Welcome to Jewish Family Service

The following information will answer some of your questions regarding our services.

Office Hours
Monday through Thursday 9:00am-6:00pm
Friday 9:00am-1:00pm

Appointment Times
It is our expectation that you arrive in a timely manner for your appointment, as it is reserved for only you.  If you must cancel or reschedule your appointment, we will do everything we can to accomodate.  There will be a charge of $25.00 if you fail to cancel 24 hours prior to your session.  Insurance companies do not pay missed appointment fees, this is your responsibility. 

About our fees…
Each session is 45-60 minutes long.  The fee per session is $110-$165.  JFS can also determine fees on a sliding scale basis if you do not have insurance.  You may discuss this with your therapist.  We are committed to working with you on an appropriate fee for your counseling needs.  Clients are expected to pay all eligible charges at the time of each appointment.  JFS cannot carry charges longer than two sessions. 

Your insurance policy is a contract between you and your insurance company.  We are not part to that contract.  JFS is an in-network provider for many insurance carriers, however, some require pre-authorization for mental health services.  It is your responsiblity to provide us with accurate and current insurance information.  If your insurance plan does not pay the amount you expected, please call them before calling us.  If we have billed in error, we will gladly re-file.  We will send monthly statements when there is a balance on your account.  All fees not paid by your insurance are billed to you.  These unpaid fees can include co-pays, co-insurance, late cancellation or no-show fees and fees from treatment not approved by your insurance provider.

All communications between you and your therapist are strictly confidential unless we feel you are in danger of hurting yourself or others. JFS complies with the State of Nebraska reporting laws on child abuse and other domestic violence. If we need to talk to other professionals regarding your situation, we will obtain your signed Release of Information.

About our staff…
All JFS therapists are licensed by the State of Nebraska and have Masters Degrees in Social Work or Counseling. JFS therapists help people with premarital issues, parent/child relationships, conflict in marriage, single parenting, adoption, dealing with illness, grief and personal adjustment to new situations in the family or at work, as well as a multitude of other issues encountered in life.


  • Clients have the right to be treated with personal dignity and respect.
  • Clients have the right to care that is considerate and respects member's personal values and belief system.
  • Clients have the right to personal privacy and confidentiality of information.
  • Clients have the right to receive information about managed care company's services, practitioners, clinical guidelines and client rights and responsibilities.
  • Clients have the right to reasonable access to care, regardless of race, religion, gender, sexual orientation, ethnicity, age or disability.
  • Clients have the right to participate in an informed way in the decision-making process regarding their treatment planning.
  • Clients have the right to discuss with their providers the medically necessary treatment options for their condition regardless of cost or benefit coverage.
  • Clients have the right of members' families to participate in treatment planning as well as the right of members over twelve years old to participate in such planning.
  • Clients have the right to individualized treatment, including

–Adequate and humane services regardless of the source(s) of financial support,
–Provision of services within the least restrictive environment possible,
–An individualized treatment or program plan,
–Periodic review of the treatment or program plan, and
–An adequate number of competent qualified and experienced professional clinical staff to supervise and carry out the treatment or program plan.

  • Clients have the right to participate in the consideration of ethical issues that arise in the provision of care and services including

–Resolving conflict, and
–Participating in investigational studies or clinical trials.

  • Clients have the right to designate a surrogate decision-make if the member is incapable of understanding a proposed treatment or procedure or is unable to communicate his or her wishes regarding care.
  • Clients and their families have the right to be informed of their rights in a language they understand.
  • Clients have the right to voice complaints or appeals about managed care company rights and responsibilities policies.
  • Clients have the right to make recommendations regarding managed care company rights and responsibilities policies.
  • Clients have the right to be informed of its rules and regulations concerning clients' conduct.
  • Clients have the responsibility to give their provider and managed care company information needed in order to receive care.
  • Clients have the responsibility to follow their agreed upon treatment plan and instructions for care.
  • Clients have the responsibility to participate, to the degree possible, in understanding their behavioral health problems and developing with their provider mutually agreed upon treatment goals.





