​Notice of Privacy Practices

The Federal Health Insurance Portability and Accountability Act (HIPAA) requires mental health professionals to issue this official Notice of Privacy Practices. This notice describes how information about you is protected, the circumstances under which it may be used or disclosed and how you may gain access to this information. Please review it carefully.
For psychotherapy to be beneficial, it is important that you feel free to speak about personal matters, secure in the knowledge that the information you share will remain confidential. You have the right to the confidentiality of your medical and psychological information, and this practice is required by law to maintain the privacy of that information.
This practice is required to abide by the terms of the Notice of Privacy Practices currently in effect, and to provide notice of its legal duties and privacy practices with respect to protected health and psychological information. If you have any questions about this Notice, please contact the Privacy Officer at this practice.
Who Will Follow This Notice:
Any health care professional authorized to enter information into your medical record, all employees, staff, and other personnel at this practice who may need access to your information must abide by this Notice. All subsidiaries, business associates (e.g., a billing service), sites and locations of this practice may share medical information with each other for treatment, payment purposes or health care operations described in this Notice. Except where treatment is involved, only the minimum necessary information needed to accomplish the task will be shared.
Uses and Disclosures for Treatment, Payment, and Health Care Operations:
This practice may use or disclose your Protected Health Information (PHI), for treatment, payment, and health care operations purposes. The following should help clarify these terms:
• • PHI refers to information in your health record that could identify you. For example, it may include your name, the fact you are receiving treatment here, and other basic information pertaining to your treatment.
• • Use applies only to activities within this office and practice group, such as sharing, employing, applying, utilizing, and analyzing information that identifies you.
• • Disclosure applies to activities outside of this office or practice group, such as releasing, transferring, or providing access to information about you to other parties. • • Authorization is your written permission to disclose confidential health information. All authorizations to disclose must be made on a specific and required form.
• • Treatment is when the therapist provides, coordinates, or manages your health care and other services related to your health care. For example, with your written authorization. The therapist may provide your information to your physician to ensure the physician has the necessary information to diagnose or treat you.
Payment:
• Your PHI may be used, as needed, in activities related to obtaining payment for your health care services. This may include the use of a billing service or providing you documentation of your care so that you may obtain reimbursement from your insurer. • • Health Care Operations are activities that relate to the performance and operation of this practice. The therapist may use or disclose, as needed, your protected health information in support of business activities. For example, when the therapist reviews an administrative assistant’s performance, they may need to review what that employee has documented in your record.
Written Authorizations to Release PHI
Any other uses and disclosures of your PHI beyond those listed above will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke your authorization at any time, in writing.
Uses and Disclosures without Authorization
The ethics code of the National Association of Social Workers, California State law, and the federal HIPAA regulations protect the privacy of all communications between a client and a mental health professional. In most situations, the therapist can only release information about your treatment to others if you sign a written authorization. This Authorization will remain in effect for a length of time determined between your therapist. You may revoke the authorization at any time, unless the therapist has taken action in reliance on it. However, there are some disclosures that do not require your Authorization. The therapist may use or disclose PHI without your consent in the following circumstances:
• • Child Abuse – If your therapist has reasonable cause to believe a child may be abused or neglected, they must report this belief to the appropriate authorities.
• • Adult and Domestic Abuse – If your therapist has reason to believe that an individual such as an elderly or disabled person protected by state law has been abused, neglected, or financially exploited, they must report this to the appropriate authorities.
• • Health Oversight Activities – Your therapist may disclose your PHI to a health oversight agency for oversight activities authorized by law, including licensure or disciplinary actions. If a client files a complaint or lawsuit against the therapist, relevant information regarding that patient may be disclosed to defend against such claims.
• • Judicial and Administrative Proceedings – If you are involved in a court proceeding and a request is made for information by any party about your treatment and the records thereof, such information is privileged under state law and is not to be released without a court order. Information about all other psychological services (e.g., psychological evaluation) is also privileged and cannot be released without your authorization or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You must be informed in advance if this is the case.
• • Serious Threat to Health or Safety – If you communicate to your therapist a specific threat of imminent harm against another individual or if your therapist believes that there is clear, imminent risk of injury being inflicted against another individual, I may make disclosures that are believed to be necessary to protect that individual from harm. If your therapist believes that you present an imminent, serious risk of injury or death to yourself, I may make disclosures deemed necessary to protect you from harm.
• • Worker's Compensation – The therapist may disclose PHI regarding you as authorized by and to the extent necessary to comply with laws relating to worker's compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.
Special Authorizations
Certain categories of information have extra protections by law, and thus require special written authorizations for disclosures.
• • Psychotherapy Notes –The therapist will obtain a special authorization before releasing your Psychotherapy Notes. "Psychotherapy Notes" are notes your therapist have made about your conversation during a private, group, joint, or family counseling session, which he/she have kept separate from the rest of your record. These notes are given a greater degree of protection than PHI.
• • HIV Information – Special legal protections apply to HIV/AIDS related information. The therapist will obtain a special written authorization from you before releasing information related to HIV/AIDS.
• • Alcohol and Drug Use Information – Special legal protections apply to
*information related to alcohol and drug use and treatment. The therapist will obtain a special written authorization from you before releasing information related to alcohol and/or drug use/treatment. You may revoke all such authorizations (of PHI, Psychotherapy Notes, HIV information, and/or Alcohol and Drug Use Information) at any time, provided each revocation is in writing, signed by you, and signed by a witness. You may not revoke an authorization to the extent that (1) The therapist has relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage. The law provides the insurer the right to contest the claim under the policy.
Patient’s Rights and Social Worker Duties Patient’s Rights:
• • Right to Request Restrictions – You have the right to request restrictions on certain uses/disclosures of PHI. However, the therapist is not required to agree to the request.
• • Right to Receive Confidential Communications by Alternative Means – You have the right to request and receive confidential communications by alternative means and locations. (For example, you may not want a family member to know that you are seeing mental health provider. On your request, I will send your bills or other related communications to another address.)
• • Right to Inspect and Copy – You have the right to inspect or obtain a copy of PHI in the therapist’s records as these records are maintained. In such cases, your therapist will discuss with you the process involved.
• • Right to Amend – You have the right to request an amendment of PHI for as long as it is maintained in the record. The therapist may deny your request. If so, your therapist will discuss with you the details of the amendment process.
• • Right to an Accounting – You generally have the right to receive an accounting of all disclosures of PHI. Your therapist can discuss with you the details of the accounting process.
• • Right to a Paper Copy – You have the right to obtain a paper copy of the Notice of Privacy Practices from the therapist upon request.
Clinical Social Worker Duties:
• • The therapist is required by law to maintain the privacy of PHI and to provide you with a notice of legal duties and privacy practices with respect to PHI.
• • The therapist reserves the right to change the privacy policies and practices described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.
• • If the therapist revises these policies and procedures, I will notify you at your next session, or by mail at the address you provided.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with the Privacy Officer at this practice or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized or discriminated against for filing a complaint.
If you have any questions about this Notice, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact:
Jessica Maness, LCSW PO Box 2077, Gualala, CA 95445
(701)690-2798; [email protected]
Effective Date, Restrictions, and Changes to Privacy Policy
This notice will go into effect on February 1, 2021 and remain so unless new notice provisions effective for all protected health information are enacted accordingly.

