PRACTICE POLICIES

APPOINTMENTS AND CANCELLATIONS

• Automated appointment reminders are sent 24 hours ahead of time via text and email per your notification settings and again prior to the appointment as a courtesy. If you know you are unable to attend, please let me know as soon as possible. I request 24 hours advance notice to cancel or reschedule. You will be responsible for the $100 late cancellation fee if you do not attend your scheduled appointment or provide prior notice. This is necessary because the session time is held exclusively for you and cannot be offered to others who may have experienced a crisis or time sensitive issue they would like support with.

• If you are late for a session, you may lose some of that session time. The standard meeting time for psychotherapy is 45-55 minutes depending on the requested length of service. Everyone receives one freebie for an emergency, and the cancellation policy will be strictly enforced thereafter. If you late cancel or no show to two or more appointments, we will discuss potential referral out or termination.

TELEPHONE ACCESSIBILITY

• If you need to contact me between sessions, please send a message through SimplePractice or text/call through Spruce. I am often not immediately available; however, I will attempt to return your call within 24 hours. If a true emergency situation arises, please call 911, 988, or visit your local emergency room. I do not provide crisis or after-hours services as I am a solo practitioner. If we determine through the course of your care that you need more frequent sessions and access to routine crisis care, we will discuss the next steps to refer out to a community organization.

SOCIAL MEDIA AND TELECOMMUNICATION

• Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Instagram, Facebook, LinkedIn, etc.). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

ELECTRONIC COMMUNICATION

• Storied Healing Counseling cannot ensure the confidentiality of any form of communication through electronic media, including text messages and emails. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

• Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine. Telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist choose to use information technology for some or all of your treatment, you need to understand that:

1. You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.

2. All existing confidentiality protections are equally applicable.

3. Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.

4. Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.

5. There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs.

• Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual observations, information, and experiences.

• When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), chronological and apparent age, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what they would consider important information, that you may not recognize as significant to present verbally the therapist.

BILLING

• Storied Healing Counseling uses a third-party billing company, Resolve Medical Billing, to submit all insurance claims and provide support with credentialing and maintaining insurance panels. Their staff have signed a confidentiality agreement to provide this service and have access to client demographic and billing information provided through SimplePractice. Clients must provide up to date information about eligibility status and inform Clinician of any changes to coverage within 24 hours. If clients drop or change coverage to an insurance provider that I am not credentialed with, arrangements must be made for cash-pay or referral out to another covered practitioner. Individual policies may vary, please check with your policy details for complete coverage and to verify in-network providers. Clients are responsible for balances not covered by their insurance.

COUPLES THERAPY: LIMITED SECRETS POLICY

• In working with relational dynamics, I honor the right of all parties to choose whether to stay together or dissolve the union with care. I believe it is important to explore such questions openly, honestly, and thoroughly. Once your goals are established, I will work diligently to support you in achieving them, whatever they may be. Second, you are entrusting me to use my professional judgment as it relates to individual confidences.

• Anything you communicate to me individually by phone, email, or any other means may be important to bring up and work on in a joint therapy session, and I reserve the right to do so at my discretion. I will encourage you to take the step to proactively share with your partner(s) and respect your autonomy in deciding if you would like to discontinue couple and family counseling if you are not in agreement with this.

NONDISCRIMATION POLICY

• Storied Healing Counseling does not exclude or discriminate against any person or family on the ground of race, color, national origin, immigration status, disability, sex, sexual orientation, gender identity, marital status, religion, political affiliation, or any other protected status.

• I provide services acknowledging the reality of historical marginalization and oppression for individuals of the global majority, gender and sexual minorities, and persecution of those belonging to migrant and indigenous communities. Mutual respect and analysis of power are a critical part of providing ethical, trauma-informed therapy. You are welcome to share experiences related to your upbringing and identities. My commitment to cultural competence informs that I receive continuing education to create a safe and affirming environment for sessions.

TERMINATION

• Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy has not resulted in expected improvements, we determine we are not a good therapeutic match based on my training and specialization, or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source.

• Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.

NOTICE OF PRIVACY PRACTICES

PROTECTING YOUR HEALTH INFORMATION

I understand that health information about you and your treatment is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all the records of your care generated by Storied Healing Counseling. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you and certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

• Make sure that protected health information (“PHI”) that identifies you is kept private.

• Give you this notice of my legal duties and privacy practices with respect to health information.

• Follow the terms of the notice that is currently in effect. When I change the terms of this Notice, such changes will apply to all information I have about you.

ROUTINE USES OF PHI

The following categories describe different ways that I use and disclose health information. Not every use or disclosure in a category will be listed. However, all the ways I am permitted to use and disclose information will fall within one of the categories.

• For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information (PHI) without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider with your written authorization, in the case of nonemergent care coordination. For example, if I were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, to assist in diagnosis and treatment of your mental health or related health condition. In the case of an emergency, your PHI may be used to coordinate with emergency services without prior written consent.

