THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.
While Seattle Christian Counseling is not directly responsible for maintaining or providing access to your health information, we are providing this Notice of Privacy Practices to explain how we may use or share your information from your Designated Record Set.This notice also explains some of the responsibilities of our Therapist Business Associates as they relate to your health information.
The Designated Record Set includes financial and health information referred to in this Notice as “Protected Health Information” (“PHI”) or simply “health information.” We are required to adhere to the terms outlined in this Notice. If you have any questions about this Notice, please contact BenjaminDeu at 10116 Main St, Suites 104 & 203, Bothell, WA 98011.
UNDERSTANDING YOUR MENTAL HEALTHSERVICES RECORD AND INFORMATION
When you complete an intake form on our website, personal health information (PHI) is collected, and when you schedule an appointment, the PHI is shared with a licensed Therapist in our network of business associates. The therapist receiving your information is responsible for providing you with his own Notice of Privacy Practices that outlines how he may use and share your information and how they will grant you access to your information. The Therapist then collects and maintains the information that makes up your Mental Health Treatment Record or Health Record. Seattle Christian Counseling houses what information is added to our G-Suite by the Therapist. While the Therapist has its own set of uses and disclosures, Seattle Christian Counseling may use and/or disclose your PHI collected to:
- provide information for medical research
- provide information to public health officials
- comply with legal requirements to release your mental health services record
Understanding what is in your record and how your health information is used helps you to:
- ensure it is accurate
- better understand who may access your health information
- make more informed decisions when authorizing disclosure to others
HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
The following categories describe the ways that we use and disclose health information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall into one of the categories.
- Business Associates. The licensed Therapists in SCC’s network of business associates are provided, with your written authorization, access to your PHI. The Therapist or Therapists authorized by you to receive your PHI are then responsible for providing you with their own Notice of Privacy Practices. Their uses of your information differ from Seattle Christian Counseling’s uses of your information, so it is important that you read and understand their Notice. Seattle Christian Counseling is not responsible for the content of their Notice.
Other Business Associates who have signed contracts containing HIPAA compliance requirements may also be provided, with your written authorization, with this information to aid with marketing efforts. Other de-identified information may also be provided to Business Associates, as permitted by law.
- Health-Related Benefits and Services and Reminders. We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- As Required By Law. We will disclose health information about you when required to do so by federal, state or local law.
- Research. Under certain circumstances, we may use and disclose health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of health information, trying to balance the research needs with patients’ need for privacy of their health information. Before we use or disclose health information for research, the project will have been approved through this research approval process. We may, however, disclose health information about you to people preparing to conduct a research project so long as the health information they review does not leave our G-Suite.
- Reporting Federal and state laws may require or permit the Therapy Practice to disclose certain health information related to the following:
- Public Health Risks. We may disclose health information about you for public health purposes, including:
- Prevention or control of disease, injury or disability
- Reporting births and deaths;
- Reporting child abuse or neglect;
- Reporting reactions to medications or problems with products;
- Notifying people of recalls of products;
- Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease;
- Notifying the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities may include audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
- Judicial and Administrative Proceedings: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you 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.
- Reporting Abuse, Neglect or Domestic Violence: Notifying the appropriate government agency if we believe a patient has been the victim of abuse, neglect or domestic violence.
Law Enforcement. We may disclose health information when requested by a law enforcement official:
In response to a court order, subpoena, warrant, summons or similar process;
To identify or locate a suspect, fugitive, material witness, or missing person;
About you, the victim of a crime if, under certain limited circumstances, we are unable to obtain your agreement;
About a death we believe may be the result of criminal conduct;
About criminal conduct at the Therapy Practice; and
In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
- National Security and Intelligence Activities. We may disclose health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU
Although your mental health record is the property of the Therapist, the information belongs to you. You have the following rights regarding your health information:
- Right to Inspect and Copy. With some exceptions, you have the right to review and copy your health information. Copies or inspections should be requested from the Therapy Practice.
You must submit your request in writing to the Therapy Practice Privacy Officer or Official, whose contact information you can obtain from your selected Therapy Practice.They may charge a fee for the costs of copying, mailing or other supplies associated with your request.
- Right to Amend. If you feel that health information in your record is incorrect or incomplete, you may ask the Therapy Practice to amend the information. You have this right for as long as the information is kept by or for the Therapy Practice.
You must submit your request in writing to the Therapy Practice Privacy Officer or Official, whose contact information you can obtain from your selected Therapy Practice. In addition, you must provide a reason for your request.
The Therapy Practice maydeny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, they may deny your request if you ask them to amend information that:
Was not created by them, unless the person or entity that created the information is no longer available to make the amendment;
Is not part of the health information kept by or for the Therapy Practice; or
Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures” made by Seattle Christian Counseling. This is a list of certain disclosures we made of your health information, other than those made for purposes such as treatment, payment, or health care operations.
You must submit your request in writing to Benjamin Deu at 10116 Main St, Suites 104 & 203, Bothell, WA 98011. Your request must state a time period which may not be longer than six years from the date the request is submitted and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a twelve month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you. For example, you may request that we limit the health information we disclose to someone who is involved in your care or the payment for your care. You could ask that we not use or disclose information about a surgery you had to a family member or friend.
We are not required to agree to your request.
You must submit your request in writing to Benjamin Deu at 10116 Main St, Suites 104 & 203, Bothell, WA 98011. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply.
Right to Revoke Authorization of Disclosure.You may revoke in writing a disclosure authorization to Seattle Christian Counseling any time unless substantial action has been taken in reliance on the authorization. You may not maintain an action against Seattle Christian Counseling for disclosures made in good-faith reliance on an authorization if Seattle Christian Counseling had no actual notice of the revocation of the authorization.
Right to Request Alternate Communications. You have the right to request that the Therapy Practice communicate with you about medical matters in a confidential manner or at a specific location. For example, you may ask that the Therapy Practice only contact you via mail to a post office box.
You must submit your request in writing to the Therapy Practice Privacy Officer or Official, whose contact information you can obtain from your selected Therapy Practice. They will not ask you the reason for your request. Your request must specify how or where you wish to be contacted. They will accommodate all reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice of Privacy Practices even if you have agreed to receive the Notice electronically. You may ask us to give you a copy of this Notice at any time.
You may obtain a copy of this Notice at our website, https://seattlechristiancounseling.com/hipaa-privacy.
To obtain a paper copy of this Notice, contactBenjamin Deu at 10116 Main St, Suites 104 & 203, Bothell, WA 98011.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current Notice on our website. The Notice will specify the effective date on the first page. In addition, if material changes are made to this Notice, the Notice will contain an effective date for the revisions and copies can be obtained by contacting Benjamin Deu.
If you believe your privacy rights have been violated, you may file a complaint with Seattle Christian Counseling with the Secretary of the Department of Health and Human Services. To file a complaint with Seattle Christian Counseling, contact Benjamin Deu at 10116 Main St, Suites 104 & 203, Bothell, WA 98011. All complaints must be submitted in writing. You will not be penalized for filing a complaint.