HIPAA
Notice of Privacy Practices

This Health Insurance Portability and Accountability Act Notice (“HIPAA Notice”) describes how medical information about the undersigned (hereinafter, the “Client”) may be used and disclosed and how the Client can get access to this information when the Client chooses to participate in a therapeutic treatment program operated by THE MALONE COLLECTIVE. Please review this document carefully.

THE MALONE COLLECTIVE is required by law to maintain the privacy and security of the Client’s protected health information (“PHI”) and to provide the Client with this HIPAA Notice. THE MALONE COLLECTIVE must abide by the terms of this HIPAA Notice, and it must notify the Client if a breach of the Client’s unsecured PHI occurs.

I. Uses & Disclosures for Treatment, Payment, & Health Care Operations

THE MALONE COLLECTIVE may use or disclose the Client’s PHI, for treatment, payment, and health care operations purposes with the Client’s consent. To help clarify these terms, the following are some definitions:

  • “PHI” refers to information in the Client’s health records that could identify the Client.
  • “Treatment, Payment, and Health Care Operations”:
    • Treatment is when THE MALONE COLLECTIVE provides, coordinates, or manages the Client’s health care and/or other services related to the Client’s health care. An example would be when THE MALONE COLLECTIVE consults with another health care provider, such as the Client’s family physician or another psychologist.
    • Payment is when THE MALONE COLLECTIVE obtains reimbursement for the Client’s health care. Examples of payment are when THE MALONE COLLECTIVE discloses the Client’s PHI to the Client’s health insurer to obtain reimbursement for the Client’s health care or to determine eligibility or coverage.
    • Health Care Operations are activities that relate to the performance and operations of THE MALONE COLLECTIVE. Examples of health care operations are quality assessment and improvement activities, business related matters such as audits and administrative services, and case management and care coordination.
  • “Use” applies only to activities within THE MALONE COLLECTIVE (its offices, clinic, and practice groups) such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies the Client.
  • “Disclosure” applies to activities outside of a practice group, such as releasing, transferring, or providing access to information about the Client to other parties.
    To the extent that THE MALONE COLLECTIVE maintains the Client’s substance use disorder records, subject to 42 CFR part 2, THE MALONE COLLECTIVE will not share that information for investigations or legal proceedings against the Client without (1) the Client’s written consent, or (2) a court order and a subpoena.

II. Uses & Disclosures Requiring Authorization

THE MALONE COLLECTIVE may use or disclose PHI for purposes outside of treatment, payment, and health care operations when the Client’s appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when THE MALONE COLLECTIVE is asked for information outside of treatment, payment, and health care operation, THE MALONE COLLECTIVE must obtain an authorization from the Client before releasing this information.

THE MALONE COLLECTIVE would also need to obtain an authorization from the Client before releasing the Client’s psychotherapy notes. “Psychotherapy Notes” or “Progress Notes” are notes THE MALONE COLLECTIVE personnel has made about conversations during a private, joint, or family counseling session, which have been kept separate from the rest of the Client’s medical record. These notes are given a greater degree of protection than PHI. The Client may revoke all such authorizations at any time, provided each revocation is in writing. The Client may not revoke an authorization to the extent that (1) THE MALONE COLLECTIVE has relied on that authorization; or, (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

THE MALONE COLLECTIVE does not use nor disclose the Client’s PHI for marketing purposes, nor does THE MALONE COLLECTIVE sell clients’ PHI.

III. Uses & Disclosures with neither Consent nor Authorization Required

THE MALONE COLLECTIVE may use or disclose PHI without the Client’s consent or authorization in the following circumstances:

