HIPAA Privacy & Confidentiality Notice

This Notice applies to each of the legal entities affiliated with Monroe Capital Holdings, LLC (“Newport Healthcare”):

Monroe Operations LLC d/b/a Newport Academy
Monroe Operations LLC d/b/a Center for Families
Maryland Health Operations LLC d/b/a Newport Academy
Virginia Health Operations LLC d/b/a Newport Academy
Virginia Health Operations LLC d/b/a Newport Institute
Washington Health Operations LLC d/b/a Newport Academy
Georgia Health Operations LLC d/b/a Newport Academy
Minnesota Health Operations LLC d/b/a Newport Academy
Wisconsin Health Operations LLC d/b/a Newport Academy
Utah Health Operations LLC d/b/a Newport Academy
North Carolina Health Operations LLC d/b/a Newport Academy
Pennsylvania Health Operations LLC d/b/a Newport Academy
Massachusetts Health Operations LLC d/b/a Newport Academy
CA YA Services LLC d/b/a Newport Institute
CT YA Services LLC d/b/a Newport Institute
Minnesota YA Services LLC d/b/a Newport Institute
Washington YA Services LLC d/b/a Newport Institute
PrairieCare LLC
Paragon Residential Treatment for Youth LLC d/b/a/ PrairieCare Residential

The confidentiality of mental health and alcohol and drug abuse client records maintained by Newport Healthcare is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 set forth at 42 U.S.C. § 132d et seq. as well as its implementing regulations at 45 C.F.R. Parts 160 & 164 (“HIPAA”), and the laws and regulations governing the confidentiality of substance use disorder patient records set forth at 42 U.S.C. § 290dd-2 and 42 C.F.R. Part 2 (“Part 2”). Newport Healthcare is a “covered entity” under HIPAA and a “Part 2 program” under Part 2. In addition, state law may provide additional restrictions to the use and disclosure of your health information.

Newport Healthcare participates in an Organized Health Care Arrangement (“OHCA”) under HIPAA. An OHCA is an arrangement that allows Newport Healthcare entities to share health information about our patients to promote the joint operations of the participating entities. The entities covered by this notice, which are listed above, have formed an OHCA and share health information with each other for the treatment, payment, and healthcare operations of the OHCA.

Newport Healthcare is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Newport Healthcare is required by law to abide by the terms of this Notice. In general, Newport Healthcare may not acknowledge to a person outside the Part 2 program that you attend the program, nor disclose any information identifying you as having a substance use disorder or disclose any other protected information except as permitted or required by federal law, described below.

Disclosures Permitted without Your Consent:

HIPAA and Part 2 permit us to use and disclose information without your written authorization in limited circumstances. For example, personnel having a need for health information in connection with their duties arising out of your care within our program and between or among our program and certain administrative entities under which we work may share your health information to coordinate care, evaluate quality, and improve our services. Federal law also permits Newport Healthcare to disclose information without your written consent as follows:

Internal Treatment. To communicate among staff members within any Part 2 programs affiliated with the facility who have a need for the information in connection with their duties to provide diagnosis, treatment, or referral for treatment.
To Qualified Service Organization/Business Associate: We may disclose your information to individuals and organizations providing services to us, such as data processing, billing, laboratory analyses, or legal, accounting, population health management, medical staffing, or other professional services under contract who have agreed to protect the privacy of your information and be bound by Part 2.
To Medical Personnel in a Medical Emergency: We may disclose your information to medical personnel to the extent necessary to treat you in a bona fide medical emergency.
Research: We may disclose your information for research purposes without your consent if certain conditions are met, such as approval by an Institutional Review Board.
Crime on Premises: We may disclose your information to police or other law enforcement officials if you commit a crime on the premises of Newport Healthcare or against Newport Healthcare’s personnel or threaten to commit such a crime.
Reports of Suspected Child Abuse or Neglect and Duty to Warn: We may disclose your information for the purpose of reporting child abuse or neglect to public health authorities or other government authorities authorized by law to receive such reports. We also may have a duty to warn third parties of specific threats of serious and imminent harm and consider our reporting obligations that permit disclosure.
Court Orders with Compulsory Process. The disclosure is allowed by a court order and that order includes a subpoena or other legal mandate requiring that we share your information after notice and an opportunity to be heard is provided to you.
Medical Emergency. To medical personnel in a medical emergency;
Law Enforcement. To law enforcement if you commit, or threaten to commit, a crime in our facilities or against our personnel.
Abuse Reporting. To report suspected child abuse and neglect as required by applicable law.
Research. To qualified personnel for research subject to approval and oversight laws.
Audit and Evaluation Activities. To qualified personnel for audit or program evaluation 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.
Public Health. To a public health authority, if the information has been de-identified.

