Notice of Psychologists’ Policies and Practices to Protect the Privacy of Your Health Information

THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

 I.  Uses and Disclosures for Treatment, Payment, and Health Care Operations   

I may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. To help clarify these terms, here are some definitions:

·        “PHI” refers to information in your health record that could identify you.

·        “Treatment, Payment 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 or another psychologist.

- Payment is when I obtain reimbursement for your healthcare.  Examples of payment are when I disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility or coverage.

- Health Care Operations are activities that relate to the performance and operation of my 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 my [office, clinic, practice group, etc.] such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.

·        “Disclosure” applies to activities outside of my [office, clinic, practice group, etc.], such as releasing, transferring, or providing access to information about you to other parties.

II.  Uses and Disclosures Requiring Authorization

I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures.  In those instances when I am asked for information for purposes outside of treatment, payment and health care operations, I will obtain an authorization from you before releasing this information.  I will also need to obtain an authorization before releasing your psychotherapy notes. “Psychotherapy notes” are notes I have made about our conversation during a private, group, joint, or family counseling session, which I have kept separate from the rest of your medical record.  These notes are given a greater degree of protection than PHI. 

You may revoke all such authorizations (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

III.  Uses and Disclosures with Neither Consent nor Authorization

I may use or disclose PHI without your consent or authorization in the following circumstances:  

§         Child Abuse: If I have reasonable cause to believe that a child has suffered abuse or neglect, I am required by law to report it to the proper law enforcement agency or the Washington Department of Social and Health Services.

§         Adult and Domestic Abuse: If I have reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred, I must immediately report the abuse to the Washington Department of Social and Health Services. If I have reason to suspect that sexual or physical assault has occurred, I must immediately report to the appropriate law enforcement agency and to the Department of Social and Health Services.  

§         Health Oversight: If the Washington Examining Board of Psychology subpoenas me as part of its investigations, hearings or proceedings relating to the discipline, issuance or denial of licensure of state licensed psychologists, I must comply with its orders.  This could include disclosing your relevant mental health information.

§         Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about the professional services that I have provided to you and the records thereof, such information is privileged under state law, and I will not release information without the written authorization of you or your legal representative, or a subpoena of which you have been properly notified and you have failed to inform me that you are opposing the subpoena, 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 will be informed in advance if this is the case.

§         Serious Threat to Health or Safety: I may disclose your confidential mental health information to any person without authorization if I reasonably believe that disclosure will avoid or minimize imminent danger to your health or safety, or the health or safety of any other individual.

§         Worker’s Compensation: If you file a worker's compensation claim, with certain exceptions, I must make available, at any stage of the proceedings, all mental health information in my possession relevant to that particular injury in the opinion of the Washington Department of Labor and Industries, to your employer, your representative, and the Department of Labor and Industries upon request. 

IV.  Patient's Rights and Psychologist's Duties

Patient’s Rights:

·        Right to Request Restrictions –You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, I am not required to agree to a restriction you request.

·        Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing me.  Upon your request, I will send your bills to another address.) 

·        Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI and psychotherapy notes in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. On your request, I will discuss with you the details of the request and denial process.  

·        Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request.  On your request, I will discuss with you the details of the amendment process.  

·        Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described in Section III of this Notice).  On your request, I will 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 from me upon request, even if you have agreed to receive the notice electronically. 

Psychologist’s Duties:

·        I am required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with respect to PHI.

·        I reserve 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 I revise my policies and procedures, I will date and post a copy of the revisions to http://www.livemoresimply.com/Privacy_Notice.htm

V.  Questions and Complaints

If you have questions about this notice, disagree with a decision I make about access to your records, or have other concerns about your privacy rights, you may contact me, Stuart N. Robinson, Ph.D. at 888-923-2256.

If you believe that your privacy rights have been violated and wish to file a complaint with me/my office, you may send your written notice of your complaint to me, Stuart N. Robinson, Ph.D., 10300 N. Central Expy, Suite 175, Dallas, TX, 75231.

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services.  I will be happy to  provide you with the appropriate address upon request.  

You have specific rights under the Privacy Rule.  I will not retaliate against you for exercising your right to file a complaint.  

VI. Effective Date. Restrictions and Changes to Privacy Policy

This notice will go into effect on January 23, 2010.

I reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that I maintain.  Revisions to this notice will be posted to this website at the time of revision. I will be happy to provide you with a written copy of these revisions upon request.

Email Policy

 Confidentiality

I cannot offer the same degree of confidentiality for email as I for other forms of communication. When you email from a given account, I will assume that it is acceptable to return mail to you at that same email address.  While I will do my best to honor requests to return mail to a different email address than the address from which your mail was sent, I do not have a system in place that can guarantee an error will not be made. Consequently, it's best to refrain from emailing me from accounts you do no wish me to return mail to. Alternatively, you can avoid embarrassing situations by setting your email program to list the address you want your mail returned to as the address that will be accessed when I press the reply button. Because email accounts require a third party to maintain, I cannot guarantee the confidentiality and privacy protection provided by the vendors involved. While I endeavor to protect my computers from hackers, viruses, worms and other threats to the security of your correspondence, I regret that I cannot fully assure their protection. 

Please do not send me emails as a substitute for therapy sessions.  If you are emailing me about a therapy issue, I will almost always postpone responding until your next appointment.      

Informed Consent

I understand that by initiating email correspondence and/or providing you with my email address, I am agreeing to use email as an acceptable form of communication for confidential information.

The Doctor-Patient Relationship

The information on www.livemoresimply.com is for general information or educational purposes only and can in no way substitute for clinical and/or healthcare services. Visiting this website or contacting me by email, text or telephone does not constitute or establish a professional or therapeutic relationship. This can only be completed in my office and after you have completed all the necessary documents and met with me in person. Neither are Meet & Greets clinical sessions. I can not provide any clinical advise or consul during a Meet & Greet. 

If You Are Experiencing An Emergency

I am not medically trained and the limitations of my licensing require me to inform you that in an emergency -- medical, psychiatric, psychological, safety, health, welfare and/or others -- you must contact your medical doctors and/or 911 and/or the proper government authority. You should also always consider going directly to a hospital emergency room or psychiatric hospital, or calling a suicide help line like Contact Dallas at 972-233-2233. There is a list of alternatives emergency contact numbers and locations on this website at http://www.livemoresimply.com/Who_to_call_for_emergency.htm 

If You Need Medication, You Must Contact A Medical Doctor

I am not licensed or qualified to prescribe medication. I feel comfortable making suggestions to a patient’s psychiatrist or family doctor with the patient’s permission, and I will always take an active interest is what medications you take and at what dose. My treatment will not be complete without doing this. You need to clear any changes in your meds, however, with your medical doctors in advance. 

This is especially true in considering whether to stop medication abruptly, or whether to decrease or increase a dosage, as opposed to phasing out a medication, or to changing a dosage slowly over time. Abrupt changes to meds can be very dangerous and I strongly advise patients to never stop taking their medication as directed until discussing the implications with their physician in person, and until then, it is very important that patients remain on whatever medications currently prescribed.