Emotional Wellness Counseling, LLC.

725 Walker Rd

(302) 865-8098 Phone (302) 865-8099 Fax

laurenhubbard@ewcdelaware.com

www.ewcdelaware.com


 

HIPAA NOTICE OF PRIVACY PRACTICES

 

I. 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.

 

II. IT IS MY LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).

By law I am required to ensure that your PHI is kept private.  The PHI constitutes information created or noted by me that can be used to identify you.  It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care.  I am required to provide you with this Notice about my privacy procedures. This Notice must explain when, why, and how I would use and/or disclose your PHI. Use of PHI means when I share, apply, utilize, examine, or analyze information within my practice; PHI is disclosed when I release, transfer, give, or otherwise reveal it to a third party outside my practice. With some exceptions, I may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, I am always legally required to follow the privacy practices described in this Notice. Please note that I reserve the right to change the terms of this Notice and my privacy policies at any time as permitted by law.  Any changes will apply to PHI already on file with me.  Before I make any important changes to my policies, I will immediately change this Notice and post a new copy of it in my office and on my website.  You may also request a copy of this Notice from me, or you can view a copy of it in my office or on my website, which is located at www.ewcdelaware.com .

 

III. YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

See the easy to read summary, examples, and further explanation of our privacy practices below in the section titled: “Your information, Your rights, and Our responsibilities.”

 

IV. PRACTICE POLICIES RELATED TO PHI

A. The Right to See and Get Copies of Your PHI.  In general, you have the right to see your PHI that is in my possession, or to get copies of it; however, you must request it in writing. If I do not have your PHI, but I know who does, I will advise you how you can get it. You will receive a response from me within 30 days of my receiving your written request. Under certain circumstances, I may feel I must deny your request, but if I do, I will give you, in writing, the reasons for the denial.  I will also explain your right to have my denial reviewed. To ensure clarity of the clinical information contained in your record, I may choose to provide you with a summary, explanation, or request that we review the information in person together, prior to releasing the records to you.  If you ask for copies of your PHI, I will charge you not more than $.25 per page.

B. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that I limit how I use and disclose your PHI. While I will consider your request, I am not legally bound to agree. If I do agree to your request, I will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that I am legally required or permitted to make.

C. The Right to Choose How I Send Your PHI to You. It is your right to ask that your PHI be sent to you at an alternate address (for example, sending information to your work address rather than your home address) or by an alternate method (for example, via e-mail instead of by regular mail). I am obliged to agree to your request providing that I can give you the PHI, in the format you requested, without undue inconvenience.  I may not require an explanation from you as to the basis of your request as a condition of providing communications on a confidential basis.

D. The Right to Get a List of the Disclosures I Have Made. You are entitled to a list of disclosures of your PHI that I have made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, or to corrections or law enforcement personnel, in certain circumstances. Disclosure records will be held for six years. If you previously received treatment by me at any practices other than Emotional Wellness Counseling, LLC., I do not own or have access to those records, and they will not be included in this list. Only Emotional Wellness Counseling, LLC. Records will be included. You must contact the other practices to find out their procedures to release your records.

 

I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I give you will include disclosures made in the previous six years (again, only from Emotional Wellness Counseling, LLC and not any other agency) unless you indicate a shorter period. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. I will provide the list to you at no cost, unless you make more than one request in the same year, in which case I will charge you a reasonable sum based on a set fee for each additional request.

E. The Right to Amend Your PHI. If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that I correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of my receipt of your request. I may deny your request, in writing, if I find that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of my records, or (d) written by someone other than me. My denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and my denial be attached to any future disclosures of your PHI. If I approve your request, I will make the change(s) to your PHI. Additionally, I will tell you that the changes have been made, and I will advise all others who need to know about the change(s) to your PHI.

F. The Right to Get This Notice by E-mail. You have the right to get this notice by e-mail. You have the right to request a paper copy of it, as well.

G. NOTIFICATIONS OF BREACHES

In the case of a breach, I am required to notify each affected individual whose unsecured PHI has been compromised. Even if such a breach was caused by a business associate, I am responsible for providing the notification directly or via the business associate.  If the breach involves more than 500 persons, OCR must be notified in accordance with instructions posted on its website. I bear the burden of proof to demonstrate that all notifications were given or that the impermissible use or disclosure of PHI did not constitute a breach and must maintain supporting documentation, including documentation pertaining to the risk assessment.

H. PHI AFTER DEATH

Generally, PHI excludes any health information of a person who has been deceased for more than 50 years after the date of death. I may disclose deceased individuals' PHI to non-family members, as well as family members, who were involved in the care or payment for healthcare of the decedent prior to death; however, the disclosure must be limited to PHI relevant to such care or payment and cannot be inconsistent with any prior expressed preference of the deceased individual.

