This notice supplements the information in our HIPAA Notice of Privacy Practices and describes the additional protections for records related to Substance Use Disorder ("SUD") treatment programs, including Dartmouth-Hitchcock's Addiction Treatment Program, which includes the Moms in Recovery Program and Doorway Program ("D-H SUD Programs"), and Cheshire Medical Center's Moms in Recovery Program and Doorway Program ("Cheshire SUD Programs").
This notice describes (i) how health information related to SUD treatment by D-H SUD Programs and Cheshire SUD Programs may be used and disclosed, (ii) your rights with respect to your SUD treatment information, and (iii) how to file a complaint concerning a violation of the privacy or security of your SUD treatment information, or of your rights concerning your SUD treatment information. You have a right to a copy of this notice, in paper or electronic form, and to discuss it with our Privacy Office, for which contact information is listed below, if you have any questions.
We are required to provide patients with this notice of our legal duties and privacy practices with respect to SUD records and to notify affected patients following a breach of unsecured SUD records.
This notice is applicable to SUD treatment information protected under 45 CFR Part 2, which is limited to SUD treatment programs and does not apply to information related to care provided outside of SUD programs, such as substance abuse screening that is performed in emergency rooms or by your primary care provider.
How health information about you may be used and disclosed
The confidentiality of SUD patient records maintained by us is protected by Federal law and regulations. We will share your SUD treatment information amongst our staff as needed to provide care to you or to bill you for services. Generally, however, we may not say to a person outside the D-H SUD Program or Cheshire SUD Program, as applicable, that you are a patient of the program or disclose any information identifying you as a person with a SUD, except in the circumstances described below.
Instances where we may share information without your consent:
- The disclosure is made to medical personnel in a medical emergency;
- The disclosure is made to qualified service organizations providing services on our behalf who agree in writing to protect the information in the same way that we are required to protect the information;
- The disclosure is made to law enforcement to report a crime you commit, or threaten to commit, in our facility or against our personnel;
- The disclosure is made to the NH Division for Children, Youth and Families to report suspected child abuse and neglect, as required by New Hampshire state law;
- The disclosure is made to qualified personnel for research purposes, subject to ethics board approval and oversight;
- The disclosure is made for audit or program evaluation purposes to qualified personnel who: a) agree in writing to protect the information as required under our policies, b) represent federal, state, or local government agencies that are authorized by law to oversee our program, or c) provide financial assistance to the program or provide payment for health care; or
- The disclosure is allowed by a court order and that order includes a subpoena or other legal mandate requiring that we share your information. In particular, note that records, or testimony about your records, cannot be shared in any civil, administrative, criminal, or legislative proceedings against you unless there is specific written consent or a court order. If there is a court order, we must let you know and provide you with an opportunity to object.
In all other circumstances, we will ask for your consent to release your information outside of our SUD program. Instances where we may share information with your consent include:
- When you ask us in writing to share your information; and
- When you consent to allow us to share information about you outside of our program for all future treatment, payment, and healthcare operations purposes. Organizations who would receive your information for these purposes are required by law or contract to protect your information as required by Federal law protecting SUD information or by HIPAA. Records that are disclosed to a SUD program, another health care provider, or business associate based on your written consent for treatment, payment, and health care operations may be further disclosed by that program, covered entity, or business associate, without your written consent, to the extent the HIPAA regulations permit such disclosure.
- Recipients who are required to protect your information as required by HIPAA may share your information only as allowed by HIPAA except that they may not re-disclose information for civil, criminal, administrative, and legislative proceedings against you; and
- If you consent to our sharing your information, you can change your mind and ask us not to at any time by letting us know in writing. If you change your mind, we will stop any future sharing of your information but will be unable to stop any information that has already been released.
Your rights with respect to your health information as a patient in the program
As a patient in a D-H SUD Program or Cheshire SUD Program, you have certain rights with regards to your information in addition to those rights described in our HIPAA Notice of Privacy Practices:
- You have a right to request restrictions of disclosures made with your prior consent for purposes of treatment, payment, and health care operations. We will review your request but are not required to agree unless the request relates to sharing information with your insurance provider and your care has already been paid by another source. If we agree to your request, we may still share your information where needed for emergency care or where required by law.
- You have a right to an accounting of disclosures of electronic records of your care by the D-H SUD Program or Cheshire SUD Program to people outside our program for the past 3 years. In addition, if you provided consent to share your information for treatment through a health information exchange, care management organization, or other intermediary, you have a right to a list of disclosures by an intermediary for the past 3 years.
- You have a right to obtain a paper or electronic copy of this notice as well as our HIPAA Privacy Notice upon request.
- We will make arrangements for you to be able to read this notice in a private space when you are a patient receiving SUD treatment or services.
- You have a right to elect not to receive fundraising communications. The D-H SUD Program or Cheshire SUD Program may use or disclose records to fundraise for the benefit of the applicable SUD Program only if we have first provided you with a clear and conspicuous opportunity to elect not to receive fundraising communications.
Changes in terms of this notice
We respect the need to maintain the confidentiality of your care. We are required to follow the terms of the notice currently in effect. If we make changes to how we manage your records, we will change our notice and provide you with a new notice at your next visit if you are still receiving care. If you are no longer receiving care in a D-H SUD Program or Cheshire SUD Program, you may request an updated copy or our notice or you may find the most recent notice in effect on our website.
If you have a concern or question about this notice or your privacy, you may contact the Privacy Office, for which contact information is provided below. In addition, you have a right to file a complaint with the Secretary of the Department of Health and Human Services. For directions on how to contact the Secretary, please contact the Privacy Office. You will not be retaliated against for filing a complaint.
Dartmouth Health Privacy Office
Phone: Toll Free: 844-754-8250
Email: privacyoffice@hitchcock.org
Effective date: February 1, 2026