Notice of Privacy Practices

About this notice

This notice explains how Saucier Psychiatry may use and share your health information. It also explains your rights and our legal duties. "Health information" means information that identifies you and relates to your physical or mental health, your care, or payment for your care. The law calls it "protected health information."

Because we provide mental health care, both federal law (HIPAA) and North Carolina law protect your information. When two laws apply, we follow the one that gives you more privacy.

This notice applies to J&P Saucier PLLC, doing business as Saucier Psychiatry, at 4820 Six Forks Rd, Suite 100, Raleigh, NC 27609, and to the telepsychiatry (video) visits we provide. All of our psychiatric providers, staff, trainees, and volunteers follow it. It covers all of our services: psychiatric evaluation, medication management, psychotherapy, ADHD assessment, GeneSight® pharmacogenomic testing, Spravato® (esketamine) treatment, and telepsychiatry.

Our duties to you

• We are required by law to keep your health information private and secure.
• We must give you this notice of our legal duties and privacy practices, and we must follow the notice that is in effect now.
• We must tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will not use or share your information in ways not described here unless you give us written permission.
• We share only the minimum information needed for the purpose, unless the law allows more (for example, for your treatment).

Extra protection for mental health information in North Carolina

North Carolina law treats information about a person who gets mental health services as confidential (G.S. 122C-52 through 122C-56). In general, we may share it only with your written consent, or when a specific state law allows it. These state rules are often stricter than HIPAA. Throughout this notice, when HIPAA would allow a disclosure but North Carolina law does not, we follow North Carolina law.

How we use and share your information for treatment, payment, and operations

To treat you

We use your information to care for you, and we share it with other health care providers who treat you. For example:

• Your psychiatric provider may share your medication list with your primary care provider so your medicines work safely together.
• We send prescriptions electronically to the pharmacy you choose.
• Before prescribing certain controlled medicines, such as some ADHD medicines, we may check the North Carolina Controlled Substances Reporting System.
• If you choose GeneSight® testing, we send your sample and the information the lab needs, and the lab sends the results back to us.
• If you receive Spravato®, we share the information required by the FDA's Spravato® REMS safety program.

To get paid for your care

We use and share information to bill and get paid by your health plan or other payers. For example, we tell your insurance company your diagnosis and the services you received. We may ask your plan to approve a treatment ahead of time, such as Spravato®. This may include your health plan, such as Medicaid, TRICARE, VA Community Care, or a private insurer. You can limit what we share with your health plan if you pay in full yourself (see "Your rights").

To run our practice

We use and share information to run our practice, improve care, and train staff. For example, we review records to check the quality of care and for audits, licensing, and legal or accounting help. Outside companies that help us, called "business associates," may see your information to do that work. Examples include our electronic health record and patient portal (Tebra), billing services, and technology support. They must sign a contract promising to protect your information and not share it further (G.S. 122C-55(f)).

To contact you

We may contact you by phone, text, email, mail, or the patient portal for appointment reminders, test results, billing, or other care-related reasons. Tell us if you want us to contact you in a certain way or at a certain place.

Sharing with family and others involved in your care

You can tell us who may be involved in your care. With your permission, we may share information with a family member, friend, or other person you name.

• Under North Carolina law, if a family member with a legitimate role in your care asks, and you agree in writing (or say yes out loud in front of a witness you choose), we will tell that person your diagnosis, outlook, medicines and doses, side effects, and progress (G.S. 122C-55(j)).
• If you cannot agree, for example in an emergency, we will share only what we believe is in your best interest and what the law allows.
• You can tell us at any time that you do not want us to share with someone.

Health information exchange (NC HealthConnex)

North Carolina law requires many providers paid by Medicaid or other State-funded health programs (such as the State Health Plan) to send certain information to the state's health information exchange, called NC HealthConnex (G.S. 90-414.4). This lets your other doctors, hospitals, and pharmacies see important facts, like your medicines and allergies, when they treat you. NC HealthConnex does not include psychotherapy notes or federally protected substance use treatment records.

You have the right to opt out of having your information shared with other providers through NC HealthConnex. You can also change your mind later (G.S. 90-414.10). We will not refuse to treat you if you opt out. To opt out, complete the form at hiea.nc.gov and mail it to the NC Health Information Exchange Authority. A parent or guardian must sign for a minor. Opting out stops providers from viewing your information through the network, but the law may still require us to send data for services paid with State funds.

Other ways we may use or share your information without your written permission

In some situations the law allows or requires us to share information without asking you first. We share only what is needed, and only as far as the stricter law allows.