• Disclosures for treatment purposes are not limited to the minimum necessary standard. Therapists and other health care providers need access to the full record and complete information to provide quality care. The word “treatment” includes, among other things, delivery of mental health counseling, case coordination between health care providers, consultation between licensed therapists and medical professionals, and referrals of a patient for health care from one health care provider to another.

• Your electronic health record (EHR) exists in a HIPAA compliant online software called SimplePractice. All appointments will be delivered through this service. Storied Healing Counseling uses a third-party billing company, Resolve Medical Billing, to submit all insurance claims and provide support with credentialing and maintaining insurance panels. Their staff have signed a confidentiality agreement to provide this service and have access to client demographic and billing information provided through SimplePractice. The practice can use and share PHI to bill and get payment from health plans or other entities through the designated EHR.

• Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. Efforts will be made to tell you about the request or to obtain an order protecting the information requested when possible.

DISCLOSURE OF PROGRESS NOTES

I obligated to keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your authorization unless the use or disclosure is:

• For my use in treating you and to facilitate a record of care, along with corresponding treatment plans that are completed routinely.

• For my supervising mental health practitioner to help improve my skills in group, joint, family, or individual counseling. All clinical documentation will be reviewed and signed by my supervisor Katie Kimmerling.

• For my use in defending myself in legal proceedings initiated by you.

• For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.

• Required to help avert a serious threat to the health and safety of others.

LIMITATIONS OF CONFIDENTIALITY

Subject to certain limitations in the law, I can use and disclose your PHI without your authorization for the following reasons:

• When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

• For public health activities, including reporting suspected child, elder, or vulnerable adult abuse, or preventing or reducing an imminent threat to health or safety.

• For health oversight activities, including audits and investigations.

• For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an authorization from you before doing so.

• For law enforcement purposes, when there is an imminent and credible risk of harm to self or others, or I am victim to a crime as a healthcare provider.

• To coroners or medical examiners, when such individuals are performing duties authorized by law.

• For workers’ compensation purposes. I may provide your PHI in order to comply with workers’ compensation laws.

• Redisclosure Warning: Information disclosed may be subject to redisclosure by the recipient and no longer protected under HIPAA (e.g. information that is requested by a judge, collected as part of a law enforcement investigation, or provided to another healthcare provider).

SUBSTANCE USE TREATMENT RECORDS SUBJECT TO 42 CFR Part 2

• If applicable, your substance use disorder (“SUD”) records are protected by federal law under 42 C.F.R. Part 2 (“Part 2”). This law provides extra confidentiality protections and requires a separate patient consent for the use and disclosure of SUD counseling notes. Each disclosure made with patient consent must include a copy of the consent or a clear explanation of the scope of the consent. It must also be accompanied by a written notice containing the language in 42 CFR Part 2.32(a). Disclosure of these records requires your explicit written consent, except in limited circumstances. You may revoke this consent at any time as provided by 45 CFR 164.508(b)(5).

• Prohibitions on Use and Disclosure of Part 2 Records: SUD records received from programs subject to Part 2, or testimony relaying the content of such records, shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless based on your written consent, or a court order after notice and an opportunity to be heard is provided to you or the holder of the record, as provided in Part 2. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested SUD record is used or disclosed.

DISCLOSURES THAT YOU OPT INTO

• Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate participates in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

• Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. You are able to opt out of these appointment reminders via email and text at any time.

• Marketing purposes. I will not share details about your care as part of my brand or provide testimonials digitally without your explicit consent.

• Artificial intelligence (AI). I do not use AI in my practice to transcribe sessions or generate clinical documentation. You have the right to know when healthcare providers use this technology.

CLIENT RIGHTS RELATED TO PROTECTED HEALTH INFORMATION

• The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I may not be able to continue to work with you if I believe it would affect provision of services. I reserve the right to disclose PHI with respect to lawful requests, state and federal mandatory reporting requirements, or obtaining payment for services rendered.

• The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

• The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (SimplePractice portal, Spruce Secure Messaging, BAA and HIPAA compliant email) or to send mail to a different address, and I will agree to all reasonable requests.

• The Right to See and Get Copies of Your PHI. You have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.

• The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time.

• The Right to Correct or Update Your PHI. If you believe that there is a mistake in your health record or that a piece of important information is missing, you have the right to request that I correct your file. I may decline your request and provide a reason for doing so within 30 days.

• The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice or the signed electronic form.

• To Receive Notification of Breach. In the event of a breach of your protected health information as defined by HIPAA, you will receive notification of the breach.

COMPLAINTS

• If you are dissatisfied with services or experience a rupture in our therapeutic relationship, I am open to feedback and would love the opportunity to work through this issue directly.

• You are welcome to talk with my supervisor Katie Kimmerling as well if you feel unsafe in broaching the issue with me.

• In the event that we cannot resolve the concern, there are other avenues available to you such as:

  • Filing a complaint with the Nebraska DHHS Licensing Board.

  • Filing a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.