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Patient Rights

HIPAA Notice of Privacy Practices

Applied Behavior Analysis (ABA) and Related Services — Jigsaw Developmental Services LLC

THIS NOTICE OF HIPAA PRIVACY PRACTICES DESCRIBES HOW YOUR OR YOUR CHILD’S HEALTH INFORMATION MAY BE USED AND DISCLOSED BY JIGSAW DEVELOPMENTAL SERVICES LLC, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the HITECH Act and the 2013 Omnibus Rule, requires healthcare providers to inform patients of their privacy rights and our legal duties regarding protected health information (“PHI”). This Notice is available in paper and electronic form. You may request a paper copy at any time, even if you previously agreed to receive it electronically.

1 Affiliated Covered Entity

Jigsaw Developmental Services LLC designates itself as a covered entity under HIPAA. Certain affiliated entities may be designated as part of an Affiliated Covered Entity (“ACE”) with Jigsaw Developmental Services LLC only where such entities are under common ownership or common control as defined by HIPAA, and have formally agreed to participate in the ACE and share centralized privacy and security compliance functions.

The ACE may include, without limitation:
Jigsaw Developmental Services LLC  ·  Synergy Partners LLC  ·  Other healthcare, therapy, or educational service entities that meet HIPAA requirements for ACE participation.

Entities that operate in coordinated arrangements with Jigsaw but are not under common ownership or control remain separate covered entities. PHI may be shared with such entities only as permitted by law, including for treatment coordination or pursuant to appropriate agreements. This designation may be updated periodically.

2 Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your PHI
  • Provide this Notice describing our legal duties and privacy practices
  • Follow the terms of the Notice currently in effect
  • Notify you in the event of a breach of unsecured PHI within 60 days of discovery
  • Ensure our workforce receives appropriate privacy and security training

PHI includes information that identifies you or your child and relates to healthcare services, diagnosis, treatment, payment, or healthcare operations. PHI may be maintained in paper or electronic form.

3 Uses and Disclosures That Do Not Require Authorization

Treatment

We may use and disclose PHI to provide, coordinate, or manage ABA services and related healthcare, including sharing information among BCBAs, RBTs, supervisors, and other providers involved in your child’s care.

Payment

We may use and disclose PHI to obtain payment for services, including submitting claims to insurance plans (including AHCCCS), determining benefits, and responding to audits or utilization reviews.

Healthcare operations

We may use and disclose PHI for operational purposes such as quality improvement, staff training and supervision, compliance, accreditation, and administrative activities.

Business associates

We may disclose PHI to vendors and service providers who perform functions on our behalf (“Business Associates”). These Business Associates are required by law and by written contract to protect your PHI and use it only as permitted.

Telehealth and electronic systems

We may provide services via telehealth and maintain PHI in electronic systems including electronic health records, secure messaging platforms, and patient portals. If you request communication via unsecure methods (such as standard email or text messaging), we may honor that request after informing you of the associated privacy risks.

Appointment reminders and health-related benefits

We may contact you without prior authorization to provide appointment reminders or information about alternative or other health-related benefits and services.

Fundraising

Jigsaw Developmental Services LLC will not contact you for fundraising purposes.

4 Uses and Disclosures Required or Permitted by Law

We may use or disclose PHI without authorization as required or permitted by law, including for:

  • Public health and safety activities
  • Mandatory reporting of suspected child abuse or neglect under Arizona law
  • Health oversight activities such as audits, investigations, and licensure
  • Judicial or administrative proceedings and law enforcement purposes
  • Workers’ compensation programs
  • Preventing a serious and imminent threat to health or safety
  • Military, national security, or protective services activities
  • Coroners, medical examiners, funeral directors, and disaster relief efforts
  • Required federal, state, or local reporting obligations

All disclosures are limited to the minimum necessary PHI to accomplish the intended purpose.

5 Minors and Parents

In Arizona, parents and legal guardians generally have the right to access a minor’s PHI. In certain circumstances, minors may consent to their own treatment under state law, and parental access may be limited accordingly. Court orders or other legal documentation may also restrict or expand parental access. Please contact our Privacy Officer with any questions regarding access to a minor’s records.

6 Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization before using or disclosing PHI for purposes not described in this Notice, including:

  • Marketing communications not permitted by HIPAA
  • Sale of PHI
  • Most uses or disclosures of psychotherapy notes

You may revoke a written authorization at any time by submitting a written request to our Privacy Officer, except to the extent we have already relied on it.

7 Psychotherapy Notes — ABA Clarification

Psychotherapy notes are narrowly defined under HIPAA and generally do not include ABA treatment plans, session notes, data collection records, or behavior intervention plans. These ABA clinical records are treated as standard PHI and governed by the disclosure rules described in this Notice.

If psychotherapy notes are separately created, they will be protected and disclosed only as permitted by law or with your written authorization.

8 Your Rights Regarding PHI

You have the following rights with respect to PHI we maintain about you or your child. All requests must be submitted in writing to our Privacy Officer.

Access & copies

Request access to or copies of your PHI in paper or electronic form. We will respond within 30 days (one 30-day extension may apply). Copies charged at no more than $0.25/page.

Request restrictions

Ask us to limit how PHI is used or disclosed. We will consider your request but are not legally bound to agree — except that we must honor restrictions on disclosures to a health plan when you pay for the service in full out-of-pocket.

Confidential communications

Request PHI be sent to an alternate address or by an alternate method. We will accommodate reasonable requests.

Amendment

Request correction of PHI you believe is inaccurate or incomplete. We will respond within 60 days (one 30-day extension may apply).

Accounting of disclosures

Request a list of certain disclosures made during the past six years. We will respond within 60 days.

Personal representative

Designate an authorized personal representative to exercise these rights on your behalf, subject to applicable law.

Breach notification

Receive written notice following a breach of unsecured PHI, as required by HIPAA and Arizona law.

Copy of this Notice

Obtain a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.

9 Changes to This Notice

We reserve the right to modify this Notice at any time. Any changes will apply to all PHI we maintain, including records created before the revision. The revised Notice will be posted on our website and made available upon request. The effective date will be updated accordingly.

10 Questions and Complaints

If you believe Jigsaw has violated your privacy rights, or if you have questions about this Notice, you may contact our Privacy Officer or file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will take no retaliatory action against anyone who files a complaint.