Notice of Privacy Practices
Milton Counseling Collaborative, LLC · 65 Adams St, Suite 6, Milton, MA 02186 · (617) 293-1657 · lmorin@miltoncounselingcollab.com
Effective date: October 11, 2026
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 information about you and your care is personal, and we are committed to protecting it. We keep a record of the care and services you receive from Milton Counseling Collaborative ("the practice," "we," or "us"). We need this record to provide quality care and to meet legal requirements. This notice applies to all records of your care created by the practice and to every clinician who works here.
We are required by law to: keep your protected health information ("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 if a breach occurs that may have compromised the privacy or security of your PHI.
We may change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office, and on our website.
II. How We May Use and Disclose Your Health Information
The categories below describe ways we use and disclose health information. Not every use or disclosure in a category is listed, but all the ways we are permitted to use and disclose information fall within one of these categories.
Treatment. We may use and share your PHI to provide and coordinate your care. For example, with your knowledge, a clinician may consult with your pediatrician, psychiatrist, or another licensed provider about your diagnosis and treatment. Disclosures for treatment are not limited to the "minimum necessary," because providers may need complete information to give quality care. Treatment includes coordinating care with other providers, consultations between providers, and referrals.
Payment. We may use and share your PHI to bill and collect payment for services. For example, the monthly superbill we give you lists your diagnosis code and the type of service so that you can seek reimbursement from your insurer.
Health care operations. We may use and share your PHI to run the practice and improve care. For example, we may review records for quality assurance, use clinical consultation or supervision, or share information with business associates (such as our electronic health record company) who are bound by contract to protect it.
Lawsuits and disputes. If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose health information about you 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.
III. Uses and Disclosures That Require Your Authorization
Psychotherapy notes. We may keep "psychotherapy notes" as defined in 45 CFR § 164.501. Any use or disclosure of these notes requires your written authorization unless it is: (1) for the clinician who wrote them to use in treating you; (2) for use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy; (3) for use in defending the practice in legal proceedings you bring; (4) for use by the Secretary of Health and Human Services to investigate our compliance with HIPAA; (5) required by law, and limited to the requirements of that law; (6) required by law for certain health oversight activities relating to the clinician who wrote the notes; (7) required by a coroner performing duties authorized by law; or (8) needed to help avert a serious threat to the health and safety of others.
Marketing. We will not use or disclose your PHI for marketing purposes.
Sale of PHI. We will not sell your PHI.
Other uses and disclosures. Any use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time. Revoking it stops future uses and disclosures, but does not affect anything already done in reliance on it.
IV. Uses and Disclosures That Do Not Require Your Authorization
Subject to certain limits in the law, we may use and disclose your PHI without your authorization:
• When required by state or federal law, limited to what that law requires.
• For public health activities, including reporting suspected abuse or neglect of a child, elder, or person with a disability, as Massachusetts law requires.
• To prevent or lessen a serious and imminent threat to the health or safety of you or others. Under Massachusetts law, this includes taking protective steps when a client communicates a serious threat of harm to a reasonably identified person, or when a client presents a clear and present danger to themselves.
• For health oversight activities, including audits and investigations.
• For judicial and administrative proceedings, including responding to a court or administrative order, although our preference is to obtain your authorization first.
• For law enforcement purposes, including reporting crimes occurring on our premises.
• To coroners or medical examiners performing duties authorized by law.
• For research purposes that meet the requirements of the law, such as studies approved by a privacy review board.
• For specialized government functions, including military missions, protection of the President, intelligence activities, and the safety of people working or housed in correctional institutions.
• For workers' compensation purposes, as required to comply with workers' compensation laws, although our preference is to obtain your authorization.
Appointment reminders and services. We may use your PHI to remind you of appointments and to tell you about treatment alternatives or other services we offer.
V. Uses and Disclosures Where You Have the Opportunity to Object
Family, friends, or others involved in your care. 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 an emergency, we may ask for your agreement afterward.
Minors. For clients under 18, a parent or guardian generally acts as the client's personal representative and may have access to records, consistent with Massachusetts law. There are exceptions, for example when a minor may lawfully consent to their own care or when sharing information could cause harm. We discuss how information will be shared with both the young person and their parents at the start of treatment.
VI. Your Rights Regarding Your PHI
Right to request limits. You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations. We are not required to agree, and we may say no if we believe it would affect your care.
Right to restrict disclosures to your health plan when you pay in full. If you pay for a service out of pocket in full, you may ask us not to share information about that service with your health plan for payment or operations. We will agree to this request unless a law requires us to share the information.
Right to choose how we contact you. You may ask us to contact you in a specific way (for example, by cell phone rather than home phone) or at a different address. We will agree to all reasonable requests.
Right to see and get copies of your PHI. Except for psychotherapy notes, you may get an electronic or paper copy of your record. We will provide a copy, or a summary if you agree, within 30 days of your written request. We may charge a reasonable, cost-based fee.
Right to a list of disclosures. You may request a list of times we disclosed your PHI for purposes other than treatment, payment, or health care operations, or disclosures you authorized. We will respond within 60 days. The list will cover the last six years unless you request a shorter period. The first list in a 12-month period is free; we may charge a reasonable, cost-based fee for additional requests.
Right to correct or update your PHI. If you believe information in your record is wrong or missing, you may ask us to correct or add to it. We may say no, but we will tell you why in writing within 60 days.
Right to be notified of a breach. You will be notified if a breach occurs that may have compromised the privacy or security of your PHI.
Right to choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
Right to a copy of this notice. You may get a paper copy of this notice at any time, even if you agreed to receive it electronically.
VII. Questions and Complaints
If you have questions about this notice or believe your privacy rights have been violated, please contact our Privacy Officer: Lisa Morin, LICSW, Privacy Officer, Milton Counseling Collaborative, LLC, 65 Adams St, Suite 6, Milton, MA 02186 · (617) 293-1657 · lmorin@miltoncounselingcollab.com
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201; by calling 1-877-696-6775; or online at www.hhs.gov/ocr/complaints.
We will not retaliate against you for filing a complaint.