Latina Baby Tee Highlight
THIS NOTICE DESCRIBES HOW MEDICAL, MENTAL HEALTH, AND PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our Responsibilities
We are required by law to:
Keep your protected health information (PHI) confidential.
Give you this notice of our legal duties and privacy practices.
Notify you if there is a breach of your unsecured PHI.
Follow the terms of this notice.
This notice applies to all programs operated by East Bay Community Care Network, including Intensive Case Management, Case Management, and Patient Care Coordination services.
Your Rights
You have the right to:
Get a copy of your records: Ask to see or receive an electronic or paper copy of your medical or service record. We will provide a copy within 5–15 business days, depending on the request type.
Request confidential communications: You may ask us to contact you in a specific way (e.g., home vs. cell phone) or send mail to a different address.
Request limits on what we use or share: You can ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree, but will consider all reasonable requests.
Correct your records: If you believe the information we have is incorrect or incomplete, you can request a correction.
Get a list of those with whom we’ve shared your information: This includes the date, purpose, and to whom your PHI was disclosed.
File a complaint: You can file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights if you feel your rights are violated. You will not be retaliated against for filing a complaint.
How We May Use and Disclose Your Information
We typically use or share your information in the following ways:
For Treatment: We may share your information with healthcare providers, social service agencies, mental health counselors, and others involved in your care or treatment coordination.
For Payment: We may use or share your information to bill for services or to obtain reimbursement from Medi-Cal, insurance, or other funding sources.
For Health Care Operations: We may use information to evaluate and improve our services, train staff, conduct audits, and manage our programs.
Other Ways We May Use or Share Your Information
We are allowed or required to share your information in other ways, usually in ways that contribute to the public good or are legally required. These include:
Mandated reporting of abuse, neglect, or harm to self/others
Court orders, subpoenas, or law enforcement requests
Emergency situations where you are incapacitated or in danger
Public health or safety threats (e.g., communicable diseases)
Audits or oversight by government agencies (e.g., DHCS)
Note: For mental health or substance use disorder records, additional protections under California Welfare & Institutions Code § 5328 and 42 CFR Part 2 may apply. In such cases, information is shared only with your written consent unless required by law.
Uses and Disclosure That Requires Your Authorization
We will never share your information for:
Marketing or sale of your information
Substance use treatment records without your written consent (unless otherwise allowed under federal law)
Psychotherapy notes, unless you authorize us
You may revoke your written authorization at any time by providing us with a written request.
How We Protect Your Information
We use physical, administrative, and technical safeguards to protect your information:
Locked files and secured EHR systems
Staff training and confidentiality agreements
Role-based access only
Changes to This Notice
We reserve the right to change this notice at any time. Updated notices will be:
Posted in our office and on our website.
Available upon request.
Provided to you if major changes affect your rights or how we use your information.
Contact Us
If you have any questions about this notice or your rights, or if you wish to file a privacy complaint, please contact:
Michael Garcia-Picazo, Executive Director
Privacy Officer, East Bay Community Care Network
31277 Meadowbrook Ave., Hayward, CA 94544
Phone: +1 (510) 598-9137
Email: michael@ebccn.org
Complaints to the Government
You can also file a complaint with the U.S. Department of Health and Human Services:
Phone: 1-877-696-6775
Purpose
This document outlines your rights and responsibilities as a client of East Bay Community Care Network. We are committed to delivering equitable, trauma-informed, and person-centered care. Your understanding of your rights and responsibilities helps us provide effective services and build trust in our care relationship.
Client Rights
As a client of East Bay Community Care Network, you have the right to:
Respect and Dignity: Be treated with respect, dignity, and compassion without discrimination of any kind, including race, ethnicity, religion, age, gender, sexual orientation, disability, immigration status, or housing status.
Confidentiality: Have all information about your care kept confidential in accordance with federal (HIPAA), state (CMIA), and local privacy laws.
Access to Services: Receive services regardless of your ability to pay, citizenship, or insurance status, as applicable to the Foundation’s mission and program eligibility.
Informed Consent: Receive clear information about the services, risks, and benefits so you can make informed choices about your care.
