privacy

PRIVACY AND HIPPA STATEMENT

(This version is effective as of 6/23/17)

What is this document about? This document serves two purposes: one to explain how important your privacy is to us, and second to fulfill requirements by state and federal law regarding the privacy of your health information. The main guiding authority for this is a law passed by Congress in 1996 and since amended. The law is the Health Insurance Portability and Accountability Act, or more commonly called “HIPAA”. The law covers in detail how your health information can be used and disclosed. It also details your individual privacy rights. All this is called “The Privacy Rule”. We are also required to have a written privacy policy for you to read which explains our policy and the law to you.

The Privacy Rule applies, for all intents and purpose, to all health care providers or facilities whether medical or mental health. It also covers insurance companies and health plans. Even businesses associated with a health care provider can be covered by HIPAA.

All forms of media are covered: electronic (such as computer records, transmittals via the internet, etc), paper, and/or oral. Any record directly or indirectly related to your health information is covered (demographic information such name and address, notes taken in session, health insurance filings, etc.). Basically any, and all, of this information, is officially defined by the term PHI (Protected Health information). All the documents together that are PHI related are called your Designated Record Set  

The federal law (HIPAA) is administered by the U.S. Dept. of Health and Human Services and within that department the Office for Civil Rights (OCR). OCR handles any complaint you might have about your privacy, our policy, and whether we are implementing it properly. They can be contacted at http://www.hhs.gov/ocr/hipaa.  

The persons to contact regarding our policy, or if you have a complaint or concern regarding your privacy rights, are either Louisa Storen, or her practice manager located in the office area by the reception desk. You can file a written complaint by sending an email to joe@snowislandllc.com (Joe Boyd practice manager).

You may request a copy of this document to keep and take with you. We will always have the most recent version available for you to review. It can change periodically so please ask us for the latest version at any of your visits.

Permitted Uses & Disclosures of your PHI : We are permitted (but not required) to use and disclose your PHI, without your authorization, for the following purposes or situations. Otherwise your authorization is required. However in certain circumstances we do ask you to sign an authorization to release information even though we are not required to do so.
Note: There is one special category called “psychotherapy notes” that will be explained later that has its own special set of rules.

  1. To you the individual (see separate heading for a further explanation of this)

  2. Treatment, Payment, and Health Care Operations (also called TPO)
    1. Treatment is defined as the provision, coordination, or management of health care and related services for an individual by one or more health care providers, including consultation between providers regarding a patient and referral of a patient by one provider to another.
      1. Collaboration with Other Professionals: In order to provide quality services, I often need to collaborate with other professionals, such as your physician, psychiatrist, past therapists, and/or other mental health professionals. You will be asked to complete a Release Of Information authorizing these exchanges prior to any collaboration with other professionals. No information will be released, or communicated, until you authorize such in writing on a separate Release Of Information form.
    2. Payment refers to anything dealing with payment of services, billing, and insurance filing.
    3. Health Care Operations encompasses business planning, development, general administrative activities, arranging for legal services, credentialing, etc.

  3. Opportunity to agree or object and informal permission
    1. Informal permission may be obtained by asking you outright or by circumstances that clearly give you the opportunity to agree, acquiesce, or object. Where you are incapacitated, or in an emergency situation, we may make such uses and disclosures if our professional judgment dictates that it’s in your best interest.
    2. We may also rely on your informal permission to disclose to your family, and/or person or persons listed as emergency contacts on your intake form.

