Privacy policy

Notice of psychologist’s policies and practices to protect the privacy of your patient’s 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

We 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” is when we provide, coordinate or manage your health care and other services related to your health care. An example of treatment would be when we consult with another health care provider, such as your family physician or another psychologist.
“Payment” is when we obtain reimbursement for your services.
“Health care operations” are activities that relate to the performance and operation of our 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 the Psychology Clinic, such as sharing, employing, applying, utilizing, examining and analyzing information that identifies you.
“Disclosure” applies to activities outside of the Psychology Clinic, such as releasing, transferring or providing access to information about you to other parties.

II) Uses and disclosures requiring authorization

We may use or disclose PHI for purposes outside of treatment, payment or 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 we are asked for information for purposes outside of treatment, payment or health care operations, we will obtain an authorization from you before releasing this information. We will also need to obtain an authorization before releasing your psychotherapy notes. "Psychotherapy notes" are notes we have made about our conversation during a private, group, joint or family counseling session, which we 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) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides the insurer the right to contest the claim under the policy.

III) Uses and disclosures with neither consent nor authorization

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

Child abuse: If we have reasonable cause to suspect child abuse or neglect, we must report this suspicion to the appropriate authorities as required by law.
Other abuse: If you are elderly and being abused or if we have reasonable cause to suspect you have been criminally abused, we must report this suspicion to the appropriate authorities as required by law.
Health oversight activities: If we receive a subpoena or other lawful request from the Department of Health or the Michigan Board of Psychology, we must disclose the relevant PHI pursuant to that subpoena or lawful request.
Judicial and administrative proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment or the records thereof, such information is privileged under state law and we will not release information without your written authorization or a court order. The privilege does not apply when you are being evaluated or 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: If you communicate to us a threat of physical violence against a reasonably identifiable third person and you have the apparent intent and ability to carry out that threat in the foreseeable future, we may disclose relevant PHI and take the reasonable steps permitted by law to prevent the threatened harm from occurring. If we believe that there is an imminent risk that you will inflict serious physical harm on yourself, we may disclose information to protect you.
Worker’s compensation: We may disclose protected health information regarding you as authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.

IV) Uses with content and authorization

The Psychology Clinic may rely on technology to communicate with you. To protect your privacy, the Psychology Clinic only communicates via text messaging with prior written consent and uses it only to schedule and confirm appointments or for other administrative matters. The Psychology Clinic only includes the minimal amount of information necessary in a message to reduce risks to your privacy if the message is received or viewed by someone other than you. If you allow us to initiate text communication with you, here are some important things to know.

SMS/text messaging

Communication from the Psychology Clinic

After obtaining your consent, the Psychology Clinic can use text messaging to send out appointment reminders. We will use the cellular phone number that you provide in your intake forms for the Psychology Clinic to send text messages. That phone number must be capable of receiving texts from the Psychology Clinic and standard text messaging rates/charges may apply. Your phone number will be stored in your electronic medical record on a secure server.

Texts may be used as two-way communication to confirm an upcoming appointment or ask that you contact the Psychology Clinic by phone or email. Text messaging may be used to check in with you if there is a safety concern or we have been unable to reach you by other means.

Text messages are generally not secure because they lack encryption and the sender does not know with certainty that the message was received and/or viewed by the recipient. If your text messages appear on your phone screen when received, there is a risk that others near you could see the text. Also, telecommunication vendors/wireless carriers may store the text messages.

Opt-in

When you opt-in to receive SMS/text messages, we collect:

Your phone number
Consent to send SMS/text messages
Your email address
Your basic contact information
Your messaging history with us

General risks with electronic communications

The Psychology Clinic cannot guarantee the security and confidentiality of electronic communications and is not responsible for the same. In addition to what is stated above, some of the general risks associated with electronic communications include:

Text messaging is vulnerable to unauthorized viewing. People in your home or other environments who access your phone. computer or other devices that you use might read your text messages.
You might lose your phone. computer or other devices that you use.
Accounts can be hacked.
Messages are stored on servers and may exist and be discoverable even after you delete them.
Misdelivery of messages.
Third parties might intercept your communication.
Electronic communications may be subject to disruptions.
Electronic communications may; be easier to falsify.

Privacy and emergency procedures

If you agree to receiving text messages from the Psychology Clinic, you understand and agree to the following:

In an emergency, you will not use text messages or messages by email to contact the Psychology Clinic since texts and emails are not always received in a timely fashion.
You recognize that neither the Psychology Clinic nor any of its personnel is responsible should our text message or email not be received and acted upon in a timely manner.
For life-threatening emergencies during evenings. weekends and university closures, you will call the Detroit Wayne Integrated Health Network (DWIHN) 24-hour helpline at 313-224-7000 or visit your nearest hospital emergency department.
You understand in an emergency that prevents other more appropriate means of contacting you (e.g., suicidal risk, natural disaster, acts of terrorism), email and/or text messaging might be used to contact you, regardless of whether you have formally permitted email or text communication.

Disclosure

We may disclose your information to a text messaging service provider solely for the purposes described above. We will not share your personal information. phone number or SMS/text message opt-in data with third parties for marketing or promotional purposes. See SMS/text messaging terms and conditions.

V) 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. However, we are 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 us. On your request, we 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 in our mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. We may deny your access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, we will discuss with you the details of the request and denial process.
Right to an accounting: You generally have the right to receive an accounting of disclosures of PHI. At your request, we 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 us upon request, even if you have agreed to receive the notice electronically.

Therapist’s duties

We are required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI.
We reserve the right to change the privacy policies and practices described in this notice. Unless we notify you of such changes, however, we are required to abide by the terms currently in effect.
If we revise our policies and procedures, we will provide individuals with a revised notice, e.g., by mail.

VI) Complaints

If you are concerned that we have violated your privacy rights or you disagree with a decision we made about access to your records, you may contact the Wayne State University Clinic Director Dr. Marilyn Franklin or the Associate Director Dr. Marya McCarroll at 313-577-2840.

You may also send a written complaint to the secretary of the U.S. Department of Health and Human Services. The person listed above can provide you with the appropriate address upon request.

VII) Effective date, restrictions and changes to privacy policy

This agreement may not include a limitation affecting the psychologist's right to make a use or disclosure that is required by law or, when in good faith, to use or disclose to avert a serious threat to the health or safety of a person or the public and such use or disclosure is to a person or persons reasonably able to prevent or lessen the threat (including the target of the threat).

We reserve the right to change the terms of this notice and to make the new notice provisions effective for all PHI that we maintain. We will provide you with a revised notice by the time the changes are in effect.