NOTICE OF PRIVACY PRACTICES

Daylily Therapy, PLLC

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on 11/1/2025

PURPOSE

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

INTRODUCTION 

We are required by law to maintain the privacy of Protected Health Information ("PHI"), to provide individuals with notice of our legal duties and privacy practices with respect to PHI, and to notify affected individuals following a breach of unsecured PHI. PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition and relates to the provision of health care or payment for the provision of health care for your past, present, or future physical or mental health or condition and related healthcare services. This Notice of Privacy Practices ("Notice") describes how we may use and disclose PHI to carry out treatment, obtain payment or perform our health care operations, and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to PHI about you. 

We are required to follow the terms of this Notice currently in effect. We will not use or disclose PHI about you without your written authorization, except as described in this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you. 

This notice is effective November 1, 2025 and applies to all protected health information as defined by federal regulations. 

OUR PLEDGE

The privacy of your PHI is important to us. We are committed to protecting health information about you. We create a record of the care and services you receive from us, which we need to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your care generated by this mental health care practice. This Notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you, and describe certain obligations we have regarding the use and disclosure of your health information. We are required by law to: 

  • Make sure that PHI that identifies you is kept private. 

  • Give you this Notice of our legal duties and privacy practices with respect to health information. 

  • Follow the terms of the Notice that is currently in effect. 

  • We can change the terms of this Notice, and such changes will apply to all information we have about you. The new Notice will be available upon request, in our office/s, and on our website. 

HOW PHI ABOUT YOUR MAY BE USED AND DISCLOSED

The following categories describe different ways that we use and disclose PHI. For each category of use or disclosure, an explanation of what is meant and some examples are provided. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose PHI will fall within one of the categories. 

  • For Treatment. We may use or disclose your health information to provide and coordinate the mental health treatment and services you receive. For example, if your mental health care needs to be coordinated with the medical care provided to you by another licensed clinician or health care provider, we may disclose your health information to that clinician or health care provider. Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

  • For Payment. We may use and disclose your health information for various payment-related functions, so that we can bill for and obtain payment for the treatment and services we provide for you. For example, your PHI may be provided to an insurance company so that they will pay claims for your care. 

  • For Healthcare Operations. We may use and disclose your health information for certain operational, administrative, and quality assurance activities in connection with our healthcare operations. These uses and disclosures are necessary to run the practice and to make sure that our patients receive quality treatment and services. For example, healthcare operations include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, accreditation, certification, licensing or credentialing activities. 

  • Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

  • Note: We may disclose your health information to our business associates for treatment purposes. Some services are provided to Daylily Therapy, PLLC through our business associates. For example: some counselors are contracted providers. When services are contracted, we may disclose your PHI to our business associates so they can do the job we've asked them to do. Our contracts with our business associates require them to protect your health information. 

CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION

We will obtain your written authorization before using or disclosing your PHI for purposes other than those described in the next section (or as otherwise permitted or required by law). If you give us an authorization, you may revoke it by submitting a written notice to our Privacy Officer at the address listed below. Your revocation will become effective upon our receipt of your written notice. If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by the written authorization.Your revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice. 

  • Appointment Reminders: We may use or disclose PHI to provide you with appointment reminders (such as voicemail messages, postcards, or letters). You have a right, as explained below, to request restrictions or limitations on the PHI we disclose. You also have a right to request that information be communicated with you in a certain way or at a certain location.

  • Electronic Communications: You may choose to communicate with us by email or text message. These methods may not be secure, and by choosing to communicate electronically, you acknowledge and accept these risks. We will not use text message for marketing purposes. 

  • Health-Related Benefits and Services: We may use and disclose PHI to tell you about health-related benefits or services that may be of interest to you. 

  • Treatment Alternatives: We may use and disclose PHI to tell you about or recommend possible alternative treatments, therapies, providers, or settings of care that may be of interest to you. 

  • Marketing Health-Related Services: We will not use or disclose your PHI for marketing purposes or communications. 

  • Sale of PHs: We will not sell your PHI. 

