Notice of Privacy Practices

Who we are

Levins Hernandez Developmental Center LLC ("LHDC," "we," "us") provides applied behavior analysis services at 453 King Street, Cocoa, FL 32922. This notice applies to all health information we create or receive about our clients. Because our clients are usually minors, "you" in this notice means the client and the parent or legal guardian acting on the client's behalf.

Our duties

We are required by law to keep your child's health information private, to give you this notice of our legal duties and privacy practices, and to follow the notice currently in effect. We will notify you if a breach occurs that may have compromised the privacy or security of your child's information.

How we may use and disclose health information

Treatment

We use your child's information to assess, plan, and deliver ABA services. We may share it with other professionals involved in your child's care, such as a pediatrician, speech-language pathologist, occupational therapist, or school team, when doing so is part of coordinating treatment. You can ask us to limit this, and we will honor requests that are reasonable and consistent with your child's care.

Payment

We use and share information to bill and collect payment from your insurance plan or other payer. This includes submitting treatment plans, session records, and progress reports a payer requires to authorize services.

Health care operations

We use information to run the clinic: supervising clinical staff, reviewing quality of care, training behavior technicians, and conducting audits and compliance activities.

Appointment reminders and treatment information

We may contact you by phone, text, or email to remind you of appointments or to share information about your child's services.

Other uses and disclosures permitted by law

• As required by federal, state, or local law
• For public health activities, including reporting suspected abuse or neglect as required by Florida law
• To health oversight agencies for audits, inspections, and licensure or enrollment activities
• In response to a court order, subpoena, or other lawful process
• To avert a serious threat to the health or safety of a person or the public
• For workers' compensation or similar programs
• To a coroner, medical examiner, or funeral director as permitted by law
• For specialized government functions, such as military and veterans activities

Uses and disclosures that require your written authorization

We will not do any of the following without your written authorization, which you may revoke in writing at any time except to the extent we have already acted on it:

• Use or disclose psychotherapy notes, if any are kept
• Use your child's information for marketing
• Sell your child's health information
• Share your child's information with a school, another provider, or any other person for a purpose not described in this notice, including photographs or video of your child

Your rights

• Inspect and copy. You may ask to see or get a copy of your child's record. We may charge a reasonable, cost-based fee. We will respond within 30 days.
• Request a correction. If you believe information in the record is wrong or incomplete, you may ask us to amend it. We may say no, and if we do we will tell you why in writing.
• Request confidential communications. You may ask us to contact you in a specific way or at a specific location, for example only by phone and not by text. We will honor reasonable requests.
• Request restrictions. You may ask us to limit how we use or share information for treatment, payment, or operations. We are not required to agree, except that if you pay for a service in full out of pocket and ask us not to share information about that service with your health plan, we will honor that request.
• Get a list of disclosures. You may ask for an accounting of the times we shared your child's information for purposes other than treatment, payment, operations, and certain other exceptions, going back six years.
• Get a copy of this notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. A parent, legal guardian, or person with medical power of attorney may exercise these rights on the client's behalf. We will confirm that person's authority before acting.

Changes to this notice

We may change this notice and the new version will apply to all information we hold. The current notice is always posted at the clinic and at levinshernandez.com/privacy.html.

Questions and complaints

If you have questions about this notice or believe your privacy rights have been violated, contact our Privacy Officer:

Joshua Levins, Privacy Officer
Levins Hernandez Developmental Center LLC
453 King Street, Cocoa, FL 32922
334-707-3213
info@levinshernandez.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201; by phone at 1-800-368-1019 (TDD 1-800-537-7697); or online at hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.