HIPAA

AWARE THERAPY SERVICES LLC

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.

This Notice applies to Aware Therapy Services LLC ("Aware Therapy," "we," "our," or "us") and to its clinicians, supervised clinicians, employees, contractors, and support personnel when they create, receive, maintain, or transmit protected health information on behalf of the practice.

Your Information. Your Rights. Our Responsibilities.

Your rights

Get an electronic or paper copy of your health record.

Ask us to correct your health record.

Request confidential communications.

Ask us to limit the information we use or share.

Receive an accounting of certain disclosures.

Get a paper copy of this Notice.

Choose someone authorized to act for you.

File a complaint if you believe your privacy rights have been violated.

Your choices

Tell us whether and how we may share information with family, close friends, or others involved in your care or payment for your care.

Tell us your preferences for communications and, when applicable, disaster-relief disclosures.

Authorize uses and disclosures that are not otherwise permitted by law, including most uses of psychotherapy notes, marketing, and the sale of information.

Our uses and disclosures

Provide, coordinate, and manage your treatment.

Operate our practice, support clinical supervision, improve care, and contact you when necessary.

Bill for services and obtain payment from health plans or other responsible payers.

Meet public-health, safety, oversight, licensing, and other legal obligations.

Respond to court orders, lawful process, workers' compensation matters, and permitted government requests, subject to applicable confidentiality protections.

Your Rights

When it comes to your health information, you have the rights described below. Contact our Privacy Officer to exercise any of these rights.

Get an electronic or paper copy of your health record

You may ask to inspect or receive an electronic or paper copy of your health record and other health information we maintain about you. Ask us how to submit the request.

We will generally provide a copy or summary within 30 days after receiving your request. We may charge a reasonable, cost-based fee as allowed by law.

The HIPAA right of access does not include separately maintained psychotherapy notes, information compiled in reasonable anticipation of a legal proceeding, or certain other information excluded by law. Progress notes that are part of your designated record set are different from psychotherapy notes.

Ask us to correct your health record

You may ask us to amend health information that you believe is incorrect or incomplete.

We may deny the request in some circumstances, but we will explain the reason in writing, generally within 60 days. You may submit a written statement of disagreement when permitted by law.

Request confidential communications

You may ask us to contact you in a particular way, such as only by cell phone, email, or patient portal, or to send mail to a different address.

We will accommodate reasonable requests. Please understand that ordinary email or text messaging may carry privacy risks unless a secure method is used.

Ask us to limit what we use or share

You may ask us not to use or disclose certain information for treatment, payment, or health care operations. We are not generally required to agree, but if we agree, we will follow the restriction except when disclosure is needed for emergency treatment or otherwise permitted by law.

If you pay for a service in full out-of-pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will agree unless a law requires the disclosure.

Receive an accounting of certain disclosures

You may request a list of certain disclosures made during the six years before your request, including who received the information and why.

The accounting generally does not include disclosures for treatment, payment, or health care operations; disclosures made directly to you; disclosures you authorized; or certain other disclosures excluded by law.

We will provide one accounting in any 12-month period without charge. We may charge a reasonable, cost-based fee for an additional accounting during that period after notifying you of the cost.

Get a copy of this Notice

You may request a paper copy at any time, even if you agreed to receive it electronically. The current Notice is also available on our website and at our office.

Choose someone to act for you

If a person has legal authority to act for you, such as a health care power of attorney or legal guardian, that person may exercise your rights and make choices about your health information within the scope of that authority.

Parents and guardians generally act as personal representatives for minors, subject to exceptions under federal and New Jersey law and the clinician's professional judgment where applicable.

We will verify the person's identity and authority before acting on a request.

File a complaint

You may complain to Aware Therapy Services LLC by contacting John Warren, COO and Privacy Officer, using the information at the end of this Notice.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting the HHS complaint website.

HHS complaint website: hhs.gov/hipaa/filing-a-complaint

We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you may tell us your preferences about what we share. If you cannot tell us your preference, we may use professional judgment and act in your best interest when the law allows. We may also disclose information when necessary to prevent or lessen a serious and imminent threat to health or safety.

Family, friends, and others involved in your care

You may tell us whether and how to share relevant information with family, close friends, or other people involved in your care or payment for your care.

For couples, family, or other multi-person counseling, New Jersey law and professional rules may require written permission from each adult participant before information received in treatment is disclosed.

Uses and disclosures requiring written authorization

We will obtain your written authorization before using or disclosing your information for purposes not described in this Notice unless the use or disclosure is otherwise permitted or required by law. In particular, written authorization is generally required for:

Most uses and disclosures of psychotherapy notes. Psychotherapy notes are a clinician's separately maintained notes documenting or analyzing the contents of a counseling session and do not include the ordinary progress notes kept in your health record.

Marketing purposes, subject to limited exceptions permitted by law.

The sale of your protected health information.

You may revoke an authorization in writing at any time. Revocation will not affect actions already taken in reliance on the authorization.

