Information disclosed during your sessions is strictly confidential. Your written permission is required before any information about your contact with Hosford Clinic is released to anyone outside of the Clinic. This means that if your partner, family member, employer, roommate, friend, or other person contacts us about you, we will not acknowledge that we know of you. It also means if you want us to release information to someone else, we cannot do so until you complete a Release of Information Form.
However, there are four specific situations in which we are required to release information:
1. If a minor child, elderly individual, or a dependent adult is at risk of being physically or sexually abused or neglected, a clinician is required to report that information to the appropriate agency to assure the safety of the person.
2. If you present an imminent risk of serious injury to yourself, the clinician would take action to assure your safety. However the clinician is also obligated to release only as much information as is judged to be necessary to protect your safety.
3. If you threaten serious harm to another person, the clinician is required to take action to warn and protect the other person. Typically, this involves contacting the person who is being threatened and contacting the police. However, the clinician is obligated to release only as much information as is judged to be necessary to protect your safety.
4. When a release of records is court-mandated.
HIPAA & Confidentiality (from UND)
A Federal law known as "HIPAA" (the Health Insurance Portability and Accountability Act of 1996) requires health care providers to implement a comprehensive approach to protect the privacy of personal health information (PHI). There are nine parts to HIPAA, but our immediate compliance will focus on three areas:
The Privacy Rule regulates the use and distribution of identifiable health information and gives individuals the right to determine and restrict access to their health information. Compliance with HIPAA's privacy regulations will be required beginning April 14, 2003. Substantial penalties, both civil and criminal, may be imposed for non-compliance.
The HIPAA Security Rule mandates that reasonable and appropriate technical, physical, and administrative safeguards be implemented with electronic identifiable health information. We must ensure the confidentiality, integrity, and availability of all electronic protected health information we create, receive, maintain or transmit. Compliance date for the Security Rule is October 16, 2003.
Transactions and Codes:
HIPAA requires DHHS to adopt standards to facilitate Electronic Data Interchange (EDI). HIPAA transaction standards apply to any health care provider that transmits any health information in electronic form.
Notice of Privacy Practices
UNIVERSITY of CALIFORNIA SANTA BARBARA - NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY OBTAIN ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY
The University of California, including the Hosford Counseling & Psychological Services Clinic at UCSB, is a teaching and research institution. Graduate students, fellows and residents may participate in your care as a part of their mental health training programs. All care is overseen and supervised by a licensed mental health professional. All information describing your mental health treatment and related health care services ("mental health information") is personal, and we are committed to protecting the privacy of the personal and mental health information you disclose to us. We are required by law to maintain the confidentiality of information that identifies you and the care you receive. When we disclose information to other persons and companies to perform services for us, we require them to protect your privacy, too. This Notice applies to your clinician, counselor, psychotherapist, psychiatrist and other health care professionals who provide care to you. We must also provide certain protections for information related to your medical diagnosis and treatment, including HIV/AIDs, and information about alcohol and other substance abuse. The Hosford Clinic abides by all state and federal laws related to the protection of this information. We are required to give you this notice about our privacy practices, your rights and our legal responsibilities.
WE MAY USE AND DISCLOSE YOUR MENTAL HEALTH INFORMATION:
For TREATMENT For example, we may give information about your psychological condition to other health care providers to facilitate your treatment, referrals or consultations.
For PAYMENT For example, we may contact your insurer to verify what benefits you are eligible for, to obtain prior authorization, and to receive payment from your insurance carrier.
For HEALTHCARE OPERATIONS For example, we give information to University psychological and medical services staff to review the quality of care provided, for performance improvement or for the training of health professionals.
For APPOINTMENTS AND SERVICES to remind you of an appointment, or tell you about treatment alternatives or health related benefits or services.
To INDIVIDUALS INVOLVED IN YOUR CARE, such as your parents, if you are a minor, or your conservator.
WITH YOUR WRITTEN AUTHORIZATION We may use or disclose mental health information for purposes not described in this Notice only with your written authorization. You may revoke that permission in writing at any time. We are unable to take back any disclosures that we have already made with your permission.
WE MAY USE YOUR MENTAL HEALTH INFORMATION FOR OTHER PURPOSES WITHOUT YOUR WRITTEN AUTHORIZATION
As REQUIRED BY LAW when required or authorized by other laws, such as the reporting of child abuse, elder abuse or dependent adult abuse.
For HEALTH OVERSIGHT ACTIVITIES to governmental, licensing, auditing, and accrediting agencies as authorized or required by law including audits; civil, administrative or criminal investigations; licensure or disciplinary actions; and monitoring of compliance with law.
In JUDICIAL PROCEEDINGS in response to court/administrative orders, subpoenas, discovery requests or other legal process.
To PUBLIC HEALTH AUTHORITIES to prevent or control communicable disease, injury or disability, or ensure the safety of drugs and medical devices.
To LAW ENFORCEMENT for, example, to assist in an involuntary hospitalization process.
To THE STATE LEGISLATIVE SENATE OR ASSEMBLY RULES COMMITTEES for legislative investigations.
For RESEARCH PURPOSES subject to a special review process and the confidentiality requirements of state and federal law.
To PREVENT A SERIOUS THREAT TO HEALTH OR SAFETY We may use and disclose mental health information about you when necessary to prevent or lessen a serious and imminent threat to your health and safety or the health and safety of the public or another person. We may notify the person(s) being threatened, tell someone who could prevent or lessen the harm or tell law enforcement officials.
To PROTECT CERTAIN ELECTIVE OFFICERS including the President, by notifying law enforcement officers of potential harm.
YOUR MENTAL HEALTH INFORMATION IS THE PROPERTY OF THE HOSFORD CLINIC. HOWEVER, YOU HAVE THE FOLLOWING RIGHTS:
To Receive a Copy of this Notice when you obtain care.
To Request Restrictions. You have the right to request a restriction or limitation on the mental health information we disclose about you for treatment, payment or health care operations. You must put your request in writing. We are not required to agree with your request. If we do agree with the request, we will comply with your request except to the extent that disclosure has already occurred or if you are in need of emergency treatment and the information is needed to provide the emergency treatment.
To Inspect and Request a Copy of Your Mental Health Record except in limited circumstances. You must make your request in writing. A fee will be charged to copy your record. You must put your request for a copy of your records in writing. If you are denied access to your mental health record for certain reasons, we will tell you why and what your rights are to challenge that denial.
To Request an Amendment and/or Addendum to your Mental Health Record. If you believe that information is incorrect or incomplete, you may ask us to amend the information or add an addendum (addition to the record) of no longer than 250 words for each inaccuracy. Your request for amendment and/or addendum must be in writing and give a reason for the request. We may deny your request for an amendment if the information was not created by us, is not a part of the information which you would be permitted to inspect and copy, or, if the information is already accurate and complete. Even if we accept your request, we do not delete any information already in your records.
To Receive an Accounting of Certain Disclosures we have made of your mental health information. You must put your request for an accounting in writing.
To Request That We Contact You by Alternate Means (e.g., fax versus mail) or at alternate locations. Your request must be in writing, and we must honor reasonable requests.
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 information we already have about you as well as any information we receive in the future. We will post a copy of the most current Notice on the Hosford Clinic website:
CONTACT INFORMATION: If you have any questions about this Notice, please contact the University's HIPAA Privacy Official at: 510-287-3858.
If you believe your privacy rights have been violated, you may file a complaint with the UCSB HIPAA Compliance Officer at SH, UCSB, Santa Barbara, CA 93106-7002 or by calling (805) 893-8520 or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.
Effective Date: [10/8]