  • Child Abuse: If THE MALONE COLLECTIVE has reason to believe that a child has been subjected to incest, molestation, sexual exploitation, sexual abuse, physical abuse, or neglect, or THE MALONE COLLECTIVE observes a child being subjected to conditions or circumstances which would reasonably result in sexual abuse, physical abuse, exploitation, or neglect, THE MALONE COLLECTIVE must immediately notify the nearest peace officer, law enforcement agency, or the California Division of Child and Family Services.
  • Adult Abuse &/or Domestic Abuse: If THE MALONE COLLECTIVE has reason to believe that a vulnerable adult (defined below) is suffering from abuse, neglect, abandonment, or exploitation, THE MALONE COLLECTIVE is required by law to make a report to either the California Adult Protective Services or the nearest law enforcement agency as soon as THE MALONE COLLECTIVE becomes aware of the situation.
    • A “vulnerable adult” means an elder adult, or an adult who has a mental or physical impairment which substantially affects his or her ability to: (a) provide personal protection; (b) provide necessities such as food, shelter, clothing, or mental or other health care; (c) obtain services necessary for health, safety, or welfare; (d) carry out the activities of daily living; (e) manage his or her own resources; or, (f) comprehend the nature and consequences of remaining in a situation of abuse, neglect, abandonment, or exploitation.
  • Health Oversight: If the Client files a complaint against THE MALONE COLLECTIVE with the California Division of Occupational and Professional Licensing, THE MALONE COLLECTIVE may disclose to them information from the Client’s records relevant to the complaint.
  • Judicial or Administrative Proceedings: If the Client is involved in a court proceeding and a request is made for information about the professional services that THE MALONE COLLECTIVE has provided the Client and/or records thereof, THE MALONE COLLECTIVE must not release this information without written authorization from the Client or the Client’s personal or legally appointed representative, or a court order. This privilege does not apply when the Client is being evaluated by a third-party or where the evaluation is court ordered. THE MALONE COLLECTIVE will inform the Client in advance if this is the case.
  • Serious Threat to Health or Safety: If the Client communicates to THE MALONE COLLECTIVE personnel an explicit threat to kill or inflict serious bodily injury upon a reasonably identifiable person, and the Client has the apparent intent and ability to carry out that threat, THE MALONE COLLECTIVE has the legal duty to take reasonable precautions. These precautions may include disclosing relevant information from the Client’s mental health records which is essential to protect the rights and safety of others. THE MALONE COLLECTIVE also has such a duty if the Client has a history of physical violence of which THE MALONE COLLECTIVE is aware and THE MALONE COLLECTIVE has reason to believe there is a clear and imminent danger that the Client will attempt to kill or inflict serious bodily injury upon the person of the Client or another reasonably identifiable person.
  • Workers’ Compensation: If the Client files a workers’ compensation claim, THE MALONE COLLECTIVE must furnish mental health records to: (1) the Client or the Client’s dependents; (2) the Client’s employer; (3) the employer’s workers’ compensation insurance carrier; (4) the United Employers’ Fund; (5) the Employers’ Reinsurance Fund; (6) the Labor Commission; or, (7) any attorney representing any of the above in an industrial injury or occupational disease claim.
  • Public Health & Safety: If a communicable disease is reported, THE MALONE COLLECTIVE is required to report that disease to the California State Department of Health. Reportable communicable diseases include, but are not limited to: AIDS, Hepatitis, Sexual Transmitted Diseases, and Smallpox. Please see California Code of Regulations, Title 17, Section 2500 et seq (17 CCR § 2500 et seq).

In all cases, including those listed here, if THE MALONE COLLECTIVE maintains substance use disorder records about the Client, subject to 42 CFR part 2, it cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against the Client without (1) the Client’s written consent, or (2) a court order and a subpoena.

IV. Client Rights

The Client maintains the following rights:

  • Right to Request Restrictions. The Client has the right to request restrictions on certain uses and disclosures of PHI about the Client. However, THE MALONE COLLECTIVE is not required to agree to a restriction that the Client has requested and may say “no” if it believes it would affect the Client’s health care.
  • Right to Receive Confidential Communications by Alternative Means & at Alternative Locations. The Client has the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, the Client may not want a family member to know that the Client is a client at THE MALONE COLLECTIVE. Upon the Client’s request, THE MALONE COLLECTIVE will send the Client’s bills to another address.)
  • Right to Inspect & Copy. The Client has the right to inspect or obtain a copy (or both) of PHI in THE MALONE COLLECTIVE’s mental health and billing records used to make decisions about the Client for as long as the PHI is maintained in the record. THE MALONE COLLECTIVE may deny the Client’s access to PHI under certain circumstances, but, in some cases, the Client may have this decision reviewed. On the Client’s request, THE MALONE COLLECTIVE will discuss with the Client the details of the request and denial process.
  • Right to Amend. The Client has the right to request an amendment of PHI for as long as the PHI is maintained in the record. THE MALONE COLLECTIVE staff may deny the Client’s request. Upon the Client’s request, THE MALONE COLLECTIVE will discuss with the Client the details of the amendment process.
  • Right to an Accounting of Disclosures. The Client generally has the right to receive an accounting of disclosures of PHI regarding the Client. On the Client’s request, THE MALONE COLLECTIVE will discuss with the Client the details of the accounting process.
  • Right to a Paper Copy. The Client has the right to obtain a paper copy of this HIPAA Notice from THE MALONE COLLECTIVE upon request, even if the Client has agreed to receive it electronically.

V. Questions & Complaints

If the Client has any concerns that THE MALONE COLLECTIVE may have compromised the Client’s privacy rights, please do not hesitate to speak with the Chief Clinical Officer immediately. THE MALONE COLLECTIVE will always be willing to speak with the Client about preserving the privacy of the Client’s protected mental health information and addressing any complaints that the Client may hold.

The Client has the right to file a written complaint with the United States Department of Health and Human Services Office for Civil Rights if the Client believes THE MALONE COLLECTIVE has violated the Client’s privacy rights. Upon request, THE MALONE COLLECTIVE will provide the Client with the current appropriate address for such complaints. THE MALONE COLLECTIVE will not retaliate against the Client should the Client file a written complaint about its privacy practices.

The Effective Date of this HIPAA Notice is February 16, 2026.
THE MALONE COLLECTIVE reserves the right to change the terms of this HIPAA Notice and to make new notice provisions effective for all PHI that THE MALONE COLLECTIVE maintains. Notice of changes in THE MALONE COLLECTIVE’s HIPAA Notice will be available upon request in its offices and on its website.