Effective Date: September 17, 2026
Your Information. Your Rights. Our Responsibilities.
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.
Horizon Community Mental Health
626 W Lancaster Blvd, Suite 59
Lancaster, CA 93534
661-441-6568
www.horizoncmh.com
Privacy contact: Privacy Officer
Email: info@horizoncmh.com
Phone: 661-441-6568
Your Rights
You have the right to:
- Get an electronic or paper copy of your medical record;
- Ask us to correct your medical record;
- Request confidential communications;
- Ask us to limit what we use or share;
- Get a list of those with whom we have shared your information;
- Get a copy of this privacy notice;
- Choose someone to act for you; and
- File a complaint if you believe your privacy rights have been violated.
Get an electronic or paper copy of your medical record
- You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you. Ask us how to make this request.
- We will usually provide a copy or summary within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You may ask us to correct health information about you that you believe is incorrect or incomplete. Ask us how to do this.
- We may deny the request, but we will explain why in writing within 60 days.
Request confidential communications
- You may ask us to contact you in a particular way, such as at home, at work, or by cell phone, or to send mail to another address.
- We will agree to reasonable requests.
Ask us to limit what we use or share
- You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We generally are not required to agree and may deny the request, including when it could affect your care. If we agree, we may still disclose the information when emergency treatment is needed.
- If you pay in full out of pocket for a service or health care item, you may ask us not to disclose that information to your health insurer for payment or health care operations. We will agree unless the law requires us to share it.
Get a list of those with whom we have shared information
- You may request an accounting of disclosures made during the six years before the date of your request, including who received your health information and why.
- The accounting will exclude disclosures for treatment, payment, and health care operations and certain other disclosures, including disclosures you asked us to make. One accounting each year is free. We may charge a reasonable, cost-based fee for another accounting requested within 12 months.
Get a copy of this privacy notice
You may ask for a paper copy at any time, even if you agreed to receive the notice electronically. We will provide a paper copy promptly.
Choose someone to act for you
- If a person has legal authority to act as your personal representative, such as through a medical power of attorney or legal guardianship, that person may exercise your rights and make choices about your health information.
- We will verify that the person has this authority before taking action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting Horizon’s Privacy Officer using the information above.
- 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.
- We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your choices about what we share. If you have a clear preference in the situations below, tell us what you want us to do and we will follow your instructions.
You have both the right and the choice to tell us to:
- Share information with family, close friends, or others involved in your care or payment for your care;
- Share information in a disaster-relief situation.
If you cannot tell us your preference, such as when you are unconscious, we may share information if we believe it is in your best interest. We may also share information when necessary to lessen a serious and imminent threat to health or safety.
We will not share your information for the following purposes without your written permission:
- Marketing;
- Sale of your information; and
- Most disclosures of psychotherapy notes.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
We may use your health information and disclose it to other professionals who are treating you.
Example: A clinician treating you asks another clinician about your overall health condition.
Run our organization
We may use and disclose your health information to operate our practice, improve your care, and contact you when necessary.
Example: We use your health information to manage your treatment and services.
Bill for your services
We may use and disclose your health information to bill and obtain payment from health plans or other entities.
Example: We provide information to your health plan so it can pay for your services.
How else can we use or share your health information?
We are permitted or required to use and disclose information in other ways, usually for public-interest purposes such as public health and research. We must meet legal conditions before using or disclosing information for these purposes.
In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.
Help with public health and safety issues
We may disclose health information about you in certain circumstances, including:
- Preventing disease;
- Assisting with product recalls;
- Reporting adverse reactions to medications;
- Reporting suspected abuse, neglect, or domestic violence; and
- Preventing or reducing a serious threat to anyone’s health or safety.
Do research
We may use or disclose your information for health research as permitted by law.
Comply with the law
We will disclose information about you when state or federal law requires it, including to the U.S. Department of Health and Human Services if it asks to verify our compliance with federal privacy law.
Respond to organ and tissue donation requests
We may disclose health information about you to organ-procurement organizations.
Work with a medical examiner or funeral director
We may disclose health information to a coroner, medical examiner, or funeral director when a person dies.
Address workers’ compensation, law enforcement, and other government requests
We may use or disclose health information about you:
- For workers’ compensation claims;
- For law-enforcement purposes or to a law-enforcement official;
- To health-oversight agencies for activities authorized by law; and
- For special government functions, including military, national-security, and presidential-protective services.
Respond to lawsuits and legal actions
We may disclose health information about you in response to a court or administrative order or in response to a subpoena, subject to applicable legal requirements.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or disclose your information other than as described in this notice unless you authorize us in writing. You may change your mind at any time by notifying us in writing.
For more information, visit HHS Notice of Privacy Practices information.
Changes to the Terms of This Notice
We may change the terms of this notice, and the changes will apply to all information we maintain about you. The revised notice will be available upon request, in our office, and on our website.
Additional Privacy Protections
California law provides additional protections for certain mental health information, including information relating to participation in outpatient psychotherapy. Horizon will use and disclose this information only as permitted or required by applicable federal and California law.