Notice of Privacy Practices

SANFORD BEHAVIORAL HEALTH​
NOTICE OF PRIVACY PRACTICES
Effective Date: February 16, 2026
THIS NOTICE DESCRIBES:
  • HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION
  • YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
  • HOW TO FILE A COMPLAINT CONCERNING A VIOLATION OF THE PRIVACY OR SECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTS CONCERNING YOUR INFORMATION
PLEASE READ IT CAREFULLY.
YOU HAVE A RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC  FORM) AND TO DISCUSS IT WITH THE SANFORD BEHAVIORAL HEALTH PRIVACY  OFFICER AT (616) 288-6970 IF YOU HAVE ANY QUESTIONS.
OUR COMMITMENT TO YOUR PRIVACY
This Notice applies to all services, programs, and levels of care provided by Sanford Behavioral Health, and to any provider who provides services through Sanford Medical Specialists, PLLC, at all agency locations.
Sanford Behavioral Health and Sanford Medical Specialists, PLLC are committed to protecting the privacy of your health information. We create and maintain records of the care and services you receive. This information is known as “Protected Health Information” (PHI). PHI includes information that identifies you and relates to:
  • Your physical or mental health condition
  • Substance use disorder diagnosis, treatment, or referral
  • Health care services provided to you
  • Payment for your care
We are required by law to:
  • Maintain the privacy of your PHI
  • Provide you with this Notice
  • Follow the terms of this Notice as it is currently in effect
We may update this Notice at any time. The revised Notice will apply to all PHI we maintain and will be available upon request and on our website.
SMS/TEXT MESSAGING PRIVACY
Data, including your mobile phone number, will not be sold or shared with third parties for promotional or marketing materials.
DISCLOSURES REQUIRING AUTHORIZATION
Psychotherapy Notes: We must obtain your specific written authorization prior to disclosing psychotherapy notes except as follows: (1) to carry out certain treatment, payment or healthcare operations (e.g., use for the purposes of your treatment, for our own training, and to defend ourselves in a legal action or other proceeding brought by you), (2) to the Secretary of the Department of Health and Human Services to determine our compliance with the law, (3) as required by law, (4) for health oversight activities authorized by law, (5) to medical examiners or coroners as permitted by state law, or (6) for the purposes of preventing or lessening a serious or imminent threat to the health or safety of a person or the public.
Genetic Information:
We must obtain your specific written authorization prior to using or disclosing your genetic information for treatment, payment or health care operations purposes. We may use or disclose your genetic information, or the genetic information of your child, without your written authorization only if permitted by law.
Marketing:
We must obtain your authorization for any use or disclosure of your PHI for marketing, except if the communication is in the form of (1) a face-to-face communication with you, or (2) a promotional gift of nominal value.
Sale of PHI:
We must obtain your authorization prior to receiving direct or indirect payment in exchange for your PHI except in limited situations allowed by law.
SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER INFORMATION
Certain records related to substance use disorder (SUD) diagnosis, treatment, or referral are protected by federal law (42 CFR Part 2).
These records may not be used or disclosed without your written consent except as specifically permitted by federal law. We will obtain your written consent before disclosing SUD-related information for:
  • Treatment
  • Payment
  • Health care operations
Federal law also prohibits the use or disclosure of SUD information in civil, criminal, administrative, or legislative proceedings against you unless authorized by you or permitted by a court order. We will follow these procedures before using or sharing your information in legal or administrative proceedings:
  • We will not use or share your information or provide testimony about your information in any civil, administrative, criminal, or legislative proceedings against you without your written consent or a court order.
  • We will only respond to a court order to use or share your health information if it is accompanied by a subpoena or other similar legal mandate requiring us to comply.
  • We will only use or share your information in proceedings against you based on a court order after we have received notice and an opportunity to be heard or you tell us that you have received notice.
  • We may use or share your information to respond to legal proceedings against our program based on a court order and you may not be notified in advance. You have the right to seek to overturn or change the court order after you learn about it.
HOW WE MAY USE AND DISCLOSE YOUR INFORMATION
1. With Your Written Consent
Most disclosures of your PHI will be made only with your written authorization. You may revoke  your authorization at any time in writing, except to the extent we acted in reliance on it. For example, when you consent to uses and disclosures for future treatment and payment purposes, we may share your information with other health care businesses for those activities. If the business who receives it is subject to HIPAA, they are allowed to use and share your information again without your consent for the purposes HIPAA allows but, after disclosure, the information may no longer be protected by HIPAA.
With your written consent, we may use and disclose your PHI as discussed below. We have included some examples, but we have not listed every permissible use or disclosure.
Treatment​
To coordinate your care with:
  • Physicians
  • Therapists
  • Hospitals
  • Pharmacies
  • Laboratories
  • Primary care providers
  • Other health care professionals
Example: A doctor treating you for a chronic condition asks a doctor at our program about
medications you are taking, for example, to avoid complications.
Payment​
To obtain payment from:
  • Insurance companies
  • Health plans
  • Government programs

Example: We disclose your PHI to your health insurance plan so it will pay for your services.

