Practice & Privacy Policies

EFFECTIVE DATE OF THIS NOTICE: This notice went into effect on December 16, 2025.

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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.

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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.

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II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that I use and disclose health information. 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.

Uses & Disclosures (Permitted Without Your Authorization):

• Treatment: Sharing info with other providers for your care. Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the client to use or disclose the client’s personal health information without the client’s written authorization. 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 client for health care from one health care provider to another.

• Payment: Billing insurance for services. Insurance companies are able to see PHI of each client. 

• Healthcare Operations: Quality improvement, business management. 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 personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

• Public Health/Safety: Reporting abuse/neglect/domestic violence, preventing serious threats.

• Required by Law: Court orders, specific state/federal mandates. 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. If I am to be subpoenaed or court ordered to speak regarding PHI in any manner, I will immediately contact the client and/or their family. 

Uses & Disclosures Requiring Authorization:

• For anything outside treatment/payment, a specific, written release (authorization) is needed (e.g., sharing with employers, legal teams) with limited exceptions. Some of these exceptions include: 1) My use treating you as the client; 2) use in defending myself in legal proceedings if instituted by you; 3) For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA; 4) required by law and the use or disclosure is limited to the requirements of such law; 5) Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes; 6) Required by a coroner who is performing duties authorized by law; and 6) Required to help avert a serious threat to the health and safety of others.

• As a psychotherapist, I will not use or disclose your PHI for marketing purposes.

• As a psychotherapist, I will not sell your PHI in the regular course of my business.

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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 clients 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.

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V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

1. Disclosures to family, friends, or others. 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.

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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.

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VII. OREGON PATIENT RIGHTS (PER ORS 430.210)

Every client is subject to rights while receiving mental health services. 

• While receiving services, every person shall have the right to:

  • Choose from available services those that are appropriate, consistent with the plan developed in accordance with paragraphs (b) and (c) of this subsection and provided in a setting and under conditions that are least restrictive to the person’s liberty, that are least intrusive to the person and that provide for the greatest degree of independence.

  • An individualized service plan, services based upon that plan and periodic review and reassessment of service needs.

  • Ongoing participation in planning of services in a manner appropriate to the person’s capabilities, including the right to participate in the development and periodic revision of the plan described in paragraph (b) of this subsection, and the right to be provided with a reasonable explanation of all service considerations.

  • Not receive services without informed voluntary written consent except in a medical emergency or as otherwise permitted by law.

  • Not participate in experimentation without informed voluntary written consent.

  • Receive medication only for the person’s individual clinical needs.

  • Not be involuntarily terminated or transferred from services without prior notice, notification of available sources of necessary continued services and exercise of a grievance procedure.

  • A humane service environment that affords reasonable protection from harm, reasonable privacy and daily access to fresh air and the outdoors, except that such access may be limited when it would create significant risk of harm to the person or others. 

  • Be free from abuse or neglect and to report any incident of abuse without being subject to retaliation.

  • Religious freedom.

  • Not be required to perform labor, except personal housekeeping duties, without reasonable and lawful compensation.

  • Visit with family members, friends, advocates and legal and medical professionals.

  • Exercise all rights set forth in ORS 426.385 (Rights of committed persons) if the individual is committed to the Oregon Health Authority.

  • Be informed at the start of services and periodically thereafter of the rights guaranteed by this section and the procedures for reporting abuse, and to have these rights and procedures, including the name, address and telephone number of the system described in ORS 192.517 (Access to records of individual with disability or individual with mental illness) (1), prominently posted in a location readily accessible to the person and made available to the person’s guardian and any representative designated by the person.

  • Assert grievances with respect to infringement of the rights described in this section, including the right to have such grievances considered in a fair, timely and impartial grievance procedure.

  • Have access to and communicate privately with any public or private rights protection organization or rights advocate.

  • Exercise all rights described in this section without any form of reprisal or punishment.

• The rights described in this section are in addition to, and do not limit, all other statutory and constitutional rights that are afforded all citizens including, but not limited to, the right to vote, marry, have or not have children, own and dispose of property, enter into contracts and execute documents.

• The rights described in this section may be asserted and exercised by the person, the person’s guardian and any representative designated by the person.

• Nothing in this section may be construed to alter any legal rights and responsibilities between parent and child. [1993 c.96 §3; 2005 c.550 §1; 2007 c.57 §2; 2009 c.595 §471; 2011 c.720 §168; 2013 c.36 §27; 2019 c.236 §2; 2021 c.97 §47]

• Your Rights (Patient):

  • Right to Inspect & Copy your records.

  • Right to Request Amendments to records.

  • Right to Request Restrictions on disclosures (e.g., to family/friends).

