Notice of Privacy Practices

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

This notice applies to Jackson Hole Behavioral Services LLC DBA Peak Behavioral Services (“Peak,” “we,” “us”). In this notice, “you” means the client and, for a child, the parent or guardian who acts for them.

How we use and share your child's information

• To provide care. We share information with the clinicians working with your child, and with other providers involved in their care.
• To get paid. We share what an insurer or Medicaid needs in order to authorize services and pay claims.
• To run our practice. We use information to supervise clinicians, check the quality of our work, and train our team.
• With family and friends involved in care. We may share relevant information with a family member or other person involved in your child’s care or payment, unless you tell us not to.

Other ways we may share information without your permission

The law allows or requires us to share information in these situations, limited to what the law permits:

• When required by law, including requests from the U.S. Department of Health and Human Services.
• Public health and safety — for example, reporting suspected child abuse or neglect, or preventing a serious threat to someone’s health or safety.
• Health oversight — audits, investigations and licensing by government agencies, including Medicaid.
• Legal proceedings and law enforcement — in response to a court order, subpoena or other lawful process, or for certain law enforcement purposes.
• Research — only when an approved process protects your privacy.
• Workers’ compensation, specialized government functions (such as military or national security), and coroners, medical examiners or funeral directors.

Where Wyoming or Idaho law gives you more protection than federal law, we follow the stricter rule.

Anything else — including most sharing with a school or another organization — needs your written permission first. You can take that permission back at any time, and we will stop, except where we have already acted on it. We never sell your information, and we do not use it for marketing without your written permission. Most sharing of psychotherapy notes also requires your written permission.

Your rights

• See or get a paper or electronic copy of your child's record, usually within 30 days. We may charge a reasonable, cost-based fee.
• Ask us to correct anything you believe is wrong or incomplete.
• Ask us to contact you a particular way, or at a particular address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. We do not have to agree, but we will tell you if we cannot. If you pay for a service in full out of pocket, you can ask us not to share information about that service with your health plan, and we will agree unless the law requires us to share it.
• Get a list of certain times we have shared information, for the six years before you ask.
• Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Name someone — a guardian, or someone with medical power of attorney — to act for you.
• Complain without any effect on your child's care.

What we have to do

We are required by law to keep your child's health information private and secure, to follow the duties and practices described in this notice, and to tell you promptly if a breach of unsecured information affects you. We reserve the right to change this notice; the new version will apply to all information we hold. The current version is always on this page, and you can ask for a copy at any of our offices.

How to raise a concern

For questions about this notice or to file a complaint, contact our Privacy Officer at 307‑212‑3284(Wyoming), 307‑257‑5487 (Idaho), or info@pkbehavior.com. You can also complain to the U.S. Department of Health and Human Services, Office for Civil Rights, through theOffice for Civil Rights Complaint Portal, by phone on1‑800‑368‑1019 (TDD 800‑537‑7697), or by mail at 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201. We will not retaliate against you for complaining.

This notice covers health information. How this website handles what you send us through a form is covered by our privacy policy.