Western Pacific Med-Corp.
Notice of Privacy Practices
THIS NOTICE DESCRIBES:
•HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
•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 ORSECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTSCONCERNING YOUR INFORMATION
PLEASE REVIEW THIS NOTICE CAREFULLY. YOU HAVE A RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC FORM) AND TO DISCUSS IT WITH OUR PRIVACY OFFICER AT (818) 956-3737 OR info@westpacmed.com IF YOU HAVE ANY QUESTIONS.
Our Uses and Disclosures
Western Pacific Med-Corp. is a narcotic treatment program that provides services to help and treat individuals with substance use disorders (“SUD”). As a result, we create or maintain records of the identity, diagnosis, prognosis, or treatment of patients in connection with SUD education, prevention, training, treatment, and rehabilitation (“SUD Records”). SUD Records are subject to federal SUD confidentiality law and regulations found at 42 U.S.C. § 290dd2 and 42 C.F.R. Part 2 (“Part 2”) in addition to the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
In this Notice, we use terms like “we,” “us”, “our”, or “Part 2 Program” to refer to Western Pacific Med-Corp., a covered entity under HIPAA and a Part 2 Program under Part 2, and its health care personnel, employees, staff, and other workforce members. This Notice applies to all programs and services offered by us.
We may not use or disclose your SUD Records without your written consent unless otherwise permitted or required by law, as detailed further below.
Uses and Disclosures That Do Not Require Your Consent
We are allowed or required to share your information in certain ways without your consent – 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. In particular, we may use or share your information in the following circumstances:
•Within our program, with an organization that has administrative control over ourprogram, and with contractors who help us run our program.
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• To a medical personnel member during a bona fide medical emergency, if we cannot obtain your consent.
• To Food and Drug Administration (“FDA”) medical personnel so that they can notify you or your physician that your health may have been compromised by an error in the manufacturing, labeling, or sale of a product regulated under the FDA.
• For research purposes, if the recipient has met certain requirements or exceptions under HIPAA and Part 2.
• For certain management audits, financial audits, and program evaluations. The individuals perform such audits or evaluations will be subject to Part 2’s restrictions on redisclosures of your information.
• To a public health authority, if your information has been de-identified so that the information cannot be used to identify you.
• To the Department of Veterans Affairs.
• To a qualified service program who is providing services to the Part 2 Program.
• To report to law enforcement when a patient commits or threatens to commit a crime within our program or against our staff.
• To state or local authorities to report suspected child abuse and neglect as required by law.
• As permitted by a valid court order.
Uses and Disclosures That Require Your Consent or Notice
If we would like to use or disclose your SUD Records in a manner which is not described above, we must first obtain your specific written consent allowing us to make the disclosure. For example, we may ask that you help us care for you and support your treatment goals by providing a written consent that allows our Part 2 Program’s providers to disclose your treatment information to your friends and advocates involved in your treatment or recovery.
With your consent, we may use and share your information in the following ways:
• To whomever you name in a consent to share your information;
• To prevent multiple enrollments in withdrawal management or maintenance treatment programs;
• To report participation in treatment required by the criminal justice system; or
• To report prescribed substance use disorder treatment medications to a state prescription drug monitoring program when required by law.
You may also execute a single written consent for all future uses and disclosures for treatment and payment purposes and to run our business, in which case we may share your information with other substance use disorder treatment programs, doctors’ offices, and health care businesses for those activities. If the person who receives it is subject to HIPAA, then they are allowed to use and share your information again without your consent for the purposes that HIPAA allows. Your information still cannot be used in legal proceedings against you unless (1) you consent or (2) based on a Part 2 court order and a subpoena (or similar legal requirement).
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• Treatment. If you execute a written consent, we can share your SUD Records with other professionals who are treating you. For example, if a doctor treating you for a chronic condition asks a doctor at our program about your health condition and medications you are taking, with your consent, we can disclose the medications to your provider, to avoid complications.
• Payment. If you provide us a written consent, we can use and share information in your SUD Records to submit claims for the services you received. For example, if your health insurance company requests information about your treatment for a bill, with you consent, we can disclose your treatment and dates of services.
• Health Care Operations. If you provide us written consent, we can use health information to improve our services, run our program, and contact you when necessary. For example, we can use your SUD Records, with your consent, to review the services we offer.