By law we are required to insure that your PHI is kept private. The PHI constitutes information created or noted by us that can be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. We are required to provide you with this Notice about our privacy procedures. This Notice must explain when, why and how we would use and/or disclose your PHI. Use of PHI means when we share, apply, utilize, examine, or analyze information within our practice; PHI is disclosed when we release, transfer, give, or otherwise reveal it to a third party outside our practice. With some exceptions, we may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, we are always legally required to follow the privacy practices described in this Notice.

Please note that we reserve the right to change the terms of this Notice and our privacy policies at any time. Any changes will apply to PHI already on file with us. Before we make any important changes to our policies, we will immediately change this Notice and post a new copy of it in our office. You may also request a copy of this Notice from us, or you can view a copy of it in our office.


We will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the different categories of our uses and disclosures, with some examples.

A. Uses and disclosures related to treatment, payment, or health care operations do not require your prior written consent. We may use and disclose your PHI without your consent for the following reasons:

  1. For treatment. We may disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are otherwise involved in your care. For example: if a psychiatrist is treating you, we may disclose your PHI to her/him in order to coordinate your care.
  2. For health care operations. We may disclose your PHI to facilitate the efficiency and correct operation of our practice. Example: quality control - we might use your PHI in the evaluation of the quality of health care services that you have received or to evaluate the performance of the health care professionals who provide you with these services. We may also provide your PHI to our attorneys, accountants, consultants, and others to make sure that we are in compliance with applicable laws.
  3. To obtain payment for treatment. We may use and disclose your PHI to bill and collect payment for the treatment and services we provided you. Examples: we might send your PHI to your insurance company or health plan in order to get payment for the health care services that we have provided to you. We could also provide your PHI to business associates, such as billing companies, claims processing companies, and others that process health care claims for our office.
  4. Other disclosures. Examples: your consent isn't required if you need emergency treatment provided that we attempt to get your consent after treatment is rendered. In the event that we try to get your consent but you are unable to communicate with us (for example, if you are unconscious or in severe pain) but we think you would consent to such treatment if you could, we disclose your PHI.

B. Certain other uses and disclosures do not require your consent. We may use and/or disclose your PHI without your consent or authorization for the following reasons:

  1. When disclosure is required by federal, state or local law; judicial, board or administrative proceedings; or, law enforcement. Example: we may make a disclosure to the appropriate officials when a law requires us to report information to government agencies, law enforcement personnel and/or in an administrative proceeding.
  2. If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.
  3. If disclosure is compelled by the client or the client's representative pursuant to Nebraska Health and Safety Codes or to corresponding federal statutes of regulations such as the Privacy Rule that requires this Notice.
  4. To avoid harm. We may provide PHI to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public.
  5. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others, and if we determine that disclosure is necessary to prevent the threatened danger.
  6. If disclosure is mandated by the Nebraska Child Abuse and Neglect Reporting law. For example, if we have a reasonable suspicion of child abuse or neglect.
  7. If disclosure is mandated by the Nebraska Elder/Dependent Adult Abuse Reporting law. For example, if we have a reasonable suspicion of elder abuse or dependent adult abuse.
  8. If disclosure is compelled or permitted by the fact that you tell us of a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.
  9. For public health activities. Example: in the event of your death, if a disclosure is permitted or compelled, we may need to give the county coroner information about you.
  10. For health oversight activities. Example: we may be required to provide information to assist the government in the course of an investigation or inspection of a health care organization or provider.
  11. For specific government functions. Examples: we may disclose PHI of military personnel and veterans under certain circumstances. Also, we may disclose PHI in the interests of national security, such as protecting the President of the United States or assisting with intelligence operations.
  12. For research purposes. In certain circumstances, we may provide PHI in order to conduct medical research.
  13. For Workers' Compensation purposes. We may provide PHI in order to comply with Workers' Compensation laws.
  14. If an arbitrator or arbitration panel compels disclosure, when arbitration is lawfully requested by either party, pursuant to subpoena dues tectum (e.g., a subpoena for mental health records) or any other provision authorizing disclosure in a proceeding before an arbitrator or arbitration panel.
  15. We are permitted to contact you, without your prior authorization, to provide appointment reminders or information about alternative or other health-related benefits and services that may be of interest to you.
  16. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law. Example: when compelled by U.S. Secretary of Health and Human Services to investigate or assess our compliance with HIPAA regulations.
  17. If disclosure is otherwise specifically required by law.

