

• Uses and disclosures for health oversight activities, such as for the licensing of therapists, for audits by Medicare or Medicaid, or for investigation of possible violations of health care laws.

• For judicial and administrative proceedings, such as in response to subpoenas or orders of courts or administrative agencies.

• For law enforcement purposes, such as to provide information about someone who is or is suspected to be a victim of a crime, to provide information about a crime at our office, or to report a crime.

• Disclosure to a medical examiner to identify a dead person or to determine the cause of death or to organizations that handle organ or tissue donations.

• For health related research.

• To prevent a serious threat to health or safety.

Your rights to provide authorization for other uses and disclosures: 

• The disclosure of personal health information not described above will only be made upon receipt of your written consent. With written authorization, you may permit us to use your health information to anyone for any purpose.

• You may revoke authorization for use or disclosure of personal health information with a written request at any time. After revoking authorization, we will no longer use or disclose your health information to the agency you requested be revoked access, but we cannot retract any disclosures performed prior to the date of your written revoke of authorization. 

Your rights in regards to your child’s personal health information

• You may inspect and obtain copies of your child’s health information as part of their medical and billing records upon submission of written request. 

• You may also designate another party to receive your child’s health information upon receipt of written consent. This request must clearly designate the intended recipient and include a specified period of time for which the disclosure or use of personal health information is authorized.

• Upon written request, you may ask to restrict the disclosure or use of any part of your child’s personal health information as part of their treatment, billing, or healthcare operations. 

• You may request an alternative form of communication regarding your child’s personal health information. This request must include a specified time frame and how you would prefer to receive information regarding your child’s personal health information.

• If you feel that any part of your child’s health information is incorrect or incomplete, you may request for us to amend the information we have on record. You must give a reason to support this request, and the providing therapist must agree with your request. We reserve the right to deny this request if the providing therapist deems the original information to be accurate and complete.

• You may request an account of disclosures made of your child’s personal health information. Your request must state a time period for the information you would like to receive, no longer than 6 years prior to the date of your request and may not include dates before October 29, 2020. 

Complaints: 

If you believe that your child’s rights and privacy has been violated, you may file a written complaint with First Step Pediatric Therapy or to the US Department of Health and Human Services, Office for Civil Rights. First Step Pediatric Therapy will not retaliate against you for filing a complaint.
First Step Pediatric Therapy reserves the right to amend our privacy practices and to apply these amendments to your child’s personal health information. Any revisions to our privacy practices will be described in a revised notice, which will be readily available in our office and upon request.

All further questions, requests, or further information regarding the privacy of your child’s personal health information can be directed to First Step Pediatric Therapy’s privacy officer, Karissa Shiraishi. 

This notice is in effect in its entirety on October 29, 2020.