Grounded Self Counseling

 

NOTICE OF PRIVACY PRACTICES
Effective Date: February 16, 2026

PURPOSE OF THIS NOTICE

This Notice describes how your Protected Health Information (PHI) may be used and disclosed and how you can access that information. It applies to federal law, including the Health Insurance Portability and Accountability Act (HIPAA), as well as Washington state confidentiality laws.

Washington state law provides additional protections for mental health records. When state law provides greater privacy protection than federal law, state law is followed.

Certain records, including those related to Substance Use Disorder (SUD) treatment, receive heightened protection under federal law.

LIMITS ON CONFIDENTIALITY

The law protects the privacy of communications between a client and therapist. In most situations, I may release information about your treatment only if you provide written authorization that meets legal requirements.

Psychotherapy notes receive special protection and generally require your separate written authorization for release.

I may disclose information without your authorization only when permitted or required by law. Any disclosure will be limited to the minimum necessary.

DISCLOSURES WITHOUT AUTHORIZATION

I may disclose information without your consent in the following circumstances:

Legal Proceedings
If you are involved in a court or legal proceeding, information may be disclosed only with your written authorization, a valid court order, or a properly issued subpoena where you have been notified and have not objected.

Health Oversight Activities
Information may be disclosed to government agencies conducting legally authorized oversight activities.

Defense of Claims
If you file a complaint or lawsuit against me, relevant information may be disclosed as necessary to defend myself.

Workers’ Compensation
If treatment is related to a workers’ compensation claim, I may be required to submit reports to authorized parties.

Business Associates
I may share the minimum necessary information with business associates who perform services on my behalf. They are legally required to protect your information.

REQUIRED DISCLOSURES TO PROTECT FROM HARM

I am legally required to disclose information in the following situations:

• Suspected child abuse, abandonment, or neglect
• Suspected abuse, neglect, or exploitation of a vulnerable adult
• Clear and immediate risk of serious physical harm to you or others

Disclosures are made only to appropriate authorities or individuals.

USE AND DISCLOSURE OF PHI

For Treatment
Your information may be used internally for your care. Sharing information with other providers generally requires your written authorization.

For Payment
Information may be used to obtain payment for services.

For Health Care Operations
Information may be used for administrative and quality-assurance purposes.

SUBSTANCE USE DISORDER (SUD) RECORDS — SPECIAL PROTECTIONS

Records related to the diagnosis, referral, or treatment of a Substance Use Disorder are protected by federal law (42 CFR Part 2) and receive stricter confidentiality protections than other health information.

• SUD records generally may not be used or disclosed for treatment, payment, or health care operations without your specific written consent, even when other health information could be shared under HIPAA.

• SUD records may not be used in civil, criminal, administrative, or legislative proceedings against you without your written consent or a specific court order that complies with federal law.

• Any consent you provide for disclosure of SUD information may be revoked in writing at any time, except to the extent that action has already been taken based on that consent.

REDISCLOSURE NOTICE

If you authorize the release of your information, including Substance Use Disorder records, the information disclosed may be subject to redisclosure by the recipient and may no longer be protected by HIPAA or other federal or state privacy laws.

FUNDRAISING COMMUNICATIONS

I do not use Substance Use Disorder records for fundraising purposes.

If I were to engage in fundraising communications in the future, you would be provided with a clear and conspicuous opportunity to opt out of receiving those communications, and opting out would not affect your treatment or payment for services.

You may opt out of any future fundraising communications at any time by notifying me in writing.

YOUR RIGHTS

You have the right to:

• Ethical, non-discriminatory treatment
• Confidentiality of mental health and SUD records
• Request restrictions on disclosures (not all requests must be granted)
• Request confidential communications
• Inspect or obtain a copy of your records (fees may apply)
• Request amendments to your records
• Receive an accounting of certain disclosures
• Receive a copy of this Notice at any time
• Designate a personal representative
• Decline or terminate services at any time
• Authorize release of information with written consent

Minors:
Washington state law provides additional confidentiality protections for minors. Disclosure to parents or guardians is governed by state law and may be limited when a minor has the legal right to consent to their own treatment.

THERAPIST’S DUTIES

I am required by law to maintain the privacy of your PHI and to provide this Notice. I may revise this Notice as required by law. Updated versions will be made available.

Clinical records are retained for at least five years after the last date of service, in accordance with Washington state regulations.

EXERCISING YOUR RIGHTS

To request access to records or exercise your rights, contact:
[email protected]

Please allow reasonable time for processing.

COMPLAINTS

If you believe your privacy rights have been violated, you may contact:

• Grounded Self Counseling
• Washington State Department of Health
• U.S. Department of Health and Human Services, Office for Civil Rights