HIPAA Notice of Privacy Practices
Effective Date: September 28, 2018
Last Updated: September 6, 2025
This Notice of Privacy Practices describes how Kaafi Counseling, LLc, our Business Associates, and their subcontractors, may use and disclose your Protected Health Information (PHI) to conduct treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI. PHI is information about you, including demographic information, which may identify you and relates to your past, present or future physical or mental health condition and related health care services. Please read it carefully.
OUR RESPONSIBILITIES:
Kaafi Counseling, LLC is committed to protecting the privacy of your health information. We are required by law to:
- Maintain the privacy and security of your protected health information (PHI).
- Provide you with this Notice of our legal duties and privacy practices.
- Notify you promptly if a breach occurs that may compromise the privacy or security of your PHI.
- Follow the terms of this Notice.
HOW DO WE TYPICALLY USE OR SHARE YOUR HEALTH INFORMATION
Your PHI may be used and disclosed by your provider, our office staff, and others outside our office involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the practice, and any other use required by law.
For Treatment
Kaafi Counseling may use and disclose your PHI to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your PHI may be provided to a referring provider to ensure the provider has the necessary information to diagnose or treat you.
For Payment
Your PHI is used to obtain payment for your health care services. For example, obtaining approval for a services may require your relevant PHI be disclosed to the health plan to obtain approval for the services provided.
For Healthcare Operations
Kaafi Counseling may use or disclose your PHI to support the business activities of your provider’s practice. These activities include, but are not limited to, quality assessment, clinical reviews, peer consultations, training of graduate intern students, registered interns, licensing, and conducting or arranging for other business activities. For example, Kaafi Counseling may disclose your PHI to student interns and registered interns at our office. In addition, Kaafi Counseling may use or disclose your PHI to remind you of your appointment and inform you about treatment alternatives or other health-related benefits and services which may be of interest to you.
OTHER USES AND DISCLOSURES PERMITTED BY LAW
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.
- Public health and safety reporting.
- Abuse, neglect, or domestic violence reporting.
- Judicial or administrative proceedings.
- Law enforcement purposes.
- Health oversight activities.
- Coroners, medical examiners, and funeral directors.
- Workers’ compensation programs.
- To avert a serious threat to health or safety.
Under the law, Kaafi Counseling must make disclosures to you upon your request. Under the law, Kaafi Counseling must also disclose your PHI when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements under 45 CFR §164.500.
USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION
Other Permitted and Required Uses and Disclosures occur only with your consent, authorization or opportunity to object unless required by law. Use or disclosure of your PHI for marketing purposes is prohibited, without your authorization. Kaafi Counseling may not sell your PHI without your authorization. Kaafi Counseling may not use or disclose most psychotherapy notes contained in your PHI.
You may revoke your authorization in writing at any time, except to the extent we have already relied on the use or disclosure indicated in the authorization.
YOUR RIGHTS REGARDING YOUR INFORMATION
The following are statements of your rights with respect to your PHI.
- Access – You have the right to inspect and copy your PHI (fees may apply) – Pursuant to your written request, you have the right to inspect or copy your PHI whether in paper or electronic format. Under federal law, however, you may not inspect or copy the following records: Psychotherapy notes, information compiled in reasonable anticipation of, or used in, a civil, criminal, or administrative action or proceeding, PHI restricted by law, information related to medical research in which you have agreed to participate, information may result in harm or injury to you or to another person, or information obtained under a promise of confidentiality.
- Amend – You have the right to request an amendment to your PHI – If Kaafi Counseling denies your request for amendment, you have the right to file a statement of disagreement. However, Kaafi Counseling may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
- Confidential Communications – You have the right to request confidential communications – You have the right to request confidential communication from us by alternative means or at an alternative location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively, for example electronically.
- Restrictions – You have the right to request a restriction of your PHI – This means you may ask us not to use or disclose any part of your PHI for the purposes of treatment, payment, or healthcare operations. You may also request any part of your PHI not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply. Your provider is not required to agree to your requested restriction except if you request the provider not disclose PHI to your health plan with respect to healthcare for which you have paid in full out-of-pocket.
- Accounting of Disclosures – You have the right to receive an accounting of certain disclosures – You have the right to receive an accounting of disclosures, paper or electronic, except for disclosures: pursuant to an authorization, for purposes of treatment, payment, healthcare operations; required by law, occurring six years prior to the date of the request
- Paper Copy of this Notice – You have the right to obtain a paper copy of this notice from us even if you have agreed to receive the notice electronically. Kaafi Counseling reserves the right to change the terms of this notice and will notify you of such changes on the following appointment. Copies of the new notice will be available upon request.
- Notice of Breach – You have the right to receive notice of a breach – Kaafi Counseling will notify you if your PHI has been breached.
- File a Complaint – You may file a complaint if you believe your privacy rights have been violated.
OUR DUTIES REGARDING CONFIDENTIALITY OF MENTAL HEALTH RECORDS
Under Florida Statutes §394.4615, mental health records are given special confidentiality protections. We will not release mental health treatment records without your consent except as permitted or required by Florida law (e.g., court orders, emergencies, or mandated reporting of abuse).
COMPLAINTS
You may file a complaint with us or the Secretary of Health and Human Services. Kaafi Counseling will not retaliate against you for filing a complaint. If you believe your privacy rights have been violated, please notify us:
Kaafi Counseling, LLC
1920 Palm Beach Lakes Blvd, Suite 210
West Palm Beach, Florida 33409
Phone: (561) 463-0884
Email: info@kaaficounseling.com
Or with:
U.S. Department of Health and Human Services
Office for Civil Rights (OCR)
https://www.hhs.gov/ocr/privacy/hipaa/complaints
You will not be penalized or retaliated against for filing a complaint.
CHANGES TO THIS NOTICE
We may change this Notice at any time. The revised Notice will apply to all PHI we maintain and will be posted on our website and available in our office.