Podcast
Questions and Answers
What does Zezulka say about informing victims?
What does Zezulka say about informing victims?
Clinician doesn't have to inform the victim, just effectively treat.
What is required for reporting child abuse?
What is required for reporting child abuse?
Report within 48 hours.
What is the reporting requirement for elder abuse?
What is the reporting requirement for elder abuse?
Report immediately.
Only LPCs have an obligation to report violations; LMFTs do not.
Only LPCs have an obligation to report violations; LMFTs do not.
If there is a breach of less than 500 people, report within ______ days of the next calendar year.
If there is a breach of less than 500 people, report within ______ days of the next calendar year.
What can happen if you violate privacy or security laws?
What can happen if you violate privacy or security laws?
The security rule only covers electronic transmission of information.
The security rule only covers electronic transmission of information.
How long should the disclosure of records and privacy practices be kept?
How long should the disclosure of records and privacy practices be kept?
What must a covered entity comply with under HIPAA and Privacy Standards?
What must a covered entity comply with under HIPAA and Privacy Standards?
What should be included in informed consent for telehealth?
What should be included in informed consent for telehealth?
What should you communicate if doing a forensic evaluation?
What should you communicate if doing a forensic evaluation?
What should be embedded in intake and consent forms regarding Chapter 611?
What should be embedded in intake and consent forms regarding Chapter 611?
What does Texas law say about requests for records?
What does Texas law say about requests for records?
A federal provision allows withholding of information from a client if it would pose ______.
A federal provision allows withholding of information from a client if it would pose ______.
You must turn records over if a subpoena is signed by a judge.
You must turn records over if a subpoena is signed by a judge.
You don't have to turn records over for just a general subpoena.
You don't have to turn records over for just a general subpoena.
What are the duties and responsibilities regarding council investigations?
What are the duties and responsibilities regarding council investigations?
When can non-therapeutic relationships occur?
When can non-therapeutic relationships occur?
How long must records be kept?
How long must records be kept?
When can you tell a parent no when they ask for a copy of the child's records? The answer is ______.
When can you tell a parent no when they ask for a copy of the child's records? The answer is ______.
What should you do if a parent asks you to buy a raffle for their child's fundraiser?
What should you do if a parent asks you to buy a raffle for their child's fundraiser?
What should you consider if a client owes you money but is in crisis?
What should you consider if a client owes you money but is in crisis?
How long does a client have to file a complaint under HIPAA privacy rules?
How long does a client have to file a complaint under HIPAA privacy rules?
What do you do when a client expresses intent to harm themselves?
What do you do when a client expresses intent to harm themselves?
How long must you keep documents created/maintained under HIPAA?
How long must you keep documents created/maintained under HIPAA?
What do you do when a federal rule differs from a state rule?
What do you do when a federal rule differs from a state rule?
Distance therapy via landline is covered by the HIPAA security rule.
Distance therapy via landline is covered by the HIPAA security rule.
What should you do if a new client is communicating with their former therapist?
What should you do if a new client is communicating with their former therapist?
A supervisor can have a social or romantic relationship with a former supervisee.
A supervisor can have a social or romantic relationship with a former supervisee.
What should you consider if a client accuses you of a crime?
What should you consider if a client accuses you of a crime?
What must be reported if a client alleges sexual misconduct with a former therapist?
What must be reported if a client alleges sexual misconduct with a former therapist?
It's okay to tell someone at a social function to call you for an appointment after they complain about their therapist.
It's okay to tell someone at a social function to call you for an appointment after they complain about their therapist.
What are three potential consequences of violating the Privacy Act?
What are three potential consequences of violating the Privacy Act?
What consequences can a counselor face under Chapter 181, 'Medical Records Privacy' of the Texas Health & Safety Code for privacy violations?
What consequences can a counselor face under Chapter 181, 'Medical Records Privacy' of the Texas Health & Safety Code for privacy violations?
Any person who believes that a covered entity is not complying with the Privacy Rule may file a complaint with the Office of Civil Rights (OCR) but must do so within 90 days of learning of the violation.
