|Responsible University Administrator:||Vice President for Student Affairs|
|Responsible Officer:||Director of Student Counseling Services|
|Current Revision Date:||02/21/13|
|Next Review Date:||02/21/17|
|End of Policy Date:||N/A|
This notice describes how your medical information may be used and disclosed and how you can gain access to the information. Please review it carefully.
YOUR PRIVACY RIGHTS, OUR RESPONSIBILITIES
The Student Counseling Services is required by law to protect the privacy of your health information and provide you with this Notice of Privacy Practices. This notice describes how we may use and share your health information and explains your privacy rights. The center will use or disclose your information only as described in this notice. We do, however, reserve the right to change our privacy practices and the terms of this notice and to make new provisions effective for all health information that we maintain. Revised notices will be posted in the waiting area, and we will make a copy of the revised notice available to you upon request.
If at any time, you have questions or concerns about the information in this notice or about our agency’s privacy policies, procedures, or practices; you may contact the HIPAA coordinator (Dr. Virginia Crawford)
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION WITHOUT AUTHORIZATION
The law permits the Student Counseling Services to use or disclose your health information without your written consent or authorization for the following purposes:
Treatment: We may use health information about you to provide treatment and services. We may disclose your health information to counselors, supervisors, or administrators at the center who are involved in your treatment. Because some of our counselors are graduate students in training, they are required to share information pertaining to your treatment with their clinical supervisor. In addition, counselors may share relevant details about your treatment during case staffing with other counselors and psychologists.
Center Operations: We may use your health information for the purposes of center operations. For example, your records will be reviewed by the center staff in order to make sure that the Student Counseling Services is the best place for you to receive treatment. In addition, your records may be reviewed by our Quality Assurance Team to assess the care, outcomes, and quality of services you receive. Since some of our counselors are in training, supervisors will regularly review and co-sign notes, and your records may be reviewed during the course of completing evaluations of these counselors.
Contacting You: We may contact you to regarding an appointment, to respond to your contact, to notify you of your discharge, provide information about services that may be of interest to you, or assess satisfaction with ongoing treatment.
Other Circumstances: In addition, we may use or disclose your health information for the following purposes without your consent or authorization:
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION THAT REQUIRES YOUR AUTHORIZATION
Except as provided in this Notice of Privacy Practices, the Student Counseling Services will not use or disclose your health information without your written authorization. If you sign an authorization form, you may withdraw your authorization at any time, as long as your withdrawal is in writing.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have several rights with regard to your health information. Specifically, you have the right to:
CONTACT FOR FURTHER INFORMATION
Connie Morgan HIPAA Coordinator The Student Counseling Services, 118 College Drive #5066 The University of Southern Mississippi Hattiesburg, MS 39406-0001 Phone: (601) 266-5390
The Director of Health Services Center is responsible for the review of this policy every four years (or whenever circumstances require immediate review).
Amendments: Month, Day, Year – summary of changes
07/01/03: Policy becomes effective.
11/01/11: Formatted for Institutional Policies website.
02/21/13: Formatted for template. Minor editing throughout.
07/03/13: HIPPA corrected to HIPAA