NOTICE OF PRIVACY PRACTICES

EFFECTIVE DATE OF THIS NOTICE: January 20, 2024

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. OUR PLEDGE REGARDING HEALTH INFORMATION

This practice understands that health information about you and your health care is personal and is committed to protecting your protected health information (“PHI”). This practice creates and maintains records of the care and services you receive in order to provide quality care and comply with legal requirements.

This Notice applies to all records of your care generated by this mental health practice. It describes how PHI may be used and disclosed, your rights regarding your PHI, and the obligations of this practice.

This practice is required by law to:

• Maintain the privacy of your PHI

• Provide you with this Notice of Privacy Practices

• Follow the terms of the Notice currently in effect

This practice reserves the right to change the terms of this Notice. Any changes will apply to all PHI maintained. The revised Notice will be available upon request, in the office, and on the website.

II. HOW PHI MAY BE USED AND DISCLOSED

Treatment, Payment, and Health Care Operations

PHI may be used or disclosed without your written authorization for treatment, payment, or health care operations. This includes consultations with other licensed health care providers, coordination of care, referrals, and administrative activities necessary to operate the practice.

Disclosures for treatment purposes are not limited to the minimum necessary standard, as full access to relevant information is often required to provide appropriate care.

Lawsuits and Disputes

PHI may be disclosed in response to a court or administrative order, subpoena, discovery request, or other lawful process, provided appropriate legal requirements are met.

III. USES AND DISCLOSURES REQUIRING AUTHORIZATION

Psychotherapy Notes

Psychotherapy notes are kept as defined by 45 CFR §164.501. Use or disclosure of psychotherapy notes requires your written authorization unless the disclosure is:

• For treatment by this practice

• For training or supervision of mental health professionals

• To defend against legal action initiated by you

• For health oversight activities

• Required by law

• Required by a coroner

• Necessary to prevent a serious threat to health or safety

Marketing and Sale of PHI

This practice does not use or disclose PHI for marketing purposes and does not sell PHI.

IV. USES AND DISCLOSURES NOT REQUIRING AUTHORIZATION

PHI may be used or disclosed without authorization when required or permitted by law, including for:

• Public health and safety activities

• Health oversight activities

• Judicial or administrative proceedings

• Law enforcement purposes

• Coroners or medical examiners

• Research purposes

• Specialized government functions

• Workers’ compensation compliance

• Appointment reminders and information about treatment alternatives or health-related services

V. DISCLOSURES WITH OPPORTUNITY TO OBJECT

PHI may be disclosed to family members, friends, or others involved in your care or payment for care unless you object. Consent may be obtained retroactively in emergency situations.

VI. YOUR RIGHTS REGARDING PHI

You have the right to:

• Request limits on certain uses and disclosures of PHI

• Request restrictions for services paid out-of-pocket in full

• Request confidential communications

• Inspect and obtain copies of your PHI, excluding psychotherapy notes

• Request electronic copies of records, including delivery by secure email when available

• Request an accounting of disclosures

• Request corrections or amendments to PHI

• Obtain a paper or electronic copy of this Notice

Requests for access to records will be processed within 30 days of receipt. Reasonable, cost-based fees may apply as permitted by HIPAA.

PRIVACY CONTACT

For questions regarding this Notice or your privacy rights, please contact:

Sarah Haynes, LPC
Email: sarah@healingventures.org