NOTICE OF PRIVACY PRACTICES

EFFECTIVE DATE: November 1, 2022 FOR California

EFFECTIVE DATE: November 1, 2022 FOR Texas

The Core Counseling Services, PLLC, is trained in HIPAA compliance and security, the AMHCA, ACA Codes of Ethics, and California and Texas statutes and regulations, and we aim to ensure the confidentiality of all communications with clients, both in-person and electronically.

California and Texas NOTICE OF PRIVACY PRACTICES

The Health Insurance Portability and Accountability Act Protected Health Information (HIPAA) is a federal law that provides privacy protections and patient rights about the use and disclosure of your (PHI) for the purposes of treatment, payment, and health care operations The Core Counseling Services, PLLC is dedicated to maintaining the privacy of all information that you disclose. However, there are sometimes when the law requires the release of certain information. These regulations are complex, and this notice is a shorter version of the full legal text. This notice describes how health information about you may be used and disclosed and how you can get access to this information.

I. USES AND DISCLOSURES FOR TREATMENT, PAYMENT, & HEALTHCARE OPERATIONS

 The Core Counseling Services, PLLC may use or disclose your Protected Health Information (PHI) for treatment, payment, and healthcare operations purposes with your consent.

To help clarify these terms, here are some definitions

·       PHI
“PHI” refers to information in your health record that could identify you.

·       Treatment
“Treatment” is when The Core Counseling Services, PLLC provides, coordinates, or manages your health care and other services related to your health care. An example of treatment would be when your clinician consults with another healthcare provider, such as your family physician or another therapist.

·       Payment
“Payment” is when The Core Counseling Services, PLLC obtains reimbursement for your healthcare. Examples of payment are when we disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.

·       Health Care Operations
“Health Care Operations” are activities that relate to the performance and operation of The Core Counseling Services, PLLC. Examples of healthcare operations are quality assessment and improvement activities, business-related matters, such as audits and administrative services, and case management and care coordination.

·       ‍Use
“Use” applies only to activities within the practice suite, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.

·       ‍Disclosure
“Disclosure” applies to activities outside of the practice suite, such as releasing, transferring, or providing access to information about you to other parties.

·       ‍Authorization
“Authorization” is your written permission to disclose confidential mental health information. All authorizations to disclose must be on a specific legally required form.

II. OTHER USES AND DISCLOSURES REQUIRING AUTHORIZATION

The Core Counseling Services, PLLC may use or disclose PHI for purposes outside of treatment, payment, and healthcare operations when your appropriate authorization is obtained. An “authorization,” as noted above, is written permission above and beyond the general consent that permits specific disclosures.  In those instances when The Core Counseling Services, PLLC is asked to provide information for purposes outside of treatment, payment, and healthcare operations, we will obtain authorization from you before releasing this information.  We will also need to obtain authorization before releasing your psychotherapy notes. “Psychotherapy notes” are notes that your clinician has made about your conversations during a private, group, joint, or family counseling session, which are kept separate from the rest of your medical record.  These notes are given a greater degree of protection than PHI.

1.     Psychotherapy Notes, any use or disclosure of such notes requires your authorization unless the use or disclosure is:
a. For my use in treating you.
b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
c. For my use in defending myself in legal proceedings instituted by you.
d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
e. Required by law and the use or disclosure is limited to the requirements of such law.
f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
g. Required by a coroner who is performing duties authorized by law.
h. Required to help avert a serious threat to the health and safety of others.

2.     Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.

3.     Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.

You may revoke all such authorizations (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that

1.     The Core Counseling Services, PLLC has relied on that authorization; or

2.     the authorization was obtained as a condition of obtaining insurance coverage, and if the law provides the insurer the right to contest the claim under the policy.

The Core Counseling Services, PLLC will also obtain an authorization form from you before using or disclosing PHI in a way that is not described in this Notice.

