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.

I. Who We Are

This Notice describes the privacy practices of Mercedes and Family, LLC, doing business as Mercedes Health, and the clinicians and staff who provide care on our behalf. It applies to every service we provide, including outpatient therapy, in-home behavioral health services, and medication management.

II. Our Commitment to Your Privacy

In providing care, we create records about you and the treatment we provide, including records related to mental health treatment and, where applicable, substance use or HIV status. These records belong to us, but we are required by law to protect the privacy of your protected health information (PHI) and to give you this Notice of our legal duties and privacy practices. We will comply with the terms of this Notice, or any revised Notice in effect at the time, whenever we use or disclose your PHI.

III. Uses and Disclosures That Do Not Require Your Authorization

We may use and disclose your PHI without your written authorization for:

• Treatment. Sharing your information among clinicians involved in your care, and with other providers involved in your treatment. For young people receiving in-home services through New Jersey's Children's System of Care, this includes coordinating with PerformCare and your assigned Care Management Organization.
• Payment. Billing your insurance carrier, NJ FamilyCare, New Jersey Medicaid, or another funding source, and verifying coverage for services.
• Healthcare operations. Internal administration, quality improvement, staff training and supervision, and working with our accountants, attorneys, and other consultants to make sure we comply with the laws that apply to us.
• Public health activities, as required by law, including reporting suspected child abuse or neglect to the appropriate authorities.
• Health oversight activities, such as audits by government health programs.
• Judicial and administrative proceedings, in response to a court order, subpoena, or other lawful process.
• Law enforcement, where required or permitted by law.
• Victims of abuse, neglect, or domestic violence, disclosed to the appropriate government authority where we reasonably believe abuse has occurred.
• Health or safety, where necessary to prevent or lessen a serious and imminent threat to you or another identifiable person.
• Workers' compensation, to the extent required by New Jersey law.
• Research, only where permitted by law and, where required, with proper authorization or waiver.
• As required by law, in any circumstance not listed above where disclosure is legally mandated.

IV. Uses and Disclosures That Require Your Written Authorization

Beyond what's described in Section III, we need your specific written authorization to use or disclose your PHI. This includes, at minimum:

• Psychotherapy notes. Notes your clinician keeps separate from your medical record, documenting or analyzing the content of a counseling session. These carry the strongest protection under the law.
• Mental health information, beyond what treatment, payment, and operations already permit.
• Drug and alcohol information.
• HIV, AIDS, or sexually transmitted infection information. In most cases, we will not release this information without your authorization expressly permitting it.
• Genetic information.
• Records related to treatment a minor consented to on their own behalf under New Jersey law. If you are a minor who sought certain kinds of treatment independently, we will not disclose those records to a parent or guardian without your specific written authorization, unless otherwise required by law.
• Marketing activities, and any arrangement where we would receive payment from a third party for sharing your PHI.

You may revoke a written authorization at any time, except to the extent we've already relied on it. Information already disclosed may be subject to redisclosure by the recipient and may no longer be protected by this Notice.

V. Special Privacy Protections for Reproductive Health Care

Where prohibited by applicable law, we will not use or disclose PHI to investigate or impose liability on any person for seeking, obtaining, providing, or facilitating reproductive health care that is lawful in the circumstances in which it was provided, nor will we use PHI to identify a person for that purpose.

VI. Disclosures to Family, Friends, or Caregivers

We may share information relevant to your care with a family member, close friend, or caregiver you identify, if you agree, if we give you the chance to object and you don't, or if we reasonably infer you wouldn't object. If you're not present or unable to agree due to incapacity or an emergency, we'll use professional judgment to determine whether sharing is in your best interest, and we'll share only what's directly relevant to that person's involvement in your care.

VII. Business Associates

We work with certain companies and individuals who perform services on our behalf and may need access to your PHI to do so, such as our billing platform and IT support. We require these business associates to sign an agreement protecting your PHI to the same standard we do.

VIII. Artificial Intelligence (AI) Tools

As part of how we support the quality and accuracy of your care, we may use artificial intelligence (AI) tools for certain administrative and clinical support functions, such as helping a clinician transcribe or summarize a session for documentation, or organizing information within your record.

Please note the following about our use of AI:

• AI tools support our clinicians. They do not make clinical decisions, do not diagnose you, and do not determine your treatment. Any AI-generated documentation is reviewed and approved by your clinician before it becomes part of your record.
• Any AI tool with access to your PHI is treated as a business associate, as described in Section VII, and is contractually required to protect your information to the same standard we do.
• If you have questions about whether AI tools are used as part of your care, or you would prefer that AI-assisted documentation not be used during your sessions, please talk with your clinician or contact our Privacy Officer.

IX. Your Rights Regarding Your PHI

• Right to inspect and copy. You can request to see or receive copies of your PHI, with certain exceptions such as psychotherapy notes. We'll respond within the timeframe required by law and may charge a reasonable fee for copies.
• Right to confidential communications. You can request we contact you by a specific method or at a specific location.
• Right to request additional restrictions. You can ask us to limit how we use or share your PHI. We'll consider every request, though we're not required to agree except where you've paid for a service in full out of pocket and ask that we not share that information with your insurer for payment purposes.
• Right to request amendment. You can ask us to correct your PHI. We'll respond in writing, and if we decline, we'll explain why and your right to submit a statement of disagreement.
• Right to an accounting of disclosures. You can request a list of certain disclosures we've made of your PHI within the prior six years.
• Right to a paper copy of this Notice, at any time, even if you've received it electronically.
• Right to be notified of a breach of your unsecured PHI.

X. Changes to This Notice

We may change this Notice at any time, and the revised terms will apply to all PHI we maintain. We'll post the current Notice at mercedeshealth.com/privacy-nondiscrimination and make it available at our office. You can request a paper copy from our Privacy Officer at any time.

XI. Complaints

If you believe your privacy rights have been violated, you may contact our Privacy Officer, or file a written complaint with the Office for Civil Rights of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

XII. Contact Information

You may contact our Privacy Officer with questions, concerns, or requests related to this Notice or your PHI:

Mercedes Health Privacy Officer
1 Broadway, Suite 104, Elmwood Park, NJ 07407
201.281.5936