Grand Rising Wellness Inc. — Notice of Privacy Practices
GRAND RISING WELLNESS
NOTICE OF PRIVACY PRACTICES
Effective Date: February 05, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND PERSONAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR PLEDGE REGARDING YOUR INFORMATION
At Grand Rising Wellness, we understand that information about you, your mental health, recovery, and life situation is deeply personal. We create a record of the peer support, coaching, and respite services you receive to provide quality care and to comply with legal and Medicaid billing requirements. We are required by law to maintain the privacy of this Protected Health Information (PHI) and to provide you with this notice of our legal duties and privacy practices.
YOUR RIGHTS
When it comes to your health information, you have certain rights. You can:
Get an electronic or paper copy of your records: You can ask to see or get a copy of your peer support logs, respite notes, and billing records. We will provide a copy or a summary, usually within 30 days. We may charge a reasonable, cost-based fee.
Ask us to correct your record: You can ask us to correct health information about you that you think is incorrect or incomplete. We may say "no" to your request, but we will tell you why in writing within 60 days.
Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will agree to all reasonable requests.
Ask us to limit what we use or share: You can ask us not to use or share certain information for support coordination, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
Note: If you pay for a service completely out-of-pocket (not through Medicaid) and ask us not to share that information with Medicaid, we will say "yes" unless a law requires us to share it.
Get a list of those with whom we’ve shared information: You can ask for a list (accounting) of the times we’ve shared your health information for up to six years prior to the date you ask, who we shared it with, and why. We will include all disclosures except for those about support/treatment, payment, and health care operations, and certain other disclosures.
Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
File a complaint if you feel your rights are violated: You can complain if you feel we have violated your privacy rights by contacting our Privacy Officer using the information at the end of this notice. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
Share information with your family, close friends, or others involved in your care or payment for your care.
Share information in a disaster relief situation.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
OUR USES AND DISCLOSURES
How do we typically use or share your health information? We windows-typically use or share your information in the following ways:
To Provide Peer Support and Respite Care (Treatment): We can use your health information and share it with other professionals within Grand Rising Wellness or external providers who are treating or supporting you.
Example: A peer support specialist may share notes about your recovery goals with a respite care worker covering an overnight shift to ensure consistency in your support plan.
To Bill Medicaid and Run Our Business (Payment & Operations): We can use and share your health information to bill and get payment from Medicaid or other entities, and to run our organization and improve the quality of our care.
Example: We submit your PHI, service dates, and peer support codes to the state Medicaid billing portal to receive payment for the services rendered.
SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER RECORDS (42 CFR PART 2)
Because Grand Rising Wellness provides peer recovery support and receives Medicaid funding, some or all of the records we maintain regarding substance use disorder (SUD) diagnosis, prognosis, or treatment are subject to strict federal confidentiality protections under 42 CFR Part 2.
Written Consent Required: We will not disclose your SUD records, or any information identifying you as someone seeking or receiving substance use recovery support, to anyone outside of Grand Rising Wellness without your explicit written consent, except in very limited circumstances (such as a bona fide medical emergency, an audit/evaluation, or a specialized court order that complies with Part 2 rules).
Prohibition on Legal Use: Your SUD patient records cannot be used against you in any civil, criminal, administrative, or legislative proceedings, nor can they be used to initiate or substantiate criminal charges or investigate you, unless you give explicit written consent or we are served with a specific court order issued under 42 CFR Part 2.
Single Consent for TPO: Under the February 2026 rules, you may sign a single, broad consent form that allows us to use and disclose your SUD records for Treatment, Payment, and Healthcare Operations (TPO). You have the right to revoke this consent at any time for future disclosures.
OTHER USES AND DISCLOSURES
We are allowed or required to share your information in other ways - usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes.
Comply with the law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Address workers’ compensation, law enforcement, and other government requests: We can use or share health information about you for workers’ compensation claims, for law enforcement purposes (subject to strict Part 2 limitations if SUD records are involved), and with health oversight agencies for activities authorized by law.
Respond to lawsuits and legal actions: We can share health information about you in response to a court or administrative order, or in response to a subpoena. (Note: Subpoenas alone are not sufficient to release Part 2 protected SUD records; a separate Part 2 court order is required.)
OUR RESPONSIBILITIES
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
CHANGES TO THE TERMS OF THIS NOTICE
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
CONTACT INFORMATION
To exercise any of your rights, file a complaint, or ask questions about our privacy practices, please contact our designated Privacy Official:
Grand Rising Wellness
Attn: Privacy Officer
Email: supportgrand@grandrisinginc.com
Phone: 715-400-9682
Address: 2809 E Hamilton Ave #2012 Eau Claire, WI 54701