Strive CLE Counseling, LLC

Strive CLE Counseling, LLC (Strive) is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy and security of your protected health information (PHI). “PHI” refers to information in your health record that could identify you and relates to your health, treatment, or payment. In addition, when clients receive substance use disorder (SUD) treatment, their SUD records are protected by another federal law, 42 CFR Part 2 (Part 2). Part 2 provides heightened privacy protections for SUD records, which limit how SUD records may be used and disclosed by Strive.

Uses and Disclosures

For purposes of this Notice, “Use” applies only to activities within our practice group, such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you. “Disclosure” applies to activities outside of our practice group, such as releasing, transferring, or providing access to information about you to other parties. Strive and its providers may use or disclose your protected health information (PHI) for the following reasons:

Treatment, Payment and Health Care Operations

• Treatment: Treatment is when we provide, coordinate, or manage your health care and other services related to your health care. An example of treatment would be when we consult with another health care provider, such as your family physician or another therapist.
• Payment: Payment is when we obtain reimbursement for your healthcare. Examples of payment are when we disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine your coverage for certain services.
• Health Care Operations: Health Care Operations are activities that relate to the performance and operation of our practice. Examples of health care operations are quality assessment and improvement activities, audits and administrative services, and case management and care coordination.

Disclosures for these purposes are called Treatment, Payment, and Healthcare Operations (TPO) disclosures. If you are receiving SUD treatment, we will obtain your separate written consent for our TPO disclosures.

At Your Authorization

We may use or disclose PHI for other purposes when you provide appropriate written authorization. Examples of disclosures requiring an authorization include disclosures to your partner, your spouse, your children and your legal counsel. Any disclosure involving psychotherapy notes or SUD counseling notes also requires your signed authorization, unless we are otherwise allowed or required by law to release them. We never share your information for marketing purposes unless you give us written permission. We will never sell your information. In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.

Other Uses and Disclosures

We may use or share your information as allowed or required by applicable laws to:

• Help with public health and safety issues
• Do research
• Report suspected or known child abuse or neglect, including sexual abuse
• Report suspected or known abuse of a domestic spouse, elder, or person with a development or cognitive disability
• Report a serious threat to the health or safety of you or others (i.e., comply with “duty to warn” laws)
• Respond to organ and tissue donation requests
• Work with a coroner, medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits, court orders, and legal actions

Special Privacy Protections for SUD Records

Subject to limited exceptions under Part 2, we will not acknowledge your presence as a client or disclose your SUD records without your written authorization. We may use or share your SUD records as permitted by Part 2, including:

• To comply with a Part 2 court order
• To qualified service organizations
• To qualified personnel for audit or program evaluations
• To report crimes on our premises or against our personnel

Your SUD records may not be used, disclosed, or introduced as evidence in civil, criminal, administrative, or legislative proceedings against you, or to investigate you, without your written consent or a court order that meets the strict requirements of Part 2. You may revoke your written consent at any time unless we have already relied on it. Revocation must be made in writing. Any SUD records and treatment information disclosed with your consent to other providers, health plans, and healthcare clearinghouses, and their business associates, may only be redisclosed in accordance with HIPAA.

Clients’ Rights and Our Duties

Clients’ Rights:

• Right to get an electronic or paper copy of your medical record.
• Right to ask us not to share PHI with certain people by stating the specific restriction requested and to whom you want the restriction to apply.
• Right to Choose Someone to Act for You.
• Right to Receive Confidential Communications by Alternative Means and at Alternative Locations.
• Right to Inspect and Copy your medical record.
• Right to request an Amendment to your medical record.
• Right to an Accounting of those with whom we’ve shared your health information.
• Right to a Copy of this Notice.
• Right to Revoke your Authorization for the use and/or disclosure of your PHI, except to the extent that action has already been taken in reliance on your earlier authorization.
• Right to file a Complaint with us or with the U. S. Department of Health and Human Services if you feel your rights are violated.
• If you pay for a service or health care item as a self-pay client, the Right to ask us not to share PHI with your health insurer.

Our Duties:

• We are required by law to maintain the privacy and security of your PHI, to provide you with a copy of this Notice, and to abide by the terms of this Notice.
• We reserve the right to change this Notice and to make those changes effective for all of the PHI we maintain.
• If we revise our Notice, we will make available a copy of the revised Notice to you on our website, and the Notice will always be available at our practice. You can always request that a paper copy be sent to you by mail.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your PHI.
• 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, then you may change your mind at any time. Let us know in writing if you change your mind.

Questions and Complaints

If you have any questions about this Notice, please contact us. If you are concerned that we have violated your privacy rights, or if you disagree with a decision we make about access to your records, you may file a complaint with our Privacy Officer.

Jessica Platt, LPCC-S is Strive’s Privacy Officer.
You may contact her at (440) 201-4488 if you have questions about this Notice or if you wish to file a complaint with the practice.

You can also 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 by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.