What You Tell a Professional Counselor is Completely Confidential Unless:

  • You are a threat to yourself or others
  • You disclose abuse of a minor child that has not previously been reported
  • You disclose information regarding abuse of a vulnerable adult



Privacy is a natural concern for all those who seek counseling through this agency and it is an important concern to all those who work within the agency. Privacy is also complicated because of federal and state laws that govern it and the general standards of the counseling profession itself. Because the rules are so complicated, some parts of this Notice are quite detailed. You may have to read them several times to understand them. If you have any questions, you may ask your therapist or contact our Privacy Officer who will be happy to help you. His or her name and contact numbers are at the end of this Notice.


A. Introduction – To Our Clients

B. What we mean by your medical information

C. Privacy and the laws about privacy

D. How your protected health information can be used and shared

1. Uses and disclosures with your consent

a. The basic uses and disclosures – For treatment, payment, and health care operations (TPO)

b. Other uses and disclosures in health care

2. Uses and disclosures requiring your Authorization

3. Uses and disclosures not requiring your Consent or Authorization

4. Uses and disclosures requiring you to have an opportunity to object

5. An Accounting of disclosures we have made

E. If you have questions or problems

A. Introduction – To our clients 

This notice will tell you about how we handle information about you. It tells how we use this information within the agency, how we share it with other professionals and organizations, and how you can see it. We want you to know all of this so you can make the best decisions for yourself and your family. We are also required to tell you about this because of the privacy regulations of a federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Because this law and the laws of this state are very complicated and we don’t want to make you read a lot that may not apply to you, we have simplified the parts relevant to our counseling agency. If you have any questions or want to know more about anything in this Notice, please ask our Privacy Officer for more explanation or more details.

B. What we mean by your medical information 

Each time you visit an Inspirit Counseling Service, Inc. clinician or any doctor’s office, hospital, clinic, or any other “healthcare provider,” information is collected about you and your physical and mental health. It may be information about your past, present or future health or conditions, the treatment or other services you get from us or from others, or about payment for healthcare services. The information we collect from you is called, in the law PHI, which stands for Protected Health Information. This information goes into your record on file at our office. In this agency, PHI is likely to include various kinds of information:

  • Your history: As a child, in school and at work, plus marital and personal history.
  • Reasons you came for treatment: your problems, complaints, symptoms, needs, goals.
  • Diagnoses. (the medical terms for your problems or symptoms).
  • A treatment plan. This is a plan for counseling and other services which we think will best help you.
  • Progress notes. Each time you come in we write down some things about how you are doing, what we observe about you, and what you tell us that is relevant to your treatment.
  • Records we request, with your knowledge, from others who have treated you or evaluated you in the past.
  • Reports from others providing supplemental treatment to you at the time of our work with you, such as psychiatrists.
  • Psychological test scores, school records, etc.
  • Information about medications you took or are taking.
  • Legal matters.
  • Billing and insurance information.

This list is not comprehensive; there may be other kinds of information that go into your healthcare record here.

We use this information for many purposes. For example, we may use it:

  • To plan your care and treatment.
  • To decide how well our treatments are working for you.
  • When we talk with other healthcare professionals who are also treating you, such as your family doctor or a psychiatrist.
  • To show that you actually have received the services from us which we billed to you or to your health insurance company.
  • To improve the way we do our job by measuring the results of our work.

When you understand what is in your record and what it is used for, you can make better decisions about who, when, and why others should have this information.

Although your health record is the physical property of the healthcare practitioner or facility that collected it, the information belongs to you. You can inspect, read, or review it. If you want a copy we can make one for you with a charge for the costs of copying (and mailing if you want it mailed to you). In some very unusual situations you cannot see all of what is in your records. If you find anything in your records that you think is incorrect, or something important is missing, you can ask us to amend (add information to) your record, although in some rare situations we don’t have to agree to do that. Our Privacy Officer, whose name is at the end of this Notice, can explain more about this.

C. Privacy and the laws 

The HIPAA law requires us to keep your PHI private and to give you this notice of our legal duties and our privacy practices, which is called the Notice of Privacy Practice or NPP. We will obey the rules of this notice as long as it is in effect, but if we change it, the rules of the new NPP will apply to all the PHI we keep. If we change the NPP we will post the new Notice in our office where everyone can see. You or anyone else can get a copy from our Privacy Officer at any time and it will be posted on our website at www.pcsm.org.

D. How your protected health information can be used and shared 

When your information is read by your therapist, or any other specially designated Inspirit  Counseling Service, Inc. employee for a specific purpose, that is called, in the law, “use.” If the information is shared with or sent to others outside this office, that is called, in the law, “disclosure.” When we use your PHI here or disclose it to others, we share only the minimum necessary PHI needed for the purpose. The law gives you rights to know about your PHI, how it is used and to have a say in how it is disclosed. We will tell you more about what we do with your information.

We use and disclose PHI for several reasons. Mainly, we will use and disclose (share) it for routine purposes and we will explain more about these below. For other uses we must tell you about them and have written authorization from you, unless the law lets or requires us to make the use or disclosure without your authorization. However, the law also says that we are allowed to make some uses and disclosures without your consent or authorization.

1. Uses and disclosures of PHI in healthcare with your consent 

After you have read this Notice you will be asked to sign a separate Consent Form to allow us to use and share your PHI. In almost all cases we intend to use your PHI here or share your PHI with other people or organizations to provide treatment to you, arrange for payment for our services, or some other internal agency functions called health care operations. Together these routine purposes are called TPO and the Consent Form allows us to use and disclose your PHI for TPO. Re-read that last sentence until it is clear because it is very important. 

