HIPAA

Privacy Statement

This notice describes how medical information about you may be used and disclosed and how you can get access to
this information. This policy also describes how THE BRIDGE may use other information about you. Please review it
carefully.

Who We Are: This Notice describes the privacy practices of THE BRIDGE, their employees (including counselors, nurses,
and treatment aides), and other individuals that work at THE BRIDGE. (THE BRIDGE refers to the THE BRIDGE’s residential
substance abuse treatment centers, intensive outpatient centers, counselor offices, and other facilities.)

1. Our Privacy Obligations: Certain laws require THE BRIDGE to maintain the privacy of medical and health
   information about you (“Protected Health Information”) and to provide you with this Notice of our legal duties
   and privacy practices with respect to Protected Health Information. When we use or disclose Protected Health
   Information, we are required to abide by the terms of this Notice (or other notice in effect at the time of the
   use or disclosure).
2. Uses and Disclosures with Your Consent or Your Authorization
   1. Use and Disclosure With Your Consent. As a condition of treatment, except in
      an emergency or other special circumstances, we will ask you to read and sign a written consent (“Your
      Consent”) to our use and disclosure of Protected Health Information for purposes of treatment provided
      to you, obtaining payment for services provided to you, and for our health care operations (e.g.,
      internal administration, quality improvement, and customer service), as detailed below:
      • Treatment. We use and disclose Protected Health Information to provide
        treatment and other services to you; for example, to diagnose and treat your injury or
        illness. In addition, we may contact you to provide appointment reminders or information
        about treatment alternatives or other health-related benefits and services that may be
        of interest to you.
      • Payment. We may use and disclose Protected Health Information to obtain
        payment for services that we provide to you at a BRIDGE facility. For example, we may
        use or disclose
        Protected Health Information to claim and obtain payment from your health insurer, HMO,
        or other company that arranges or pays the cost of some or all of your health care
        (“Your
        Payer”), and to verify that Your Payer will pay for health care.
      • Health Care Operations. At THE BRIDGE, we use and disclose Protected
        Health Information for our health care operations, which include internal administration
        and planning and various activities that improve the quality and cost effectiveness of
        the care that we deliver to you.
   2. Use or Disclosure with Your Authorization. As described above, Your Consent only permits us to use Protected Health
      Information for purposes of treatment, payment, and our health care operations. We may use or disclose Protected Health
      Information for any reason other than treatment, payment, and health care operations only when (1) you give us your
      authorization on our authorization form (“Your Authorization”) or (2) there is an exception described in Section IV
      below.
3. Uses and Disclosures Without Your Consent or Your Authorization
   1. Use or Disclosure For Treatment, Payment, and Health Care Operations Without Your Consent or Your Authorization. At
      THE BRIDGE, we may use or disclose Protected Health Information for purposes of treatment, obtaining payment, and our
      health care operations without Your Consent or Your Authorization under the following three circumstances: (1) when you
      require emergency treatment; (2) when we are required by law to treat you and we attempt to obtain Your Consent, but are
      unable to obtain it; and (3) when we attempt to obtain Your Consent but are unable to obtain it due to substantial
      barriers to communicating with you (e.g., you are unconscious or otherwise incapacitated) and we reasonably infer that
      you would have consented in the absence of the barriers.
   2. Disclosure to Relatives and Close Friends. When you are present in a BRIDGE facility and are capable of communicating, we may use or disclose Protected Health
      Information to a family member, other relative, a close personal friend, or to any other person identified by you, if we
      (1) obtain your agreement; (2) provide you with the opportunity to object to the disclosure and you do not object; or
      (3) reasonably infer that you do not object to the disclosure.
      
      

      If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided
      because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether
      a disclosure is in your best interests. If we disclose information to a family member, other relative, or a close
      personal friend, we would disclose only information that is directly relevant to the person’s involvement with your
      health care.

