Haven Mental Health Solutions, LLC

NOTICE OF PRIVACY PRACTICES

Effective Date: April 10, 2022

Updated: May 28, 2026

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. OUR PLEDGE REGARDING YOUR HEALTH INFORMATION

Haven Mental Health Solutions, LLC (“Haven,” “we,” “us,” or “our”) understands that information about you and your health care is personal and confidential. We are committed to protecting your Protected Health Information (“PHI”). PHI includes information that identifies you and relates to your mental health, health care services, or payment for services.

We create and maintain records of the care and services you receive in order to provide quality treatment and to comply with legal requirements. This Notice applies to all PHI created or maintained by Haven Mental Health Solutions, LLC.

We are required by law to:

• Maintain the privacy of your PHI

• Provide you with this Notice of our legal duties and privacy practices

• Provide you with adequate notice of your rights and our legal duties if we create or maintain records protected by 42 C.F.R. Part 2

• Follow the terms of this Notice currently in effect

We reserve the right to change this Notice at any time. Any changes will apply to all PHI we maintain. The revised Notice will be available upon request, in our office, and on our website.

II. HOW WE MAY USE AND DISCLOSE YOUR PHI

The following categories describe the ways we may use and disclose your PHI. Not every possible use or disclosure is listed, but all permitted uses and disclosures fall within these categories.

A. Treatment, Payment, and Health Care Operations

We may use and disclose your PHI without your written authorization for treatment, payment, and health care operations.

• Treatment: We may use and disclose PHI to provide, coordinate, or manage your mental health care. This may include consultations with other licensed health care providers, referrals, or coordination of care.

• Payment: We may use and disclose PHI to bill and receive payment for services, including submitting claims to insurance companies, verifying benefits, and collecting outstanding balances.

• Health Care Operations: We may use and disclose PHI for operations necessary to run our practice, such as quality assurance, training, supervision, licensing, and administrative activities.

If your records are protected under 42 C.F.R. Part 2, certain uses and disclosures permitted by HIPAA for treatment, payment, and health care operations are materially limited by the stricter standards of those regulations. Furthermore, information disclosed pursuant to these rules may be subject to redisclosure by the recipient and may no longer be protected by federal privacy standards.

Disclosures for treatment purposes are not limited to the minimum necessary standard, as providers may need full access to relevant information to provide appropriate care.

B. Lawsuits and Legal Proceedings

We may disclose your PHI in response to a court or administrative order. We may also disclose PHI in response to a subpoena or other lawful process if efforts have been made to notify you or obtain an order protecting the information. However, for records protected by 42 C.F.R. Part 2, such records or testimony relaying their content shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide specific written consent or a court order is issued in accordance with 42 C.F.R. Part 2.

III. USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION

Psychotherapy Notes

We maintain psychotherapy notes as defined by federal law (45 CFR §164.501). Psychotherapy notes are kept separate from your medical record. We will not use or disclose psychotherapy notes without your written authorization except in the following circumstances:

• For our use in treating you

• For training or supervision of mental health practitioners

• To defend ourselves in legal proceedings initiated by you

• For oversight by the Secretary of Health and Human Services

• As required by law

• To prevent a serious and imminent threat to health or safety

• As required by a coroner or medical examiner

Substance Use Disorder (SUD) Counseling Notes

Substance Use Disorder (SUD) Counseling Notes. We may also maintain “SUD counseling notes,” which are notes recorded by a substance use disorder provider documenting the contents of a counseling session. Any use or disclosure of these notes requires your separate written authorization, which cannot be combined with a consent for other types of records. You can revoke your consent at any time except to the extent that we have already acted upon it to disclose these notes in accordance with your initial authorization.

Marketing

We do not use or disclose your PHI for marketing purposes.

Sale of PHI

We do not sell your PHI.

IV. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

Subject to applicable law, we may use and disclose your PHI without your authorization for the following purposes:

• When required by state or federal law

• For public health and safety activities, including reporting abuse, neglect, or threats of serious harm

• For health oversight activities such as audits or investigations

• For judicial or administrative proceedings

• For law enforcement purposes

• To coroners or medical examiners as authorized by law

• For workers’ compensation purposes, as permitted by law

Appointment Reminders and Care-Related Communications

We may contact you by phone, voicemail, text message, email, or client portal to remind you of appointments or provide information related to your treatment, unless you request alternative communication methods.

Research

Haven Mental Health Solutions, LLC does not use or disclose PHI for research purposes without your written authorization or unless otherwise permitted or required by law.

V. DISCLOSURES WHERE YOU HAVE THE OPPORTUNITY TO OBJECT

We may disclose your PHI to family members, friends, or other individuals involved in your care or payment for care unless you object. In emergency situations, consent may be obtained retroactively when possible.

Fundraising

If we intend to use or disclose your records protected by 42 C.F.R. Part 2 for fundraising for our benefit, we will provide you with a clear and conspicuous opportunity to opt-out before any such use or disclosure occurs.

VI. ELECTRONIC COMMUNICATIONS AND TELEHEALTH

We may communicate with you electronically, including through email, text messaging, client portals, and telehealth platforms such as SimplePractice. While we take reasonable steps to protect your privacy, electronic communications involve some risk to confidentiality that is beyond our control.

You are responsible for ensuring that your environment during telehealth sessions is private and secure.

VII. YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding your PHI:

• Right to Request Restrictions: You may request limits on how we use or disclose your PHI. We are not required to agree to all requests.

• Right to Restrict Disclosures to Health Plans: You may request that PHI related to services you paid for in full out-of-pocket not be disclosed to your health plan.

• Right to Request Confidential Communications: You may request that we communicate with you in a specific way or at a specific location.

• Right to Access Your PHI: You may request a paper or electronic copy of your medical record, excluding psychotherapy and SUD counseling notes. Requests will be fulfilled within 30 days when possible. Reasonable, cost-based fees may apply.

• Right to Request Amendments: You may request corrections or additions to your PHI. We may deny the request but will explain our decision in writing.

• Right to an Accounting of Disclosures: You may request a list of certain disclosures made in the past six years. One request per year is provided at no charge. You also have the right to request an accounting of disclosures specifically for your substance use disorder records protected under 42 C.F.R. Part 2.

• Right to a Copy of This Notice: You may request a paper or electronic copy of this Notice at any time.

VIII. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Haven Mental Health Solutions, LLC or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

Privacy Officer: Channing Ferrer, LMSW
Phone: 734-747-1803
Email: channingferrer@outlook.com