Last updated: September 2, 2021
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
At Sylvia Brafman Mental Health Center LLC, we are committed to preserving the privacy and confidentiality of your health information whether created by us or maintained on our premises. We are required by certain federal and state regulations to implement policies and procedures to safeguard the privacy of your health information. Copies of our privacy policies and procedures are maintained in the legal office at our main address listed hereunder. We are required by federal and state regulations to abide by the privacy practices described in this notice and any future revisions that we may make to the notice as may become necessary or as authorized by law.
Protected health information is any individually identifiable information about your past, present, or future physical or mental health or condition, the provisions of health care to you, or payment for the health care treatment or services you receive. As such, we are required to provide you with this Notice of Privacy Practices that contains information regarding our privacy practices that explains how, when and why we may use or disclose your protected health information and your rights and our obligations regarding any such uses or disclosures. Except in specified circumstances, we will use or disclose only the minimum necessary protected health information to accomplish the intended purpose of use or disclosure of such information.
We have a limited right to use and disclose your health information for purposes of treatment, payment, or for the operations of our facility. For other purposes, you must give us your written authorization to release your protected health information unless the law permits or requires us to make the use or disclosure without your authorization.
We may use a limited amount of your protected health information when raising money for our facility and its operations. The information we may use will be limited to your name, address, telephone number, and dates for which you received services at our facility.
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations.
- We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
- We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information shared during each New Client Orientation or ask us how to do this.
- You can 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 visiting hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
- Contact you for fundraising efforts
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
- Maintain the privacy of your health information;
- Inform you about our privacy practices regarding health information we collect and maintain about you;
- Notify you if we are unable to agree to a requested restriction;
- Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations; and,
- Honor the terms of this notice or any subsequent revisions of this notice.
Sylvia Brafman Mental Health Center LLC reserves the right to change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by contacting our office, 954-758-4174 and requesting that a revised copy be sent to you in the mail.
Sylvia Brafman Mental Health Center LLC understands that health information about you is personal and is committed to protecting your health information. Sylvia Brafman Mental Health Center LLC will not use or disclose your health information without your permission, except as described in this notice and as permitted by applicable federal and state laws.
Our Uses and Disclosures
We will use and disclose your health information to provide, coordinate, or manage your treatment and any related services. This includes the coordination or management of your health care with another provider.
- We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Use with Business Associates
- We may disclose your health information to business associates so that they can perform their duties.
- Business associates are required to protect and safeguard your health information in accordance with all applicable federal laws.
Run our organization
- We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
Use for Public Health:
We may use or disclose your health information to public health or other appropriate government authorities as follows:
- We may use or disclose your health information to government authorities that are authorized by law to collect or receive such information.
Example: We may use for the purpose of preventing or controlling disease, injury, or disability, or conducting public health surveillance, investigations, and interventions.
- We may disclose your health information to government authorities that are authorized by law to receive reports of child abuse or neglect; authorized by law to collect or receive such information.
Example: We may use to provide important information to pertinent government agencies for legal purposes.
- We are authorized by law to disclose your health information to an individual who may have been exposed to a communicable disease.
Example: We may use your information when others are at risk of contracting or spreading a disease or condition.
Health Oversight Authorities:
We may use or disclose your health information to health oversight agencies
Example: Staff members from the Florida Department of Children and Families or Joint Commission that conduct activities audits, surveys or investigations.
We may use or disclose your health information in certain other situations involving compelling circumstances.
- We may use your information when affecting the health or safety of other individuals.
- We may use or disclose protected health information if we believe it is necessary to prevent or lessen a serious or imminent threat to the health and safety of a person;
- We may use or disclose protected health information to report a crime committed on Sylvia Brafman Mental Health Center LLC premises;
- We may make any other disclosures that are required by law.
Example: We may disclose limited protected health information when requested by a law enforcement official for the purpose of identifying or locating a suspect, fugitive, material witness or missing person, to respond to an imminent threat or to abide by the law.
Non-Violation of this Notice:
- We are not in violation of this notice or the HIPAA Privacy Rule if any of its employees or its contractors (business associates) discloses protected health information under the following circumstances:
Disclosure by Whistleblowers: We believe we would act in good faith should we engage in conduct that is unlawful or otherwise violates clinical and professional standards or that the care or services provided had the potential of endangering one or more clients or members of the workplace or the public and discloses such information to:
- A public health oversight authority (for example, the Florida Department of Health Care Services) authorized by law to investigate or otherwise oversee the relevant conduct or the suspected violation, or an appropriate health care accreditation organization for the purpose of reporting the allegation of failure to meet professional standards or misconduct by Sylvia Brafman Mental Health Center LLC; or
- An attorney on behalf of an employee or contractor (business associate) for the purpose of determining their legal options regarding the suspected violation.
- Disclosures by Employee Crime Victims: Under certain circumstances, our employees (or contractor) who are victims of a crime on or off the premises may disclose information about suspects to law enforcement officials provided that:
- The information disclosed is about the suspect who committed the criminal act.
- The information disclosed is limited to identifying and locating the suspect.
How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
- We can use or share your information for health research.
Comply with the law
- We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
- We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
- We can share health information with a coroner, medical examiner, or funeral director when an individual die.
Address workers’ compensation, law enforcement, and other government requests
- We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
- We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Understanding Your Health Record & Information.
When you enroll at Sylvia Brafman Mental Health Center LLC a record of personal health information is created. As you progress through your services at our facility, this record is updated. Typically, this record contains your symptoms, examination, lab test results, diagnoses, and plan for future care. This information, often referred to as your health record, serves as a:
- Plan for your care and treatment;
- Communication source between health care professionals;
- Tool with which we can check results and continually work to improve the care we provide;
- Means by which private insurance payers can verify the services billed; and,
- Legal documentation that describes the care you receive.
Understanding what is in your health record and how the information is used helps you to:
- Ensure its accuracy;
- Better understand why others may review your health information; and,
- Make an informed decision when authorizing disclosures.
For more information see: www.sylviabrafman.com
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Effective Date: August 01, 2021
This Notice of Privacy Practices applies to the following organizations:
Sylvia Brafman Mental Health Center provides behavioral health services nationwide and is located in Broward County at 7710 NW 71st Court, Ste. 102, Tamarac, FL 33321; contact our office at 954-758-4174.
Secretary of Health and Human Services
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
Toll Free: 1-877-696-6775