   3. Fundraising Communications. We may contact you to request a tax deductible contribution to support important activities
      of THE BRIDGE. In connection with any fundraising, we may disclose to our fundraising staff demographic information
      about you (e.g., your name, address, and phone number) and dates of health care that we provided to you.
   4. Marketing Communications. We may use or disclose Protected Health Information to identify health-related services and products that may be
      beneficial to your health and then contact you about the services and products.
   5. Public Health Activities. We may disclose Protected Health Information for the following public health activities and purposes: (1) to report
      health information to public health authorities for the purpose of preventing or controlling disease, injury, or
      disability, as required by law and public health concerns; (2) to report child abuse and neglect to public health
      authorities or other government authorities authorized by law to receive such reports; (3) to report information about
      products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been
      exposed to a communicable disease or may otherwise be at risk to contracting or spreading a disease or condition; and
      (5) to report information to your employer as required under laws addressing work related illnesses and injuries or
      workplace medical surveillance.
   6. Victims of Abuse, Neglect, or Domestic Violence. We may disclose Protected Health Information without Your Consent or Authorization to a government authority, including
      a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic
      violence, if we reasonably believe you are a victim of abuse, neglect, or domestic violence.
   7. Health Oversight Activities. We may disclose Protected Health Information to a health oversight agency that oversees the health care system and
      ensures compliance with the rules of government health programs such as Medicare or Medicaid.
   8. Judicial and Administrative Proceedings. We may disclose Protected Health Information in the course of a judicial or administrative proceeding in response to a
      legal order or other lawful process.
   9. Law Enforcement Officials. We may disclose Protected Health Information to the police or other law enforcement officials as required by law or in
      compliance with a court order.
   10. Health or Safety. We may disclose Protected Health Information to prevent or lessen a serious and imminent threat to a person’s or the
       public’s health or safety.
   11. Specialized Government Functions. We may disclose Protected Health Information to units of the government with special functions, such as the U.S.
       military or the U.S. Department of State.
   12. Decedents. We may disclose Protected Health Information to a coroner or medical examiner as authorized by law.
   13. Organ and Tissue Procurement. We may disclose Protected Health Information to organizations that facilitate organ, eye, or tissue procurement,
       banking, or transplantation.
   14. Research. We may use or disclose Protected Health Information without your consent or authorization if our Institutional Review
       Board or Privacy Board approves a waiver of authorization for disclosure.
   15. Workers’ Compensation. We may disclose Protected Health Information as necessary to comply with workers’ compensation laws.
4. Your Individual Rights
   1. For Further Information; Complaints. If you desire further information about your privacy rights, are concerned that we have violated your privacy rights, or
      disagree with a decision that we made about access to Protected Health Information, you may contact our Privacy Officer.
      You may also file written complaints with the Director, Office of Civil Rights of the U.S. Department of Health and
      Human Services. Upon request, the Privacy Office will provide you with the correct address for the Director. We will not
      retaliate against you if you file a complaint with the Director or us.
   2. Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of Protected Health Information (1) for treatment, payment, and
      health care operations, (2) to individuals (such as a family member, other relative, close personal friend, or any other
      person identified by you) involved with your care or with payment related to your care, or (3) to notify or assist in
      the notification of such individuals regarding your location and general condition. While we will consider all requests
      for additional restrictions carefully, we are not required to agree to a requested restriction.
   3. Right to Receive Confidential Communications. You may request, and we will accommodate, any reasonable written request for you to receive Protected Health Information
      by alternative means of communication or at alternative locations.
   4. Right to Inspect and Copy Your Health Information. You may request access to your medical record file, as well as your enrollment, payment, claims adjudication, case,
      medical management records, and your billing records maintained by us in order to inspect and request copies of the
      records. Under limited circumstances, we may deny you access to a portion of your records. If you request a copy or
      copies of your record, you will be charged a cost-based fee for each copy.
   5. Right to Amend Your Records. You have the right to request that we amend Protected Health Information maintained in your medical record file,
      enrollment, payment, claims adjudication, case, medical management records, or billing records. We will comply with your
      request unless we believe that the information that would be amended is accurate and complete or other special
      circumstances apply.
   6. Right to Receive Paper Copy of This Notice. Upon request, you may obtain a paper copy of this Notice, even if you agreed to receive such notice electronically.
5. Effective Date and Duration of This Notice
   1. Effective Date. This Notice describes the privacy policy of THE BRIDGE that will become effective on or before April 14, 2003, the date
      that federal law specifies for these protections of Protected Health Information. Prior to the effective date, THE
      BRIDGE will continue to protect your Protected Health Information as required by other applicable laws, regulations, and
      policies.
   2. Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective
      for all Protected 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 waiting areas around THE BRIDGE Facilities, and
      on our Internet site at https://www.bridgeinc.org. You also may obtain any new notice by contacting the Privacy Officer.
6. Privacy Officer

   You may contact the Privacy Officer at:

   Privacy Officer The Bridge, Inc.,
   3232 Lay Springs Road, Gadsden, AL 35904
   info@bridgeinc.org

​Child Nutrition Program

The Bridge Wellness Policy

The Bridge is committed to the optimal development of every client. We believe that for clients to have the opportunity
to achieve personal, academic, developmental, and social success, we need to create a positive, safe, and healthy
learning environment. This policy outlines The Bridge’s approach to ensuring environments and opportunities for all
clients to practice healthy eating and physical activity behaviors throughout the day. This policy applies to all
clients enrolled in a residential program on the Gadsden campus of The Bridge. The designated staff member for
implementation of this policy is the Performance Improvement Director of The Bridge.
This policy and any subsequent revision will be maintained on The Bridge web site at https://www.bridgeinc.org under the
compliance tab for public review and comment.

