A Child’s Voice

Notice of Privacy Practices


This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment or health care operations and for other purposes that are permitted or required by law.  It also describes you rights to access and control your protected health information.  “Protected health information” (PHI) is information about you, including demographic information, that may identify you and that related to your past, present, or future physical or mental health or condition and related health care services.

We are required to abide by the terms of this Notice of Privacy Practices.  We may change the terms of our notice at any time.  The notice will be effective for all protected health information that we maintain at the time.  Upon your request, we will provide you with any revised Notice of Privacy Practices by calling our office and requesting that a revised copy be sent to you in the mail or by asking for one at the time of your next appointment.

Our Pledge

We understand that health information about you and the health care you receive is personal.  We are committed to protecting you personal health information.  When you receive treatment from us, we create a record of the services that you received.  We need this record to provide you with quality care and comply with legal requirements.

We are required by law to make sure that information that identifies you is kept private in accordance with relevant law; give you this notice of our legal duties and privacy practices with respect to your personal health information; follow the terms of the notice that is currently in effect for all of your personal health information.

1. Uses and Disclosures of Protected Health Information

Your protected health information may be used and disclosed by your counselor, or office staff, and others outside of our office that are involved in your case and treatment for the purpose of providing health care services to you.

The following are examples of the types of uses and disclosures of you PHI that we are permitted to make.

These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our center.

Treatment: We will use and disclose 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 a third party that has already obtained your permission to have access to your protected PHI.  For example, we would disclose your PHI, as necessary, to physicians who may be treating you or to whom you have been referred to ensure that they have the necessary information to diagnose or treat you.  We may disclose your PHI from time-to-time to another counselor or health care provider who, at your request, becomes involved in your treatment. 

Operations: We may use or disclose your PHI, as needed, for our day-to-day operations to support the business activities of this facility and to provide quality care to all clients.  These activities include, but are not limited to, quality assessment and improvement activities, training programs including those in which students, trainees, or practitioners in health care can learn under supervision, licensing or credentialing activities, review and auditing, including compliance reviews, medical reviews, legal services and maintaining compliance programs, and business management and general administrative activities.  For example, we may disclose your PHI to counseling students that see clients and to counselors who are supervising the work of staff and students.  In addition, we may call you by name in the waiting room when your counselor is ready to see you.  We may use or disclose your PHI, as necessary, to contact you to remind you of your appointment or provide information on treatment alternatives or other health related services that may be of interest.  We may also combine health information about our clients with health information from other health care providers to decide what additional services A Child’s Voice should offer, to compare how we are doing with others and to see where we could improve, or for funding from grants and other resources.  We may remove information that identifies you from this set of health information so others may use it without learning who our clients are.

Uses and Disclosures of Protected Health Information Based upon Your Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by lay as described below.  You may revoke this authorization, at any time, in writing, except to the extent that this center has taken an action in reliance on the use or disclosure indicated in the authorization.

Psychotherapy Notes

We may use or disclose psychotherapy notes, defined as detailed notes recorded by a mental health professional documenting or analyzing the contents of conversations during a private, family or group counseling session, with your specific consent for (1) treatment purposes by the person who created the psychotherapy notes, (2) to conduct training programs in which students, trainees or practitioners in mental health learn under supervision to practice or improve their skills in group, joint, family or individual counseling, or (3) define a legal action or proceeding brought by you, but only to your defense attorney.

Others Involved In Your Healthcare: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your PHI that directly relates to that person’s involvement in your health care.  If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.  We may use or disclose PHI to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death.

Other Permitted and Required Uses and Disclosures That May Be Made With Your Authorization or Opportunity to Object.

 We may use or disclose your PHI in the following instances without your authorization.  These situations include:

Required by Law: We may use or disclose your PHI to the extent that law requires the use or disclosure.  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, as required by law, of any such uses or disclosures.

Public Health: We may disclose your PHI for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information.  The disclosure will be made for the purpose of controlling disease, injury or disability.  We may also disclose your PHI, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Communicable Diseases: We may disclose your PHI, if authorized by law, to the public health authority or to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose PHI to a health oversight agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections and licensure.  These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Abuse or Neglect: We 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 or agency authorized to receive such information.  In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Psychotherapy Notes:  We may disclose PHI with neither consent nor authorization for: (1) required for enforcement purposes, (2) when mandated by law, (3) when needed for oversight of the provider who created the notes, (4) when needed by a coroner or medical examiner, or (5) when needed to avert a serious and imminent threat to health or safety.

Legal Proceedings: We 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), in certain conditions in response to a subpoena, discovery request or other lawful process.