• When the law requires it. For example, we must share information with the U.S. Department of Health and Human Services if it wants to check that we follow privacy law.
• To report abuse or neglect. North Carolina law requires anyone who suspects that a child is abused, neglected, or dependent to report it to the county Department of Social Services (G.S. 7B-301). Adults must also report certain violent or sexual crimes against children to law enforcement (G.S. 14-318.6). We must report to the county Department of Social Services if we believe a disabled adult needs protective services, for example because of abuse, neglect, or exploitation (G.S. 108A-102). State confidentiality law allows these reports (G.S. 122C-54(h)).
• To prevent serious harm. If your provider believes there is an imminent danger to your health or safety or someone else's, or that a felony or violent misdemeanor is likely, the provider may share the information needed to help prevent it. The information may go to the person at risk, your family, or law enforcement (G.S. 122C-55(d); 45 CFR 164.512(j)). North Carolina law allows this, but does not generally require it.
• In a medical emergency. We may share information with a doctor or other provider who is giving you emergency care (G.S. 122C-55(e)).
• Involuntary commitment or guardianship. If needed for your safety, and if it is in your best interest, we may share information to file a petition for involuntary commitment, or for guardianship (G.S. 122C-54(a1)).
• Public health and safety. We may report certain diseases to public health authorities as required by law. We may report medicine side effects or product problems to the FDA, and take part in required drug safety programs such as the Spravato® REMS.
• Health oversight. We may share information with agencies that oversee health care, such as licensing boards (including the North Carolina Board of Nursing and the North Carolina Medical Board), and Medicaid or Medicare auditors (G.S. 122C-56(c)).
• Courts and lawsuits. We will share information if a court orders us to (G.S. 122C-54(a)). Under North Carolina law, a subpoena alone is generally not enough for us to release your mental health records. We will need your written permission or a court order. We may also share information with our own lawyer when needed for legal advice or a legal case (G.S. 122C-54(g)).
• Law enforcement. We share information with police only when the law requires it, when a court orders it, or to prevent serious harm as described above.
• Government benefits. If you may qualify for benefits from a government agency, we may share the information needed to set up those benefits (G.S. 122C-55(g)).
• Jail or prison. If you are in jail or prison and need mental health treatment, North Carolina law allows us to share information with the prison system or the sheriff when they ask (G.S. 122C-55(c) and (c1)).
• Military, veterans, and national security. We may share information when federal law requires it, such as for members of the armed forces or authorized national security activities.
• Workers' compensation. We may share information as North Carolina workers' compensation law allows or requires (G.S. 97-25.6).
• Medical examiners and organ donation. We may share information with a medical examiner or coroner, or with an organ donation group, as the law allows.
• Research. We will use or share your information for research only with your written permission, or when the law allows it and your identity is protected (G.S. 122C-56; 45 CFR 164.512(i)). We do not currently conduct research.

Uses that require your written permission

• Psychotherapy notes. Some therapists keep separate notes about therapy conversations, called psychotherapy notes. These are kept apart from your medical record. We need your written permission to use or share them, except in a few cases the law allows. For example, the law allows use for training our own therapists, to defend ourselves in a legal case you bring, or when required by law.
• Marketing. We will never use or share your information for marketing without your written permission.
• Sale of information. We do not sell health information. The law requires your written permission for any sale.
• Fundraising. We do not use your information for fundraising. If we ever do, you will have the right to tell us not to contact you.
• Anything else. We will make any other use or disclosure not described in this notice only with your written permission.

You can take back (revoke) your permission at any time, in writing. This will not undo anything we already shared while we had your permission.

Special types of information

Children and teens

A parent or guardian usually makes health care decisions for a child under 18 and can usually see the child's records. North Carolina law has important exceptions:

• A minor may consent on their own to treatment for emotional disturbance, as well as for substance use, pregnancy, and certain diseases (G.S. 90-21.5).
• When a minor gets care under that law, the provider will not tell a parent or guardian without the minor's permission, unless the provider believes telling them is essential to the minor's life or health. If a parent or guardian contacts the provider about this care, the provider may share information (G.S. 90-21.4(b)). For that care, the minor, not the parent, controls the information under HIPAA (45 CFR 164.502(g)(3)), and the provider uses professional judgment about what to share.
• For other care, a parent or guardian generally must give consent (G.S. 90-21.10B) and may see the child's records as HIPAA allows (G.S. 114A-10). There are limits. For example, access may be limited when a parent is the subject of an investigation for abuse or a crime against the child.
• A provider may hold back information that would harm the patient's physical or mental well-being. If that happens, you may ask us to send it to a physician or psychologist you choose (G.S. 122C-53(c) and (d)).
• Emancipated minors control their own health information (G.S. 90-21.5(b)).

HIV and other reportable diseases

If our records show that you have or may have HIV, AIDS, or another disease that must be reported to public health, North Carolina law keeps that information strictly confidential (G.S. 130A-143). We will share it only with your written permission; for treatment, payment, or operations as HIPAA allows; to protect public health as state rules require; under a court order or a subpoena issued by a judicial official; or as that law otherwise allows.

