HIPAA Notice of Privacy Practices

Adult & Child Counseling & Psychiatric Center, PA (“we,” “us,” or “our”) is committed to protecting the privacy of your health information. As a healthcare provider, we are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to maintain the privacy of your protected health information (PHI) and to provide you with this Notice of Privacy Practices.

We may use and disclose your protected health information for the following purposes:

• Treatment: We may use and disclose your health information to provide, coordinate, or manage your healthcare and any related services. This includes sharing information with other healthcare providers involved in your care.
• Payment: We may use and disclose your health information to obtain payment for services we provide to you. This includes submitting claims to your insurance company, verifying insurance coverage, and collecting payment from you.
• Health Care Operations: We may use and disclose your health information for our healthcare operations, including quality assessment and improvement activities, training of staff and students, accreditation, licensing, and conducting or arranging for other business activities.

The law permits or requires us to use or disclose your health information without your authorization in the following situations:

• As Required by Law: We will disclose your health information when federal, state, or local law requires it.
• Public Health Activities: We may disclose your health information to public health authorities for purposes such as preventing or controlling disease, injury, or disability, and reporting births, deaths, and reactions to medications.
• Victims of Abuse, Neglect, or Exploitation: We are required by Florida law to report suspected abuse, neglect, or exploitation of a child or a vulnerable adult, including an elderly or disabled adult, to the Florida Department of Children and Families, and we may disclose your health information to a government authority authorized to receive those reports.
• To Prevent a Serious and Imminent Threat: If you communicate a specific threat to cause serious bodily injury or death to an identified or readily available person, and your clinician judges that you have the apparent intent and ability to carry it out imminently, Florida law requires or permits your clinician to disclose enough information to communicate the threat to a law enforcement agency, and permits disclosure to warn the potential victim.
• Health Oversight Activities: We may disclose your health information to agencies that oversee the health care system, including for audits, investigations, inspections, and licensure.
• Judicial and Administrative Proceedings: We may disclose your health information in response to a court or administrative order, or in response to a subpoena where the required assurances about notice to you or a protective order have been provided.
• Law Enforcement: We may disclose your health information to a law enforcement official in the limited circumstances the law allows, such as to respond to a court order or to help identify or locate a suspect, fugitive, material witness, or missing person.
• Coroners, Medical Examiners, and Funeral Directors: We may disclose your health information as necessary for these officials to carry out their duties.
• Organ and Tissue Donation: We may disclose your health information to organizations that handle organ, eye, or tissue procurement, banking, or transplantation.
• Research: We may use or disclose your health information for research that an institutional review board or privacy board has approved, and that has established protections for your privacy.
• Workers' Compensation: We may disclose your health information as authorized by workers' compensation laws.
• Specialized Government Functions: We may disclose your health information for military and veterans activities, national security and intelligence activities, protective services, and correctional institutions, in the circumstances the law allows.
• Family, Friends, and Others Involved in Your Care: We may share information directly relevant to your care with a family member, friend, or other person you identify, or in a disaster relief effort. Where you are present and able to decide, we will give you the opportunity to agree or object first. Where you are not present or are unable to decide, we will use our professional judgment about whether the disclosure is in your best interest.
• Business Associates: We may disclose your health information to companies that perform services for us, such as our electronic health record and secure email providers. Each of them is bound by a written agreement requiring them to protect your information.

The following uses and disclosures of your protected health information will be made only with your written authorization. You may revoke any authorization you provide, at any time, in writing.

• Marketing: Any use or disclosure of your health information for marketing purposes, where we would receive direct or indirect financial remuneration from a third party, requires your prior written authorization.
• Sale of Protected Health Information: We will not sell your protected health information without your written authorization. This includes any disclosure where we receive direct or indirect remuneration from the party receiving the information, except in limited circumstances permitted by HIPAA (such as public-health activities, research meeting specific requirements, or a permitted business associate transaction).
• Psychotherapy Notes: Most uses and disclosures of psychotherapy notes require your written authorization. Psychotherapy notes are notes recorded by a mental health professional documenting or analyzing the contents of a counseling session, kept separate from the rest of your medical record. They do not include your medication prescription and monitoring, session start and stop times, the modalities and frequency of your treatment, results of clinical tests, or a summary of your diagnosis, functional status, treatment plan, symptoms, prognosis, and progress. The law allows us to use or disclose psychotherapy notes without your authorization in a limited set of situations: use by the clinician who wrote them for your treatment, use by our practice for training staff and students in mental health, use by our practice to defend ourselves in a legal action or other proceeding you bring, disclosure to the Secretary of Health and Human Services for a compliance investigation, disclosure required by law, oversight of the clinician who wrote them, disclosure to a coroner or medical examiner, and disclosure to prevent a serious and imminent threat to health or safety.
• Other Uses and Disclosures: Any use or disclosure of your protected health information not described in this Notice or otherwise permitted by law will be made only with your written authorization.

