NOTICE OF PRIVACY PRACTICES (HIPPA)

“Protected Health Information” (PHI) refers to any information that we create or receive, and relates to an individual’s past, present, or future physical or mental health or conditions and related care services or the past, present, or future payment for the provision of health care to an individual; and identifies the individual or there is a reasonable basis to believe the information can be used to identify the individual. PHI includes any such information described above that we transmit or maintain in any form, this includes Psychotherapy Notes. HIPAA and federal law regulate the use and disclosure of PHI when transmitted electronically.

This Notice of Privacy Practices describes how Soul Invitation Counseling LLC may use and disclose your medical PHI to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI, as well as certain obligations Soul Invitation Counseling LLC has regarding the use and disclosure of your health information. We understand that health information about you and your health care is personal and are committed to protecting health information about you. Soul Invitation Counseling LLC and its employees create a record of the care and services you receive as we need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Soul Invitation Counseling LLC.

1. GENERAL POLICIES AND HIPPA

Soul Invitation Counseling LLC believes it may be a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) and thus provides its clients with this Notice of Practices and complies with the procedures and protocols listed herein. If Soul Invitation Counseling LLC is determined not to be a covered entity under HIPAA, it will still follow this Notice of Privacy Practices regarding use and disclosure of PHI; however, the client may not be entitled to the rights set forth in the “Your Rights as a Client” section.

It is Soul Invitation Counseling LLC’s policy to:

·      Fully comply with the requirements of the HIPAA General Administrative Requirements, the Privacy and Security Rules

·      Make sure that PHI that identifies you is kept private.

·      Provide every client this notice of my legal duties and privacy practices with respect to health information called the Notice of Privacy Practices.

·      Follow the terms of the notice that is currently in effect, noting that I can change this notice and the new notice is effective once provided to the client.

·      Obtain from each client an informed Authorization for Release of Protected Health Information form when required.

Soul Invitation Counseling LLC is required to follow all state and federal statutes and regulations governing testing for and reporting of TB, HIV AIDS, Hepatitis, and other infectious diseases, and maintaining the confidentiality of PHI.

2. USES AND DISCLOSURES OF PHI

Your PHI may be used and disclosed by Soul Invitation Counseling LLC and employees including your therapist, office staff and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you. Soul Invitation Counseling LLC may use and disclose PHI, without an individual’s written authorization, for the following purposes:

·      Treatment: using and disclosing your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with another provider including other physicians who may be treating you. This includes consultation with clinical supervisors or other treatment team members and for coverage arrangements during your therapist’s absence, and for sending appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

·      Payment: using and disclosing your PHI to as needed, to obtain payment for your health care services provided by us. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as: deciding eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.

·      Health Care Operations: using and disclosing your PHI to as needed to support the business activities of Soul Invitation Counseling LLC. We will share your PHI with third party business associates that perform various activities (for example, billing or transcription services) for our practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of your PHI.

3. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION

Other permitted and required uses and disclosures that may be made without your authorization or opportunity to agree or object. These situations include:

·      In Compliance with State and/or Federal Laws and Regulations: Soul Invitation Counseling LLC may use or disclose your PHI to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures.

o   Criminal Activity: Consistent with applicable federal and state laws, Soul Invitation Counseling LLC may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Soul Invitation Counseling LLC may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend an individual. Also, when reporting crimes occurring on business premises.

o   Health Oversight: Soul Invitation Counseling LLC may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

o   Abuse or Neglect: Soul Invitation Counseling LLC may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity authorized to receive such information.

o   Legal Proceedings: Soul Invitation Counseling LLC may disclose PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.

§  Responding to lawsuit and legal actions (Disclosure by a court order, in response to a complaint filed against Soul Invitation Counseling LLC, etc. This does not include a request by you or another party for your records).

§  For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

o   Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits.

§  Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

o   Workers’ Compensation: We may disclose your PHI as authorized to comply with workers’ compensation laws and other similar legally-established programs.

o   Medical purposes: to coroners or medical examiners, when such individuals are performing duties authorized by law or to respond to organ and tissue donation requests.

·      Business Associates: Soul Invitation Counseling LLC may enter into contracts with business associates to provide billing, legal, auditing, and practice management services that are outside entities. In those situations, protected health information will be provided to those contractors as is needed to perform their contracted tasks. Business associates are required to enter into a confidentiality agreement maintaining the privacy of the protected health information released to them.

4. SPECIAL AUTHORIZATIONS

Based upon your written authorization, known as a Release of Information (ROI) other uses and disclosures of your PHI can be made beyond those required by law. You may revoke this authorization in writing at any time. If you revoke your authorization, Soul Invitation Counseling LLC will no longer use or disclose your PHI for the reasons covered by your written authorization. Soul Invitation Counseling LLC and its employees are unable to take back any disclosures already made with your authorization.

·      Emergency Contact(s): Soul Invitation Counseling LLC and its employees may provide your PHI to a family member, friend, or other person that you indicate as an emergency contact. By providing the contact, you consent to this person being contacted in emergency situations and minimal necessary release of PHI. Whenever possible, a Release of Information (ROI) will be obtained to specify the information provided, however, the opportunity to consent may be obtained retroactively in emergency situations. Soul Invitation Counseling LLC and its employees are unable to take back any disclosures already made in emergency situations.

Certain categories of information have extra protections by law, and thus require special written authorizations for disclosures.