1. Wellness Committee

   The Bridge has appointed a Wellness Committee that is made up of representatives of the Northwood program, the nursing department, food services department and administrative staff. This committee will meet at least one
   time per year to develop an annual plan, review satisfaction data, menus, critical incidents, and compliance with this
   policy. Recommendations or suggested changes will be submitted to senior administrative staff for review and possible
   actions. An annual report will also be prepared and will be available for review by any stakeholder.

   Leadership

   Senior administrative staff (The Bridge Executive Committee) is made up of the Executive Director, Associate Executive
   Director, Performance Improvement Director, and Clinical Director. This wellness leadership team meets monthly and will be actively involved in ensuring on-going compliance with this policy.

   Public Involvement

   The Bridge will solicit input from teachers, campus employees, clients and family members in the development,
   implementation and compliance with the Wellness Plan. This will be done through staff meetings, family counseling
   sessions and satisfaction surveys from clients.

2. Wellness Policy Implementation

   Implementation Plan

   The Wellness Committee will develop an annual implementation plan. This plan will include goals and objectives for
   improvement and corrections, as well as the assignment of staff to be responsible for each action item. Records will be
   kept of all meetings of the Wellness Committee, as well as the progress made on each identified goal in the
   implementation plan. All records related to the Wellness Policy and the implementation plan will be maintained on file
   and will be available during any compliance/audit visit. These records will also be available for public review.

3. Nutrition

   School Meals

   The Bridge is committed to serving healthy meals to children, with plenty of fruits, vegetables, whole grains, and
   fat-free and low-fat milk; moderate in sodium, low in saturated fat, and zero grams trans-fat per serving (nutrition
   label or manufacturer’s specification); and to meet the nutrition needs of clients within their calorie requirements.
   The meal program aims to improve the diet and health of clients, help mitigate childhood obesity, model healthy eating
   to support the development of lifelong healthy eating patterns, and support healthy choices while accommodating cultural
   food preferences and special dietary needs.
   The Bridge participates in the USDA child nutrition program, including the National School Lunch Program (NSLP), the
   School Breakfast Program (SBP). Meals served at The Bridge:

   • Are accessible to all clients.
   • Are appealing and attractive to children.
   • Are served in clean and pleasant settings.
   • Meet or exceed current nutrition requirements established by local, state, and Federal statutes and regulations. (The
     Bridge offers reimbursable school meals that meet USDA nutrition standards.)
   • Menus will be posted and will include nutrient content and ingredients.
   • Menus will be created/reviewed by a Registered Dietitian or other certified nutrition professional.
   • Meals are administered by a team of child nutrition professionals.
   • The Bridge child nutrition program will accommodate clients with special dietary needs.
   • Clients will be allowed at least 10 minutes to eat breakfast and at least 20 minutes to eat lunch, counting from the
     time they have received their meal and are seated. Meals are served at a reasonable and appropriate time of day.

   Marketing and advertising of food and beverages is not allowed on the campus of The Bridge.

   Staff Qualifications and Professional Development

   All school nutrition program directors, managers, and staff will meet or exceed hiring and annual continuing
   education/training requirements as required by the USDA. These school nutrition personnel will receive continuous
   training relevant to their job.

   Water

   To promote hydration, free, safe, unflavored drinking water will be available to all clients throughout the day. The
   Bridge will make drinking water available where meals are served during mealtimes. All water sources and containers will
   be maintained on a regular basis to ensure good hygiene standards.

   Nutrition Education

   The Bridge aims to teach, model, encourage, and support healthy eating by clients. We will provide nutrition education
   and engage in nutrition promotion that will encourage clients to eat healthy during and after leaving the campus
   programs of The Bridge.

4. Physical Activity

   In addition to proper nutrition, The Bridge campus programs offer recreation activities on a daily basis. These
   activities include numerous sports and games done both outside and in the campus gymnasium. These activities include
   basketball, kickball, softball, and other team activities. A walking track is also available for clients.

5. Triennial Assessments

   An on-going assessment will be conducted to determine compliance with this policy. However, The Bridge will conduct a
   thorough assessment every three years to determine:

   • Overall compliance with the Wellness Policy
   • How the Wellness Policy compares to other model wellness policies, and
   • Progress made in attaining the goals of the Wellness Policy

   The results of the triennial assessments will be made available to the public through The Bridge web site and for anyone
   requesting a copy.

   In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and
   policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA
   programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or
   retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
   Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large
   print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for
   benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal
   Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than
   English.

   To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found
   online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to
   USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form,
   call (866) 632-9992. Submit your completed form or letter to USDA by:

   1. Mail: U.S. Department of Agriculture
      Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW
      Washington, D.C. 20250-9410;
   2. Fax:(202) 690-7442
   3. Email:program.intake@usda.gov.

   The Bridge is an equal opportunity provider.