NOTICE OF PRIVACY PRACTICES

NOTICE OF PRIVACY PRACTICES SUMMARY OF NOTICE 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. 

MICHAEL J. BROWN, MSC, LMFT keeps medical information about you. This information is personal and private. I need to use this information in many ways. First, I use the information when I treat you or refer you for treatment. Second, I use this information for our health care operations and quality assurance.

Under the law, each client has certain rights to the medical information kept by MICHAEL J. BROWN, MSC, LMFT. These rights are:

  • Access. You can request to view your medical information.
  • Restriction. You can ask to limit who has access to your medical information. You can ask to limit what information is sent out of MICHAEL J. BROWN, MSC, LMFT.
  • Accounting. You can request to review the list of places where your medical information has been sent.
  • Amending. You can request that changes be made to your medical information if you feel that there are inaccuracies.

A complete notice with explanations of uses, disclosures, rights, and information on how to file a privacy complaint is available at your request.

A client also has the right to file a complaint regarding privacy of their medical information with the Secretary of Health and Human Services toll-free at 1-877-696-6775.

Florida Statutes Florida statutorily grants patients the right of access to medical records maintained by healthcare practitioners. The disclosure of patient information by providers is generally prohibited without the patient’s consent, subject to specified exceptions. Florida also has numerous laws protecting the confidentiality of health information held by a variety of entities and government agencies.

  • (Responsible party if client is a minor)

Download the entire “Notice of Privacy Practices” by clicking here.

Notice of Privacy Practices Required by Federal Law Includes Privacy Protections Under State Law

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.

The HIPAA Privacy Practices

1. PURPOSE: MICHAEL J. BROWN, MSC, LMFT follows the privacy practices described in this Notice. MICHAEL J. BROWN, MSC, LMFT keeps your mental health information in records that will be maintained and protected in a confidential manner, as required by law.

2. HOW WILL MICHAEL J. BROWN, MSC, LMFT USE MY PROTECTED HEALTH INFORMATION?
Your personal mental health record will be retained by MICHAEL J. BROWN, MSC, LMFT for approximately seven years after your last clinical contact. After that time has elapsed, the record will be shredded, burned or otherwise destroyed in a way that protects your privacy.
Until the records are destroyed they may be used, unless you request restrictions on a specific use or disclosure, for the following purposes:

  • Appointment reminders;
  • Notification when an appointment is canceled or rescheduled by me;
  • As may be required by law;
  • For public health purposes such as reporting of child or elder abuse or neglect; reporting reactions to medications; infectious disease control; notifying authorities of suspected abuse, neglect, or domestic violence (if you agree or as required by law);
  • Mental health oversight activities, e.g., Audits, inspections or investigations of administration and management of MICHAEL J. BROWN, MSC, LMFT;
  • Lawsuits and disputes (I will attempt to provide you advance notice of subpoena before disclosing information from your record.);
  • Law enforcement (e.g., in response to a court order or other legal process) to identify or locate an individual being sought by authorities; about victim of a crime under restricted circumstances; about a death that may be the result of criminal conduct; about criminal conduct that occurred in the facility; when emergency circumstances occur relating to a crime;
  • To prevent a serious threat to health or safety;
  • To carry out treatment and health care operations functions through transcription and billing services;
  • To military command authorities if you are a member of the armed forces or a member of a foreign military authority;
  • National security and intelligence activities;
  • Protection of the President or other authorized persons for foreign heads of state, or to conduct special investigations.
  • Psychotherapy Notes that are kept separate from the medical record enjoy special protection.
  • The term Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date, employment, application, utilization, examination, or analysis of such information within an entity that maintains such information.

Alcohol and drug abuse information has special privacy protections. MICHAEL J. BROWN, MSC, LMFT will not disclose any information identifying an individual as being a client or provide any mental health or medical information relating to a client’s substance abuse treatment unless: (i) the client consents in writing; (ii) a court order requires disclosure of the information; (iii) medical personnel need the information to meet a medical emergency; (iv) qualified personnel use the information for the purpose of conducting research, management audits, or program evaluation; or (v) it is necessary to report a crime or a threat to commit a crime or to report abuse or neglect as required by law.

  1. YOUR AUTHORIZATION IS REQUIRED FOR OTHER DISCLOSURES. Except as described previously, I will not use or disclose information from your record unless you authorize (permit) in writing the facility to do so. You may revoke your permission, which will be effective only after the date of your written revocation.

    5. YOU HAVE RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
    .
    You have the following rights regarding your health information, provided that you make a written request to invoke the right on the form provided by MICHAEL J. BROWN, MSC, LMFT:
  • Right to request restriction. You may request limitations on your mental health information I may disclose, but I are not required to agree to your request. If I agree, I will comply with your request unless the information is needed to provide you with emergency treatment.
  • Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify in writing how or where you wish to be contacted.
  • Right to inspect and copy. You have the right to inspect and copy your mental health information regarding decisions about your care; however, psychotherapy notes may not be inspected and copied. I may charge a fee for copying, mailing, and supplies. Under limited circumstances, your request may be denied; you may request review of the denial by another licensed mental health professional chosen by MICHAEL J. BROWN, MSC, LMFT. MICHAEL J. BROWN, MSC, LMFT will comply with the outcome of the review.
  • Right to request clarification of the record. If you believe that the information I have about you is incorrect or incomplete you may ask to add clarifying information. You may ask for a form for that purpose and the form will require certain specific information. MICHAEL J. BROWN, MSC, LMFT is not required to accept the information that you propose.
  • Right to accounting of disclosures. You may request a list of the disclosures of your mental health information that have been made to persons or entities other than for treatment or health care operations in the last six (6) years, but not prior to April 14, 2003.
  • Right to a copy of this Notice. You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy.
  1. REQUIREMENTS REGARDING THIS NOTICE.
    MICHAEL J. BROWN, MSC, LMFT is required to provide you with this Notice that governs privacy practices. MICHAEL J. BROWN, MSC, LMFT may change his policies or procedures in regard to privacy practices. If and when changes occur, the changes will be effective for mental health information I have about you as well as any information I receive in the future. Any time you come in to MICHAEL J. BROWN, MSC, LMFT for an appointment, you may ask for and receive a copy of the Privacy Notice that is in effect at the time.7. COMPLAINTS.
    If you believe your privacy rights have been violated, you may file a complaint with MICHAEL J. BROWN, MSC, LMFT. You will not be penalized or retaliated against in any way for making a complaint.

    Contact: Please call MICHAEL J. BROWN, MSC, LMFT to discuss issues of privacy.

If you have a complaint; you have any questions about this notice, you wish to request restrictions on uses and disclosure for health care treatment or operations; or you may obtain any of the forms mentioned to exercise your individual rights described above.

Download the entire “Notice of Privacy Practices” by clicking here.

 

Share This