  4. Incidental Use and Disclosure
    1. The Privacy Rule does not require that every risk of an incidental use or disclosure of PHI be eliminated. A disclosure that occurs as a result of, or as “incident to”, an otherwise permitted use is permitted as long as reasonable safeguards are in place.
  5. Public Interest and Benefit Activities: The Rule permits use and disclosure of PHI without your authorization or permission, for 12 national priority purposes. Although these disclosures are permitted, they not all are required by the Rule.
    1. Required by Law: We may disclose information as required by law, including by statute, regulation, or court orders.
    2. Public Health Activities: Rule allows disclosure to public health authorities for preventing injury or disability or reports of child abuse and neglect. Also information may be disclosed to employers if requested by employer for information concerning a work-related illness or injury, or workplace related medical surveillance, because such information is needed by the employer to comply with Occupational Safety and Health Administration (OHSA).
    3. Victims of Abuse, Neglect or Domestic Violence: In certain circumstances, we may have to disclose PHI to appropriate government authorities regarding victims of abuse, neglect, or domestic violence.
    4. Health Oversight Activities: We may have to disclose PHI to purposes of government oversight activities such as audits or investigations of health care system and government benefits programs.
    5. Judicial & Administrative Proceedings: We may disclose information if so ordered by a court or administrative tribunal. PHI may also be disclosed in response to a subpoena or other lawful process. 
    6. Law Enforcement Purposes: We may disclose PHI to law enforcement official under the following circumstances.
      1. As required by law (court orders, warrants, subpoenas, etc.).
      2. To identify or locate a suspect, fugitive, material witness, or missing person.
      3. In response to law enforcement’s request for information about a victim or someone suspected of a crime.
      4. To alert law enforcement of a person’s death if it is thought that criminal activity caused the death.
      5. If it believed PHI is evidence of a crime that occurred on our premises.
      6. Medical emergency not occurring on our premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or victims, and the perpetrator of the crime.
    7. Research: PHI can be used for research purposes provided all regulations and laws governing medical research are followed.
    8. Serious Threat to Health or Safety: PHI may be disclosed if we believe it is necessary to prevent or lessen a serious and imminent threat to a person or the public.
    9. Essential Government Functions: including conducting intelligence and national security activities authorized by law, or determining eligibility for or conducting enrollment in certain government benefit programs.
    10. Worker’s Compensation: may disclose PHI as authorized by, and to comply with, worker’s compensation laws.

Disclosure Accounting: 
  1. You have the right to an accounting of the disclosures of your PHI (who has received your information), except for the following:
  2. For treatment, payment, or health care operations.
  3. To your personal representative.
  4. For notification of or to persons involved in your health care or payment.
  5. Pursuant to an authorization.
  6. For national security or intelligence purposes.
  7. To law enforcement officials as stipulated by law.
  8. Incident to otherwise permitted or required uses or disclosures.


Authorizing Use and Disclosure of PHI: For any disclosure or use of PHI, except as already detailed in this document, a specific written authorization is required to be signed by you. We will have you sign our form for these purposes. It will list to whom the information can be released to, and what that information is. You have right to revoke the authorization any time you wish by providing a written request.

Psychotherapy Notes: This is a very special category! Psychotherapy notes are basically the written or typed notes that Ms. Storen takes during your session. They document or analyze your conversations. It is recognized here, and under law, that this type of very personal information needs to be protected more than other PHI. In fact these notes need to be kept separate from other PHI.  

We have to obtain your individual written authorization to use or disclose these notes, except, in the following circumstances – exception meaning we can do the following without your authorization:
● We may of course use them for treatment
● For our own training
● To defend ourselves in court
● For US Health & Human Services, and other health oversight agency investigations 
     regarding adherence to HIPAA
● To avert a serious and imminent threat to public health or safety
● For health oversight agencies
● In South Carolina these notes can be subpoenaed through a court order signed by a
     judge

Duty To Warn Mandate: Ms. Storen is mandated by state and federal regulations – through duties to warn – to breach confidentiality if she discovers any of the following:
  1. You are threatening self-harm or suicide.
  2. You are threatening to harm another or homicide.
  3. A child has been or is being abused or neglected.
  4. A vulnerable adult has been or is being abused or neglected.

Rights Regarding Access To Your Records: All PHI information, including psychotherapy notes, are solely the property of Louisa Storen. However, except for psychotherapy notes, you have a right to review and obtain a full, or partial copy (we can charge a small fee for this), of your PHI record set unless it is deemed by us that releasing this information would cause harm to your emotional or physical well-being, or emotional or physical well-being of another person who has given information about you. If access is denied to you by us to your PHI - excluding psychotherapy notes however - then you do have the option to have such denials reviewed by a licensed health care professional for a second opinion. This option does not pertain to psychotherapy notes; as stated earlier, psychotherapy notes have been setup as a special category by state and federal law.


You also have the right to request that your PHI be amended if you believe the information is inaccurate or not complete. Your request can be denied but if it is denied then we must provide you with a written denial and allow you to submit a statement of disagreement for inclusion in your record. 

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