·      Psychotherapy Notes: Soul Invitation Counseling LLC may keep and maintain “Psychotherapy Notes”, which may include but are not limited to notes Soul Invitation Counseling LLC makes about your conversation during a private, group, joint, or family counseling session, which is kept separately from the rest of your record. These notes are given a greater degree of protection than PHI. These are not considered part of your “client record.” Soul Invitation Counseling LLC will obtain a special authorization before releasing your Psychotherapy Notes.

·      HIV Information: Special legal protections apply to HIV/AIDS related information. Soul Invitation Counseling LLC will obtain a special written authorization from you before releasing information related to HIV/AIDS.

·      Alcohol and Drug Use Information: Special legal protections apply to information related to alcohol and drug use and treatment. Soul Invitation Counseling LLC will obtain a special written authorization from you before releasing information related to alcohol and/or drug use/treatment.

·      You may revoke all such authorizations to release information (PHI, Psychotherapy Notes, HIV information, and/or Alcohol and Drug Use Information) at any time, provided each revocation is in writing, signed by you, and signed by a witness. You may not revoke an authorization to the extent that (1) Soul Invitation Counseling LLC has relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, the law provides the insurer the right to contest the claim under the policy.

5. YOUR RIGHTS

Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights.

·      You have the right to inspect and obtain a copy your PHI. This means you may inspect and obtain a copy of your records about you for so long as we maintain the PHI which is no more than seven years. You may obtain your medical and billing records and any other records that we use for making decisions about you.

o   As permitted by federal or state law, we may charge you a reasonable copy fee for a copy of your records. Soul Invitation Counseling LLC will provide you with a summary of your health information usually within 30 days of your written request.

o   Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to PHI. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer (Casey Dunne, LPCC, casey@soulinvitationcounselingllc.com) if you have questions about access to your medical record.

·      You have the right to ask us to correct your mental health 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’ll tell you why in writing within 60 days.

·      You have the right to request a restriction of your PHI. This means you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment or health care operations if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full. Your request must state the specific restriction requested and to whom you want the restriction to apply.

·      You have the right to request confidential communications/choose how Soul Invitation Counseling LLC sends PHI to you. You have the right to ask Soul Invitation Counseling LLC to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and we will agree to all reasonable requests.

·      You have the right to receive an accounting of certain disclosures we have made, if any, of your PHI. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement (as provided in the privacy rule) or as part of a limited data set disclosure. You have the right to receive specific information regarding these disclosures that occur after January 1, 2009. The right to receive this information is subject to certain exceptions, restrictions and limitations. We will charge a reasonable, cost-based fee for this request.

·      You have the right to get a paper and/or electronic copy of this Notice.

·      You have the right to 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. We will make sure the person has this authority and can act for you before we take any action.

6. COMPLAINTS

You can complain if you feel we have violated your rights by contacting us using the information on this form. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. • We will not retaliate against you for filing a complaint. You may also file a complaint with the local regulatory agency that oversees the license of your therapist. Please note that these regulatory agencies may direct you to file your complaint with the U.S. Department of Health and Human Services Office for Civil Rights listed above and may not be able to take any action on your behalf.

7. SAFEGUARDS OF PHI

As a covered entity under the Privacy and Security Rules, Soul Invitation Counseling LLC is required to reasonably safeguard PHI from impermissible uses and disclosures. Safeguards may include, but are not limited to the following:

·      Not leaving test results or records unattended where third parties without a need to know can view them.

·      Any PHI received as an employee of Soul Invitation Counseling LLC about a client or potential client, may not be used or disclosed to unauthorized individuals. Soul Invitation Counseling LLC may only use and disclose such PHI as described above.

·      When speaking with a client about their PHI where third parties could possibly overhear, the conversation will be moved to a private area.

·      Seeking legal counsel or clinical supervision in uncertain situations and/or incidences.

·      Obtaining a Business Associates Agreement with those third-parties that have access to and/or store client information. Some of the functions of the practice may be provided by contracts with business associates. For example, some of the billing, legal, auditing, and practice management services may be provided by contracting with outside entities to perform those services.

·      Obtaining your verbal or written consent prior to sending any PHI by unsecure electronic transmissions.

·      Providing information on Soul Invitation Counseling LLC’s electronic record-keeping.

·      Cyber security protection including two passwords (i.e device and EHP site) and/or dual factor authentication to access records.

7. CHANGES TO THIS NOTICE
Soul Invitation Counseling LLC can change the terms of this notice, and the changes will apply to all information Soul Invitation Counseling LLC has about you. The new notice will be available upon request.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive upon request a “Good Faith Estimate” explaining how much your medical and mental health care will cost. You have the right to receive upon request a Good Faith Estimate for the total expected cost of any non- emergency healthcare services, including psychotherapy services. You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

Learn More

For mental health emergencies call 988. Services available in the United States 24/7/365. 

Colorado Crisis Line: 1-844-493-8255 or text “TALK” to 38255  

LGBTQ National Hotline: (888) 843-4564

Trevor Project (LGBTQ+ youth): text START to 678-678

National Alliance on Mental Illness (NAMI) HelpLine: (800) 950-NAMI (6264)

National Domestic Violence Hotline: (800) 799-7233

Self Harm Crisis Line: Text HOME to 741741

Mental Health Partners Crisis Line: (303) 447-1665. 

National Sexual Assault Telephone Hotline: (800) 656-HOPE (4673)

For life threatening emergencies, call 911.