Notice of Privacy Practices
Effective Date: August 14, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
CAPS & Maple City is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices explains how we may use and disclose your protected health information, your rights regarding that information, and our responsibilities under applicable law.
How We May Use and Share Your Health Information
We may use or share your health information for the following purposes without obtaining separate written authorization when permitted by law:
Treatment: We may use and share your health information with physicians, dentists, therapists, pharmacies, hospitals, specialists, and other health care professionals involved in your care.
Payment: We may use and share your health information to bill and obtain payment from health plans, insurers, or others responsible for paying for your care.
Health Care Operations: We may use and share your information to operate our organization, improve quality and safety, coordinate services and referrals, train staff, conduct audits, and evaluate the care and services we provide.
Appointment and Health Care Communications: We may contact you regarding appointments, follow-up care, referrals, lab results, prescriptions, preventive care, health reminders, and other services related to your care.
We may also use or disclose your information when permitted or required by law, including for:
Public health and safety activities;
Reporting suspected abuse, neglect, or domestic violence;
Health oversight activities;
Workers' compensation;
Certain law enforcement purposes;
Coroners, medical examiners, funeral directors, and organ donation organizations;
Research when legal requirements are met;
Court, administrative, or other legal proceedings; and
Other purposes required by federal or state law.
When a use or disclosure is not otherwise permitted by law, we will obtain your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.
Specially Protected Information
Certain types of information may receive additional protections under federal or state law, including certain mental health, substance use disorder, HIV/AIDS, genetic, and other sensitive health information. CAPS & Maple City will comply with any laws that provide greater privacy protection than HIPAA.
To the extent CAPS & Maple City maintains substance use disorder patient records protected by 42 CFR Part 2, those records will receive the additional protections required by federal law. Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or an applicable court order and subpoena.
Health Information Exchanges and Organized Health Care Arrangements
CAPS & Maple City may participate in health information exchanges and other arrangements that allow participating health care organizations to securely share information for treatment, payment, and health care operations as permitted by law. This sharing can help providers coordinate your care, manage referrals, reduce duplicate services, and improve quality and safety.
CAPS & Maple City participates in Organized Health Care Arrangements (OHCAs), including Indiana Lakes and the Clinically Integrated Network of Indiana (CINI). When permitted by law, CAPS & Maple City may share protected health information with other participants for treatment and health care operations of the arrangement, including activities related to care coordination, quality improvement, clinical review, information technology, referrals, and population health.
Text Messaging and Mobile Communications
If you provide a mobile telephone number and opt in to receive text messages from CAPS & Maple City, we may send messages related to your health care and our services. Messages may include appointment confirmations and reminders, requests to schedule follow-up care, general health reminders, care coordination information, and other communications related to CAPS & Maple City services.
Mobile information and text messaging opt-in consent will not be shared with third parties or affiliates for their marketing or promotional purposes.
Message frequency varies depending on your care and services. Message and data rates may apply.
You may reply STOP to a text message at any time to opt out of further text messages from that messaging program. Reply HELP for assistance.
Wireless carriers are not liable for delayed or undelivered messages.
Your decision whether to receive text messages does not affect your ability to receive care or services from CAPS & Maple City. Other communication methods may be available upon request.
CAPS & Maple City complies with the CTIA Messaging Principles and Best Practices.
Your Rights
You have certain rights regarding your health information.
Access your records: You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will generally provide access within the timeframe required by law and may charge a reasonable, cost-based fee when permitted.
Request a correction: You may ask us to correct health information that you believe is incorrect or incomplete. We may deny your request in certain circumstances but will explain the decision to you in writing.
Request confidential communications: You may ask us to contact you in a specific way or at a different address or telephone number. We will accommodate reasonable requests.
Request restrictions: You may ask us not to use or share certain information for treatment, payment, or health care operations. We are generally not required to agree to these requests.
Restriction on out-of-pocket payments: If you pay for a health care service or item in full out of pocket, you may ask us not to share information about that service with your health plan for payment or health care operations. We will honor the request unless disclosure is required by law.
Receive an accounting of disclosures: You may request a list of certain disclosures we have made of your health information during the period allowed by law. The list does not include all disclosures, such as many disclosures made for treatment, payment, or health care operations.
Receive a copy of this notice: You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose someone to act for you: If another person has legal authority to act on your behalf, such as a legal guardian or person holding an applicable medical power of attorney, that person may exercise your privacy rights as permitted by law.
Your Choices
In certain situations, you may tell us your preferences about how we share your information, including sharing information with family members, friends, or others involved in your care or payment for your care.
We will obtain your written authorization before using or disclosing your health information for purposes that require authorization under HIPAA, including:
Most uses and disclosures of psychotherapy notes;
Marketing when authorization is required; and
Sale of protected health information.
We may contact you regarding fundraising activities as permitted by law. You may tell us that you do not want to receive future fundraising communications.
Our Responsibilities
CAPS & Maple City is required by law to:
Maintain the privacy and security of your protected health information;
Follow the privacy practices described in the Notice currently in effect;
Provide you with this Notice explaining our legal duties and privacy practices; and
Notify you following a breach of unsecured protected health information when notification is required by law.
We will not use or disclose your health information other than as described in this Notice or otherwise permitted by law unless you authorize us to do so in writing.
Changes to This Notice
We may change the terms of this Notice and our privacy practices. Changes may apply to all health information we maintain, including information created or received before the change.
When we make a material change, the revised Notice will be available on our website, at CAPS & Maple City locations, and upon request.
Questions or Complaints
If you have questions about this Notice, want to exercise your privacy rights, or believe your privacy rights have been violated, please contact:
Ellen Graber-McCrae
Privacy Officer
CAPS & Maple City
574-383-9474
egraber-mccrae@capselkhart.org
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
CAPS & Maple City will not retaliate against you for filing a complaint or exercising your privacy rights.