Any person who believes that a covered entity is not complying with the Privacy Rule may file a complaint with the Office of Civil Rights (OCR) but must do so within 90 days of learning of the violation.
OCR can conduct compliance reviews of your practice to ensure compliance with the Privacy Rule.
OCR can conduct compliance reviews of your practice to ensure compliance with the Privacy Rule.
A counselor who transmits protected health information (PHI) in electronic form is a 'Covered Entity' under both State and Federal privacy law.
A counselor who transmits protected health information (PHI) in electronic form is a 'Covered Entity' under both State and Federal privacy law.
What is the definition of psychotherapy notes?
What is the definition of psychotherapy notes?
Who constitutes a business entity under HIPAA?
Who constitutes a business entity under HIPAA?
The provisions of the HIPAA Privacy Rule will always preempt and supersede state privacy law.
The provisions of the HIPAA Privacy Rule will always preempt and supersede state privacy law.
A covered entity must retain this documentation for six (6) years from the date of its creation or the date when it last was in effect, whichever is later.
A covered entity must retain this documentation for six (6) years from the date of its creation or the date when it last was in effect, whichever is later.
A covered entity must have in place appropriate administrative, technical, and physical safeguards to protect the privacy of PHI.
A covered entity must have in place appropriate administrative, technical, and physical safeguards to protect the privacy of PHI.
A covered entity must have and apply appropriate sanctions against members of its workforce who fail to comply with the privacy policies of the covered entity.
A covered entity must have and apply appropriate sanctions against members of its workforce who fail to comply with the privacy policies of the covered entity.
Explain the 'Scalability Rule'.
Explain the 'Scalability Rule'.
List three permitted uses and disclosures of a person's PHI.
List three permitted uses and disclosures of a person's PHI.
Explain the minimum necessary rule.
Explain the minimum necessary rule.
A covered entity must document satisfactory assurances that a billing contractor for the practice associate will appropriately safeguard the PHI through a written contract.
A covered entity must document satisfactory assurances that a billing contractor for the practice associate will appropriately safeguard the PHI through a written contract.
HIPAA provides that PHI for a minor client may be disclosed or withheld from parents pursuant to state law.
HIPAA provides that PHI for a minor client may be disclosed or withheld from parents pursuant to state law.
A covered entity may require the individual to make a request for confidential communication in writing.
A covered entity may require the individual to make a request for confidential communication in writing.
A covered health care provider may not require an explanation from the individual as to the basis for the request as a condition of providing communications on a confidential basis.
A covered health care provider may not require an explanation from the individual as to the basis for the request as a condition of providing communications on a confidential basis.
When is a covered entity not required to obtain an authorization for any use of psychotherapy notes? List 3.
When is a covered entity not required to obtain an authorization for any use of psychotherapy notes? List 3.
A client who executes an authorization for his PHI does not have to state a specific purpose and can simply state 'at the request of the individual'.
A client who executes an authorization for his PHI does not have to state a specific purpose and can simply state 'at the request of the individual'.
A covered entity may disclose PHI to a health oversight agency for oversight activities authorized by law.
A covered entity may disclose PHI to a health oversight agency for oversight activities authorized by law.
List three things from a client's PHI a covered entity may disclose in response to a law enforcement official's request.
List three things from a client's PHI a covered entity may disclose in response to a law enforcement official's request.
A covered entity may disclose PHI to a coroner or medical examiner for the purpose of identifying a deceased person.
A covered entity may disclose PHI to a coroner or medical examiner for the purpose of identifying a deceased person.
A covered entity is obligated to disclose PHI if it believes the use is necessary to prevent a serious and imminent threat.
A covered entity is obligated to disclose PHI if it believes the use is necessary to prevent a serious and imminent threat.
Explain the 'minimum necessary rule'.
Explain the 'minimum necessary rule'.
A covered entity may deny an individual access to their records if access is likely to endanger life or physical safety.