Legal Proceedings and Court Orders
We must follow certain procedures before using or sharing your information for investigations and legal 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.
Fundraising
We may contact you about fundraising, but we won’t use or share your SUD Records for fundraising unless we first give you a clear opportunity to opt-out of fundraising communications.
Representatives
You can choose someone to act for you.
• If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your SUD Records.
• We will make sure the person has this authority and can act for you before we take any action.
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Revoking Consent
You may revoke your written consent in writing in accordance with HIPAA and Part 2, except to the extent that we or others have already relied on the consent in using or disclosing your information. If you signed the written consent because you are participating in the Part 2 Program as a condition of a criminal justice proceeding, such as probation or parole, your consent can be revoked upon the conclusion of certain events, such as the end of your probation or parole.
Your Rights
You have the following rights in connection to your SUD Records:
Provide Consent when we Use or Share your Information for Most Purposes
• As noted above, 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.
Ask us to Limit what we Use or Share
• You can ask us not to use or share certain SUD Records 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 an Accounting of Disclosures
• You can ask for a list (accounting) of the times we have shared your electronic SUD Records for three (3) years prior to the date you ask, who we shared it with, and why.
• If you have given written consent to an intermediary (such as a health information exchange) to use or share your SUD Records, you can ask the intermediary for a list of the times they have shared your SUD Records for three (3) years prior to the date you ask, who received the records and when, and what parts of your records were disclosed.
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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.
Ask Us to Correct Your Medical Record
You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. W may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request Confidential Communications
You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
Get a Copy of, or Inspect, Your Medical Record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. You will have to submit this request in writing. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee, to the extent permitted by law.
Receive a Copy of this Notice
You can 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.
Discuss this Notice with someone in our program
You can ask questions or obtain more information about this Notice and our privacy practices by calling or emailing the contact person at the top of this Notice.
Choose in advance about fundraising
You have the right to a clear and obvious notice in advance of, and a choice about whether to receive, fundraising communications for our program, as described above.
File a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights by contacting us in writing at info@westpacmed.com.
• You can 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 https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
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• We will not retaliate against you for filing a complaint.
Our Responsibilities
• We are required to obtain your consent for most uses and sharing of your SUD Records, as detailed above.
• We are required by law to maintain the privacy and security of your SUD Records.
• We must let you know promptly if a breach occurs that may have compromised the privacy or security of your SUD Records.
• 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 SUD Records other than as described in this Notice 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.
• In some circumstances, we may be required to provide more restrictive treatment to certain categories of health information that may limit or preclude some accesses, uses or disclosures described in this Notice, such as records containing psychotherapy notes, genetic testing information, information on persons with developmental disabilities, information concerning HIV/AIDS testing, treatment for mental health conditions or substance use disorders, or information regarding emancipated minors. Government health benefit programs, such as Medi-Cal, may also limit the disclosure of beneficiary information for purposes unrelated to the program.
• In the case of psychotherapy notes (meaning notes recorded, in any medium, by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record, but not including any medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date), we may not use or disclose psychotherapy notes without your written authorization unless otherwise permitted or required by law.
• In the case of SUD counseling notes (meaning notes recorded in any medium by a Part 2 Program provider who is a SUD or mental health professional documenting or analyzing the contents of conversation during a private SUD counseling session or a group, joint, or family SUD counseling session and that are separated from the rest of the patient’s SUD and medical record, but excluding medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date): We may not use or disclose SUD counseling notes without your written authorization unless otherwise permitted or required by law.
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Changes to the Terms of this Notice
We reserve the right to change the terms of this Notice at any time. We reserve the right to make the new Notice provisions effective for all SUD Records that we currently maintain, as well as any health information we receive in the future. If we make material or important changes to our privacy practices, we will promptly revise our Notice. We will post a copy of the current Notice in our offices. Each version of the Notice will have an effective date, along with the date it was last updated on the first page. Updates to this Notice are also available at our website.
Effective Date
This Notice is effective as of February 16, 2026.
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Western Pacific Med-Corp.
Acknowledgement of Receipt of Notice of Privacy Practices
Applicable law requires us to give you a notice of our privacy practices and to acknowledge your receipt of the notice.
What is the Notice of Privacy Practices?
The Notice of Privacy Practices explains how your SUD Records may be used or disclosed by us. In addition, it explains your rights with regard to your SUD Records, as well as our legal responsibilities.