Disclosures Permitted with Your Consent:

Generally, we may use or disclose your health information when you give your authorization to do so in writing on a form that meets the requirements of applicable laws and regulations. Any such written consent may be revoked by you in writing, except to the extent that Newport Healthcare has already made a disclosure in reliance on your consent. If you wish to revoke your consent, please contact Newport Healthcare’s Privacy Officer using the contact information provided below. The following are some examples of common disclosures for which we must obtain your consent for external disclosures:

Treatment, Payment, and Healthcare Operations (“TPO”). We may use and disclose your Part 2 records for TPO purposes. You may provide a single consent for all future TPO uses or disclosures. If your Part 2 records are shared under a consent for this purpose with another Part 2 program or a HIPAA regulated entity (including the components of Newport Healthcare which are not SUD Programs) your records may be further disclosed by the recipient to the extent permitted by HIPAA, or if the Part 2 program is not subject to HIPAA, to the extent permitted by your consent.
Proceedings Against You. Except where required by a court order, any use or disclosure of your Part 2 records, or testimony relaying the content of such records, in any civil, administrative, criminal, or legislative proceedings against you requires your written consent. Your consent for this purpose must be separate from your consent for any other use or disclosure.
Prescription Drug Monitoring Programs. We may report any medication prescribed or dispensed by the program to the applicable state prescription drug monitoring program (“PDMP”) if required by applicable state law.

Additional Statements Regarding Part 2 Records.

Right to Accounting. In addition to the right to accounting discussed below, if you provided consent to share your Part 2 records through a health information exchange, accountable care organization, care management organization, or other intermediary, you have a right to a list of disclosures by that intermediary for the past 3 years by contacting the Privacy Officer.
Revocation. You have the right to revoke your consent for Part 2 disclosures at any time, except to the extent that action has already been taken in reliance on your consent.
SUD Counseling Notes. A separate consent is required and must specifically address the use and disclosure of SUD counseling notes (if maintained). This consent cannot be combined with any other legal permission.
Redisclosure. If your Part 2-protected information is disclosed with your consent, recipients of that information are generally prohibited from redisclosing it unless permitted by law. However, as described above, records that are disclosed to a part 2 program or HIPAA regulated entity pursuant to the patient’s written consent for TPO may be further disclosed by that part 2 program or HIPAA regulated entity, without the patient’s written consent, to the extent the HIPAA regulations permit such disclosure.

State Laws Regarding Confidentiality and Rights of Minors:

State laws regarding confidentiality of mental health and substance use disorder records and the rights of minors with respect to such information vary among states. To see the laws that apply to you, please review the information below for the state in which you are receiving services from Newport Healthcare:

California

Under California law, a minor who is twelve (12) years of age or older may consent to medical care and counseling related to the diagnosis and treatment of a drug or alcohol-related problem. A minor who is twelve (12) years of age or older may also consent to outpatient mental health or counseling services if, in the opinion of the attending professional person, the minor is mature enough to participate intelligently in the mental health treatment or counseling services. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

Connecticut

Under Connecticut law, a minor may seek out and provide legal consent for treatment or rehabilitation for alcohol or drug dependence, and the fact that the minor sought such treatment or rehabilitation or the fact that the minor is receiving such treatment or rehabilitation may not be disclosed to the minor’s parent or legal guardian without the minor’s consent. Connecticut law allows minors sixteen (16) years of age or older to apply for voluntary admission to an inpatient mental health treatment facility. Additionally, a licensed psychiatrist, psychologist, clinical social worker, or marital and family therapist may provide outpatient mental health treatment to a minor without the consent or notification of a parent or guardian at the request of the minor under certain circumstances. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment. Connecticut law also permits Newport Healthcare to provide some treatment information to your parent/legal guardian if you are receiving treatment solely for mental health, not a substance use disorder, and your provider determines that such disclosure is necessary for your well-being.