C. Certain uses and disclosures require you to have the opportunity to object.

  1. Disclosures to family, friends or others. We may provide your PHI to a family member, friend or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.

D. Other uses and disclosures require your prior written authorization. In any other situation not described in Sections IIIA, IIIB and IIIC above, we will request your written authorization before using or disclosing any of your PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that we haven't taken any action subsequent to the original authorization) of your PHI by us.


These are your rights with respect to your PHI:

A. The right to see and get copies of your PHI. In general, you have the right to see your PHI that is in our possession, or to get copies of it; however, you must request it in writing. If we do not have your PHI, but we know who does, we will advise you how you can get it. You will receive a response from us within 30 days of our receiving your written request. Under certain circumstances, we may feel we must deny your request, but if we do, we will give you, in writing, the reasons for the denial. We will also explain your right to have our denial reviewed.

If you ask for copies of your PHI, we will charge you not more than $.25 per page with a processing fee of $25. We may see fit to provide you with a summary of explanation of the PHI, but only if you agree to it, as well as to the cost, in advance.

B. The right to request limits on uses and disclosures of your PHI. You have the right to ask that we limit how we use and disclose your PHI. While we will consider your request, we are not legally bound to agree. If we do agree to your request, we will put those limits in writing and abide by them except in emergency situations. You do not have the right to limit the uses and disclosures that we are legally required or permitted to take.

C. The right to choose how we send your PHI to you. It is your right to ask that your PHI be sent to you at an alternate address (for example, via e-mail instead of by regular mail). We are obliged to agree to your request providing that we can give you the PHI, in the format you requested, without undue inconvenience.

D. The right to get a list of the disclosures we have made. You are entitled to a list of disclosures of your PHI that we have made. The list will not include uses or disclosures to which you have already consented, i.e., those for treatment, payment, or health care operations, sent directly to you, or to your family; neither will the list include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003. After April 15, 2003, disclosure records will be held for 7 years or the length of time required by law to keep the record.

We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we give you will include disclosures made in the previous six years (the first six year period being 2003-2009), unless you indicate a shorter period. The list will include the date of the disclosure, to which PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. We will provide the list to you at no cost, unless you make more than one request in the same year, in which case we will charge you a reasonable sum based on a set fee for each additional request.

E. The right to amend your PHI. If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that we correct the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request. We may deny your request, in writing, if we find that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of our records, or (d) written by someone other than us. Our denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial.  If you do not file a written objection, you still have the right to ask that your request and our denial be attached to any future disclosures of your PHI. If we approve your request, we will make the change(s) to your PHI. Additionally, we will tell you that the change(s) have been made, and we will advise all others who need to know about the change(s) to your PHI.

F. The right to get this notice by e-mail. You have the right to get this notice by e-mail. You have the right to request a paper copy of it as well.


If, in your opinion, we may have violated your privacy rights, or if you object to a decision we made about access to your PHI, you are entitled to file a complaint with the person listed in Section VI below.  You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W., Washington, D.C. 20201.  If you file a complaint about our privacy practices, we will take no retaliatory action against you.


If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact Karen Gustafson, Director, Jewish Family Service, 333 South 132nd Street, Omaha, NE 68154 or e-mail her at kgustafson(at)jfsomaha.com.


This notice went into effect April 14, 2003.