Avoiding The Couch Privacy Notice

THIS NOTICE DESCRIBES HOW MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

General Information

Information regarding your health care, including payment for health care, is protected by law: the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) 42 USC 1320d et seq. Under these laws, Avoiding the Couch (ATC) may not say to a person outside ATC that you attend the program, nor may CCH disclose any information identifying you disclosing any other protected information except as permitted by federal law.

This means that ATC must handle and store your information in a way that maintains its confidentiality. ATC must obtain your written consent before it can disclose information about your treatment. For example, ATC must resist in all judicial proceedings, any attempt to access your protected information. Only you can give written permission to ATC Services before information about your treatment can be shared with any individual or organization. ATC must also obtain your written consent before using or disclosing your health information for marketing purposes or as a part of a sale of information. Generally, you must sign a written consent before ATC can share information for treatment purposes or for health care operations.

However, federal law permits ATC to disclose information without your written permission:

1. Pursuant to an agreement with a qualified service organization/business associate;

2. For research, audit or evaluations;

3. To report a crime committed on ATC’s premises or against ATC personnel;

4. To medical personnel in a medical emergency;

5. To appropriate authorities to report suspected abuse or neglect;

6. As allowed by a court order or law;

7. Mental health records may be disclosed to 3rd party payors for services rendered.

8. As mandated by Washington state law relating to an individual’s propensity to violence.

Before ATC can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.

Your Rights

Under HIPAA, you have the right to request restrictions on certain uses and disclosures of your health information.  You have the right to restrict the disclosure of your health information to a health plan when you have paid out of pocket for a health service.  ATC is not required to agree to other restrictions you may request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency.  

You have the right to request that we communicate with you by alternative means or at an alternative location.  ATC will accommodate such requests that are reasonable and will not request an explanation from you.  Under HIPAA, you also have the right to inspect and copy your own health information maintained by ATC, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances.

Under HIPAA, you also have the right, with some exceptions, to amend health care information maintained in ATC’s records, and to request and receive an accounting of disclosures of your health-related information made by ATC during the six years prior to your request.  You have the right to opt out of receiving fundraising communications from ATC.  You also have the right to receive a paper copy of this notice.  You have the right to receive notice if any of your protected health information has been breached.

ATC’s Duties

ATC is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. ATC is required by law to abide by the terms of this notice. ATC reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains. If there are changes in the laws regarding confidentiality, ATC will provide you with an updated notice regarding your rights and how health care information may/may not be shared.

Complaints and Reporting Violations

You may complain to ATC and the Secretary of the United States Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA. You will not be retaliated against for filing such a complaint.

For complaints to ATC, you may contact the by telephone at 253-999-9079 or via email at admin@avoidingthecouch.com. You may also make a report by fax at 253-368-0502. If you wish to receive a call back, please leave a voice message.

Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.