Privacy Policy

Last updated: December 23, 2023

Your Privacy Information. Your Privacy Rights. Our Privacy Responsibilities. Your Responsibilities.

Reclaiming Hope Wellness Center, PC, (hereinafter the “Practice”) is strongly committed to respecting the basic human rights, worth and dignity of each person receiving services. In addition, you have the legal rights which are guaranteed by the constitution and state and federal laws and regulations. You also have responsibilities regarding your treatment.

This notice is a summary how mental health records and information about you may be used and disclosed and how you can get access to this information. Your rights are established pursuant to HIPAA (Health Insurance Portability and Accountability Act), the Illinois Mental Health and Developmental Disabilities Confidentiality Act, state and federal alcohol and substance abuse privacy laws and the exceptions provided therein. Please review it carefully.

The Right of Confidentiality

The right of confidentiality of all records and communications, as provided by Federal law with a few exceptions:

  • If your therapist suspects child or elder abuse.

  • If your therapist suspects you may harm yourself or someone else.

  • If your therapist receives a court order.

  • If you enter into litigation against the Practice and/or your therapist.

  • If you have an outstanding bill, the Practice can use a collection agency.

  • If the client is a minor, your therapist may discuss aspects of the client’s care with the client’s parents or legal guardians.

  • If your therapist seeks consultation with another professional about your case.

The Right of Informed Consent

  • The right of confidentiality of all records and communications, as provided by Federal law with a few exceptions: If child or elder abuse is suspected; if your therapist suspects you may harm yourself or someone else, if your therapist receives a court order; if you enter into litigation against the Practice and/or your therapist; if you have an outstanding bill, the Practice can employ a collection agency.

  • The right and responsibility to participate in developing a treatment plan with your therapist.

  • The right to receive and read a copy of your medical record, as long as doing so causes no harm.

  • The right to maintain HIV status as confidential unless you provide written consent.

  • The right to receive an itemized bill, including third party reimbursement paid toward the bill.

Your Rights

You have the right to:

  • Get a copy of your paper or electronic mental health record

  • Correct your paper or electronic mental health record

  • Request confidential communication

  • Ask us to limit the information we share

  • Get a list of those with whom we’ve shared your information

  • Get a copy of this privacy notice

  • Choose someone to act for you

  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

  • We may not disclose any mental health records or information except as provided under HIPAA, the Illinois Mental Health and Developmental Disabilities Confidentiality Act, state and federal alcohol and substance abuse privacy laws and the exceptions provided therein.

  • We may not tell any third-party family and friends about your condition except as provided for in the above identified laws. For example: only pursuant to a valid subpoena, release of information, pursuant to the Abused and Neglected Child Reporting Act, and under certain other circumstances of immanent risk of harm.

Our Uses and Disclosures

We may use and share your information as we:

  • Treat you

  • Run our organization

  • Bill for your services

  • Help with public health and safety issues

  • Do research

  • Comply with the law

  • Work with a medical examiner or funeral director

  • Address certain workers’ compensation, law enforcement, and other government requests and subject to certain conditions

  • Respond to lawsuits and legal actions

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. You may:

  • Ask to get an electronic or paper copy of your mental health record.
  • Ask to see or get an electronic or paper copy of your mental health record and other health information we have about you. Ask us how to do this.
  • Be provided with a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. 
  • Ask us to correct your mental health record if you think is it incorrect or incomplete. Ask us how to do this. We may say “no” to your request, but we’ll tell you why in writing within 60 days.
  • Request confidential communications.
  • Ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
  • Ask us to limit what we use or share.
  • Ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • Ask us not to share information for the purpose of payment or our operations with your health insurer if you pay for a service or health care item out-of-pocket in full. We will say “yes” unless a law requires us to share that information.
  • Get a list of those with whom we’ve shared information.
  • Ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  • Get a copy of this privacy notice.
  • Ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
  • Choose someone to act for you.
  • Have a person exercise your rights and make choices about your health information if you have given someone mental health power of attorney or if someone is your legal guardian.  We will make sure the person has this authority and can act for you before we take any action.

You have:

  • The right to have all reasonable requests responded to promptly and adequately.
  • The right to ask for and obtain a copy of all rules and policies which apply to clients.
  • The right and responsibility to choose a therapist and mode of treatment that meets your needs.
  • The right to ask questions about your therapist’s training, therapeutic approach, and progress of treatment.
  • The right to be informed, when treatment begins, of expected results and/or side effects of treatment. ·  The right to refuse treatment, unless court ordered.
  • The right to life-saving treatment. 
  • The right to refuse to be a research subject.
  • The right to adequate care or to be referred to another provider.
  • The right to request the name and specialty of any person responsible for care or coordination of care.
  • The right to revoke your authorization, in writing, to release or discuss your medical record except when action has already been taken.
  • The right to complain if you feel we have violated your rights by contacting Practice founder Lisa Mandl via postal mail, Reclaiming Hope Wellness Center, PC, 8926 N. Greenwood Ave, Suite 103, Niles, IL 60714 or via email at lmandl@reclaiminghopewellnesscenter.com to set up a time to discuss the issue.
  • The right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. You can also file a complaint with the Illinois Department of Financial and Professional Regulation by sending a letter to Department of Financial and Professional Regulation, Division of Professional Regulation Complaint Intake Unit, 555 West Monroe Street, 5th Floor, Chicago, IL 60661, calling 312-814-6910, or visiting https://idfpr.illinois.gov/admin/dpr/dprcomplaint.html
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care

  • Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Our Uses and Disclosures

How do we typically use or share your health information?

Subject to HIPAA, the Illinois Mental Health and Developmental Disabilities Confidentiality Act, state and federal alcohol and substance abuse privacy laws and the exceptions provided therein, we typically use or share your health information in the following ways.

  • Treat you

  • Run our organization

  • Bill for your services

  • We can use and share your health information to bill and get payment from health plans or other entities.

  • We may contract with business associates to do work directly for us related to your treatment; this may include billing, consultation, legal, and related business practices. In such circumstances, the business associate will be subject to a Business Associates Agreement which obligates any such associate to maintain privacy consistent with the state and federal requirements outlined herein.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html, and the Illinois Mental Health and Developmental Disabilities Confidentiality Act, state and federal alcohol and substance abuse privacy laws and the exceptions provided therein.

Subject to certain exceptions, we can share health information about you for certain situations such as:

  • Preventing disease

  • Helping with product recalls

  • Reporting adverse reactions to medications

  • Reporting suspected abuse, neglect, or domestic violence

  • Preventing or reducing a serious threat to anyone’s health or safety

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

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 web site.

  • This notice was updated December 23, 2023.

  • Lisa Mandl, LCPC
    Reclaiming Hope Wellness Center, PC
    8926 N. Greenwood Ave, Suite 103
    Niles, IL 60714
    Email: lmandl@reclaiminghopewellnesscenter.com

  • We never market or sell personal information.

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