III. USES AND DISCLOSURES WITH NEITHER CONSENT NOR AUTHORIZATION

The Core Counseling Services, PLLC may use or disclose PHI without your consent or authorization in the following circumstances:

·       Child Abuse
‍If your clinician, in their professional capacity, has reasonable cause to believe that a minor child is suffering physical or emotional injury resulting from abuse inflicted upon him or her and causes harm or substantial risk of harm to the child’s health or welfare (including sexual abuse), or from neglect (including malnutrition), they must immediately report such knowledge or suspicions to the California and Texas Department of Social Services or other appropriate authority.

·       Adult and Domestic Abuse
If your clinician has reasonable cause to believe that an elderly person (age 60 or older) is suffering from or has died as a result of abuse, they must immediately make a report to the California and Texas Department of Elder Affairs. They must also make a report to the Disabled Persons Protection Commission and/or other appropriate agencies if they have reasonable cause to believe that a mentally or physically disabled person is suffering from or has died as a result of a reportable condition, which includes non-consensual sexual activity. They need not report abuse if you are a disabled person, and you invoke the therapist-patient privilege to maintain confidential communications.

·       Health Oversight
The Board of Registration of Allied Mental Health and Human Services Professionals has the power, when necessary, to subpoena relevant records should your clinician be the focus of an inquiry or investigation.

·       Judicial or Administrative Proceedings
If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and The Core Counseling Services, PLLC will not release information without written authorization from you or your legally appointed representative, or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. You will be informed in advance if this is the case.

·       Serious Threat to Health or Safety
If you communicate to your clinician an explicit threat to kill or inflict serious bodily injury upon an identified person and you have the apparent intent and ability to carry out the threat, your clinician must take reasonable precautions. Reasonable precautions may include warning the potential victim, notifying law enforcement, or arranging for your hospitalization. Your clinician must also do so if they know you have a history of physical violence and believe there is a clear and present danger that you will attempt to kill or inflict bodily injury upon an identified person. Furthermore, if you present a clear and present danger to yourself and refuse to accept further appropriate treatment, and they have a reasonable basis to believe that you can be committed to a hospital, they must seek said commitment and may contact members of your family or other individuals if it would assist in protecting you.

·       Worker’s Compensation
If you file a worker’s compensation claim, your records relevant to that claim will not be confidential to entities such as your employer, the insurer, and the Division of Worker’s Compensation.

·       Appointment Reminders
The Core Counseling Services, PLLC may use PHI to remind you of an appointment.

·       Business Associates
The Core Counseling Services, PLLC may use/disclose PHI to contractors, agents, and other business associates who need the information to assist The Core Counseling Services, PLLC with obtaining payment or carrying out its business operations. If The Core Counseling Services, PLLC discloses your PHI to a business associate, The Core Counseling Services, PLLC will have a written contract with that business associate to ensure that it also agrees to protect your PHI.

There may be additional disclosures of PHI that The Core Counseling Services, PLLC is required or permitted by law to make without your consent or authorization; however, the disclosures listed above are the most common.

IV. BREACH NOTIFICATION PROVISIONS

·       When The Core Counseling Services, PLLC becomes aware of or suspects a breach of PHI, we will conduct a risk assessment. We will keep a written record of that risk assessment.

·       Unless The Core Counseling Services, PLLC determines that there is a low probability that PHI has been compromised, you will be given notice of the breach.

·       The risk assessment can be done by a business associate if involved in the breach. While the business associate will conduct a risk assessment of a breach in its control, The Core Counseling Services, PLLC will provide any required notice to patients and Health and Human Services.

V. PATIENT’S RIGHTS AND THERAPIST’S DUTIES

PATIENT’S RIGHTS

·       Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, The Core Counseling Services, PLLC is not required to agree to a restriction that you request.

·       Right to Receive Confidential Communications by Alternative Means and at Alternative Locations
You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are in therapy. Upon your request, we will send your bills to another address.)

·       Right to Inspect and Copy
You have a right to access PHI. The Core Counseling Services, PLLC may deny your access to PHI under certain circumstances. However, in some cases, you may have this decision reviewed. On your request, The Core Counseling Services, PLLC will discuss with you the details of the request and denial process.

·       Right to Amend
You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. The Core Counseling Services, PLLC may deny your request. On your request, we will discuss with you the details of the amendment process.

·       Right to an Accounting
You generally have the right to receive an accounting of disclosures of PHI. On your request, The Core Counseling Services, PLLC will discuss with you the details of the accounting process.

