Notice of Privacy Practices

Effective Date: August 12, 2025

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. Our Pledge Regarding Your Health Information

We understand that your health information is personal. Living Rivers Counseling is committed to protecting health information about you. We create a record of the care and services you receive from us, and we need this record to provide you with quality care and to comply with certain legal requirements.

This Notice applies to all records of your care generated by this mental health care practice. It describes the ways in which we may use and disclose your health information, your rights regarding that information, and certain obligations we have in connection with its use and disclosure.

We are required by law to:
• Keep protected health information (“PHI”) that identifies you private.
• Provide you with this Notice of our legal duties and privacy practices with respect to your health information.
• Follow the terms of the Notice currently in effect.
• Notify you promptly in the event of a breach of your unsecured PHI (see Section VII below).

We reserve the right to change the terms of this Notice at any time. Changes will apply to all health information we maintain about you. The updated Notice will be available upon request and on our website.

II. How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose your health information. Not every specific use or disclosure within a category is listed; however, all permitted uses and disclosures will fall within one of these categories.

Treatment, Payment, or Health Care Operations 

Federal privacy rules permit health care providers with a direct treatment relationship with a patient to use or disclose that patient’s PHI without written authorization for treatment, payment or health care operations purposes. For example, if we consult with another licensed health care provider about your condition, we may share your PHI to assist in your diagnosis and treatment. Disclosures for treatment purposes are not subject to the minimum necessary standard, as providers require access to complete information to deliver quality care. “Treatment” includes coordination and management of care with third parties, consultations between providers, and referrals.

Lawsuits and Legal Disputes

If you are involved in a lawsuit or administrative proceeding, we may disclose your health information in response to a court or administrative order, or in response to a subpoena, discovery request, or other lawful process. We will make reasonable efforts to notify you before making such a disclosure or to seek a protective order.

III. Uses and Disclosures That Require Your Authorization

The following uses and disclosures require your written authorization, except as specifically noted:
1. Psychotherapy Notes. We maintain “psychotherapy notes” as defined under 45 CFR § 164.501. Any use or disclosure of such notes requires your written authorization unless the use or disclosure is: (a) for treatment purposes; (b) for training or supervising mental health practitioners; (c) for use in legal proceedings initiated by you; (d) for review by the Secretary of Health and Human Services; (e) required by law; (f) required for health oversight activities; (g) required by a coroner performing legal duties; or (h) necessary to avert a serious threat to the health or safety of others.
2. Marketing. We will not use or disclose your PHI for marketing purposes without your written authorization.
3. Sale of PHI. We will not sell your PHI in the regular course of business.
4. Communications. This website does not request, collect, or store phone numbers. We do not communicate via SMS or telephone through this platform. If you contact us through other means, we will handle your PHI accordingly.

IV. Uses and Disclosures That Do Not Require Your Authorization

Subject to certain limitations in the law, we may use and disclose your PHI without your authorization for the following reasons:
1. When required by state or federal law, consistent with the requirements of such law.
2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
3. For health oversight activities, including audits and investigations.

For judicial and administrative proceedings, including responding to a court or administrative order. We prefer to obtain your authorization before doing so whenever possible.
4. For law enforcement purposes, including reporting crimes occurring on our premises.
5. To coroners or medical examiners performing duties authorized by law.
6. For legitimate research purposes, such as studying and comparing outcomes among patients who received different forms of therapy for the same condition.
7. For specialized government functions, including military missions, protection of the President, intelligence operations, and safety in correctional institutions.
8. For workers’ compensation purposes. We prefer to obtain your authorization before disclosing PHI, but may do so as required by applicable workers’ compensation laws.
9. For appointment reminders, treatment alternatives, or other health care services or benefits we offer.

V. Uses and Disclosures Where You Have the Opportunity to Object

1. Disclosures to Family, Friends, or Others. We may share your PHI with a family member, friend, or other person you identify as involved in your care or payment for your care, unless you object in whole or in part. In emergency situations, your opportunity to object may be obtained after the fact.

VI. Your Rights Regarding Your Health Information
You have the following rights with respect to your PHI:
2. The Right to Request Limits on Uses and Disclosures. You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree, and may decline if we believe it would affect your health care.
3. The Right to Request Restrictions for Out-of-Pocket Services. If you have paid for a health care item or service entirely out of pocket, you have the right to request that we not disclose the related PHI to your health plan for payment or operations purposes.
4. The Right to Choose How We Contact You. You may ask us to contact you in a specific way or at a specific address, and we will accommodate all reasonable requests.
5. The Right to Access and Obtain Copies of Your PHI. Except for psychotherapy notes, you have the right to receive an electronic or paper copy of your health records. We will provide a copy or summary within 30 days of receiving your written request, and may charge a reasonable, cost-based fee.
6. The Right to an Accounting of Disclosures. You may request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided an authorization. We will respond within 60 days. The list will cover the prior six years unless you request a shorter period. The first accounting each year is free; additional requests in the same year may be subject to a reasonable fee.

The Right to Request Corrections or Amendments. 

If you believe your PHI contains an error or is incomplete, you may request a correction or addition. We may decline your request, but will provide a written explanation within 60 days. You may request a paper or electronic copy of this Notice at any time, regardless of whether you have previously agreed to receive it electronically.

VII. Breach Notification

We are required by federal law to notify you without unreasonable delay, and in no case later than 60 days following discovery, if there has been a breach of your unsecured PHI. Notice will be provided to you in writing at your last known address. If the breach affects 500 or more individuals in a state or jurisdiction, we will also notify prominent media outlets in that area. In the event of a large-scale breach, we will notify the Secretary of Health and Human Services. For smaller breaches, we will maintain a log and report to the Secretary annually.

If you believe your PHI may have been compromised, please contact us immediately using the information below.

VIII. Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, you may contact us directly. You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. 

Living Rivers Counseling
Website: LivingRiversCounseling.org
Email: AlexandraR@LivingRiversCounseling.org
U.S. Department of Health and Human Services
Office for Civil Rights: http://www.hhs.gov/ocr/privacy/hipaa/complaints

IX. Texas Consumer Rights — HB 4224 (Effective September 1, 2025)

 In accordance with Texas House Bill 4224 and Section 181.105 of the Texas Health and Safety Code, the following information is required to be prominently posted for all Texas mental health licensees.

Requesting Your Health Care Records

You have the right to request and receive a copy of your mental health records. To obtain your records, submit a written request to your provider via email, secure portal, or mail. This is in accordance with Texas Health & Safety Code §611.0045.

Your provider has 15 days to respond to your written request, in accordance with Texas Health & Safety Code §611.008(a).

To submit a records request to Living Rivers Counseling, please contact us at:
• Email: AlexandraR@LivingRiversCounseling.org
• Mail: 4400 State Hwy 121, Suite 300, Lewisville, TX 75056

Texas Behavioral Health Executive Council (BHEC)

If you have questions about a licensed mental health professional or wish to file a complaint against a licensee, contact BHEC directly:
• Address: 1801 Congress Avenue, Suite 7.300, Austin, Texas 78701
• Website: bhec.texas.gov/discipline-and-complaints/
• Email: Enforcement@bhec.texas.gov
• Phone: 1-800-821-3205
• Online complaint form available at the BHEC website above

Filing a Consumer Complaint with the Texas Attorney General

To file a consumer complaint about mental health services in Texas, visit the Texas Office of the Attorney General’s Consumer Protection Division:

• Website: texasattorneygeneral.gov/consumer-protection