Notice of Privacy Practices

Alpine’s Empowerment Agency, PLLC

HIPAA & 42 CFR Part 2 Privacy Notice

Effective Date: November 3, 2026

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PLEASE REVIEW THIS NOTICE CAREFULLY.

This Notice describes how your medical, mental health, and substance use disorder treatment information may be used or disclosed, how you may access your information, and the privacy rights available to you.

 

1. Our Commitment to Your Privacy

At Alpine’s Empowerment Agency, PLLC, we respect your privacy and are committed to protecting your personal health information.

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We maintain confidential treatment records to provide quality behavioral health services, coordinate care, process payments, and meet applicable legal requirements.

Our privacy practices comply with the Health Insurance Portability and Accountability Act (HIPAA), 42 CFR Part 2 when applicable, and relevant state privacy laws.

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These protections apply to all approved services, including individual counseling, family therapy, substance use treatment, intensive outpatient programs, and in-person and telehealth services.

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We are required to:

• Protect the privacy and security of your health information.

• Provide you with information about our privacy practices.

• Follow the terms of our current Notice of Privacy Practices.

• Notify affected individuals of breaches of unsecured protected health information as required by law.

 

2. How We May Use or Share Your Information

Alpine’s may use or disclose protected health information for legally permitted purposes, including:

Treatment: To provide counseling, assessments, treatment planning, referrals, and coordination with other healthcare professionals.

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Payment: To submit claims, verify coverage, process payments, and manage billing.

Healthcare Operations: To support quality improvement, clinical supervision, compliance reviews, staff training, and other authorized practice operations.

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We may also use or disclose information when permitted or required by law for:

• Public health and safety activities.

• Mandatory reporting of suspected abuse or neglect.

• Certain health oversight activities.

• Qualifying medical emergencies.

• Workers’ compensation matters.

• Certain research activities.

• Authorized law enforcement or government activities.

• Coroner or medical examiner responsibilities.

• Judicial and administrative proceedings, subject to applicable legal protections.

Additional confidentiality protections apply to certain substance use disorder treatment records.

 

3. Additional Privacy Protections for Substance Use Disorder Records

Federal law, 42 CFR Part 2, provides additional protections for qualifying substance use disorder treatment records.

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When required by law, Alpine’s will obtain your written consent before using or disclosing these records.

A valid consent may authorize future disclosures for treatment, payment, and healthcare operations in accordance with federal regulations.

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Certain disclosures may occur without consent only when specifically permitted or required by law, such as qualifying medical emergencies, authorized research or audits, and other limited exceptions.

 

Redisclosure of Information

When Part 2 information is disclosed pursuant to a valid consent for treatment, payment, or healthcare operations, certain recipients regulated by HIPAA may further use or disclose that information as HIPAA permits.

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However, special restrictions continue to protect Part 2 records from use in legal proceedings against you.

 

Legal Proceedings

Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your specific written consent or an appropriate Part 2 court order accompanied by the required legal process.

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Substance Use Disorder Counseling Notes

Separately maintained substance use disorder counseling notes receive additional protections and generally require separate written consent for use or disclosure, subject to applicable exceptions.

 

Fundraising

If Alpine’s uses Part 2 information for fundraising communications, you will receive advance notice and a choice about whether to receive those communications.

You have the right to file a complaint if you believe your Part 2 confidentiality rights have been violated.

 

4. Uses and Disclosures Requiring Your Authorization

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We will obtain your written authorization when required by law, including for:

• Most uses or disclosures of separately maintained psychotherapy notes.

• Most uses or disclosures of separately maintained substance use disorder counseling notes.

• Marketing activities requiring authorization under HIPAA.

• The sale of protected health information.

• Other purposes not otherwise permitted by law or covered by an applicable consent.

 

Alpine’s does not sell client health information.

You may revoke an authorization or consent in writing, subject to applicable law and actions already taken in reliance on it.

 

5. Your Privacy Rights

You have the right to:

Access Your Records

Request to inspect or obtain an electronic or paper copy of your health records, subject to applicable legal exceptions. We generally respond within 30 days, with any legally permitted extension.

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Request Corrections

Request that inaccurate or incomplete information be amended. If your request is denied, we will explain the decision in writing.

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Request Confidential Communications

Ask us to contact you using a specific telephone number, mailing address, or other reasonable communication method.

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Request Restrictions

Ask us to limit certain uses or disclosures of your information. Some requests must be honored by law, while others may be subject to review.

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When you pay for a healthcare service in full out of pocket, you may request that we not disclose information about that service to your health plan for payment or healthcare operations, except when disclosure is required by law.

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Request an Accounting of Disclosures

Request information about certain disclosures of your health information, subject to the scope, exceptions, and timeframes established by law.

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Choose a Personal Representative

Authorize a legally recognized representative to exercise applicable privacy rights on your behalf. We will verify their authority before providing access.

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Receive a Copy of This Notice

Request a paper or electronic copy of our Notice of Privacy Practices at any time.

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File a Complaint

Submit a privacy complaint to Alpine’s or the U.S. Department of Health and Human Services without fear of retaliation.

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6. Your Choices About Sharing Information

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You may express preferences about sharing information with family members, caregivers, or others involved in your treatment or payment for care.

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We will follow your instructions as required by applicable law, and additional written consent may be necessary for information protected by 42 CFR Part 2.

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When you cannot communicate your preferences, certain limited disclosures may be permitted in your best interest or during an emergency.

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For adolescent clients, parent and guardian access to treatment records will be handled in accordance with applicable minor-consent and confidentiality laws.

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7. Confidentiality During In-Person and Telehealth Services

Alpine’s uses reasonable administrative, physical, and technical safeguards to protect your information across approved service settings.

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These safeguards include:

• Secure electronic health records through approved systems.

• Restricted access to confidential information.

• Approved telehealth and electronic communication platforms.

• Secure handling and storage of records.

• Workforce confidentiality and privacy training.

• Appropriate security controls for electronic information.

 

Although Alpine’s takes measures to protect confidential information, no electronic communication system can be guaranteed completely free from security risks.

 

8. Accessibility and Language Assistance

Alpine’s is committed to ensuring that clients can understand their rights and participate meaningfully in services.

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Qualified interpreter services, accessible communication formats, and other appropriate language or disability-related accommodations are available consistent with applicable law.

You may request assistance understanding this Notice or exercising your privacy rights.

 

9. Privacy Complaints and Contact Information

If you have questions about this Notice, wish to request access to your records, or believe your privacy rights have been violated, please contact:

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Alpine’s Empowerment Agency, PLLC

Privacy Officer

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Colorado Office: 719-347-1753

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Additional Office Number: 314-516-3718

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Mailing Address:

3609 Austin Bluffs Pkwy, Suite 311023
Colorado Springs, CO 80918-6658

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You may also file a complaint directly with:

U.S. Department of Health and Human Services — Office for Civil Rights

Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html

Phone: 1-877-696-6775

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Clients receiving services regulated by the Colorado Behavioral Health Administration may also contact BHA through its official website:

https://bha.colorado.gov

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Alpine’s will not retaliate against anyone for filing a privacy complaint or exercising protected privacy rights.

 

10. Changes to This Notice

Alpine’s reserves the right to update this Notice of Privacy Practices as permitted by law.

Changes may apply to information we already maintain as well as information received in the future.

The current Notice will be available on our website, upon request, and at our physical office.

Effective Date: November 3, 2026

Alpine’s Empowerment Agency, PLLC

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Compassionate, Trauma-Informed, and Culturally Responsive Behavioral Health Services