·       Right to a Paper Copy
You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive the Notice electronically.

·       Right to Restrict Disclosures When You Have Paid for Your Care Out-of-Pocket
You have the right to restrict certain disclosures of PHI to a health plan when you pay out-of-pocket in full for services with Comfort Counseling Center PLLC.

·       Right to Be Notified if There is a Breach of Your Unsecured PHI
You have a right to be notified if: (a) there is a breach (a use or disclosure of your PHI in violation of the HIPAA Privacy Rule) involving your PHI; (b) that PHI has not been encrypted to government standards; and (c) our risk assessment fails to determine that there is a low probability that your PHI has been compromised.

OUR OBLIGATIONS

·       The Core Counseling Services, PLLC is required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI.

The Core Counseling Services, PLLC reserves the right to change the privacy policies and practices described in this Notice. Unless you are notified of such changes, The Core Counseling Services, PLLC is required to abide by the terms currently in effect.

If The Core Counseling Services, PLLC revises its policies and procedures, you will be notified in writing.

Keeping Treatment Records, Massachusetts 262 CMR 8.02: Standards of Conduct Applicable to all Allied Mental Health Practitioners Licensed by the Board of Allied Mental Health and Human Services Professions – Treatment Records are to be kept for the minimum of 7 years from the date of the client’s last professional contact.

Texas Behavioral Health Executive Council and Texas State Board of Examiners of Professional Counselors Rules -Subchapter B. Rule of Practice

(r) In the absence of applicable state and federal laws, rules, or regulations, records held by a licensee must be kept for a minimum of seven (7) years from the date of termination of services with the client, or five (5) years after the client reaches the age of majority, whichever is greater.

(s) Records created by licensees during the scope of their employment by agencies or institutions that maintain client records are not required to comply with (q) and (r) of this section.

Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Rule 64B4-9.001, F.A.C. states in part, “A full record of services shall be maintained for 7 years after the date of the last contact with the client or user.” Definitions related to client records are outlined in Rule 64B4-9.002, F.A.C.

V. QUESTIONS AND COMPLAINTS

If you are concerned that your privacy rights have been violated if you disagree with a decision made about access to your records, or any other complaints,

California

Please send a written complaint to the Department of Consumer Affairs Board of Psychology at 1625 North Market Blvd., Suite N-215 Sacramento CA 95834.

Texas

Texas Behavioral Health Executive Council and Texas State Board of Examiners of Professional Counselors - 333 Guadalupe St, Tower 3, Room 900

Austin, Texas 78701 - Investigations/Complaints 24-hour, toll-free system (800) 821-3205

The Texas Behavioral Health Executive Council investigates and prosecutes professional misconduct committed by marriage and family therapists, professional counselors, psychologists, psychological associates, social workers, and licensed specialists in school psychology. Although not every complaint against or dispute with a licensee involves professional misconduct, the Executive Council will provide you with information about how to file a complaint. Please call 1-800-821-3205 for more information.

The Core Counseling Services, PLLC and its staff will not retaliate against you for exercising your right to file a complaint.

VI. EFFECTIVE DATE, RESTRICTIONS, AND CHANGES TO PRIVACY POLICY

This notice goes into effect on November 1, 2022, for California. This notice goes into effect on November 1, 2022, for Texas. THE CORE COUNSELING Services, PLLC reserves the right to change the terms of this notice and to make the new notice provisions effective for all PHI that we maintain. THE CORE COUNSELING, PLLC will provide you with a revised written notice at your next scheduled appointment following any changes that are made to this notice.

EFFECTIVE DATE OF THIS NOTICE

THIS NOTICE WENT INTO EFFECT ON 11/1/2022 FOR California

THIS NOTICE WENT INTO EFFECT ON 11/1/22 FOR Texas

THIS FORM WILL BE SIGN ANNUALLY ON JANUARY 1ST AND WHEN AMENDED

Acknowledgement of Receipt of Privacy Notice

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box below, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.

BY CLICKING ON THE CHECKBOX BELOW I AM AGREEING THAT I HAVE READ,

UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.