  • Right to Request Confidential Communications (alternative means/locations).

  • Right to an Accounting of Disclosures.

  • Right to a Paper Copy of the Notice.

  • Right to be Notified of a Breach.

• Uses & Disclosures (Permitted Without Your Authorization):

  • Treatment: Sharing info with other providers for your care.

  • Payment: Billing insurance for services.

  • Healthcare Operations: Quality improvement, business management.

  • Public Health/Safety: Reporting abuse/neglect/domestic violence, preventing serious threats.

  • Required by Law: Court orders, specific state/federal mandates.

• Uses & Disclosures Requiring Authorization:

  • For anything outside treatment/payment/ops, a specific, written release (authorization) is needed (e.g., sharing with employers, legal teams).

  • Psychotherapy Notes: Require separate, explicit written authorization, with limited exceptions.

• Your Authorization & Revocation: You can revoke written permission anytime, but it's effective when received (unless action already taken).

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VIII. MINORS RIGHTS IN MENTAL HEALTH SERVICES

A minor who is 14 years or older may access outpatient mental health, drug, or alcohol diagnosis or treatment (except for methadone) without parental or guardian consent, if those services are administered by a licensed provider listed in ORS

109.675. These services may include, but are not limited to:

• Help from a psychiatrist or psychologist

• Mental health therapy from a counselor, therapist, or social worker

• Treatment for drug or alcohol use

What happens with cost of treatment? 

• If diagnosis or treatment services are provided to a minor without the consent of their parent or guardian, the parent or guardian is not liable for the payment of the services provided.

How is confidentiality addressed with minors?

• Most people, minors included, expect some level of confidentiality when receiving health care services. However, Oregon law says a provider may advise a parent or legal guardian of the minor’s care, diagnosis, treatment, or the need for any treatment, without the consent of the minor.

• When a minor consents to health care services, providers are encouraged to use their best clinical judgment in deciding whether to share information with the parent or guardian. For minors, best practice is that parent(s)/guardian(s) be involved in their treatment as early as possible. In all situations, Oregon rules state that by the end of the minor’s treatment, providers are required to involve parent(s)/guardian(s) in the minor’s care unless: 

• The parent or guardian refuses involvement;

• There are clear clinical indications, documented in the treatment record, that

• notifying the parent(s)/guardian(s) would be detrimental to the health of the minor and/ or parental/guardian involvement would be contrary to any prescribed treatment plans, goals, or progress;

• There is identified sexual abuse by a parent or guardian; or

• The minor has been emancipated and/or separated from the parent(s) or guardian(s) for at least 90 days.

During the minor’s mental health, drug, or alcohol treatment, providers may disclose health information to a minor’s parent or guardian without the minor’s consent if:

It is clinically appropriate and in the minor’s best interests;

• The minor must be admitted to a detoxification program;

• The minor’s condition has deteriorated or the minor is at risk of dying by suicide and requires inpatient admission; or

• The minor is assessed to be at serious and imminent risk of a suicide attempt but inpatient treatment is not necessary or practicable. Note that in this circumstance the provider shall disclose information.

What does involvement mean for adults in a minor’s choice to engage in therapy?

• It is important to note that involvement does not mean that adults always have access to a minor’s mental health or chemical dependency records. Federal regulation 42 CFR 2.14 states that if a minor is able to self-consent for drug or alcohol treatment, the minor’s treatment records cannot be disclosed without the minor’s written consent (including to the parent or guardian). For more intensive types of mental health treatment, such as day treatment or residential care, parent(s)/guardian(s) must be notified of the minor’s treatment plan; minors may only be admitted to treatment with their parent(s)/guardian(s)’ consent.

How do federal privacy laws address the release of a child’s behavioral health

record from one provider to another provider without parental signature?

• HIPAA regulations generally allow sharing patient behavioral health information, excluding psychotherapy notes, between providers when medically appropriate, regardless of the patient’s age. See 45 CFR §§ 164.506, 164.508. 

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IX. PSYCHOTHERAPY NOTES VERSUS PROGRESS NOTES USED IN SERVICES

I used SimplePractice as an Electronic Health Record to track progress notes after each session. 

• The HIPAA Privacy Rule defines psychotherapy notes specifically as “notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record.” The definition of psychotherapy notes expressly excludes specific types of information that might otherwise be included in service/progress notes, including “medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.” See 45 CFR § 164.501. Note that ORS 179.505 also defines psychotherapy notes for purposes of ORS 179.505.

• Why is this the case? According to HHS, “Psychotherapy notes are treated differently from other mental Health information both because they contain particularly sensitive information and because they are the personal notes of the therapist that typically are not required or useful for treatment, payment, or health care operations purposes, other than by the mental health professional who created the notes.”​​