Terms and Conditions of Use & Website Privacy Policy

NOTICE OF PRIVACY PRACTICES

TRACY E. HILL, PH.D. & ASSOCIATES LLC

Center Street Center · 539 Center Street, Bethlehem, PA 18018

Brown Street Center · 112 East Brown Street, East Stroudsburg, PA 18301

North Denver Center · 3612 Hudson Street, Denver, CO 80207

Virtual Counseling Centers

Sosua Villa Familia Centro

Mediation & Custody Evaluation Services (MCES)

(484) 896-9161 · info@centerstreetcenter.com

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice applies to all services provided by Tracy E. Hill, Ph.D. & Associates LLC at the locations and programs listed above.

I. Our pledge regarding health information

We understand that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. 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 this mental health care practice. This notice will tell you about the ways in which we may use and disclose health information about you. It also describes your rights to the health information we keep about you, and certain obligations we have regarding the use and disclosure of your health information.

We are required by law to:

1. Make sure that protected health information (“PHI”) that identifies you is kept private.

2. Give you this notice of our legal duties and privacy practices with respect to health information.

3. Follow the terms of the notice that is currently in effect.

4. Notify you if a breach occurs that may have compromised the privacy or security of your information.

5. Provide you with adequate notice of your rights and our legal duties if we create or maintain records protected by 42 C.F.R. Part 2.

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our offices, and on our website.

II. How we may use and disclose health information about you

The following categories describe different ways that we use and disclose health information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment, Payment, or Health Care Operations. Federal privacy rules (regulations) allow health care providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client's personal health information without the patient's written authorization, to carry out the health care provider's own treatment, payment or health care operations. We may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization.

Treatment: For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

Payment: For example, we may send your insurance company information such as your diagnosis and dates of service so that it will pay for your care.

Health care operations: For example, we may use your information to review the quality of care our clinicians provide, to supervise interns and pre-licensed clinicians, and for audits and compliance reviews.

If your records are protected under 42 C.F.R. Part 2, certain uses and disclosures permitted by HIPAA for treatment, payment, and health care operations are materially limited by the stricter standards of those regulations. Furthermore, information disclosed pursuant to these rules may be subject to redisclosure by the recipient and may no longer be protected by federal privacy standards.

Disclosures for treatment purposes are not limited to the minimum necessary standard, because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes. If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose health information about you or your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. However, for records protected by 42 C.F.R. Part 2, such records or testimony relaying their content shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide specific written consent or a court order is issued in accordance with 42 C.F.R. Part 2.

State law. Where Pennsylvania, Colorado or another applicable state law gives your mental health or substance use information greater protection than federal law, we follow the more protective law.

III. Certain uses and disclosures require your authorization

1. Psychotherapy Notes. We do keep “psychotherapy notes” as that term is defined in 45 C.F.R. § 164.501, and any use or disclosure of such notes requires your authorization unless the use or disclosure is:

(a) For our use in treating you.

(b) For our 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 our use in defending ourselves in legal proceedings instituted by you.

(d) For use by the Secretary of Health and Human Services to investigate our 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. Substance Use Disorder (SUD) Counseling Notes. We may also maintain “SUD counseling notes,” which are notes recorded by a substance use disorder provider documenting the contents of a counseling session. Any use or disclosure of these notes requires your separate written authorization, which cannot be combined with a consent for other types of records. You can revoke your consent at any time, except to the extent that we have already acted upon it to disclose these notes in accordance with your initial authorization.

3. Marketing Purposes. We will not use or disclose your PHI for marketing purposes.

4. Sale of PHI. We will not sell your PHI.

5. Other uses and disclosures. Uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on it.

IV. Certain uses and disclosures do not require your authorization

Subject to certain limitations in the law, we can use and disclose your PHI without your authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone's health or safety.

3. For health oversight activities, including audits and investigations.

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

5. For law enforcement purposes, including reporting crimes occurring on our premises.

6. To coroners or medical examiners, when such individuals are performing duties authorized by law.

7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

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

9. For workers' compensation purposes. Although our preference is to obtain an authorization from you, we may provide your PHI in order to comply with workers' compensation laws.

10. Appointment reminders and health-related benefits or services. We may use and disclose your PHI to contact you to remind you that you have an appointment with us. We may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that we offer.

V. Certain uses and disclosures require you to have the opportunity to object

1. Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

2. Fundraising. If we intend to use or disclose your records protected by 42 C.F.R. Part 2 for fundraising for our benefit, we will provide you with a clear and conspicuous opportunity to opt out before any such use or disclosure occurs.

VI. You have the following rights with respect to your PHI

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask us not to use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree to your request, and we may say “no” if we believe it would affect your health care.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for in Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes 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.

3. The Right to Choose How We Send PHI to You. You have the right to ask us 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.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes” and “SUD counseling notes,” you have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost-based fee for doing so.

5. The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided us with an authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable cost-based fee for each additional request. You also have the right to request an accounting of disclosures specifically for your substance use disorder records protected under 42 C.F.R. Part 2.

6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that we correct the existing information or add the missing information. We may say “no” to your request, but we will tell you why in writing within 60 days of receiving your request.

7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this notice, and you have the right to get a copy of this notice by email. Even if you have agreed to receive this notice by email, you also have the right to request a paper copy of it.

VII. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. This includes complaints about records protected by 42 C.F.R. Part 2.

To file a complaint with us, contact our Privacy and Compliance Officer using the information in Section VIII.

To file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, send a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit www.hhs.gov/ocr/complaints.

We will not retaliate against you in any way for filing a complaint.

VIII. Questions and contact information

If you have questions about this notice or wish to exercise any of the rights described in it, please contact:

Privacy and Compliance Officer

Tracy E. Hill, Ph.D. & Associates LLC

539 Center Street, Bethlehem, PA 18018

compliance@centerstreetcenter.com · (484) 896-9161