​Website Standard Terms and Conditions

​1. Introduction.
These Website Standard Terms and Conditions (these “Terms” or these “Website Standard Terms and Conditions”) contained herein on this webpage, shall govern your use of this website, including all pages within this website (collectively referred to herein below as this “Website”). These Terms apply in full force and effect to your use of this Website and by using this Website, you expressly accept all terms and conditions contained herein in full. You must not use this Website, if you have any objection to any of these Website Standard Terms and Conditions.
What are website standard terms and conditions?
Website standard terms and conditions is a formulated list of terms and conditions, or rules rather, which are created to form the basis of a business’ relationship and can also be used to regulate repetitive actions on a website.
2. Intellectual Property Rights.
Other than content you own, which you may have opted to include on this Website, under these Terms, Jessi Maness, Inc. and/or its licensors own all rights to the intellectual property and material contained in this Website, and all such rights are reserved.
You are granted a limited license only, subject to the restrictions provided in these Terms, for purposes of viewing the material contained on this Website, booking appointments or reading blog. 
3. Restrictions.
You are expressly and emphatically restricted from all of the following:
1. publishing any Website material in any media;
2. selling, sublicensing and/or otherwise commercializing any Website material;
3. publicly performing and/or showing any Website material without stated permission from Jessi Maness.
4. using this Website in any way that is, or may be, damaging to this Website;
5. using this Website in any way that impacts user access to this Website;
6. using this Website contrary to applicable laws and regulations, or in a way that causes, or may cause, harm to the Website, or to any person or business entity;
7. engaging in any data mining, data harvesting, data extracting or any other similar activity in relation to this Website, or while using this Website;
8. using this Website to engage in any advertising or marketing;
Certain areas of this Website are restricted from access by you and Jessi Maness, Inc. may further restrict access by you to any areas of this Website, at any time, in its sole and absolute discretion.
4. No warranties.
This Website is provided “as is,” with all faults, and Jessi Maness, Inc. makes no express or implied representations or warranties, of any kind related to this Website or the materials contained on this Website. Additionally, nothing contained on this Website shall be construed as providing consult or advice to you.
5. Limitation of liability.
In no event shall Jessi Maness, Inc., nor any of its officers, directors and employees, be liable to you for anything arising out of or in any way connected with your use of this Website, whether such liability is under contract, tort or otherwise, and Jessi Maness, Inc., including its officers, directors and employees shall not be liable for any indirect, consequential or special liability arising out of or in any way related to your use of this Website.
6. Indemnification.
You hereby indemnify to the fullest extent Jessi Maness, Inc. from and against any and all liabilities, costs, demands, causes of action, damages and expenses (including reasonable attorney’s fees) arising out of or in any way related to your breach of any of the provisions of these Terms.
7. Severability.
If any provision of these Terms is found to be unenforceable or invalid under any applicable law, such unenforceability or invalidity shall not render these Terms unenforceable or invalid as a whole, and such provisions shall be deleted without affecting the remaining provisions herein.
8. Variation of Terms.
Jessi Maness, Inc. is permitted to revise these Terms at any time as it sees fit, and by using this Website you are expected to review such Terms on a regular basis to ensure you understand all terms and conditions governing use of this Website.
9. Assignment.
Jessi Maness, Inc. shall be permitted to assign, transfer, and subcontract its rights and/or obligations under these Terms without any notification or consent required. However, you shall not be permitted to assign, transfer, or subcontract any of your rights and/or obligations under these Terms.
10. Entire Agreement.
These Terms, including any legal notices and disclaimers contained on this Website, constitute the entire agreement between Jessi Maness, Inc. and you in relation to your use of this Website, and supersede all prior agreements and understandings with respect to the same.
11. Governing Law & Jurisdiction.
These Terms will be governed by and construed in accordance with the laws of the State of California, and you submit to the non-exclusive jurisdiction of the state and federal courts located in California for the resolution of any disputes.