I. INDIVIDUALS’ RIGHT TO RESTRICT DISCLOSURES; RIGHT OF ACCESS

To implement the 2013 HITECH Act, the Privacy Rule is amended. I am required to restrict the disclosure of PHI about you, the patient, to a health plan, upon request, if the disclosure is for the purpose of carrying out payment or healthcare operations and is not otherwise required by law. The PHI must pertain solely to a healthcare item or service for which you have paid the covered entity in full. (OCR clarifies that the adopted provisions do not require that covered healthcare providers create separate medical records or otherwise segregate PHI subject to a restricted healthcare item or service; rather, providers need to employ a method to flag or note restrictions of PHI to ensure that such PHI is not inadvertently sent or made accessible to a health plan.)

 

The 2013 Amendments also adopt the proposal in the interim rule requiring me, to provide you, the patient, a copy of PHI if you, the patient, requests it in electronic form. The electronic format must be provided to you if it is readily producible. OCR clarifies that I must provide you only with an electronic copy of their PHI, not direct access to their electronic health record systems. The 2013 Amendments also give you the right to direct me to transmit an electronic copy of PHI to an entity or person designated by you. Furthermore, the amendments restrict the fees that I may charge you for handling and reproduction of PHI, which must be reasonable, cost-based and identify separately the labor for copying PHI (if any). Finally, the 2013 Amendments modify the timeliness requirement for right of access, from up to 90 to 30 days, with a one-time extension of 30 additional days.

J. NPP

My NPP must contain a statement indicating that most uses and disclosures of progress notes, marketing disclosures and sale of PHI do require prior authorization by you, and you have the right to be notified in case of a breach of unsecured PHI.

K. EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on January 1, 2019.

 

 

Additional Summary, Examples, and Further Explanation of Emotional Wellness Counseling, LLC. Privacy Practices:

 

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated
  • Tell family and friends about your condition
  • Provide disaster relief
  • Include you in a hospital directory
  • Provide mental health care
  • Market our services and sell your information
  • Raise funds

Your Choices

You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition
  • Provide disaster relief
  • Include you in a hospital directory
  • Provide mental health care
  • Market our services and sell your information
  • Raise funds

Our Uses and Disclosures

We may use and share your information as we:

  • Treat you
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Respond to organ and tissue donation requests
  • Work with a medical examiner or funeral director
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions


Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

Ask us to correct your medical record

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.
  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
  • 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.

Ask us to limit what we use or share

Get a list of those with whom we’ve shared information

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us using the information on page 1.
  • 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/...
  • We will not retaliate against you for filing a complaint.
  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory
  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes
  • We may contact you for fundraising efforts, but you can tell us not to contact you again.


Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

In the case of fundraising:


Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

 Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

 Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

 Example: We give information about you to your health insurance plan so it will pay for your services.

 How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.


Additional Uses and Disclosures Information

  • Requests for copies of your Protected Health Information (PHI) must be in writing. You will receive our response within 30 days of receipt of the written request. Please contact me or see our office policies for further information related to these requests. You will be advised in advance if there are charges related to the copying of the records. Separate psychotherapy notes are not created or maintained by this practice.
  • If you believe there is an error or omission in your PHI, you may request in writing that existing information be corrected or missing information added. Please contact me or see our office policies for further information regarding requests for changes or additions to your PHI record.
  • I am a mandated reporter of child abuse and/or neglect.  When child abuse or neglect is disclosed or suspected, as occurring presently or having occurred in the past (even if the person who was abused is now over 18 years old), a report will be made to Delaware Family Services (DFS), and/or Law Enforcement, as mandated by the Delaware Child Abuse Prevention and Treatment Act, Del. Code Ann. tit. 16 §§ 901 et seq.
  • I am a mandated reporter of abuse and/or neglect of elderly, disabled, or vulnerable adults. If abuse or neglect of an elderly, disabled, or vulnerable adult is disclosed or suspected, a report will be made to the Department of Health and Social Services, as mandated by the Del. Code tit. 31 § 3910.
  • In compliance with CFR 42, part 2: We will not share any substance abuse treatment records without the patient's written permission, unless obligated by law or in the case of an emergency. This practice will follow all Federal and State laws that are applicable to confidentiality, disclosure, and the protection of PHI.


Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

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 office, and on our web site.

 

Other Instructions for Notice

  • Privacy Officer: Lauren Hubbard. Phone: (302) 865-8098. Email: laurenhubbard@ewcdelaware.com
  • We do not market or sell personal information.
  • This Notice of Privacy Practices applies to the following organizations:

Emotional Wellness Counseling, LLC.

725 Walker Rd

Dover, DE 19904

  • This practice regularly consults with other professionals, regarding patients, to ensure appropriate medical, therapeutic, legal, and ethical considerations are addressed in treatment. Each patient's identity remains completely anonymous and confidentiality is fully maintained during these consultations.
  • Each of the Licensed Mental Health Care providers at this address are independent practitioners. This is not a group practice. We do not share patient records. Each provider who works at this address is responsible for his/her own record keeping and compliance with all professional standards and regulations.
  • The effective date of this notice is January 1, 2019.

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