Some of the care we provide involves records protected by an additional federal law, 42 CFR Part 2, which covers records of substance use disorder diagnosis, treatment, or referral for treatment. For those records we follow that law's requirements in addition to HIPAA, and where the two differ we follow the stricter rule.

Records protected by 42 CFR Part 2, and testimony describing what those records contain, may not be used or disclosed in any civil, criminal, administrative, or legislative proceeding against you unless you give specific written consent, or a court issues an order after you or the holder of the record has been given notice and an opportunity to be heard. A court order authorizing use or disclosure must also be accompanied by a subpoena or similar legal requirement compelling disclosure before the record is used or disclosed.

Florida law protects mental health information more strictly than HIPAA does in several respects, and where that is the case we follow Florida law. Communications between a patient and a psychiatrist are confidential under section 456.059, Florida Statutes, and communications between a patient or client and a licensed mental health counselor, clinical social worker, or marriage and family therapist are confidential under section 491.0147. Section 456.057 separately limits who may receive your records or discuss your condition without your written authorization.

These statutes also make certain disclosures mandatory rather than optional. Where Florida law requires your clinician to disclose information, such as the duty to communicate a specific threat described in section 03 above, that disclosure will be made.

You have the following rights regarding your protected health information. To exercise any of them, submit a written request to our Privacy Officer, whose contact information appears at the end of this Notice.

• Right to Access: You have the right to inspect and obtain a copy of your health information that we maintain. We may charge a reasonable, cost-based fee for providing copies.
• Right to Amend: If you believe that information in your record is incorrect or incomplete, you have the right to request that we amend your health information. We may deny your request in certain circumstances.
• Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we have made of your health information for purposes other than treatment, payment, or health care operations.
• Right to Request Restrictions: You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or health care operations. We are not required to agree to your request, with one exception: if you pay in full, out of pocket, for a service, we must agree not to share information about that service with your health plan for payment or operations purposes, unless the law requires us to share it.
• Right to Confidential Communications: You have the right to request that we communicate with you about your health information in a certain way or at a certain location. For example, you may request that we contact you only at your work phone number.
• Right to a Paper Copy: You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically.
• Right to Be Notified of a Breach: You have the right to be notified if a breach occurs that compromises the privacy or security of your health information.

If you have legal authority to make health care decisions for another person, we will generally treat you as that person's personal representative and give you the same rights over their health information that they would have. We may decline to do so where the law allows, for example where we reasonably believe that treating you as the personal representative could endanger the patient.

Parents and legal guardians are usually the personal representatives of their minor children. Florida law provides exceptions. Under section 394.4784, Florida Statutes, a minor 13 or older who is experiencing an emotional crisis and perceives the need for professional help may request and receive a limited number of outpatient mental health evaluation, crisis intervention, therapy, or counseling visits without parental consent. Those services do not include medication, and a clinician is not required to provide them. Where a minor lawfully consents to their own care, we may be required to treat the minor, rather than the parent, as the person who controls that information. If you have questions about how this applies to your family, please speak with our Privacy Officer.

We are required to:

• Maintain the privacy of your protected health information.
• Provide you with this Notice of our legal duties and privacy practices.
• Notify you if a breach occurs that compromises the privacy or security of your protected health information.
• Follow the terms of the Notice currently in effect.
• Notify you if we are unable to agree to a requested restriction on the use or disclosure of your health information.
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our privacy practices and the terms of this Notice at any time. Any changes will apply to health information we already have about you as well as any information we receive in the future. We will post a copy of our current Notice in our office and on our website. You may request a copy of the most current Notice at any time.

Information we disclose under this Notice may be redisclosed by the person who receives it and may no longer be protected by federal privacy law. This does not apply to records protected by 42 CFR Part 2, which carry restrictions on redisclosure that follow the record.

All clinical records and protected health information are stored within InSync, our practice management and electronic health records platform, which represents to us that it maintains encryption in transit and at rest, role-based access controls, and audit logging. Adult & Child Counseling & Psychiatric Center, PA has executed a Business Associate Agreement (BAA) with the platform provider governing the handling of all protected health information.

This marketing website does not store, process, or transmit any protected health information.

Language assistance services and appropriate auxiliary aids and services are available to you free of charge and in a timely manner. Call (321) 779-9838. This Notice is available in other languages and in alternate formats on request. Our Notice of Nondiscrimination and Language Assistance carries the full set of translated notices.

If you believe that your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services (HHS). To file a complaint with HHS, visit hhs.gov/hipaa/filing-a-complaint.

We will not retaliate against you for filing a complaint. All complaints must be submitted in writing.

If you have questions about this Notice, wish to exercise any of your rights described above, or want to file a complaint about our privacy practices, please contact our designated Privacy Officer: