Who This Notice Covers

This notice applies to Liv Associates, Inc. and to every clinician and staff member who provides services or handles records on our behalf, whether employed by us or independently contracted. It covers care delivered in our Warminster office and by telehealth.

"Protected health information" (PHI) means information that identifies you and relates to your mental or physical health, the care you receive, or payment for that care. In this notice, "we" and "us" mean Liv Associates and the clinicians and staff described above.

Our Legal Duties

We know that information about your mental health care is personal, and we are committed to protecting it. The law requires us to:

How We Use and Share Your Information

Federal law allows us to use and share your PHI for the purposes below without your written authorization. Pennsylvania's Mental Health Procedures Act was aligned with HIPAA for treatment, payment, and health care operations by Act 32 of 2022, so we generally do not need additional state-law consent for those purposes. Stricter Pennsylvania rules continue to apply in other areas described in this notice (see "Pennsylvania Law and Minors").

• Treatment. We use your PHI to provide and coordinate your care. Example: your clinician consults with another treating clinician or a clinical supervisor, or with your physician, to coordinate your care.
• Payment. We use and share your PHI to bill and get paid for your care. Example: we send your insurance plan the dates of service, diagnosis code, and type of service so it can process your claim, or request prior authorization for continued sessions.
• Health care operations. We use your PHI to run our practice and improve care. Example: we review records to check the quality of care, train and supervise clinicians, credential with insurance plans, or prepare for an audit.

Business associates

Some services are provided for us by outside companies, such as our electronic health record, billing, and telehealth vendors. We share only the PHI they need, and each must sign a written agreement to protect it.

Appointment reminders and services

We may contact you by phone, text, email, or mail to remind you of appointments or to tell you about treatment options or services we offer. Tell us if you prefer a particular method.

Other Uses and Disclosures Without Your Authorization

The law allows or requires us to share PHI without your authorization in the situations below. We share only what the law requires or permits, and where state law is stricter, we follow it.

1. When required by law.
2. Abuse or neglect reporting. We are mandated reporters. We must report suspected abuse or neglect of a child to ChildLine or law enforcement as Pennsylvania's Child Protective Services Law requires, and may report suspected abuse of an older or dependent adult to the appropriate agency. When a child is involved, we do not notify a parent or caregiver first if doing so could put the child at risk or interfere with an investigation.
3. Serious threat to health or safety. We may share information to prevent or lessen a serious and imminent threat to you or to another person, including warning a person you have threatened or contacting emergency services. Where Pennsylvania mental-health confidentiality rules apply, emergency disclosure is limited to the information necessary to prevent serious bodily harm or death.
4. Public health activities, as the law requires.
5. Health oversight. To agencies that audit, inspect, or license health care providers, such as state licensing boards.
6. Lawsuits and legal proceedings. We review any court order, subpoena, or similar request against applicable Pennsylvania confidentiality and privilege protections before releasing mental health records or testifying about them. Pennsylvania law protects therapist-client communications. We respond only as Pennsylvania law allows, which for mental health records ordinarily means a court order that satisfies applicable confidentiality rules, your written authorization, or other legal process Pennsylvania law specifically authorizes. This includes custody, separation, and divorce proceedings: we do not release a child's records to either parent's attorney, or testify about them, without a court order that meets these requirements or valid written authorization from the person legally entitled to give it.
7. Law enforcement. In limited circumstances, such as reporting a crime on our premises or responding to a court order or warrant.
8. Coroners and medical examiners, when performing duties authorized by law.
9. Research. Only when an institutional review board or privacy board has approved the research and waived the authorization requirement, or as otherwise permitted by law.
10. Specialized government functions, such as certain military, national security, or correctional purposes.
11. Workers' compensation, as needed to comply with applicable laws.
12. To the Department of Health and Human Services, when it is investigating our compliance with privacy law.

Information we disclose under the HIPAA Privacy Rule may be redisclosed by the recipient and, once redisclosed, may no longer be protected by the Privacy Rule.

Sharing With Family and Others Involved in Your Care

We may share relevant PHI with a family member, friend, or other person you identify as involved in your care or in paying for it, unless you object, and only as Pennsylvania mental health confidentiality law allows. In couples, family, or teen therapy, we discuss at the start what will and will not be shared. If you are unable to agree or object, we may share limited information that we believe is in your best interest, consistent with Pennsylvania law. We will tell you afterward when feasible.

Parents who share custody

When a minor client's parents are separated or share custody, clinically relevant communications from a parent may be documented in the child's record. Documenting a communication does not automatically give the other parent a right to see or receive it. Access continues to depend on the minor's age and rights under Pennsylvania law (including Act 65), who consented to treatment, the requester's legal authority, and any applicable safety concerns. Tell us right away about any protection from abuse order or other safety concern so we can protect information such as your address.

Uses That Require Your Written Authorization

• Psychotherapy notes. Some of our clinicians keep psychotherapy notes, which are a therapist's separate notes analyzing session content. These are kept apart from your main record. We will not use or share them without your written authorization, except for your clinician's own use in treating you, supervised training of clinicians, defending ourselves in a legal action you bring, a compliance investigation by HHS, or when the law requires it.
• Marketing. We do not use or share your PHI for marketing.
• Sale of PHI. We do not sell your PHI.
• Everything else. Any use or disclosure not described in this notice requires your written authorization.

You may revoke an authorization at any time by writing to our Privacy Officer. Revoking it stops future uses and disclosures. It does not undo any disclosure we already made in reliance on it.

Pennsylvania Law and Minors

Pennsylvania law continues to provide stronger protections than federal law in certain situations. When state law is stricter, we follow it. Act 32 of 2022 aligned the Mental Health Procedures Act with HIPAA for treatment, payment, and health care operations. Stricter Pennsylvania rules still apply in other areas, including legal proceedings, information about minors, HIV-related information, and substance use disorder records.

Minors

Under Pennsylvania law (Act 65 of 2020), a minor 14 or older may consent to outpatient mental health treatment, and a parent or legal guardian may also consent for a minor under 18. Who controls the minor's information depends on the minor's age and on who consented to treatment:

• Under 14: a parent or legal guardian consents to treatment and generally exercises the minor's privacy rights.
• Ages 14 to 17, when the minor consented: the minor generally controls access to and release of their records, including to parents. Outside limited exceptions, we will not release the minor's records without the minor's written consent.
• Ages 14 to 17, when a parent or guardian consented: the parent or guardian has access to the information needed to make informed decisions about the minor's treatment and may authorize release of records to the minor's other providers, subject to Act 65.

A parent or guardian does not automatically have unrestricted access to a minor's mental health records. We will explain how this applies to your family at intake.

Personal representatives

A parent or guardian of a minor, a court-appointed guardian, or a person holding a valid health care power of attorney may generally exercise your rights under this notice, as state law allows. We may decline to treat a person as your personal representative if we reasonably believe you have been or may be subjected to abuse or neglect by that person.

Substance use disorder records

We do not provide substance use disorder treatment, but we may receive records from programs that do. Records protected by federal law (42 CFR Part 2) receive additional protection:

• We use and disclose them only as your written consent allows or as Part 2 permits.
• We will not use or disclose these records, or testify about their content, in any civil, criminal, administrative, or legislative proceeding against you, unless you give specific written consent or a court orders it after you receive notice and an opportunity to be heard.
• We do not use these records for fundraising.

Your Rights

To use any of these rights, contact our Privacy Officer. Some requests must be in writing.

1. See and get a copy of your record. You may ask to see or get an electronic or paper copy of your PHI, other than psychotherapy notes. We will respond within 30 days. We may charge a reasonable, cost-based fee.
2. Ask us to correct your record. If you believe information in your record is wrong or incomplete, you may ask us in writing to correct it. We will respond within 60 days.
3. Ask for confidential communications. You may ask us to contact you in a specific way or at a different address. We will agree to all reasonable requests.
4. Ask us to limit what we use or share. You may ask us not to use or share certain PHI for treatment, payment, or operations. If you pay out of pocket in full and ask us not to disclose information about that service to your health plan, we will agree (unless the law requires us to share it).
5. Get a list of those we have shared with. You may ask for a list of the times we disclosed your PHI in the six years before your request, excluding disclosures for treatment, payment, operations, and those you authorized. The first list in any 12-month period is free.
6. Get a copy of this notice at any time, even if you agreed to receive it electronically.
7. Choose someone to act for you. If you have given someone health care power of attorney, or someone is your legal guardian, that person can exercise your rights. We will confirm their authority before we act.

Changes to This Notice

We may change this notice, and any change will apply to all PHI we hold about you. The current notice will be posted in our office and on our website. You can ask us for a paper copy at any time.