Privacy Policies

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Gentle People Therapy

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.

PLEASE NOTE THAT THE FOLLOWING INFORMATION PERTAINS TO THOSE WHO

ENTER INTO A FORMAL THERAPIST-CLIENT RELATIONSHIP WITH GENTLE

PEOPLE THERAPY.

I. MY PLEDGE REGARDING HEALTH INFORMATION:

I understand that health information about you and your health care is personal. I am

committed to protecting health information about you. I create a record of the care and

services you receive from me. I need this record to provide you with quality care and to

comply with certain legal requirements. This notice applies to all of the records of your

care generated by this mental health care practice. This notice will tell you about the

ways in which I may use and disclose health information about you. I also describe your

rights to the health information I keep about you, and describe certain obligations I have

regarding the use and disclosure of your health information. I am required by law to:

● Make sure that protected health information (“PHI”) that identifies you is kept

private.

● Give you this notice of my legal duties and privacy practices with respect to

health information.

● Follow the terms of the notice that is currently in effect.

● I can change the terms of this Notice, and such changes will apply to all

information I have about you. The new Notice will be available upon request, in

my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health

information. For each category of uses or disclosures I will explain what I mean and try

to give some examples. Not every use or disclosure in a category will be listed.

However, all of the ways I am permitted to use and disclose information will fall within

one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations)

allow health care providers who have direct treatment relationship with the patient/client

to use or disclose the patient/client’s personal health information without the patient’s

written authorization, to carry out the health care provider’s own treatment, payment or

health care operations. I may also disclose your protected health information for the

treatment activities of any health care provider. This too can be done without your

written authorization. For example, if a clinician were to consult with another licensed

health care provider about your condition, we would be permitted to use and disclose

your person health information, which is otherwise confidential, in order to assist the

clinician in diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard.

Because therapists and other health care providers need access to the full record

and/or full and complete information in order to provide quality care. The word

“treatment” includes, among other things, the coordination and management of health

care providers with a third party, consultations between health care providers and

referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health

information in response to a court or administrative order. I may also disclose health

information about your child 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. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1. 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:

a. For my use in treating you.

b. For my use in training or supervising mental health practitioners to help

them improve their skills in group, joint, family, or individual counseling or

therapy.

c. For my use in defending myself in legal proceedings instituted by you.

d. For use by the Secretary of Health and Human Services to investigate my

compliance with HIPAA.

e. Required by law and the use or disclosure is limited to the requirements of

such law.

f. Required by law for certain health oversight activities pertaining to the

originator of the psychotherapy notes.

g. Required by a coroner who is performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others.

2. Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI

for marketing purposes.

3. Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course

of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR

AUTHORIZATION.

Subject to certain limitations in the law, I can use and disclose your PHI without your

Authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure

complies with and is limited to the relevant requirements of such law.

2. For public health activities, including reporting suspected child, elder, or

dependent adult abuse, or preventing or reducing a serious threat to anyone’s

health or safety.

3. For health oversight activities, including audits and investigations.

4. For judicial and administrative proceedings, including responding to a court or

administrative order, although my preference is to obtain an Authorization from

you before doing so.

5. For law enforcement purposes, including reporting crimes occurring on my

premises.

6. To coroners or medical examiners, when such individuals are performing

duties authorized by law.

7. For research purposes, including studying and comparing the mental health of

patients who received one form of therapy versus those who received another

form of therapy for the same condition.

8. Specialized government functions, including, ensuring the proper execution of

military missions; protecting the President of the United States; conducting

intelligence or counter-intelligence operations; or, helping to ensure the safety

of those working within or housed in correctional institutions.

9. For workers’ compensation purposes. Although my preference is to obtain an

Authorization from you, I may provide your PHI in order to comply with

workers’ compensation laws.

10.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.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE

OPPORTUNITY TO OBJECT.

I may provide your PHI to a family member, friend, or other person that you indicate is

involved in your care or 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.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have

the right to ask me not to use or disclose certain PHI for treatment, payment, or

health care operations purposes. I am not required to agree to your request,

and I may say “no” if I believe it would affect your health care.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full.

You have the right to request restrictions on disclosures of your PHI to health

plans for payment or health care operations purposes if the PHI pertains solely

to a health care item or a health care service that you have paid for

out-of-pocket in full.

3. The Right to Choose How I Send PHI to You. You have the right to ask me to

contact you in a specific way (for example, home or office phone) or to send

mail to a different address, and I will agree to all reasonable requests.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy

notes,” you have the right to get an electronic or paper copy of your medical

record and other information that I have about you. I will provide you with a

copy of your record, or a summary of it, if you agree to receive a summary,

within 30 days of receiving your written request, and I may charge a

reasonable, cost based fee for doing so.

5. The Right to Get a List of the Disclosures I Have Made.You have the right to

request a list of instances in which I have disclosed your PHI for purposes

other than treatment, payment, or health care operations, or for which you

provided me with an Authorization. I will respond to your request for an

accounting of disclosures within 60 days of receiving your request. The list I

will give you will include disclosures made in the last six years unless you

request a shorter time. I will provide the list to you at no charge, but if you

make more than one request in the same year, I will charge you a reasonable

cost based fee for each additional request.

6. The Right to Correct or Update Your PHI. If you believe that there is a mistake

in your PHI, or that a piece of important information is missing from your PHI,

you have the right to request that I correct the existing information or add the

missing information. I may say “no” to your request, but I will tell you why in

writing within 60 days of receiving your request.

7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right

get a paper copy of this Notice, and you have the right to get a copy of this

notice by e-mail. And, even if you have agreed to receive this Notice via e-mail,

you also have the right to request a paper copy of it.