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Confidentiality and Privacy

Confidentiality

All aspects of your participation in counseling at the Counseling Center, including the scheduling of appointments, contents of counseling sessions, all contents of counseling records and outcomes of counseling are confidential by state law. A confidential record of the counseling services provided to you will be maintained by the Counseling Center, as required by state law. If you are participating in couple’s counseling, a separate record is kept for each individual, and all confidentiality policies apply independently to each record. Only the specific individual may have access to his or her file. If you are participating in group counseling, group notes are kept and distributed to each individual file, and all confidential policies apply independently to the notes for each individual. An individual may have access only to her or his independent notes. Your counseling record consists of both paper file and electronic database components. All parts of your record are highly secured, physically and/or electronically, and are protected by the same confidentiality and privacy laws.

The Counseling Center operates as a single entity, which means that counselors and psychologists within the Counseling Center may share your information in order to consult with each other, and/or with the campus psychiatrists who are under contract with the Counseling Center, in order to provide you the most effective services. Only professional counseling staff may access clinical progress notes, test data, or other clinical information in your file. Support staff may have access only to contact and demographic information and diagnostic codes for the purposes of statistical tracking and reports. No record of counseling is made on an academic transcript or job placement file. Ownership of all physical records is retained by the Counseling Center, which is responsible for establishing policies regarding the retention of counseling records. No information may be released to anyone without your written permission, with the following exceptions.

Exceptions to Confidentiality

  • Texas law requires that counselors who learn of or have strong suspicions of child abuse or neglect report this information to Child Protective Services or to law enforcement personnel. This pertains specifically to knowledge of: child abuse or neglect of a client who is under 18 years of age; any child under 18 years of age suspected of being at risk of abuse or neglect; or abuse or neglect by a client toward a person who is under 18 years of age. Such disclosures in counseling of child abuse or neglect according to the criteria mentioned above will be reported by our counselors and are not protected by confidentiality.
     
  • Texas law requires abuse or neglect of elderly or disabled persons to be reported to the proper authorities.
  • If a counselor assesses that you pose an imminent danger to yourself or others, the counselor may do what is necessary to protect life within the limits of the law. Appropriate university officials and staff (e.g., University Police, Vice Present for Student Affairs, Residence Hall Director, etc.) who bear responsibility or may incur liability for the welfare of Texas State students may be notified about the student’s situation. Only university officials and staff who have a “need to know” to protect the safety of students will be given this information.
  • A court-ordered subpoena can require the release of records kept at the Counseling Center or require a counselor to give testimony at a court hearing.
  • Texas law requires a counselor to report client abuse or sexual exploitation by a previous therapist to the appropriate county district attorney and licensing board. Client anonymity will be preserved if requested.

Privacy Statement

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 the documents below carefully.

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Uses and Disclosures for Treatment, Payment, and Health Care Operations

The Texas State Counseling Center (CC) staff may use or disclose your protected health information (PHI) for treatment, payment and health care purposes with your consent.

  • PHI refers to information in your Counseling Center record that could identify you and that concerns your past, present, or future health condition.
     
  • Treatment includes when CC staff provide, coordinate, or manage your health care and other services related to your well-being. An example of treatment would be consulting with a referral source, another therapist, or a treating physician or psychiatrist in the Student Health Center.
     
  • Payment – Counseling Center services are free; no payment is involved
     
  • Health care operations are activities that relate to the performance and operation of the CC. Examples of health care operations are quality assessment, business-related matters such as audits and administrative services, case management, and care coordination.
     
  • Use applies only to activities within the Counseling Center (including psychiatrists under contract with the CC) such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
     
  • Disclosure applies to activities outside the CC such as releasing, transferring, or providing access to information about you to other parties.

Uses and Disclosures Requiring Authorization

Counseling Center staff may use or disclose PHI for purposes outside of treatment and health care operations when your appropriate authorization is obtained. An authorization is written permission above and beyond general consent that permits only specific disclosures. We will obtain an authorization form from you before releasing information for purposes outside of treatment and health care operations. You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that it has already been relied upon in releasing PHI.

Uses and Disclosures with Neither Consent nor Authorization

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

  • Child Abuse - If a staff member has reason to believe that a child has been, or may be, abused, neglected, or exploited, he or she must make a report of such within 48 hours to the Texas Department of Protective and Regulatory Services (DPRS) or to any local or state law enforcement agency.
     
  • Adult Abuse - If a staff member has reason to believe that an elderly or disabled person is in a state of abuse, neglect, or exploitation, she or he must immediately report such to DPRS.
     
  • Health Oversight - If a complaint is filed against your therapist with their respective state licensing board, they have the authority to subpoena confidential mental health information from the CC relevant to that complaint.
     
  • Judicial or Administrative Proceedings - If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and it will not be released by the CC, without written authorization from you or your personal or legally appointed representative, or a court order. The privilege does not apply when you are being evaluated by 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 a CC staff member determines that there is a probability of imminent physical injury by you to yourself or others, or there is a probability of immediate mental or emotional injury to you, they may disclose relevant confidential mental health information to medical or law enforcement personnel.
     
  • Worker’s Compensation - If you file a worker’s compensation claim, the CC may disclose records relating to your diagnosis and treatment to your employer’s insurance carrier.
     
  • Abuse or Sexual Exploitation by Therapist - Texas law requires a counselor to report client abuse or sexual exploitation by a previous therapist to the appropriate county district attorney and licensing board.
     
  • As Otherwise Required by Law - For example, for national security or intelligence purposes.

Client's Rights and Counseling Center's Duties

Client’s Rights:

  • Right to Request Restrictions – You have the right to ask the CC to limit how it uses and discloses your PHI. The CC will consider your request, but is not required to agree to it. If the CC agrees to your request, it will put the agreement in writing and will follow the agreement unless you need emergency treatment, and the information that you asked be limited is needed for your emergency care. You cannot limit the uses and disclosures that the CC is legally required to make.
     
  • 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 (e.g., you may not want your roommate or parents to know that you are being seen and may ask to receive calls on your cell phone). You must be specific about where and how to be contacted.
     
  • Right to Inspect and Copy – You have the right to inspect and/or obtain a copy of the PHI contained in your official CC record for as long as the PHI is maintained in the record. The CC may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. Upon your request, CC staff will discuss with you the details of the request and denial process.
     
  • Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. CC staff may deny your request under certain circumstances. Upon your request, CC staff will discuss with you the details of the amendment process.
     
  • Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization. Upon your request, CC staff 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 this notice upon request.

Counseling Center’s Duties:

  • The CC is 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.
     
  • The CC reserves the right to change the privacy policies and practices described in this notice at any time and to make the new notice provisions effective for all PHI that it maintains.
     
  • If the CC makes an important change that affects what is in this notice, such revisions will be noted on its web site, and a copy of the revised notice will be distributed to current clients at their next appointment. A revised notice will be distributed to past clients upon their next contact with the CC.

Questions and Complaints

If you have questions about this notice, disagree with a decision that is made about access to your records, or have other concerns about your privacy rights, you may contact the Texas State Counseling Center Privacy Officer at 512-245-2208. If you believe that your privacy rights have been violated and wish to file a complaint with the CC, you may send or deliver your written complaint to:

Privacy Officer, Counseling Center
Texas State University-San Marcos
601 University Drive
San Marcos, TX 78666.

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. The Privacy Officer can provide you with the appropriate address upon request. You have specific rights under the Privacy Rule. CC staff will not retaliate against you for exercising your right to file a complaint.

This notice will go into effect on September 1, 2003.