Law Enforcement: We may also disclose PHI, so long as applicable legal requirements are met, for law enforcement purposes.  These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of the practice, and (6) medical emergency (not on our premises) and it is likely that a crime has occurred.

Research: We may utilize your PHI for research with established protocols to ensure the privacy of your PHI.

Criminal Activity: Consistent with applicable federal and state laws, we 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 heath or safety of a person or the public.  We may also disclose PHI if it is necessary for law enforcement authorities to identify or apprehend and individual.

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, or (3) to foreign military authority if you are a member of that foreign military services.  We may also disclose your PHI to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized. 

Workers Compensation:  Your PHI may be disclosed by A Child’s Voice as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Required Uses and Disclosures:  Under the law, we must make disclosures to you and when required by the Secretary for the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. seq.

Alcohol and Drug Abuse: The confidentiality of alcohol and drug abuse client records maintained by A Child’s Voice is protected by federal law and regulations (42 CFR, Chapter 1, Part 2).  Generally, we may not say that a client attends any program, or disclose any information identifying the client as alcohol or drug abuser unless (1) the client consents in writing, (2) the disclosure is allowed by court order, (3) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation.  Violation of the federal law and regulations by a program is a crime.  Suspected violations may be reported to appropriate authorities in accordance with federal regulations.  Federal law and regulations do not protect any information about a crime committed by a client either at our facility or against any person who works at our facility or any threat to commit such a crime.  Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate or local authorities.

2. Your Rights

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

You have a right to inspect and copy your protected health information. This means you may inspect and obtain a copy of PHI about you that is contained in a designated record set for as long as we maintain the PHI.  A “designated record set” contains medical and billing records and any other records that we use for making decisions about you.  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 of proceeding, and protected health information that is subject to law that prohibits access to PHI.  In or proceeding, and protected health information that is subject to law that prohibits access to PHI.  In some circumstances, you may have to right to have this decision reviewed.

You have to right to request a restriction of you protected health information.  This means you may ask us not to use or disclose any part of your PHI of the purposes of treatment, payment or healthcare operation.  You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the Notice of Privacy Practices.  Your request must state the specific restriction requested and to whom you want the restriction to apply.

We are not required to agree to a restriction that you may request.  If we believe it is in your best interest to permit use and disclosure of you PHI, your PHI will not be restricted.  If we do agree to the requested restriction, we may not use or disclose your PHI in violation of that restriction unless it is needed to provide emergency treatment.  With this in mind, please discuss any restriction you wish to request with A Child’s Voice.  You may request a restriction by requesting a Revocation of Authorization for Disclosure of Health Information for from us.

You have the right to request to receive confidential communications from A Child’s Voice by alternative means or at an alternative location.  We will accommodate reasonable requests.  We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact.  We will not request and explanation from you as to the basis for the request.  Please make this request in writing to A Child’s Voice.

You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.  This right applies to disclosures for purposes other than treatment, payment, or healthcare operations as described in this Notice of Privacy Practices.  It excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes.  You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003.  You may request a shorter timeframe.  The right to receive this information is subject to certain exceptions, restrictions and limitation.

You have the right to obtain a paper copy of this notice from A Child’s Voice, upon request.

You have the right to receive the following without regard to race, color, sex, religion, ethnicity, or national origin: (1) the opportunity to participate in appropriate therapeutic services provided  by A Child’s Voice, (2) respectful, professional attention to any problem which falls within the scope of services provided at A Child’s Voice, (3) answers to questions or concerns related to services provided, (4) participation in the development of individual treatment plans and any subsequent recommendations, (5) knowledge of the staff’s credentials and experience, (6) information on the nature of the care, procedures, and treatment that will be provided, (7) information on the present and future use and disposition of products or special observational and audio-visual techniques such as tape recorders, videos, television, photographs, (8) information on the risks, side effects and benefits of all treatment procedures, (9) information an the anticipated length and duration of intervention,  (10) information on the treatment therapy models used by the agency therapists and services offered, (11) the participation of other family members in the treatment process, when appropriate, (12) information on the client’s right to refuse participation in any research project conducted by the agency, (13) the right to obtain assistance in interpretation for non- English speaking clients, (14) the right to expect reasonable continuity of care within the scope of services and staffing at the agency, (15) the right to respect for the client’s civil rights and religious opinions, (16) the right to examine and receive a full explanation of any changes made by the facility regardless of the source of payment.

3. Complaints   

You may complain to A Child’s Voice or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us.  Please notify A Child’s Voice in writing.  We will not retaliate against you for filing a complaint.

This notice was published and becomes effective on February 14, 2019.