SHARON LEMIRE LICENSED CLINICAL SOCIAL WORKER INC.
Sharon Lemire, DSW, LCSW
California Licensed Clinical Social Worker #124869
PO Box 27581
Los Angeles, CA 90027
sharonlemirelcsw@gmail.com
(323) 880-7971
NOTICE OF PRIVACY PRACTICES
EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on August 20, 2024. This revised Notice of Privacy Practices is effective September 17, 2026.
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. MY PLEDGE REGARDING HEALTH INFORMATION
I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record 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 I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:
Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of my legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.
I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.
I am also required to maintain reasonable administrative, physical, and technical safeguards to protect your PHI and to notify you if a breach occurs that may have compromised the privacy or security of your unsecured PHI, as required by law.
The current version of this notice will be available upon request and on my website at www.sharonlemirelcsw.com.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.
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.
Payment includes activities necessary to obtain reimbursement for the services provided to you. These activities may include verifying insurance eligibility or benefits, submitting claims, responding to utilization reviews, demonstrating medical necessity, obtaining authorization for treatment, addressing claim questions, or conducting collection activities permitted by law.
Health care operations include activities necessary to operate the practice and provide appropriate services. These activities may include quality review, practice administration, appointment management, record maintenance, payment processing, audits, compliance activities, legal or professional consultation, and maintenance of electronic systems.
Administrative vendors and other business associates may receive limited PHI when necessary to provide services to the practice. Business associates are required to protect the information they receive in accordance with applicable law and contractual privacy requirements.
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.
A subpoena alone may not automatically require the disclosure of privileged psychotherapy information. When appropriate, I may assert privilege, seek legal guidance, request satisfactory assurances, seek a protective order, or require a court order or valid written authorization before releasing information.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes. I do 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:
a. For my use in treating you.
b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
c. For my use in defending myself in legal proceedings instituted by you.
d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
e. Required by law and the use or disclosure is limited to the requirements of such law.
f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
g. Required by a coroner who is performing duties authorized by law.
h. Required to help avert a serious threat to the health and safety of others.
Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.
Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.
Other Uses and Disclosures. Uses and disclosures of your PHI that are not described in this notice generally require your written Authorization.
You may revoke an Authorization in writing at any time. Revocation will apply to future uses and disclosures but will not affect actions already taken in reliance on your Authorization.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION
Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:
When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
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.
For health oversight activities, including audits and investigations.
For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.
For law enforcement purposes, including reporting crimes occurring on my premises.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
Specialized government functions, including ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.
Appointment reminders and health-related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.
To prevent or reduce a serious threat to health or safety. I may use or disclose information when necessary and legally permitted to prevent or reduce a serious threat to your health or safety or the health or safety of another person. Information will be disclosed only to individuals or organizations reasonably able to help address the threat.
For disaster-relief purposes. I may disclose relevant information to a disaster-relief organization to help notify your family or other appropriate individuals about your location, condition, or safety, when permitted by law.
For other purposes specifically permitted or required by federal or California law.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT
Disclosures to family, friends, or others. 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 health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
Only information directly relevant to that person’s involvement in your care or payment for care will be disclosed. If you are unable to express a preference, I may disclose relevant information if I believe doing so is in your best interest and the disclosure is permitted by law.
VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.
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 a health care service that you have paid for out-of-pocket in full.
The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way, for example by home or office phone, or to send mail to a different address, and I will agree to all reasonable requests.
The Right to See and Get Copies of 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 I have about you. I 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 I may charge a reasonable, cost-based fee for doing so.
In certain circumstances, access to some information may be limited or denied as permitted by law. If access is denied, you will receive an explanation and information about any available review rights.
The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.
The Right to Correct or Update Your PHI. If you believe that 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 I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
If I deny your request, you may submit a written statement of disagreement to be included in your record as permitted by law.
The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by email. Even if you have agreed to receive this Notice by email, you also have the right to request a paper copy of it.
The Right to Choose Someone to Act for You. If you have given someone medical power of attorney or another person is legally authorized to act as your personal representative, that person may exercise your rights and make choices about your PHI. I will verify the person’s identity and legal authority before taking action.
The Right to File a Complaint. You have the right to file a complaint with me if you believe your privacy rights have been violated. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
I will not retaliate against you for asking questions, exercising a privacy right, or filing a complaint.
VII. SUBSTANCE-USE-DISORDER RECORDS
Records protected under federal substance-use-disorder confidentiality law, including 42 CFR Part 2, receive additional protection.
If I create, maintain, or receive records protected by Part 2, those records will be used and disclosed only as permitted by HIPAA, Part 2, and other applicable law.
Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order that satisfies Part 2 requirements.
A separate written consent may be required for the use or disclosure of substance-use-disorder counseling notes or for the use of Part 2 records in legal proceedings against you.
You may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights if you believe Part 2 records were used or disclosed in violation of federal law.
VIII. MINORS AND PERSONAL REPRESENTATIVES
Parents and legal guardians generally act as a minor client’s personal representative and may have access to the minor’s health information.
Exceptions may apply when:
A minor lawfully consents to treatment.
Another person is legally authorized to consent.
A court or applicable law limits parental access.
The parent or guardian agrees to a confidential relationship between the minor and provider.
Access could endanger the minor or another person.
Another exception under federal or California law applies.
California law may give minors additional privacy rights under particular circumstances. These matters will be discussed when relevant to treatment.
IX. MORE PROTECTIVE LAWS
Mental-health records, psychotherapy notes, substance-use-disorder records, HIV-related information, genetic information, and other sensitive health information may receive additional protection under federal or California law.
When another applicable law is more protective of your privacy than HIPAA, I will generally follow the more protective requirement.
X. ELECTRONIC HEALTH INFORMATION AND COMMUNICATIONS
I use administrative, physical, and technical safeguards designed to protect your health information.
Electronic health records, client portals, telehealth platforms, billing systems, payment processors, email, telephone, voicemail, and other administrative services may be used as part of operating the practice. Vendors that receive PHI are required to comply with applicable privacy and security requirements.
No form of electronic storage or communication can be guaranteed to be completely secure. If a breach of unsecured PHI occurs, I will notify affected individuals as required by law.
XI. MY RESPONSIBILITIES
I am required by law to:
Maintain the privacy and security of your PHI.
Provide you with this Notice of Privacy Practices.
Explain my legal duties and privacy practices.
Follow the terms of the notice currently in effect.
Notify you if a breach occurs that may have compromised the privacy or security of your unsecured PHI.
Honor your privacy rights as required by law.
Refrain from retaliating against you for exercising your privacy rights or filing a complaint.
I will not use or disclose your information other than as described in this notice unless you provide written permission or the use or disclosure is otherwise permitted or required by law.
If you provide written permission, you may revoke it in writing for future uses or disclosures.
XII. CHANGES TO THIS NOTICE
I can change the terms of this Notice, and such changes will apply to all information I have about you.
The current Notice will be available upon request, in my office, and on my website at www.sharonlemirelcsw.com. A revised notice will include a new effective date.
XIII. QUESTIONS, REQUESTS, OR COMPLAINTS
To ask questions, exercise a privacy right, request additional information, or file a privacy complaint, contact:
Sharon Lemire, DSW, LCSW
Privacy Contact
Sharon Lemire Licensed Clinical Social Worker Inc.
PO Box 27581
Los Angeles, CA 90027
Telephone: (323) 880-7971
Email: sharonlemirelcsw@gmail.com
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue SW
Washington, DC 20201
Telephone: 1-800-368-1019
TDD: 1-800-537-7697
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
I will not retaliate against you for filing a complaint.