Participation in Care: Be actively involved in developing and reviewing your care plan, goals, and services.
Access to Records: Request and receive a copy of your records and request corrections as permitted by law.
Safety: Receive services in a safe, clean, and supportive environment.
Grievance Process: File a complaint or grievance without fear of retaliation, and receive a response in a timely and respectful manner.
Support Services: Receive culturally relevant, linguistically appropriate, and disability-accessible services.
Refuse Services: Decline or withdraw from services at any time without penalty or loss of future eligibility for appropriate services.
Client Responsibilities
As a client of East Bay Community Care Network, you agree to:
Respect Others: Treat staff, volunteers, and other clients with dignity, respect, and nonviolence.
Participate Actively: Engage honestly in your care, provide accurate information, and follow through with agreed-upon plans whenever possible.
Communicate Needs: Let us know if your needs change, or if you cannot attend scheduled appointments or meetings.
Maintain Safety: Refrain from bringing weapons, drugs, or alcohol (except prescribed medication) to any Foundation location or service site.
Confidentiality of Others: Respect the privacy and confidentiality of other clients and staff.
Grievance Use: Use the grievance process responsibly to resolve concerns or disagreements.
Purpose
East Bay Community Care Network is committed to ensuring all clients are treated with dignity, respect, and fairness. This policy outlines procedures for clients to express concerns or dissatisfaction regarding services, staff conduct, or decisions made as part of their ICM, CM, or PCC services. It ensures compliance with California Health and Safety Code § 123110 and Welfare & Institutions Code § 5325.1.
Policy Statement
Clients of East Bay Community Care Network have the right to:
File a grievance without fear of retaliation
Receive a timely and fair review of their complaint
Request an appeal or second review if they are not satisfied with the resolution
Continue receiving services while the grievance or appeal is under review (unless doing so poses a health/safety risk)
Definitions
Grievance: A formal or informal complaint about services, treatment, interactions with staff, or program conditions.
Appeal: A formal request to review a decision made about services (e.g., denial, termination, or change in services).
Who May File a Grievance or Appeal
A grievance or appeal may be submitted by:
The client
A legal guardian or authorized representative
An advocate or service provider with the client's permission
How to File a Grievance or Appeal
Grievances and appeals can be submitted:
In person to a staff member
By phone: +1 (510) 598-9137
By email: info@ebccn.org
By mail: East Bay Community Care Network, 31277 Meadowbrook Ave., Hayward, CA 94544
Anonymously, if the client chooses
Grievance and Appeal Forms are available upon request or can be submitted in writing using plain language.
Timeline for Submission
A grievance should be submitted within 30 days of the incident or issue.
An appeal should be submitted within 15 business days of receiving the original decision regarding services.
Review and Resolution Timeline
All grievances will be acknowledged within 5 business days of receipt.
A resolution will be provided within 15 business days of submission.
Appeals will be reviewed and resolved within 20 business days from the date received.
Appeal Process
If a client is dissatisfied with the resolution of a grievance or a decision made about services, they may request an appeal. The process will include:
Review by a Program Supervisor or Director not previously involved in the original decision
Optional client meeting to provide additional context
Written response detailing the outcome of the appeal
Documentation
All grievances and appeals, along with outcomes, are documented and maintained in a secure and confidential file for at least 7 years. This documentation will not be included in the client’s official case file unless requested by the client.
Non-Retaliation
Clients are protected from retaliation or service denial for filing a grievance or appeal. Filing a grievance does not affect your eligibility for services or your treatment plan.
Assistance with Filling
If a client needs help submitting a grievance or appeal, staff members must:
Assist in completing forms or writing statements
Provide interpreter services or disability accommodations as needed
Ensure the process is accessible and trauma-informed
External Resources
If a client is not satisfied with the internal grievance or appeal process, they may also contact:
California Department of Health Care Services (DHCS)
Mental Health Ombudsman: (800) 896-4042
Email: ombuds@dhcs.ca.gov
Disability Rights California: 1-800-776-5746
Local County Behavioral Health Grievance Unit (if applicable)