Part 2 also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

Georgia

In Georgia, a minor may consent for medical or surgical care or services related to conditions or illnesses arising out of substance use. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

Newport Healthcare and your treating physician may also, but is not obligated to, inform the spouse, parent, custodian, or guardian of the minor as to the treatment given or needed for substance use. Part 2 also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

Maryland

Under Maryland law, a minor has the same capacity as an adult to consent to treatment for or advice about drug abuse and alcoholism. A minor who is twelve (12) years of age or older who is determined by a health care provider to be mature and capable of giving informed consent has the same capacity as an adult to consent to consultation, diagnosis, and treatment of a mental or emotional disorder. A minor who is sixteen (16) years of age or older may apply for voluntary admission to an institution or clinic that provides treatment or other services for individuals who have mental disorders. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

Massachusetts

In Massachusetts, minors aged 12 or older who are found to be drug-dependent by at least two physicians can consent to their own medical care for treatment of that dependency without parental permission (other than methadone maintenance therapy). A minor who is at least 16 years old may commit himself or herself for mental health treatment without parental consent. If you are a minor consistent with the above, and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

However, if you do not fit within the exceptions above, Newport Healthcare must receive your parental consent prior to providing you care. If you parent must consent to the care, your parent may also receive information about your care as your personal representative. Part 2 also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

Minnesota

In Minnesota, a minor may consent to alcohol or drug use evaluation services. In addition, any person 16 years of age or older may request to be admitted to a treatment facility as a voluntary patient for observation, evaluation, diagnosis, care and treatment without making formal written application. Any person under the age of 16 years may be admitted as a patient with the consent of a parent or legal guardian if it is determined by independent examination that there is reasonable evidence that (1) the proposed patient has a mental illness, developmental disability, or chemical dependency; and (2) the proposed patient is suitable for treatment. A minor may also consent to medical, mental, and other health services to determine the presence of or to treat alcohol and other drug abuse. If you are a minor consistent with the above, and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment unless disclosure is necessary for your treatment or otherwise required or permitted by law.

Parents and guardians have access to their minor children’s health records, unless the minor legally consents to services. In those cases, parents or guardians do not have access to the minor’s health records without the minor’s authorization. However, Newport Healthcare may inform a minor’s parent or guardian of treatment if, in its professional’s judgement, failure to inform the parent or guardian would seriously jeopardize the minor’s health. Part 2 also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

North Carolina

In North Carolina, any minor may give effective consent for medical health services for the prevention, diagnosis and treatment of abuse of controlled substances or alcohol or emotional disturbance & mental health conditions. If you are a minor consistent with the above, and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment. However, parental consent is required for admission to a 24-hour facility and certain procedures requiring a higher level of medical risk.

Pennsylvania

Under Pennsylvania law, a minor may consent to the furnishing of medical care or counseling relating to diagnosis or treatment of a substance use disorder. A minor who is fourteen (14) years of age or older may consent to voluntary inpatient mental health treatment or outpatient mental health treatment. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

Utah

In Utah, a minor receiving “tobacco and nicotine cessation services” is authorized to consent for any health care not prohibited by law. If you are a minor seeking these specific services, and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

However, if you do not fit within the exception above, and in most situations, Newport Healthcare must receive your parental consent prior to providing you care. If you parent must consent to the care, your parent may also receive information about your care as your personal representative. Part 2 also permits Newport Healthcare to share information regarding your treatment with your parent or legal guardian if we determine that: (1) your situation poses a substantial threat to the life or physical wellbeing of you or another individual; (2) that this threat may be reduced by communicating relevant facts to your parent or legal guardian; and (3) that you lack the capacity because of extreme youth or a mental or physical condition to make a rational decision regarding whether to disclose information regarding your treatment with your parent or legal guardian.