  • Psychotherapy Notes: We keep "psychotherapy notes" as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is: 

    • For my use in treating you. 

    • For my use in training or supervising mental health practitioners to help them improve their skills in group, family, or individual counseling or therapy. 

    • For my use in defending myself in legal proceedings instituted by you. 

    • For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA. 

    • Required by law and the use or disclosure is limited to the requirements of such law. 

    • Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. 

    • Required by a coroner who is performing duties authorized by law. 

    • Required to help avert a serious threat to the health and safety of others. 

CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION

We are permitted under federal and applicable state law to use or disclose your PHI without your permission only when certain circumstances may arise. We are likely to use or disclose your PHI without your permission for the following purposes: 

  • As required by laws: We may use and disclose your health information as required by state, federal and local law.

  • Public health activities: We may disclose your health information to public authorities or other agencies and organizations conducting public health activities, such as preventing or controlling disease, injury or disability, reporting births, deaths, child abuse or neglect, domestic violence, potential problems with products regulated by the Food and Drug Administration or communicable diseases.

  • Victims of abuse, neglect or domestic violence: We may disclose your health information to an appropriate government agency if we believe you are a victim of abuse, neglect, domestic violence and you agree to the disclosure or the disclosure is required or permitted by law. We will let you know if we disclose your health information for this purpose unless we believe that advising you or your caregiver would place you or another person at risk of serious harm.

  • Health oversight activities. We may disclose your health information to federal or state health oversight agencies for activities authorized by law such as audits, investigations, inspections and licensing surveys.

  • Judicial and administrative proceedings:. We may disclose your health information in the course of any judicial or administrative proceeding in response to an appropriate order of a court or administrative body.

  • Law enforcement purposes: We may disclose your health information to a law enforcement agency to respond to a court order, warrant, summons or similar process, to help identify or locate a suspect or missing person, to provide information about a victim of a crime, a death that may be the result of criminal activity, or criminal conduct on our premises, or, in emergency situations, to report a crime, the location of the crime or the victims, or the identity, location or description of the person who committed the crime.

  • Deceased individuals: We may disclose your health information to a coroner, medical examiner or a funeral director as necessary and as authorized by law.

  • Organ or tissue donations: We may disclose your health information to organ procurement organizations and similar entities.

  • For research: We may use or disclose your health information for research purposes. We will use or disclose your health information for research purposes only with the approval of our Institutional Review Board, which must follow a special approval process. When required, we will obtain a written authorization from you prior to using your health information for research.

  • Health or safety. We may use or disclose your health information to prevent or lessen a threat to the health or safety of you or the general public. We may also disclose your health information to public or private disaster relief organizations such as the Red Cross or other organizations participating in bio-terrorism countermeasures.

  • Specialized government functions: We may use or disclose your health information to provide assistance for certain types of government activities. If you are a member of the armed forces of the United States or a foreign country, we may disclose your health information to appropriate military authority as is deemed necessary. We may also disclose your health information to federal officials for lawful intelligence or national security activities.

  • Military and Veterans: If you are a member of the armed forces, we may release your PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate military authority. 

  • Workers’ compensation: We may use or disclose your health information as permitted by the laws governing the workers’ compensation program or similar programs that provide benefits for work-related injuries or illnesses.

  • Individuals involved in your care: We may disclose your health information to a family member, other relative or close personal friend assisting you in receiving health care services. If you are available, we will give you an opportunity to object to these disclosures, and we will not make these disclosures if you object. If you are not available, we will determine whether a disclosure to your family or friends is in your best interest, taking into account the circumstances and based upon our professional judgment.

  • Disclosures to Parents or Legal Guardians:. If you are a minor or have a legal guardian, we may release your PHI to your parents or legal guardians when we are permitted or required under federal and applicable state law. 

  • Incidental Uses and Disclosures: Incidental uses and disclosures of your health information sometimes occur and are not considered to be a violation of your rights. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.

CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT

I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your healthcare, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations. 

YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI

You have privacy rights under federal and state laws that protect your health information. These rights are important for you to know. You can exercise these rights, ask questions about them, and file a complaint if you think that your rights are being denied or your health information isn't being protected. Providers and health insurers who are required to follow federal and state privacy laws must comply with the following rights: 

  • The Right to Request Restrictions on Certain Uses and Disclosures of PHI. You have the right to request restrictions on our use or disclosure of your PHI by sending a written request to the Privacy Officer. We are not required to agree to those restrictions if we believe it could affect your health care. We cannot agree to restrictions on uses or disclosures that are legally required, or which are necessary to administer our business. 

  • The Right to Request Restrictions for Out-of-Pocket Expenses Paid for in Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or health care service that you have paid for out- of-pocket in full. 

  • The Right to Choose How We Send PHI to You. You have the right to ask us to contact you in a specific way (for example, home, cell, or office phone) or to send mail to a different address. We will agree to all reasonable requests. 

  • The Right to Access Your PHI. Other than "psychotherapy notes," you have the right to get an electronic or paper copy of your medical record and other information that we have about you; you may not be able to obtain all of your information if your treatment provider determines that the information may endanger you or someone else. We will provide you with a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost-based fee for doing so (to include the costs of copying, mailing, supplies, and time that are necessary to fulfill your request), and we are generally not required to produce requested records until the fee is paid. 

  • The Right to Request to Correct or Update Your PHI. If you believe there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that we correct the existing information or add the missing information. Requests must identify: (i) which information you seek to amend, (ii) what corrections you would like to make, and (iii) why the information needs to be amended. We will respond to your request in writing within 60 days. In our response, we will either: (i) agree to make the amendment, or (ii) inform you of our denial, explain our reason, and outline appeal procedures. If denied, you have the right to file a statement of disagreement with the decision. We will provide a rebuttal to your statement and maintain appropriate records of your disagreement and our rebuttal. The Right to Receive a List of Disclosures. You have the right to 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 me with an Authorization. Your request must state a time period. The time period for the list of disclosures must be limited to less than 6 years from the date of the request. We will respond in writing within 60 days of receipt of your request. We will provide a list once per 12-month period free of charge, but you may be charged for the cost of any subsequent list. We will notify you in advance of the cost involved, and you may choose to withdraw or modify your request at that time. 

  • The Right to Notification in the Event of a Breach. You have a right to be notified of an impermissible use or disclosure that compromises the security or privacy of your PHI. We will provide notice to you as soon as is reasonably possible and no later than sixty (60) calendar days after discovery of the breach and in accordance with federal and state law. 

  • The Right to File a Complaint. You will not be penalized or retaliated again in any way for filing a complaint. If you choose to pursue a complaint through an external agency, your therapist may discuss whether continuing therapy is clinically appropriate and, if needed, provider referrals to another provider to ensure continuity of care. 

  • Behavioral Health Executive Council upon request. You will not be penalized in any way for filing a complaint. Our ethical code may require us to terminate therapy with you and refer you to other providers if you file a complaint with one of the listed entities. 

  • The Right to Obtain a Paper Copy of the Notice Upon Request. You may request a copy of our current Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a paper copy from the Privacy Officer at the address below. A reasonable fee may be charged for the costs of copying, mailing or other supplies associated with your request, and we are generally not required to provide the requested records until the fee is paid. 

CHANGES TO THIS NOTICE

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changed Notice effective for all health information that we maintain, including health information we created or received before we made the changes. When we make a change in our privacy practices, we will change this Notice and make the new Notice available to you. 

ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By agreeing to this form, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.

SIGNATURES AND DOCUMENTATION OF CONSENT

By my signature, I hereby state that I have read, understood, and agree to the terms of this document. My electronic signature is considered the same as my handwritten signature. 

IF YOU WOULD LIKE MORE INFORMATION ABOUT OUR PRIVACY PRACTICES OR HAVE QUESTIONS OR CONCERNS, PLEASE CONTACT US: 

Privacy Officer:

Vanessa Fischer, M.A., LPC-S

Daylily Therapy, PLLC

9597 Jones Road #885

Houston, TX 77065

832-271-2929

info@daylilytheapytx.com