A covered entity may deny an individual access to their records if access is likely to endanger life or physical safety.
What can clients be charged when they request copies of their records?
What can clients be charged when they request copies of their records?
Describe the procedure when clients seek changes to their health care records.
Describe the procedure when clients seek changes to their health care records.
What is the retention period for records and documentation required by HIPAA?
What is the retention period for records and documentation required by HIPAA?
What is an accounting of disclosures of PHI?
What is an accounting of disclosures of PHI?
Compliance with the Security Rules starts with a risk assessment.
Compliance with the Security Rules starts with a risk assessment.
What is the difference between a required implementation specification and an addressable implementation specification?
What is the difference between a required implementation specification and an addressable implementation specification?
The Security Rule is intended to create a minimum level of security.
The Security Rule is intended to create a minimum level of security.
What are four general security standards required of all covered entities?
What are four general security standards required of all covered entities?
In deciding on which security measures to use under the Scalability Rule, what factors must a covered entity take into account?
In deciding on which security measures to use under the Scalability Rule, what factors must a covered entity take into account?
A covered entity must implement policies and procedures to limit physical access to its electronic information systems.
A covered entity must implement policies and procedures to limit physical access to its electronic information systems.
For how long must a covered entity retain written records of its Security Standards actions?
For how long must a covered entity retain written records of its Security Standards actions?
It is recommended that mental health professionals develop a security log or security manual.
It is recommended that mental health professionals develop a security log or security manual.
What does 'HITECH' stand for?
What does 'HITECH' stand for?
The HITECH Act strengthens enforcement of the HIPAA privacy rule.
The HITECH Act strengthens enforcement of the HIPAA privacy rule.
The term 'breach' under the HITECH Act means the unauthorized acquisition of PHI which compromises security.
The term 'breach' under the HITECH Act means the unauthorized acquisition of PHI which compromises security.
The HITECH Act gives individuals the right to receive an electronic copy of their PHI.
The HITECH Act gives individuals the right to receive an electronic copy of their PHI.
In the event of a breach of unsecured PHI, the covered entity must notify individuals whose information has been accessed.
In the event of a breach of unsecured PHI, the covered entity must notify individuals whose information has been accessed.
If the breach involves PHI for fewer than 500 individuals, when must a report be filed with the Secretary of HHS?
If the breach involves PHI for fewer than 500 individuals, when must a report be filed with the Secretary of HHS?
The HITECH Act defines unsecured PHI as information that is not secured through specified technology.
The HITECH Act defines unsecured PHI as information that is not secured through specified technology.
What would you put into informed consent if doing telehealth that you wouldn't put in for face-to-face services?
What would you put into informed consent if doing telehealth that you wouldn't put in for face-to-face services?
What kind of communication is covered by HIPAA security rules?
What kind of communication is covered by HIPAA security rules?
If you find out someone is practicing LPC without a license, what do you do?
If you find out someone is practicing LPC without a license, what do you do?
When a mental health professional has an ethical dilemma, who should they consult?
When a mental health professional has an ethical dilemma, who should they consult?
What's the primary mission of the licensing board?
What's the primary mission of the licensing board?
Why do mental health professionals keep records?
Why do mental health professionals keep records?
Are you required to render a diagnosis when you treat every client?
Are you required to render a diagnosis when you treat every client?
Who owns the client file?
Who owns the client file?
Do you have an obligation if the owner is doing what's expected for maintenance and security of records?
Do you have an obligation if the owner is doing what's expected for maintenance and security of records?
How long do you have to respond to a request for records by a client in Texas?
How long do you have to respond to a request for records by a client in Texas?
What is the HIPAA privacy rule response period?
What is the HIPAA privacy rule response period?
Is a parent always entitled to a complete release of a child's records?
Is a parent always entitled to a complete release of a child's records?
What if you're in a custody case and a judge asks which parent you think they should go for?
What if you're in a custody case and a judge asks which parent you think they should go for?
How do you share records with others if something happens to you?
How do you share records with others if something happens to you?