Virginia

Under Virginia law, a minor is deemed an adult for the purpose of consenting to medical or health services needed in the case of outpatient care, treatment, or rehabilitation for substance abuse, mental illness, or emotional disturbance. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

Washington

Under Washington law, a minor who is thirteen (13) years of age or older may consent to receive inpatient or outpatient treatment for a substance use disorder or mental illness without parental consent. If you are a minor and have consented to receive treatment from Newport Healthcare, Newport Healthcare will obtain your written consent to disclose information regarding your treatment to your parent/legal guardian or your health insurance company in order to obtain payment for your treatment.

Wisconsin

In Wisconsin, except for very limited situation such as in emergencies or where a parent cannot be location, parental consent is required for inpatient substance abuse treatment and mental health treatment. In these situations, Newport Healthcare must receive your parental consent prior to providing you care. If you are a minor aged 12 or older, you can consent to certain limited outpatient services such as screening, assessment, evaluation, preventative or diagnostic services. However, this is does not make your treatment confidential and we must notify your parent as soon as practicable. If your parent must consent to the care, your parent may also receive information about your care as your personal representative.

Your Rights with Respect to Your Health Information:

You have certain rights with respect to your health information under HIPAA and Part 2, including the right to:

Request Restrictions: At your request, we will not disclose information to your health plan if the disclosure is for a health care item or service for which you have paid Newport Healthcare out of pocket in full. You may request additional restrictions on our use and disclosure of your health information for treatment, payment and healthcare operations purposes. Newport Healthcare is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency.
Request Confidential Communications: You have the right to request that we communicate with you by alternative means or at an alternative location. Newport Healthcare will accommodate such requests that are reasonable and will not request an explanation from you.
Request Access: Under HIPAA you also have the right to inspect and copy your own health information maintained by Newport Healthcare except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances.
Request Amendment: You have the right to request that we amend your information in Newport Healthcare’s records. Under certain circumstances, we have the right to deny your request to amend your records and will notify you of this denial as provided in the HIPAA regulations. If your requested amendment to your records is accepted, a copy of your amendment will become a permanent part of the medical record.
Request Accounting of Disclosures: Upon request, you may obtain a list of instances that we have disclosed your health information other than when you gave written authorization or those related to your treatment and payment for services, or our health care operations. The accounting will apply only to covered disclosures prior to the date of your request provided such period does not exceed six years. If you request an accounting more than once during a twelve (12) month period, there may be a charge. You will be told the cost prior to the request being filled.
Be Notified of a Breach: You will be notified in the event we discover a breach has occurred such that your health information may have been compromised.
Receive a Copy of this Notice: Upon request, you may obtain a paper copy of this Notice. Revisions to this Notice:

Newport Healthcare reserves the right to revise the terms of this Notice at any time. If we change this Notice, we may make the new Notice terms effective to all health information that we maintain, including any information created or received prior to issuing the new Notice. If we change this Notice, we will post the new Notice in public access areas at our service sites and on our Internet site at [www.newporthealthcare.com and www.newportinstitute.com]. You may also obtain any new Notice by contacting our Privacy Officer.

Questions and Complaints:

If you have questions about this Notice, desire further information about your privacy and confidentiality rights or would like to file a complaint you may contact Newport Healthcare’s Privacy Officer at 615-701-6816 and privacy@newporthealthcare.com.

If you believe that your privacy rights have been violated, you also may file a written complaint with the Secretary of the United States Department of Health and Human Services. Upon request, we will provide you with the correct address and procedures for submitting a complaint. We will not retaliate against you if you file a complaint.

Violation of the federal law and regulations on Confidentiality of Substance Use Disorder Patient Records is a crime and suspected violations of 42 CFR Part 2 may be reported to the United States Attorney in the district where the violation occurs. Upon request, we will provide you with the appropriate agency contact information if you would like to report a violation.

Effective Date: This Notice became effective on May 1, 2009, was last revised on April 1, 2026. Acknowledgement: I hereby acknowledge that I received a copy of this Notice.

Client Signature:

Date:

Parent/Guardian Signature:

Date:

Newport Healthcare was unable to obtain this acknowledgement of receipt due to:

□ Client refused to sign acknowledgement

□ Client was unable to sign acknowledgement

□ Client left the facility before the end of the assessment and is not entering treatment

□ Other:

Newport Healthcare Staff Signature:

Date: