THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our commitment
Restorative Care Counseling LLC ("we," "us," or "the practice") is required by law to protect the privacy of your health information, to provide you with this Notice describing our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.
This Notice applies to all records of your care maintained by the practice, whether created by your therapist, a registered intern under supervision, or administrative staff.
We provide services by telehealth to individuals located in Florida. Your clinical records are maintained in SimplePractice, a HIPAA-compliant practice management platform operating under a Business Associate Agreement with us.
How we may use and disclose your health information
Treatment
We use your health information to provide and coordinate your care.
Example: Your therapist reviews your history and treatment plan before each session. If you are seeing a registered intern, your case is discussed in clinical supervision so that a licensed supervisor can oversee the quality of your care.
Payment
We use your health information to bill and receive payment for services.
Example: We send your insurance company your diagnosis, dates of service, and the type of service provided so your claim can be processed. If your plan requires prior authorization, we provide the limited clinical information necessary to obtain it.
Health care operations
We use your health information to run the practice and maintain quality of care.
Example: We review records to evaluate the quality of services provided, to train and supervise staff, and to conduct business planning and administration.
Uses and disclosures that do not require your authorization
Law permits or requires us to use or disclose your health information without your authorization in the following circumstances:
When required by law. When federal, state, or local law requires disclosure.
Abuse, neglect, or exploitation. Our clinicians are mandated reporters under Florida law. We are required to report reasonable suspicion of abuse or neglect of a child, or abuse, neglect, or exploitation of an elderly or vulnerable adult, to the Florida Abuse Hotline (1-800-962-2873) or other appropriate authorities.
Serious threat to health or safety. If you communicate a credible threat of serious harm to yourself or an identifiable person, we may disclose information necessary to prevent that harm — which may include contacting law enforcement, emergency services, the intended victim, or a person able to help.
Judicial and administrative proceedings. In response to a court order, or to a subpoena or discovery request where the required legal protections are satisfied. When it is legally possible to do so, we will notify you of the request and limit disclosure to what is legally required.
Health oversight activities. To agencies authorized to conduct audits, investigations, licensure actions, and inspections.
Public health activities. To authorities responsible for preventing or controlling disease, injury, or disability.
Law enforcement. In limited circumstances permitted by law, such as responding to a court order or reporting certain injuries.
Coroners and medical examiners. As necessary to identify a deceased person or determine cause of death.
Workers' compensation. As authorized by workers' compensation laws.
Specialized government functions. For national security, protective services, or military purposes as permitted by law.
Business associates. To vendors who perform services for us — such as our practice management platform, payment processor, and email provider. Each is required by written agreement to protect your information and use it only as permitted.
Appointment reminders. To contact you about appointments by phone, text message, or email, using the contact preferences you provide.
Persons involved in your care. With your agreement, or where you do not object, we may share relevant information with a family member or other person involved in your care. If you are unable to agree or object due to incapacity or emergency, we will use professional judgment to determine whether disclosure is in your best interest.
Uses and disclosures that require your written authorization
Any use or disclosure not described in this Notice requires your written authorization. In particular, we will not use or disclose your information for:
Marketing purposes
Sale of your health information
Any other purpose not described above
You may revoke an authorization at any time in writing. Revocation applies going forward and does not affect disclosures already made in reliance on your authorization.
[REVIEW NOTE — delete before publishing. The standard psychotherapy notes provision is omitted because RCC does not maintain psychotherapy notes separately from the clinical record. HIPAA requires that statement only where a covered entity maintains such notes. If Merieme begins keeping separate process notes after discussion with her supervisor, this Notice must be updated to add a psychotherapy notes authorization provision.]
Your rights regarding your health information
Right to inspect and copy
You may inspect and obtain a copy of your record. Request it in writing. We will respond within 30 days and may charge a reasonable, cost-based fee for copies. If you request an electronic copy of information we maintain electronically, we will provide it in the form and format you request if readily producible.
In limited circumstances we may deny a request; if we do, you may have the denial reviewed.
Right to request an amendment
If you believe information in your record is incorrect or incomplete, you may request in writing that we amend it, including your reason. We will respond within 60 days. If we deny the request, you may submit a statement of disagreement to be included in your record.
Right to an accounting of disclosures
You may request a list of disclosures we have made of your health information, other than disclosures for treatment, payment, or health care operations, and certain others excluded by law. Requests may cover up to six years. The first accounting in a 12-month period is free.
Right to request restrictions
You may request that we limit how we use or disclose your information for treatment, payment, or health care operations, or to a person involved in your care. We are not required to agree to most restriction requests, but if we do, we will honor it except in an emergency.
Right to restrict disclosure to your health plan when you pay in full
We are required to agree to a request that we not disclose information to your health plan about a service you paid for in full, out of pocket, provided the disclosure is not otherwise required by law. If you want a particular session kept out of your insurance record, tell us before the session and pay for it in full.
Right to confidential communications
You may request that we contact you at a specific phone number, address, or by a specific method. We will accommodate reasonable requests and will not ask why.
Right to a paper copy of this Notice
You may request a paper copy at any time, even if you received this Notice electronically.
Right to be notified of a breach
You will be notified if a breach occurs that compromises the privacy or security of your health information.
To exercise any of these rights, contact our Privacy Officer using the information at the end of this Notice.
Our legal duties
We are required by law to:
Maintain the privacy and security of your health information
Provide you with this Notice of our legal duties and privacy practices
Follow the terms of the Notice currently in effect
Notify you if a breach occurs that compromises your information
We reserve the right to change this Notice and to make the revised Notice effective for information we already hold as well as information we receive in the future. If we make a material change, we will post the revised Notice on our website at restorativecarecounseling.com and make copies available at your request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us or with the federal government. You will not be penalized, retaliated against, or denied services for filing a complaint.
Confidentiality of therapy communications. Communications between you and a licensed mental health professional are confidential under Florida Statutes § 491.0147, in addition to the federal protections described in this Notice.
Record retention. Florida law requires us to retain your clinical record for a minimum of seven years from the date of your last professional contact with the practice. We cannot delete your clinical record on request during that period, even where you would otherwise have a right to request deletion.
Minors. For clients under 18, treatment generally requires the consent of a parent or legal guardian, and a parent or guardian may have a legal right to access some or all of the minor's record. Your clinician will discuss with you and your family what information is appropriate to share and what remains confidential. Florida law governs when a minor may consent to their own treatment and when a parent may access those records.
This Notice is available on our website and in paper form upon request. If you need it in an alternative format or have difficulty accessing it, contact us and we will assist you.
If you are in crisis, this is not an emergency service. Call or text 988, or dial 911.
