Notice of Privacy Practices

Effective April 14, 2003
See HIPAA Notice of Privacy Practice

Who will follow this notice?

Central Clinic Behavioral Health provides health care to our clients in partnership with other professionals and organizations. The privacy of information practices in this notice will be followed by:

  • Any health care professional that treats you at any of our locations.
  • All divisions of Central Clinic, including Child and Family Treatment Center, Court Clinic, Adult Services, CDC Behavioral Health Services, Mental Health Access Point (MHAP) and Family Access to Integrated Recovery (FAIR).
  • All staff, residents, trainees or students within our organization.
  • Any business associate or partner of Central Clinic with whom we share health information.

What is done with your medical information?

We understand that medical information about you is personal, and we are committed to protecting that information. To provide you with quality care, and to comply with legal requirements, we create a record of the care and services you receive here, which is your chart. Since we are required by law to, we will:

  • Keep medical information about you private.
  • Give you notice of all up-to-date privacy policies.
  • Follow the terms of the notice.

What if there are changes in our policy?

We may change our policies at any time, which could apply to the medical information we already have about you and any new information after the change occurs, but before we make a significant change in our policies, we will change our notice and post it in waiting areas. You can receive a copy of the latest notice at any time. The effective date is listed just below the title. You will be offered a copy of the current notice each time you register at our facility for treatment. You will also be asked to acknowledge in writing your receipt of this notice.

When would we use and disclose medical information about you?

  • We may use and disclose medical information about you: 1) for treatment, e.g., sending medical information about you to a specialist as part of a referral, 2) to obtain payment for treatment, such as sending billing information to your insurance company or Medicare, 3) to support our healthcare operations, such as comparing client data to improve treatment methods.
  • We may use or disclose medical information about you without your prior authorization for several other reasons. Subject to certain requirements, we may give out medical information about you without prior authorization for public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements and organ donation, workers’ compensation purposes, and emergencies. We also disclose medical information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders.
  • We also may contact you for appointment reminders, or to tell you about or recommend possible treatment options, alternatives, health-related benefits or services that may be of interest to you, or to support fundraising efforts.

Other uses of medical information

  • In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing medical information about you. If you chose to authorize use or disclosure, you can later revoke that authorization by notifying us in writing of your decision.

Your rights regarding medical information about you.

  • In most cases (except for Forensic Evaluations completed by the Court Clinic), you have the right to look at or get a copy of medical information that we use to make decisions about your care, when you submit a written request. If you request copies, we may charge a fee for the cost of copying, mailing or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision.
  • If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the records, by submitting a request in writing that provides your reason for requesting the amendment. We could deny your request to amend a record if the information was not created by us; if it is not part of the medical information maintained by us; or if we determine that record is accurate. You may appeal, in writing, a decision by us not to amend a record.
  • You have the right to a list of those instances where we have disclosed medical information about you, other than for treatment, payment, health care operations or where you specifically authorized a disclosure, when you submit a written request. The request must state the time period desired for the accounting, which must be less than a 6-year period and starting after April 14, 2003. You may receive the list in paper or electronic form. The first disclosure list request in a 12-month period is free; other requests will be charged according to our cost of producing the list. We will inform you of the cost before you incur any costs.
  • If this notice was sent to you electronically, you have the right to a paper copy of this notice.
  • You have the right to request that medical information about you be communicated to you in a confidential manner, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you.
  • You may request, in writing, that we not use or disclose medical information about you for treatment, payment or healthcare operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency. We will consider your request, but we are not legally required to accept it. We will inform you of our decision on your request.

All written requests or appeals should be submitted to our Privacy contact listed at the bottom of this notice.


  • If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to your records, you may contact our Privacy Officer (listed below).
  • Finally, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights. Our Privacy Officer can provide you the address.
  • Under no circumstance will you be penalized or retaliated against for filing a complaint.

Privacy Officer:
Barb Phillips, LISW-S
Central Clinic Behavioral Health
311 Albert Sabin Way
Cincinnati, OH 45229
Phone: 513.558.2941
Fax: 513.558.3880