Fundraising

Aware Therapy does not currently use protected health information for fundraising communications. If this practice changes, we will revise this Notice as required and provide any legally required opportunity to opt out.

How We Use and Disclose Your Information

HIPAA permits certain uses and disclosures without a separate written authorization. New Jersey law and professional licensing rules may provide greater confidentiality protection for counseling communications and mental health records. When another applicable law is more protective than HIPAA, we follow the more protective law and obtain consent when required.

Treatment

We may use your information and share it with professionals involved in your care to provide, coordinate, or manage treatment, subject to applicable law and any required consent. For example, with the permission required by law, your clinician may coordinate care with another therapist, psychiatrist, physician, or other treating provider.

Payment

We may use and disclose information to bill and obtain payment for services. For example, we may verify benefits, request authorization, submit a claim containing diagnosis and service information, respond to a health plan's lawful request, or collect amounts you owe. Where New Jersey law requires consent for disclosure of counseling information to a payer, we will obtain it.

Health care operations

We may use and disclose information to operate the practice and improve care. Activities may include quality review, clinical supervision, credentialing, licensing, compliance, auditing, legal and accounting services, business planning, appointment reminders, patient communications, and operation of our electronic health record and patient portal. We may share information with business associates that perform services for us only under agreements requiring appropriate safeguards.

Other permitted or required uses and disclosures

We may use or disclose information in the circumstances below only when the applicable legal requirements and confidentiality protections are satisfied:

Required by law. We will disclose information when federal or New Jersey law requires it, including to HHS when necessary to verify our compliance with HIPAA.

Abuse, neglect, or domestic violence. We may make reports required or permitted by law, including mandated reports involving suspected child abuse or neglect and other legally reportable circumstances.

Serious threats to health or safety. We may use or disclose information when permitted by law and reasonably necessary to prevent or lessen a serious threat to a person or the public.

Public-health activities. We may disclose information for public-health activities authorized by law, such as preventing or controlling disease or reporting adverse events.

Health oversight. We may disclose information to authorized oversight agencies for audits, inspections, investigations, licensing, or disciplinary proceedings.

Judicial and administrative proceedings. We may disclose information in response to a valid court or administrative order or other lawful process only to the extent permitted by HIPAA, New Jersey law, counselor-client privilege, and other applicable protections. A subpoena alone may not always authorize disclosure.

Law enforcement and government requests. We may make disclosures for limited law-enforcement or government purposes when the request and disclosure satisfy all applicable legal requirements.

Workers' compensation. We may disclose information as authorized by and necessary to comply with workers' compensation or similar laws.

Coroners, medical examiners, and funeral directors. We may disclose information as authorized by law when an individual dies.

Research. We do not ordinarily conduct health research. If research is undertaken, information will be used or disclosed only as permitted by law and subject to required approvals or authorization.

New Jersey Counseling Confidentiality

Communications between clients and New Jersey licensed professional counselors or licensed associate counselors receive confidentiality protection under New Jersey law and professional rules. We preserve that confidentiality and disclose counseling information only as permitted or required by applicable law, such as with valid written permission when required, pursuant to a qualifying legal requirement or court order, for mandated reporting, to address a clear and present danger, for authorized professional supervision or consultation, or in a limited defense of a claim arising from the counseling. Confidentiality generally continues after a client's death.

Substance Use Disorder Records We May Receive

Aware Therapy does not operate a formal substance use disorder treatment program subject to 42 C.F.R. Part 2. However, we may receive or maintain substance use disorder treatment records from a provider or program that is subject to Part 2. To the extent we maintain such records, the following additional protection applies:

Part 2 records, or testimony describing their contents, will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless based on your written consent or a qualifying court order entered after notice and an opportunity to be heard, as provided by Part 2.

A court order authorizing use or disclosure of Part 2 records must be accompanied by a subpoena or other legal requirement compelling disclosure before the records are used or disclosed.

When Part 2 or another applicable law is more protective than HIPAA, we follow the more protective law.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.

We will notify affected individuals following a breach of unsecured protected health information as required by law.

We must follow the duties and privacy practices described in the Notice currently in effect.

We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or the law otherwise permits or requires it.

Changes to This Notice

We reserve the right to change the terms of this Notice and to make the revised Notice effective for all protected health information we maintain, including information created or received before the revision. When we make a material change, the revised Notice will be available upon request, at our office, and on our website. The revised Notice will state its effective date.

Contact and Complaints

For questions, requests, or complaints about this Notice or our privacy practices, contact:

Privacy Officer: John Warren, COO

Practice: Aware Therapy Services LLC

Address: 2 Tree Farm Road, Suite A200, Pennington, NJ 08534

Telephone: (908) 229-0750

Email: andrew@awaretherapyservices.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. Aware Therapy Services LLC will not retaliate against you for filing a complaint.

HHS Office for Civil Rights: hhs.gov/hipaa/filing-a-complaint

This Notice is intended to satisfy the HIPAA Notice of Privacy Practices requirements. It is not a consent to treatment or a waiver of any privacy right.

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