Mistake in documentation for a client, how do you fix it?
Mistake in documentation for a client, how do you fix it?
What is the most common basis that mental health information is disclosed?
What is the most common basis that mental health information is disclosed?
What are penalties a licensing board can impose on you?
What are penalties a licensing board can impose on you?
What does taking the Fifth Amendment mean?
What does taking the Fifth Amendment mean?
What's the difference between privilege and confidentiality?
What's the difference between privilege and confidentiality?
Do you have liability if an employee accidentally disclosed info about a client to a third party?
Do you have liability if an employee accidentally disclosed info about a client to a third party?
You provide counseling sessions to a married couple. One asks for copies of marital therapy records. What do you do?
You provide counseling sessions to a married couple. One asks for copies of marital therapy records. What do you do?
If a client states they are going to kill someone, who do you inform?
If a client states they are going to kill someone, who do you inform?
What does Tarasoff refer to?
What does Tarasoff refer to?
Study Notes
Privacy Act Violations
- Violating the Privacy Act can lead to administrative actions by the HHS Office of Civil Rights.
- Maximum civil penalties are $100 per violation, up to $25,000 per calendar year.
- Criminal penalties range from 1-10 years in prison with fines up to $50,000 for egregious violations.
Texas Health & Safety Code (Chapter 181)
- Possible penalties for privacy violations include sanctions, probation, and license suspension or revocation.
- Civil penalties can reach $3,000 per violation, totaling up to $250,000.
Filing Complaints and Compliance
- Complaints about non-compliance with the Privacy Rule must be filed within 180 days of discovering the violation.
- The OCR can conduct compliance reviews to ensure adherence to the Privacy Rule.
Covered Entities and Protected Health Information (PHI)
- Counselors transmitting PHI electronically are considered "Covered Entities" under both federal and state laws.
- Psychotherapy notes are distinct from progress notes and include content from counseling conversations.
Business Entities Under HIPAA
- A business entity can be a mental health worker providing care or billing services, or professionals dealing with client financial and health information.
Interaction of HIPAA with State Laws
- State privacy laws are not automatically superseded by HIPAA regulations.
Document Retention and Safeguards
- Covered entities must retain documentation for six years from the creation date or last effective date.
- Must implement administrative, technical, and physical safeguards for protecting PHI privacy.
Minimum Necessary Rule and Disclosures
- When disclosing PHI, only the minimum necessary information should be shared to fulfill the request.
- Common permitted uses of PHI include personal access, treatment, payment processes, and legal requirements.
Business Associate Contracts
- Covered entities must secure assurances from business associates regarding the safeguarding of PHI through written agreements.
Rights of Minors and Confidentiality
- The discretion to disclose PHI concerning minor clients may be guided by state laws.
Breach Notification and HITECH Act
- The HITECH Act mandates notifying individuals of unsecured PHI breaches.
- Defines a "breach" as unauthorized use or disclosure of PHI compromising security and privacy.
Security Standards & Compliance
- Organizations should continually assess risks and establish electronic PHI security measures.
- Covered entities should maintain records of security actions for six years.
Ethical Considerations in Mental Health Practice
- Counselors should document procedures for technological failures during telehealth sessions.
- They must maintain appropriate records for legal proceedings and client continuity of care.
Client Access and Record Keeping
- Rights related to client PHI access include written request procedures.
- Professional records should be maintained for a minimum of six years to ensure legal and ethical compliance.
Reporting Obligations
- Clinicians must report suspected child abuse within 48 hours and elder abuse immediately.
- There are specific guidelines regarding consent and disclosure when handling married clients.
Mental Health Ethics and Liability
- Legal right to confidentiality differs from privilege, which can be excluded in legal contexts.
- Counselors can be held liable for their employees' accidental disclosures if adequate training was not provided.
Consequences of Violating Privacy Laws
- Violation consequences include federal fines and potential prison time for serious infractions while licensing boards can revoke licenses based on complaints.
