Notice of Privacy Practices

Section 1Who this notice covers

This notice applies to Hope Envisioned Counseling & Consulting LLC and to all clinicians, employees, students, and contractors working under its direction. It describes how we may use and disclose your protected health information ("PHI") and the rights you have regarding that information.

PHI is information that identifies you and relates to your physical or mental health, the health care we provide you, or payment for that care. It includes your record of counseling sessions, assessments, scheduling, and billing.

Section 2Our legal responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information
• Provide you with this notice describing our legal duties and privacy practices
• Follow the terms of the notice currently in effect
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information
• Comply with your written request to restrict certain disclosures, where the law requires us to do so

We may not use or disclose your information in ways other than those described in this notice without your written authorization, except where federal or state law permits or requires it.

Section 3How we may use and share your information

For treatment

We use your health information to provide, coordinate, and manage your care. For example, with your consent, we may consult with or share relevant information with another provider involved in your treatment, such as your primary care physician or a psychiatrist. Disclosures of substance use disorder records for treatment are subject to the additional protections described in Section 5.

For payment

We may use and disclose information to bill and collect payment for services, including verifying insurance coverage, obtaining prior authorization, and submitting claims. If you pay for a service in full out of pocket, you have the right to restrict disclosure of that service to your health plan — see Section 8.

For health care operations

We may use information for activities necessary to run the practice, including scheduling, quality review, professional consultation and supervision, training, business management, and compliance activities.

Appointment reminders and follow-up

We may contact you to remind you of an appointment, follow up after a session, or discuss treatment alternatives. You may ask us to use a particular method or number — see "Confidential communications" in Section 8.

Section 4Other permitted and required disclosures

Federal and Georgia law permit or require us to disclose information without your authorization in limited circumstances, including:

• Suspected abuse or neglect — we are mandated reporters and must report suspected abuse, neglect, or exploitation of a child, an elderly person, or a disabled adult to the appropriate authorities.
• Serious threat to health or safety — if you communicate a serious threat of physical violence against a reasonably identifiable person, or a threat to harm yourself, we may disclose information as necessary to prevent the harm, consistent with Georgia law and our professional obligations.
• Court orders and legal proceedings — in response to a court order, and in response to a subpoena or discovery request only as permitted by law. Special limits apply to substance use disorder records (Section 5) and to psychotherapy notes (Section 6).
• Health oversight — to licensing boards and agencies conducting audits, investigations, or licensure actions.
• Public health activities — to authorities authorized to receive such reports.
• Workers' compensation — as authorized by and to the extent necessary to comply with workers' compensation laws.
• Law enforcement and specialized government functions — in the narrow circumstances the law permits.
• Coroners, medical examiners, and funeral directors — as necessary for them to carry out their duties.
• Business associates — to vendors who perform services for us, such as our electronic health record and client portal provider. Each is bound by a written Business Associate Agreement requiring them to protect your information.

Section 6Psychotherapy notes

Psychotherapy notes are notes we may record documenting the contents of a counseling conversation, kept separately from the rest of your record. They receive heightened protection: most uses and disclosures require your specific written authorization. Exceptions are narrow and include our own use for treatment, our supervision and training activities, defending ourselves in a legal action you bring, and disclosures required by law or necessary to avert a serious and imminent threat.

Your general right to access your record does not extend to psychotherapy notes.

Section 7Uses that require your written authorization

We will not use or disclose your information for the following purposes without your written authorization:

• Most uses and disclosures of psychotherapy notes
• Marketing purposes
• The sale of your protected health information
• Most disclosures of substance use disorder records, as described in Section 5
• Any other purpose not described in this notice

You may revoke an authorization at any time by notifying us in writing. Revocation does not affect disclosures we already made while the authorization was in effect.

Section 8Your rights

Request restrictions

You may ask us to limit how we use or disclose your information for treatment, payment, or health care operations. We are not required to agree to every request. However, we must agree if you ask us not to disclose information to your health plan about a service you paid for in full, out of pocket, and the disclosure is not otherwise required by law.

Request confidential communications

You may ask us to contact you in a specific way or at a specific location — for example, only by a certain phone number, or not by email. We will accommodate reasonable requests.

Inspect and receive a copy of your record

You may inspect and request a copy of your health record, including an electronic copy where we maintain it electronically. We will respond within the time federal law allows and may charge a reasonable, cost-based fee for copies. In limited circumstances we may deny a request, and you may have the denial reviewed. This right does not extend to psychotherapy notes.

Request an amendment

If you believe information in your record is incorrect or incomplete, you may ask us in writing to amend it. We may deny the request and will explain why in writing; you may then submit a statement of disagreement to be included in your record.

Request an accounting of disclosures

You may request a list of certain disclosures we have made of your information. Disclosures for treatment, payment, and health care operations, and those you authorized, are generally not included.

Receive a copy of this notice

You may request a paper or electronic copy of this notice at any time, even if you agreed to receive it electronically.

Choose someone to act for you

If you have given someone medical power of attorney or a legal guardian has been appointed, that person can exercise your rights and make choices about your information. We will verify the person's authority before acting.

Be notified of a breach

You have the right to be notified if a breach occurs that may have compromised the privacy or security of your information.

File a complaint

You may file a complaint if you believe your privacy rights have been violated. We will not retaliate against you in any way for filing a complaint. See Section 10.

Section 9Telehealth and electronic communication

We provide services through a secure, HIPAA-compliant telehealth platform, and we maintain your record in an electronic health record system operated by a business associate under a written agreement.

Standard email, text messaging, website contact forms, and social media are not secure methods of communication and may be accessed by others. If you choose to communicate with us through these channels, you accept that risk. Please use our client portal or telephone for anything confidential. Let us know at any time if you would like us to stop using a particular method to reach you.

Section 10How to file a complaint

If you believe your privacy rights have been violated — including your rights regarding substance use disorder records under 42 CFR Part 2 — you may file a complaint with either or both of the following:

With our practice

Contact our Privacy Officer using the information in Section 12. Complaints should be submitted in writing where possible.

With the federal government

U.S. Department of Health and Human Services, Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: (877) 696-6775
Online: www.hhs.gov/ocr/privacy/hipaa/complaints

We will not retaliate against you, and you will not be penalized in any way, for filing a complaint.

Section 11Changes to this notice

We may change this notice at any time, and the changes will apply to all information we maintain, including information created or received before the change. The revised notice will be posted on our website and made available in our practice. The effective date appears at the top of this page. You may request a copy of the current notice at any time.