NOTICE OF PRIVACY PRACTICES Effective Date: 06/04/2025 Last Revised: 06/05/2025

As Required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Applicable Florida 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.

  1. OUR COMMITMENT TO YOUR PRIVACY

LifeBuilders Christian Counseling Center is committed to maintaining the privacy of your Protected Health Information (PHI). We are required by law to maintain the confidentiality of your PHI and to provide you with this Notice of our legal duties and privacy practices.

This Notice explains:

  • How we may use and disclose your PHI
  • Your rights regarding your PHI
  • Our obligations regarding the use and disclosure of your PHI

We reserve the right to change our privacy practices and update this Notice. Updates will apply to all PHI we maintain. The current Notice will be available at our office and on our website (if applicable).

  1. USES AND DISCLOSURES OF YOUR PHI
  2. Routine Uses and Disclosures

We may use and disclose your PHI for:

  • Treatment – To provide, coordinate, or manage your healthcare.
  • Payment – To obtain payment for services rendered (with your prior written authorization if required).
  • Healthcare Operations – To support daily business activities such as quality assessment and staff training.
  • Client Contact – To remind you of appointments or provide information about treatment alternatives.
  1. Special Circumstances

We may use or disclose your PHI without your consent or authorization under the following circumstances:

  • As Required by Law
  • Public Health Activities (e.g., disease control, child abuse reporting)
  • Victims of Abuse, Neglect, or Domestic Violence
  • Health Oversight Activities (e.g., audits, licensure)
  • Judicial and Administrative Proceedings
  • Law Enforcement Purposes
  • Coroners, Medical Examiners, and Funeral Directors
  • Organ Donation
  • Research Purposes (with appropriate safeguards or authorization)
  • To Avert a Serious Threat to Health or Safety
  • Military and National Security
  • Correctional Institutions (if you are an inmate)
  • Workers’ Compensation Programs
  1. ADDITIONAL PROTECTIONS
  2. Breach Notification

We are required by law to notify you promptly if a breach of your unsecured PHI occurs.

  1. Restrictions on Disclosures to Health Plans

You have the right to restrict disclosure of PHI to a health plan if you paid for a service in full out-of-pocket.

  1. Business Associates

We may share your PHI with third-party business associates (e.g., billing companies, IT providers) who are required by law to protect your privacy.

Our Business Associates: Emu and ACTS IT services.

  1. Electronic Communications

If you choose to communicate with us via email, text, or other unsecured methods, you acknowledge and accept any associated risks.

  1. Third-Party Apps and Technology Integration

We used the Zoom telehealth HIPPA compliant service to perform our Telehealth services. It is our policy to not disclose your PHI through telehealth services.

  1. YOUR RIGHTS REGARDING YOUR PHI
  2. Right to Request Confidential Communications

You may request how and where we contact you (e.g., home vs. work).

  1. Right to Request Restrictions

You may request restrictions on the use or disclosure of your PHI. We are not required to agree but will comply if legally obligated.

  1. Right to Inspect and Copy

You may inspect or obtain copies of your PHI, except for psychotherapy notes. Requests must be submitted in writing. A fee may apply.

  1. Right to Amend

You may request amendments to your PHI. Requests must be in writing and must include a reason. We may deny requests under specific circumstances.

  1. Right to an Accounting of Disclosures

You may request a list of non-routine disclosures made in the past six years. One request per year is free; additional requests may incur a fee.

  1. Right to a Paper Copy of This Notice

You may request a printed copy of this Notice at any time.

  1. Right to File a Complaint

You may file a complaint if you believe your privacy rights have been violated. Submit your complaint in writing to:

Christian Counseling Center – Privacy Office
306 W. Sadie Street
Brandon, FL 33510

Or to the U.S. Department of Health and Human Services – Office for Civil Rights

You will not be retaliated against for filing a complaint.

  1. Right to Authorize Other Uses

We will not use or disclose your PHI for purposes not covered by this Notice without your written authorization. You may revoke an authorization at any time in writing.

  1. 9. State Law (Florida)

“In certain cases, Florida law may provide more stringent privacy protections than federal regulations. Where applicable, we will follow the most protective standard.”

  1. CONTACT INFORMATION

If you have questions about this Notice or need additional information, please contact:

Christian Counseling Center – Officer Manager
306 W. Sadie Street
Brandon, FL 33510
Telephone: (813) 438-5949

This Notice reflects our current privacy practices and obligations under federal and state law.

In the Future: updates to this policy will be communicated via our website at Lifebuildercounseling.org.