Health Care Operations​
To support our operations, such as:
  • Quality improvement
  • Staff supervision and training
  • Accreditation
  • Auditing
  • Business associates who assist in providing services

Example: We use health information about you to manage your treatment and services.

2. Without your Written Consent
In certain limited circumstances, we may use or disclose your PHI without your consent when required or permitted by law including the following:
  • To communicate within our program and with contractors
    We can share your information within our program, with an organization that has administrative control over our program, and with contractors who help us run our program.
  • For medical emergencies
    We can share your information during a bona fide medical emergency with the personnel and health care providers responding to your emergency, even when you are unable to consent because of the emergency. We can also share your identifying information to assist the federal Food and Drug Administration in notifying you or your doctor about unsafe products you may be using.
  • To help with public health
    We can share health information that does not identify you for certain situations such as preventing disease or reporting adverse reactions to medications
  • To aid scientific research
    We can use or share your information to conduct or help with health research. Researchers cannot include any patient identifying information in their reports about the research.
  • To respond to management and financial audits and program evaluations
    We can use or share your information to improve the quality of our services, obtain needed credentials, and cooperate with oversight agencies for activities authorized by law, as long as those who view or receive the information agree to destroy or return the information when they are finished and agree not to use it against you.
  • To assist with cause of death inquiries
    We can share patient identifying information about a deceased patient as required or allowed by laws that collect information relating to cause of death.
  • To report suspected child abuse and neglect
    We will only report the information required by law.
  • To prevent or reduce crime in our program
    We may report to law enforcement when a patient commits or threatens to commit a  crime within our program or against our staff. In all these circumstances, we must protect your information and limit how we use and share it.
Reproductive Rights Privacy
We will not use or disclose PHI related to your, or your family’s, reproductive health care for the
sole purposes of:
  1. Conducting a criminal, civil, or administrative investigation into any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care, and/or
  2. Impose criminal, civil, or administrative liability on any person for the mere act of seeking, obtaining, providing, or facilitating reproductive health care, and/or
  3. Identifying any person for any purpose described in (1) and (2) above.
Reproductive health care can include any information that affects the health of an individual in all matters relating to the reproductive system and to its functions and processes. These protections assume the reproductive health care you received was lawful in the state(s) where services were provided, or they were authorized by Federal law regardless of the state in which such health care was provided. Some examples of seeking, obtaining, providing, or facilitating reproductive health care include: using reproductive health care; performing, furnishing, or paying for reproductive health care; providing information about reproductive health care;
arranging, insuring, administering, providing coverage for, approving, or counseling about
reproductive health care; or attempting any of these activities.

YOUR RIGHTS

Provide consent when we use or share your information for most purposes

  • You may provide a single consent for all future uses or disclosures for treatment, payment, and health care operations purposes.
  • You may provide consent for more limited purposes (for example, to only disclose information to another health care provider for your treatment); however, doing so may affect the services we can provide you or how you pay for services.
  • You may provide a general consent to share your information through certain third parties, such as a health information network or a research institution, where your treating health care providers can access it.
Access Your Records​
You have the right to request to inspect or receive a copy of your PHI, subject to limited exceptions.
Request Amendments​
You have the right to request corrections to your records if you believe information is inaccurate or incomplete.
Request an Accounting of Disclosures​

You have the right to receive a list of certain disclosures made outside of treatment, payment, and operations. Request Restrictions​ You have the right to request that we not use or share certain health information for treatment, payment, or our health care operations after you have provided consent for all those purposes. We are not required to agree to your request, and we may say “no” if, for example, it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.

If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our health care operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Request Confidential Communications​
You have the right to ask us to communicate with you in a specific way or at a specific location.
Receive Breach Notification​
You have the right to be notified if a breach occurs involving your unsecured protected health information.
Opt out of Fundraising
You have the right to receive a clear and obvious notice in advance of, and a choice about whether to receive, fundraising communications.
Receive and Discuss this Notice
You have the right to receive 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. You also have a right to discuss this Notice with our Privacy Officer at (616) 288-6970 if you have any questions.
File a Complaint​
You have the right to file a complaint if you believe your privacy rights have been violated. We
will not retaliate against you for filing a complaint. You may file a complaint with:
Shelby Kendrick​
Privacy Officer​
Sanford Behavioral Health​
15146 16th Ave​
Marne, MI 49435​
(616) 288-6970
You may also file a complaint with:
U.S. Department of Health and Human Services​
200 Independence Avenue, S.W.​
Washington, D.C. 20201​

1-877-696-6775

You will be asked to sign an acknowledgment that you received this Notice.