1a. For treatment, payment, or health care operations 

We need information about you and your condition to provide care to you. In order to provide the counseling services you seek, you have to agree to let us collect the information and to use it and share it, as necessary, to care for you properly. You must sign the Consent Form before we begin to treat you because if you do not agree and consent we cannot treat you.

When you come to see us, several people from our agency may collect some information about you and it may go into your healthcare records here. Generally, we use or disclose your PHI for three purposes: treatment, obtaining payment, and what are called healthcare operations. Let’s see what these are about:

For treatment 

We use your medical information to provide you with psychological treatment or services. These might include individual, couple, child/adolescent, family, or group therapy, treatment planning, or measuring the effects of our services.

We may share or disclose your relevant PHI with others, like psychiatrists or family doctors who may also provide treatment to you. We may refer you to other professionals or consultants for services we cannot offer, such as special testing or medication evaluation. When we do this we need to tell them some things about you and your conditions. We will get their findings and opinions and those will go into your records here. If you receive treatment in the future from other professionals we can also share your PHI with them upon request. These constitute how we use and disclose your PHI for treatment. 

For payment 

We may use your information to bill you, your insurance provider, or other third party payers for the treatment we provide to you. We may contact your insurance company to check on exactly what your insurance covers. We may have to tell them about your diagnoses, what treatments you have received, and what we expect as we treat you. We will need to tell them when we meet, changes in your symptoms, your progress, and other similar things. These constitute use of PHI for payment. 

For health care operations 

There are some other ways we may use or disclose your PHI which are called health care operations. For example, we may use your PHI to see where we can make improvements in the care and services we provide. We also have internal agency procedures which may use PHI for quality assurance and risk management purposes. When you terminate treatment with your therapist your record must be archived for up to six years by law. Access to those files is protected and limited to appropriate agency personnel. These constitute use for operations. 

1b. Other uses in healthcare 

Appointment Reminders. We may use and disclose medical information to reschedule or remind you of appointments. If you wish to specify the ways in which we contact you to further protect your privacy please make that clear to us. We can usually make those arrangements because we, too, are concerned with your privacy. Just tell us.

Treatment Alternatives. We may use and disclose your PHI to tell you about or recommend possible treatments or alternatives that may be of interest to you.

Other Benefits and Services. We may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you.

Staff Training and Research. We may use or share your information to do research and improve treatments. For example, case studies may be presented in a training setting to expand the staff therapists’ expertise in the area of a particular clinical concern. In all cases your name, address and other information that reveals who you are will be removed to protect your anonymity. If there is ever a need to share specific identifying information, we will discuss the project with you and you will have the option to sign a special Authorization Form before any information is shared.

Business Associates. There are some jobs which we hire other businesses to do for us. In the law, they are called our Business Associates. Examples include our Answering Service and our Accounting Service. These business associates need to receive some PHI to do their jobs properly. To protect your privacy, we have a contractual agreement with them to safeguard your information.

2. Uses and disclosures requiring your Authorization 

If we want to use your information for any purpose besides the TPO or those we described above, we need your permission on an Authorization Form. We don’t expect to need this very often.

If you do authorize us to use or disclose your PHI, you can revoke (cancel) that permission, in writing, at any time. After that time we will not use or disclose your information for the purposes that we agreed to. Of course, we cannot take back any information we had already disclosed with your permission or that we had used in our office.

3. Uses and disclosures of PHI from mental health records Not requiring Consent or Authorization 

The laws lets us use and disclose some of your PHI without your consent or authorization in some cases.

When required by law 

There are some federal, state, or local laws which require us to disclose PHI.

  • We have to report suspected child abuse, both current and past.
  • If you are involved in a lawsuit or legal proceeding and we receive a subpoena, discovery request, or other lawful process, we may have to release some of your PHI. We will only do so after trying to tell you about the request, consulting your lawyer, or trying to get a court order to protect the information they requested.
  • We have to release (disclose) some information to the government agencies which check on us to see that we are obeying the privacy laws.

For specific government functions 

We may disclose PHI of military personnel and veterans to government benefit programs relating to eligibility and enrollment, to Workers’ Compensation programs, to correctional facilities if you are an inmate, and for national security reasons.

To Prevent a Serious Threat to Health or Safety 

If we come to believe that there is a serious threat to your health or safety or that of another person, because you reveal, in the context of our treatment with you, some serious thoughts of self-harming, suicide or other-harming, we can disclose some of your PHI. We will only do this to persons who can prevent the danger and to the extent necessary.

4. Uses and disclosures requiring you to have an opportunity to object 

Generally speaking, your confidentiality is maintained within the relationship with your therapist. We cannot share information about you with your family or any other interested persons without your awareness and approval. We will honor and respect the confidentiality of our conversations with you as long as it is not against the law. In the case of treatment with a minor child, information may be shared with the custodial parent(s) as is considered in the best interest of the child.

If there is an emergency and we cannot ask your approval, we can share information if we believe that it is what you would have wanted and if we believe it will help you if we do share it. If we do share information in an emergency, we will tell you as soon as we can. If you don’t approve we will stop, as long as it is not against the law.

5. An accounting of disclosures 

When we disclose your PHI we keep records of whom we sent it to, when we sent it, and what we sent. You can get an accounting (a list) of many of these disclosures.

E. If you have questions or problems 

If you need more information or have questions about the privacy practices described above, please speak to the Privacy Officer. If you have a problem with how your PHI has been handled or if you believe your privacy rights have been violated, contact the Privacy Officer. You have the right to file a complaint with us and with the Secretary of the Federal Department of Health and Human Services. We promise that we will not in any way limit your care here or take any actions against you if you complain.

If you have any questions regarding this notice or our health information privacy policies, please contact Herb Lodder, who is our Executive Director. He can be reached by phone at 410-433-8861, ext. 135 or by e-mail at info@inspiritmaryland.org.