Genetic information, including GeneSight®

GeneSight® is a genetic test that looks at how your genes may affect the way your body handles certain medicines. Your results become part of your health record and get the same protection as the rest of it. We use them to help choose your medicines and doses. We may share them with your other providers for treatment and with your health plan for payment. We will not share your genetic test results with an employer, or with a life, disability, or long-term care insurer, without your written permission.

Federal law (the Genetic Information Nondiscrimination Act) and North Carolina law (G.S. 58-3-215 and 95-28.1A) generally stop health insurers and employers from using genetic information against you. Health plans may not use genetic information to decide coverage or price (45 CFR 164.502(a)(5)(i)). These laws do not protect against use by life, disability, or long-term care insurers. The GeneSight® lab is a separate company and has its own privacy notice.

Substance use disorder treatment records (42 CFR Part 2)

Some records of substance use disorder treatment are protected by a federal law, 42 CFR Part 2. If we receive these records from a Part 2 program, we protect them as that law requires. SUD treatment records we receive from programs subject to 42 CFR Part 2, or testimony describing what is in those records, will not be used or shared in civil, criminal, administrative, or legislative proceedings against you unless you give written consent, or a court orders it after you (or the record holder) get notice and a chance to be heard. A court order allowing use or disclosure must come with a subpoena or other legal requirement before the records are used or shared. We do not use Part 2 records for fundraising.

Your rights

You have the following rights. To use any of them, contact our Privacy Officer (see "How to contact us"). We may ask you to make your request in writing.

• Get a copy of your records. You can ask to see or get a paper or electronic copy of your health and billing records. Much of it is also in your patient portal. We will usually respond within 30 days. We may charge a reasonable, cost-based fee. If your provider believes some information would harm your physical or mental well-being, we may hold it back. You may then ask us to send it to a physician or psychologist you choose (G.S. 122C-53(c)), and you may ask for a review of the denial. Psychotherapy notes are not included in this right.
• Ask us to correct your records. You can ask us to correct information you think is wrong or incomplete. Tell us why in writing. We may say no, but we will explain why in writing within 60 days. You can then send a statement of disagreement for your record.
• Ask us to contact you privately. You can ask us to reach you a certain way (for example, only on your cell phone) or at a different address. You do not have to tell us why. We will say yes to reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment, or operations. We do not have to agree, and we may say no if it would affect your care. If you pay for a service or item in full out of pocket, you can ask us not to share that information with your health plan for payment or operations. We will say yes unless a law requires us to share it.
• Get a list of those we shared with. You can ask for a list (accounting) of the times we shared your information in the 6 years before your request, who we shared it with, and why. The list will not include sharing for treatment, payment, or operations, or sharing you gave us permission for, and certain other sharing. One list every 12 months is free. We may charge a reasonable, cost-based fee for more.
• Get a paper copy of this notice. You can ask for a paper copy at any time, even if you agreed to get it electronically. It is also on our website.
• Choose someone to act for you. If you have a health care power of attorney, a legal guardian, or an advance instruction for mental health treatment (G.S. 122C-71 and following), that person or document can guide decisions about your information. We will check that the person has authority before we act.
• Be told about a breach. You have the right to be notified if a breach affects your unsecured health information.
• Opt out of NC HealthConnex. See "Health information exchange" above.
• Take back your permission. You can revoke a written permission (authorization) at any time, in writing.
• File a complaint. See "Complaints" below.

If there is a breach

If a breach of unsecured health information affects you, we will notify you without unreasonable delay and no later than 60 days after we discover it, as HIPAA requires (45 CFR 164.404). We will also report it to the U.S. Department of Health and Human Services.

If the breach also involves personal information such as your Social Security number, driver's license number, or a financial account number, North Carolina's Identity Theft Protection Act also applies (G.S. 75-61 and 75-65). Our notice will tell you what happened in general terms, and what type of information was involved. It will also tell you what we are doing to protect you, give you a phone number to call, and remind you to watch your account statements and free credit reports. It will list how to reach the major credit bureaus, the Federal Trade Commission, and the North Carolina Attorney General's Office for help preventing identity theft. We will also notify the Attorney General's Consumer Protection Division, as state law requires. Notice may be delayed if law enforcement tells us that it would hurt an investigation.

Changes to this notice

We may change this notice, and the changes will apply to all information we have about you. If we make an important change, the new notice will be posted in our office and on our website, and you can ask us for a copy at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the federal government. We will not retaliate against you, or treat you differently, for filing a complaint.

• With us: Contact our Privacy Officer by phone, mail, or in person (see below). You may ask for a complaint form, or we can help you write your complaint.
• With the U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue, S.W., Washington, D.C. 20201; call 1-877-696-6775; or visit www.hhs.gov/ocr/privacy/hipaa/complaints.
• For a data breach or identity theft: You may also contact the North Carolina Department of Justice, Consumer Protection Division, at 1-877-566-7226 or ncdoj.gov.

How to contact us

Effective date

This notice is effective October 19, 2026.