Privacy Practices.
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
THE PRIVACY OF YOUR HEALTH CARE INFORMATION IS IMPORTANT TO ME.
IMPORTANT DEFINITIONS
I may use or disclose your protected health information (PHI), for treatment and health care operations purposes with your written authorization. To help clarify these terms, here are some definitions:
PHI: Refers to information in your health record that could identify you.
Treatment and Health Care Operations: Treatment is when I provide, coordinate or manage your health care and other services related to your health care. An example of treatment would be when I consult with another health care provider, such as your family physician and/or psychiatrist.
Health Care Operations: Activities that relate to the performance and operation of our practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.
Use: Applies only to activities within our office such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
Disclosure: Applies to activities outside of our office such as releasing, transferring, or providing access to information about you to other parties.
USES AND DISCLOSURES REQUIRING AUTHORIZATION
I may use and/or disclose PHI when your appropriate authorization is obtained. An authorization is written permission that permits only specific disclosures. In those instances when I am asked for information, I will obtain an authorization from you before releasing this information.
You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that I have relied on that authorization.
Examples of use:
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:
For my use in providing mental health counseling services to you
For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counselling.
For my use in defending myself in legal proceedings instituted by you.
For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
Required by law and the use or disclosure is limited to the requirements of such law.
Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
Required by a coroner who is performing duties authorized by law.
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.
Client Support System: Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, and/or other person that you have identified as being part of your care and/ or for 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.
USES AND DISCLOSURES THAT DO NOT REQUIRE CONSENT OR AUTHORIZATION
I may use and/ or disclose PHI without your consent or authorization in some circumstances, including:
Investigations of Abuse/ Neglect on Vulnerable Persons: If there is an investigation of child abuse, elder abuse, or abuse of an otherwise determined by law vulnerable person, I may be compelled to turn over your relevant records.
Serious Threat to Health or Safety: I may disclose confidential information when I judge that disclosure is necessary to protect against a clear and substantial risk of imminent serious harm being inflicted by you on yourself and/or another person. I must limit disclosure of the otherwise confidential information to only those persons and only that content which would be consistent with the standards of the profession in addressing such problems.
Regulatory Board Oversight: The Oregon Board of Licensed Professional Counselors and Therapists may subpoena relevant records from us should I be the subject of a complaint.
Judicial Or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your evaluation, diagnosis and treatment and the records thereof, such information is privileged under state law, and I must not release your information without written authorization by you or your personal or legally-appointed representative, or a court order. This privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. You will be informed in advance if this is the case.
Worker’s Compensation: If you file a worker’s compensation claim, this constitutes authorization for us to release your relevant protected health information to involved parties and officials. This would include a past history of complaints or treatment of a condition similar to that in the complaint.
National Security: I may be required to disclose your health information to authorized federal officials who are conducting national security and intelligence activities or providing protective services to the President or other important officials.
For law enforcement purposes: I may be required to disclose your health information to authorized law enforcement officials when reporting crimes occurring on the premises.
To coroners or medical examiners: I may be required to disclose your health information to such individuals when they are performing duties authorized by law.
OUR USES AND DISCLOSURES
I will typically use or share your health information in the following ways.
To coordinate care with other healthcare professionals. I can use your health information and share it with other professionals who are treating you to coordinate care and/ or obtain consultation.
For business operations. I can use and share your health information to run my practice, improve your care, and contact you when necessary.
To bill for your counseling services. We can use and share your health information to bill and get payment from health insurance plans and/or other entities.
To provide 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.
PROVIDER RESPONSIBILITIES
I am required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI. The information that you share with me during your treatment will be kept private. All treatment documentation (i.e. completed forms, assessments, progress notes, etc.) are stored on a secure, HIPAA compliant electronic medical record, Simple Practice. Any written records will be filed in a locked filing cabinet or in a locked brief case if there is a need to transport them.
• I am required by law to maintain the privacy and security of your protected health information.
• I will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will not use or share your information other than as described here unless you tell me I can in writing. If you tell us I can, you may change your mind at any time. Let me know in writing if you would like to revoke authorization of disclosure.
PATIENT/CLIENT RIGHTS AND RESPONSIBILITIES
You have the right to confidentiality. The information that you share with me during your treatment will be kept private. All treatment documentation (i.e. completed forms, assessments, progress notes, etc.) are stored on a secure, HIPAA compliant electronic medical record, Simple Practice. Any written records will be filed in a locked filing cabinet or in a locked brief case if there is a need to transport them.
However, there are a few exceptions to confidentiality including:
Reporting suspected child abuse;
Reporting imminent danger to you or others;
Reporting information required in court proceedings or by your insurance company, or other relevant agencies;
Providing information concerning licensee case consultation or supervision; and
Defending claims brought by you against me
If any of the above steps were to be take, I would make every effort to inform you ahead of time about what is going to happen and to offer the opportunity for you to be involved in the process, if possible.
To expect that a licensee has met the qualifications of training and experience required by state law
You have the right to receive clear and accurate information about me, my practice, education, and other qualifications.
You have the right and responsibility to participate in all decision regarding your counseling experience. You have the right to terminate services at any time and to be provided the appropriate referrals if I cannot meet your needs.
To examine public records maintained by the Board and to have the Board confirm credentials of a licensee
To obtain a copy of the Code of Ethics (Oregon Administrative Rules 833-100);
To report complaints to the Board
To be informed of the cost of professional services before receiving the services
You have the right to considerate and respectful care. In our counseling relationship you have the right to be free from discrimination because of age, color, culture, disability, ethnicity, national origin, gender, race, religion, sexual orientation, marital status, or socioeconomic status.
COMPLAINTS
If you are concerned that I have violated your privacy rights, you disagree with a decision I have made about access to your records, and/or if problems arise in our counseling relationship, please discuss your concerns with me as soon as possible. I will try to work out a solution that is fair and ethical for all parties. If we cannot come to an agreement or you are unsatisfied after we have attempted to resolve your concerns, you may contact the Oregon Board of Licensed and Professional Counseling and Therapist to file a complaint:
Oregon Board of Licensed Professional Counselors and Therapists
3218 Pringle Rd SE, #120, Salem, OR 97302-6312
Telephone: (503) 378-5499 Email: lpct.board@mhra.oregon.gov
Website: www.oregon.gov/OBLPCT
For additional information about this counselor or therapist, consult the Board’s website.
You have the following rights in any dealing with the Board of Licensed and Professional Counselors:
You have the right to expect that a licensee has met the qualifications of training and experience required by state law
You have the right to examine public records maintained by the Board and to have the Board confirm credentials of a licensee
As a Licensed Professional Counseling (LPC) with the Oregon Board of Licensed Professional Counselors and Therapists, I abide by its Code of Ethics. You have the right to obtain a copy of the Code of Ethics (Oregon Administrative Rules 833-100).
You have the right to report complaints to the Board.
NOTICE EFFECTIVE DATE
I reserve the right to change the privacy policies and procedures described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect. If I revise any policies and procedures, I will give you a copy of the revision at our next session following the revision.
This notice will go into effect on October 22, 2021.
PRIVACY OFFICER
Name of Privacy Officer: Kathryn Smith LPC NCC Phone: 541-919-5156 I Email: Info@KathrynLPC.com
Every client will be provided a copy of these privacy practices prior to intake session. If you have any questions or concerns about the above policies please contact the privacy officer listed above.