Notice of Privacy Practices

Connections Counseling Services of Utah PLLC, including services provided through its DBA, Becoming Institute
5295 S. Commerce Dr. Suite 575, Murray, UT 84107
Phone: 801-272-3420 · Becoming Institute: 385-507-3220

I. Our commitment to protecting your health information

Connections Counseling Services of Utah PLLC, including services provided through its DBA, Becoming Institute, is committed to protecting the privacy and confidentiality of your health information. We maintain records of the treatment and services provided to support quality care, coordinate treatment, process payments, and fulfill applicable legal obligations.

This Notice of Privacy Practices applies to protected health information maintained by Connections Counseling Services of Utah PLLC, including information associated with Becoming Institute.

We are required by law to protect your health information, explain our privacy practices, and follow the terms of the notice currently in effect.

II. How we may use and disclose your health information

We may use or disclose your protected health information for treatment, payment, healthcare operations, and other purposes permitted or required by applicable law.

Treatment: We may use and share relevant information with authorized healthcare professionals involved in providing or coordinating your treatment.

Payment: We may use or disclose information as necessary to obtain payment for services, including communicating with insurance companies when applicable.

Healthcare operations: We may use information to manage our practice, improve services, conduct quality reviews, supervise clinical staff, and support administrative operations.

When you participate in services through Becoming Institute, authorized members of the treatment team may access relevant information as permitted by law to coordinate your care.

Participation in couples treatment does not automatically authorize unrestricted disclosure of one partner's individual health information to the other partner. Additional confidentiality policies and treatment agreements may apply.

III. Uses and disclosures requiring authorization

Certain uses and disclosures of protected health information require written authorization. These may include:

• Most uses or disclosures of separately maintained psychotherapy notes, except where legally permitted.
• Uses or disclosures for marketing when authorization is required.
• The sale of protected health information.
• Other disclosures requiring authorization under applicable federal or state law.

Other uses and disclosures not described in this notice will be made only with your written authorization.

When written authorization is required, we will obtain it before releasing the information. You may revoke an authorization in writing, subject to applicable legal limitations and disclosures already made in reliance on that authorization.

IV. Uses and disclosures permitted or required by law

We may use or disclose protected health information without your authorization when permitted or required by applicable law. These circumstances may include:

• Reporting suspected child abuse, neglect, or other abuse when required by law.
• Responding to certain serious threats involving health or safety.
• Public health activities authorized by law.
• Health oversight activities, including authorized investigations and audits.
• Certain law enforcement requests.
• Judicial or administrative proceedings when the applicable legal requirements have been satisfied.
• Workers' compensation matters.
• Disclosures to medical examiners, coroners, or funeral directors when authorized.
• Research activities that meet applicable legal requirements.
• Other disclosures required by federal or state law.

We will comply with applicable restrictions and procedural requirements before releasing information.

V. Additional protections for substance use disorder records

Certain substance use disorder treatment records receive additional confidentiality protections under federal law, including 42 CFR Part 2. When we maintain records protected by Part 2, additional requirements may apply to their use and disclosure. For records subject to Part 2:

• Consent may be required for uses or disclosures that would otherwise be permitted under HIPAA.
• Certain consents may authorize future uses and disclosures for treatment, payment, and healthcare operations.
• Information may be disclosed without consent only when an applicable legal exception permits it.
• Records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your consent or the specific legal process required by Part 2.
• Additional protections may apply when information is shared with outside providers or organizations.

Connections Counseling Services will follow the confidentiality requirements applicable to the particular records and services involved.

VI. Your rights regarding your health information

You have the following rights, subject to applicable law.

1. Access your health records. You may request to inspect or obtain an electronic or paper copy of your health records and other information maintained about you. We generally respond within 30 days and may charge a reasonable, cost-based fee where permitted. Certain information, including separately maintained psychotherapy notes, may be excluded from access under applicable law.

2. Request corrections. If you believe information in your health record is inaccurate or incomplete, you may request an amendment. If we deny your request, we will provide a written explanation within the time required by law.

3. Request confidential communications. You may ask us to contact you through a particular method or at a specific location. We will accommodate reasonable requests.

4. Request restrictions. You may request limitations on certain uses or disclosures of your health information. We are not always required to agree, except in circumstances where the law requires us to honor a restriction. If you pay for a service entirely out of pocket, you may request that information about that service not be disclosed to your health plan for payment or healthcare operations. We will honor qualifying requests unless disclosure is required by law.

5. Request an accounting of disclosures. You may request information about certain disclosures of your protected health information during the preceding six years. Some disclosures, including certain treatment, payment, and healthcare operations disclosures, may be excluded as permitted by law.

6. Obtain a copy of this notice. You may request a paper or electronic copy of this Notice of Privacy Practices at any time.

7. Designate a personal representative. You may authorize an individual to act on your behalf regarding your health information. We will verify the person's authority before allowing them to exercise your rights.

8. File a privacy complaint. You may submit a complaint if you believe your privacy rights have been violated. You may contact our Privacy Contact: Chris Adams, Administrative Director, Connections Counseling Services of Utah PLLC, 801-272-3420, info@connectionscs.com. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, www.hhs.gov/hipaa/filing-a-complaint. You will not be retaliated against for filing a complaint.

9. Be notified of a breach. You have the right to be notified if a breach compromises the privacy of your health information.

VII. Your choices regarding information sharing

In certain situations, you may express preferences regarding the use or disclosure of your health information. For example, you may identify family members, friends, or others involved in your care with whom information may be shared, as permitted by law.

When you are unable to communicate your preferences, we may make disclosures permitted by law based on the circumstances and your best interests.

If you participate in couples or group therapy, additional confidentiality agreements may apply. We will explain the applicable expectations and limitations of confidentiality before providing those services.

VIII. Confidentiality in couples and group treatment

Connections Counseling Services and Becoming Institute may provide individual, couples, and group-based behavioral health services. Information disclosed during these services is handled according to applicable privacy laws and the relevant treatment agreements.

Because couples and group treatment involve multiple participants, confidentiality considerations may differ from those associated with individual therapy. Clients participating in these services will be provided additional information regarding:

• Confidentiality between partners.
• Information sharing among authorized treatment professionals.
• Privacy expectations for group participants.
• Limitations on confidentiality involving other participants.
• Treatment records and access to information.

Participation in group treatment may involve disclosures to other group members. Although participants are expected to protect one another's privacy, the organization cannot guarantee that other participants will maintain confidentiality.

IX. Our responsibilities

Connections Counseling Services of Utah PLLC is responsible for maintaining the privacy and security of protected health information in accordance with applicable law. We will:

• Implement appropriate measures to safeguard protected health information.
• Follow the privacy practices described in the notice currently in effect.
• Provide access to this notice upon request.
• Notify affected individuals of breaches when required by law.
• Obtain authorization for uses or disclosures that require it.
• Respect applicable federal and state confidentiality requirements.

X. Changes to this notice

Connections Counseling Services reserves the right to revise this Notice of Privacy Practices as permitted by law. Revisions may apply to protected health information already maintained by the practice, as well as information received after the effective date of the revision. Updated notices will be available upon request, at our office, and through our website.