Record Sharing and Documentation Corrections
- A formalized plan must be in place for record accessibility in cases of the counselor's incapacity.
- Corrections in documentation should be made transparently, maintaining clear records of alterations.### Informed Consent for Telehealth
- Essential to have a plan for potential technology failures.
- Clearly outline the risks and benefits associated with the telehealth format.
Forensic Evaluation Communication
- Inform clients that assessment results will be shared with relevant parties.
- Advise clients that findings may not support their plea.
- Disclose the funding source for the evaluation.
Use of PHI for Fee Collection
- Chapter 611 allows using PHI to collect fees; collections agencies can be employed.
- Embed this information in intake and consent forms.
- Recommended to avoid sending bills to collections; allow debts to go.
Request for Records
- Texas law mandates a 15-day response timeframe, extendable by 15 days.
- HIPAA allows 30 days, extendable by 30 days; adhere to Texas laws, which are stricter.
- Charging for electronic records capped at $6.50; no search fees allowed.
- Compliance with requests for paper or electronic copies should not impose unreasonable burden.
Withholding Client Information
- Federal law permits withholding information if revealing it poses physical harm.
- Texas law enables withholding records that could cause reasonable emotional distress.
- Documentation of withheld records must include the date, reason, and means to file complaints.
Subpoenas and Record Disclosure
- Records must be provided if a subpoena is signed by a judge.
- General subpoenas do not necessitate turning over records.
Duties and Responsibilities
- Mandatory cooperation with council investigations.
- Clients must be informed about complaint filing procedures included in documentation.
- Required to display the complaint process prominently in the office and website.
Non-Therapeutic Relationships
- Engaging in non-therapeutic relationships with former clients is restricted to specific timeframes.
- Sexual contact permitted five years post-therapy if consensual and non-exploitative.
Record Retention Policy
- Retain records for at least seven years post-termination or five years after a client reaches the age of majority.
- If records are maintained by another agency, retention requirements may differ.
Parental Access to Child's Records
- May deny a parent access to a child's records if it could harm the child or if parenting rights are not established.
Maintaining Therapeutic Boundaries
- Counselors must uphold therapeutic boundaries, as engaging in fundraising activities outside therapy is prohibited.
Client Debt and Services
- Sending a client to collections without prior agreement in informed consent is not advisable.
- In vulnerable situations, offering sessions despite unpaid fees may be necessary to avoid abandonment.
Filing Complaints Under HIPAA
- Clients have a 180-day window to file complaints regarding privacy rule violations.
Risk of Client Self-Harm
- If a client exhibits suicidal tendencies, implement a safety plan while maintaining regular therapy sessions.
- Higher-level care may be recommended.
Document Maintenance Requirements
- Required to maintain documents relevant to HIPAA for six years; state laws may extend this to seven years.
Discrepancies Between Federal and State Law
- Adhere to the stricter of the two regulations.
Telehealth and HIPAA Security
- Distance therapy via landline is not covered under HIPAA if it is not considered electronic communication.
Former Therapist Interaction
- Counselors have an extended period (2-5 years) relating to relationships with former clients, differing by professional licensing.
- Confidentiality from the client takes precedence over reporting unless required by mandated reporting statutes.
Supervisor/Supervisee Relationships
- Social or romantic relationships between supervisors and former supervisees are not strictly prohibited.
Addressing Accusations Against Counselors
- Legal counsel should be considered if facing accusations of criminal activity or ethical concerns.
- A cease-and-desist letter may be warranted if threatened with a lawsuit.
Reports of Past Client Interactions
- Counselors must report allegations of sexual misconduct within a mandated timeframe based on licensing parameters.
Client Recruitment Ethics
- Counselors cannot solicit clients who are currently receiving therapy from another practitioner.
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Description
This quiz covers the key aspects of Privacy Act violations, including penalties and administrative actions under the HHS Office of Civil Rights. It also addresses the Texas Health & Safety Code regarding privacy violations and the requirements for filing complaints. Test your knowledge on the regulations surrounding covered entities and protected health information (PHI).
