Notice of Privacy Practices (HIPAA)
Last Updated April 15th, 2026
The Health Insurance Portability and Accountability Act (HIPAA) was to provide protections for the privacy of your personal health information This Notice describes how medical information about you may be used and disclosed and how you can get access to this information.
What is protected health information (PHI)? This is information that would enable a person reading or hearing it to identify you individually relating to: your physical or mental health or condition; the health care you receive; the payment related to your health services or your Genetic information
Release of Information: We will release your personal health information only if your Legal Guardian signs the SAYS Release of Information. Your Legal Guardian (the individual with legal authority) can refuse to allow us to release or use your information.
How do we typically use or share your health information? We typically use or share your health information in the following ways:
Treat- use and share your information with treating professionals to coordinate needed services
With consent- from individuals with legal authority to make healthcare decisions
Run our organization-for operations, to improve your care, and contact you when necessary.
Bill for services- to bill and get payment from health plans and other funding entities
How else can we use or share your health information?
Health authorities- to prevent or control disease, reporting adverse reactions to medications
For research- health related research studies
Comply with the law- as required by state or federal laws, with a court order or subpoena, disclosure to authorities to prevent threats to wellbeing or preventing harm, reporting suspected abuse, neglect, or abandonment.
When we are inspected, investigated, having a license renewed, or oversight agencies for audit.
Your Rights Regarding Your Personal Health Information
Right to Revoke or Request Restrictions: You (or the individual with legal authority) can tell us exactly how much of your personal health information we can use in your treatment, payment, or what we share in coordinating your care. You may revoke a release of information in writing at any time.
Right to Access: You (or the individual with legal authority) can ask for a copy of your record. You will need to give us at least 30 days to send you this information. Your request must be in writing to the program office.
Right to confidential communication: You can ask us to contact you in a specific way (for example, you could request we contact you at your workplace or via email). Your request must be written to the program office that maintains your records.
Right to amend information: You can ask us to correct health information about you that you think is incorrect or incomplete. Your request must be written to the program office that maintains your records. We may deny your request, but we will tell you why in writing within 60 days.
Right to list of information shared: You (or the individual with legal authority) can ask for a list (Accounting of Disclosures) of the times we’ve shared your health information, who we shared it with, and why. You will need to give us at least 30 days to send you this information. Your request must be written to the program office that maintains your records.
Right to a Copy of this Notice: You (or the individual with legal authority) can ask for a copy of this Privacy Notice at any time from the Privacy Officer at SAYS. Any revision to this Privacy Notice will posted and a new copy given to you if you are currently recipient of services.
COMPLAINTS
If you (or the individual with legal authority) feel like SAYS is not respecting your privacy or rights regarding your personal health, you file a complaint in writing to the Privacy Contact, Privacy Officer of the US Department of Health and Human Servies. You can get a complaint form from the Privacy Officer who can be reached at (904) 829-1770. We will not retaliate against you for filing a complaint.
FOR ANY OTHER QUESTIONS OR FURTHER INFORMATION
Please contact the Privacy (HIPPA) Officer: St. Augustine Youth Services, 201 Simone Way, St. Augustine Youth Services, FL. 32086, (904) 829-1770.
Effective: 04-15-2026