At Kennebec Counseling Services, we understand that health information about you and your care is personal, and we are committed to protecting your health information. We create a record of the care and services you receive from us, which is essential for providing you with quality care and for complying with legal requirements. This notice applies to all records of your care generated by this practice and explains how we may use and disclose your health information. It also outlines your rights regarding the health information we maintain and describes our legal obligations regarding its use and disclosure.

We are required by law to:

• Ensure that protected health information (“PHI”) that identifies you is kept private.

• Provide you with this notice of our legal duties and privacy practices with respect to health information.

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

Changes to This Notice: We reserve the right to change the terms of this Notice at any time. Any changes will apply to all information we have about you. The updated Notice will be available upon request in our office and on our website.

The following categories describe different ways that we may use and disclose your health information. Although not every use or disclosure is listed, all permissible uses and disclosures will fall within one of these categories:

Treatment, Payment, or Health Care Operations

Federal privacy rules allow healthcare providers with a direct treatment relationship with you to use or disclose your personal health information without your written authorization for the purposes of treatment, payment, or healthcare operations. For example, if a clinician consults with another licensed healthcare provider about your condition, we may use and disclose your personal health information to assist in the diagnosis and treatment of your mental health condition.

• Treatment: This includes coordinating and managing your care with other healthcare providers, consultations between healthcare providers, and referrals.

• Payment: We may use and disclose your PHI to process your payment for the healthcare services you receive.

• Health Care Operations: We may use and disclose your PHI as necessary to run our practice and ensure that all clients receive quality care.

Lawsuits and Disputes

If you are involved in a lawsuit, we may disclose health information 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, but only if efforts have been made to notify you or to obtain an order protecting the information.

Some uses and disclosures of your PHI require your explicit authorization. These include:

• Psychotherapy Notes: We maintain “psychotherapy notes” as defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your authorization unless the use or disclosure is:

  • For our treatment of you.

  • For training or supervising mental health practitioners.

  • To defend ourselves in legal proceedings initiated by you.

  • Required by law for oversight activities, health and safety, or compliance with regulations.

• Marketing Purposes: We will not use or disclose your PHI for marketing purposes without your explicit authorization.

• Sale of PHI: We will not sell your PHI as part of our business operations.

ubject to certain limitations, we may use and disclose your PHI without your authorization for the following reasons:

• Compliance with Laws: When disclosure is required by state or federal law and is limited to the relevant requirements.

• Public Health Activities: Reporting suspected child, elder, or dependent adult abuse, or preventing a serious threat to health or safety.

• Health Oversight Activities: Including audits, investigations, and inspections.

• Judicial and Administrative Proceedings: In response to a court or administrative order.

• Law Enforcement Purposes: Including reporting crimes occurring on our premises.

• Coroners and Medical Examiners: When they are performing duties authorized by law.

• Appointment Reminders and Health-Related Services: To remind you of appointments or to inform you about treatment alternatives or other health-related benefits and services.

Certain Uses and Disclosures Require You to Have the Opportunity to Object

We may disclose your PHI to a family member, friend, or other person involved in your care for the payment for your healthcare unless you object. In emergency situations, the opportunity to consent may be obtained retroactively.

You have the following rights with respect to your PHI:

• Right to Request Limits on Uses and Disclosures: You can request that we not use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree, but we will consider your request.

• Right to Request Restrictions for Out-of-Pocket Expenses: You can request that we restrict disclosures of your PHI to health plans for payment or health care operations if you have paid for the service in full out-of-pocket.

• Right to Choose How We Contact You: You can ask us to contact you in a specific way (e.g., home or office phone) or to send mail to a different address. We will accommodate all reasonable requests.

• Right to See and Get Copies of Your PHI: You can request an electronic or paper copy of your medical record and other health information. We will provide it within 30 days of your request and may charge a reasonable, cost-based fee.

• Right to Get a List of Disclosures: You can request a list of the times we’ve disclosed your PHI for reasons other than treatment, payment, or healthcare operations. We will provide this list for the past six years within 60 days of your request.

• Right to Correct or Update Your PHI: If you believe your PHI contains an error or missing information, you can request that we correct or add the information. We will respond within 60 days of your request.

• Right to Get a Paper or Electronic Copy of This Notice: You can request a paper or electronic copy of this Notice at any time, even if you have agreed to receive it electronically.