CARE Counseling Services LLC

Notice of Privacy Practices

Effective date: August 2026 · Version 1.0

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.

In this Notice, “CARE,” “we,” “us,” and “our” refer to CARE Counseling Services LLC and its workforce (including therapists, supervisors, and administrative and billing staff who need access to your information to do their jobs). “You” and “your” refer to the client, or the parent/legal guardian acting on a minor client’s behalf.

I. Our Pledge Regarding Health Information

We understand that health information about you and your care is personal, and we are committed to protecting it. We create a record of the care and services you receive to provide you with quality care and to comply with legal requirements. This Notice applies to all records of your care that CARE generates. It describes the ways we may use and disclose your protected health information (“PHI”), your rights regarding that information, and our legal duties. We are required by law to:

•Keep your PHI private;

•Give you this Notice of our legal duties and privacy practices;

•Follow the terms of the Notice currently in effect; and

•Notify you following a breach of unsecured PHI.

II. How We May Use and Disclose Health Information

For Treatment. We use and disclose your PHI to provide, coordinate, and manage your care, including sharing information among CARE clinicians and supervisors and, when appropriate, with other health care providers involved in your care. Because providers need complete information to deliver quality care, treatment disclosures are not limited to the “minimum necessary” standard.

For Payment. We use and disclose your PHI to bill and obtain payment from you, an insurer, or another payer (for example, submitting claims and verifying benefits).

For Health Care Operations. We use and disclose your PHI for our operations, such as quality review, clinical supervision and training, and business management.

Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose PHI in response to a court or administrative order, or in response to a subpoena or other lawful process if efforts have been made to notify you or to obtain a protective order. Substance use disorder records protected by 42 C.F.R. Part 2 receive additional protections described in Section VI.

III. Uses and Disclosures That Require Your Written Authorization

Psychotherapy Notes. We keep “psychotherapy notes” as defined in 45 CFR § 164.501. Most uses or disclosures of psychotherapy notes require your written Authorization, except in limited circumstances permitted by law (for example, our own treatment use; training or supervising practitioners; defending a legal proceeding you bring; HHS compliance investigations; when required by law; certain health-oversight of the notes’ originator; a coroner’s authorized duties; or to avert a serious and imminent threat to health or safety).

Marketing; Sale of PHI. CARE will not use or disclose your PHI for marketing that requires authorization, and CARE will not sell your PHI. These activities would require your written Authorization.

Other Authorizations. Other uses and disclosures not described in this Notice will be made only with your written Authorization, which you may revoke in writing at any time (except to the extent we have already acted on it).

IV. Uses and Disclosures That Do Not Require Your Authorization

Subject to limits in the law, we may use or disclose your PHI without your Authorization:

•When required by federal or state law;

•For public health activities, and to report suspected abuse or neglect of a child, elder, or dependent/vulnerable adult;

•To prevent or lessen a serious and imminent threat to the health or safety of you or others;

•For health oversight activities such as audits and investigations;

•For judicial and administrative proceedings, including in response to a court or administrative order (we prefer to obtain your Authorization first);

•For specified law enforcement purposes;

•To coroners, medical examiners, and funeral directors performing legally authorized duties;

•For specialized government functions (such as military, national security, or correctional-institution purposes);

•For workers’ compensation as authorized by law (we prefer to obtain your Authorization first); and

•To remind you of appointments or to tell you about treatment alternatives or other health-related benefits and services we offer.

V. Research and Quality Improvement

CARE may review and analyze information about the care we provide to evaluate treatment outcomes, improve the quality and effectiveness of our services, develop and refine clinical practices, and contribute to a better understanding of mental health treatment.

CARE may also use aggregated or de-identified information for internal research, education, quality improvement, or other analytical purposes and may share findings publicly, including through educational materials, presentations, reports, publications, or other professional communications. Information shared publicly will not identify you or reasonably allow you to be identified.

If CARE conducts research involving identifiable protected health information, CARE will use or disclose that information only as permitted by law, which may include obtaining your written authorization or approval of a waiver of authorization by an Institutional Review Board or Privacy Board, when required.

VI. Special Protections for Substance Use Disorder (SUD) Records — 42 C.F.R. Part 2

If you receive substance use disorder services that make your records subject to the federal Part 2 regulations, those records receive additional protection:

•We will obtain your written consent before using or disclosing Part 2 records, except in limited circumstances permitted by Part 2 (such as medical emergencies, certain audits and evaluations, or as otherwise required by law).

•Consistent with the 2024 Part 2 final rule, you may provide a single written consent for future uses and disclosures for treatment, payment, and health care operations. Where you give such consent, a HIPAA covered entity or business associate that receives your records may redisclose them as permitted by HIPAA, subject to Part 2’s continuing restrictions.

•Part 2 records (and testimony conveying their content) may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you give specific written consent or a court issues an order under Part 2.

•Part 2 limits the use of these records to initiate or substantiate criminal charges against you.

•You may request a list (accounting) of certain disclosures of your Part 2 records.

SUD counseling notes. Any use or disclosure of SUD counseling notes requires your separate written authorization, which cannot be combined with consent for other records. You may revoke it at any time except to the extent we have already acted on it.

VII. Uses and Disclosures Where You May Object

To Family, Friends, or Others Involved in Your Care. Unless you object, we may share PHI with a family member, friend, or other person you identify as involved in your care or payment for your care. In an emergency, we may use professional judgment and obtain your agreement afterward.

Fundraising. CARE does not use your PHI for fundraising.

VIII. Your Rights Regarding Your Health Information

Request restrictions on uses or disclosures for treatment, payment, or operations. We are not required to agree, except that we must agree to restrict disclosure to a health plan for payment or operations when you have paid for the item or service in full, out of pocket.

Request confidential communications — ask us to contact you a certain way or at a certain location; we will accommodate reasonable requests.

Inspect and copy your record (other than psychotherapy notes and SUD counseling notes), in paper or electronic form, generally within 30 days of your written request; a reasonable, cost-based fee may apply.

Request an accounting of certain disclosures, generally for the prior six years, within 60 days of your request (one free per 12 months). This includes an accounting of certain disclosures of Part 2 records.

Request amendments to your PHI if you believe it is incorrect or incomplete; we may deny the request and will explain in writing.

Get a paper or electronic copy of this Notice on request, even if you agreed to receive it electronically.

Be notified following a breach of your unsecured PHI.

IX. Our Duties

We are required by law to maintain the privacy of your PHI, to provide you this Notice of our duties and privacy practices, to follow the Notice currently in effect, and to notify you following a breach of unsecured PHI. We may change this Notice, and changes will apply to information we already have. A revised Notice will be available in our office, upon request, and on our website, with a new effective date.

X. Complaints

If you believe your privacy rights have been violated, you may file a complaint with CARE’s Privacy Officer (below) or with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR): 200 Independence Avenue, S.W., Washington, D.C. 20201; 1-877-696-6775; www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.

XI. Contact — Privacy Officer

CARE Counseling Services LLC · Attn: Privacy Officer, Sonya Gelinas

70 Stark St, Manchester, NH 03101 · (603) 270-9181 · therapy@carenh.com