Each time that you utilize the services of the ESU Department of Students Wellness and its Units of Student Health Services and Counseling Services (hereinafter "Units"), and/or the Office of Disability Services, we make a record of your visit. This record may include medical and mental health information about you such as test results, billing information, diagnoses, treatment and mental health information. This Notice describes our privacy practices including how we may use and disclose your medical and mental health information and your rights and our responsibilities regarding this information. This Notice applies to all of the records of your care generated by the Department of Student Wellness and its Student Health Services and Counseling Services units. As allowed by law, we may use or disclose (share) medical and mental health information with each other for treatment, payment and day to day operations. TheOffice of Disability Services is also covered by this Notice and disclosures may be made by Disability Services as specifically described in this Notice.
What is "Protected Health Information"?: Protected Health Information is all the information regarding your medical and mental health care at ESU Department of Student Wellness and its Units, Student Health Services and Counseling Services, health care information given to us at your request by other providers, and health care billing information. Generally, it is the information in your medical and mental health records. The Office of Disability Services maintains certain student, medical and mental health information.
Our Responsibilities Regarding Your Medical and Mental Health Information: ESU Student Wellness strives to protect your medical and mental health information and records. The law requires Student Wellness Units keep your medical and mental health information private. ESU must give you this Notice about our privacy practices, follow these practices, and notify you if ESU cannot agree to a request to restrict use or disclosure of your information. The Office of Disability Services is required to keep student, medical and mental health records confidential unless disclosure is allowed by law.
Uses and Disclosures With Your Written Consent: You will be requested to sign a written consent form enabling Student Health Services and Counseling Servcies to use and disclose your protected health information for treatment, payment, and day-to-day health care operations:
You will be requested to sign a consent form to release information from records of the Office of Disability Services when disclosure is requested, if not otherwise allowed by law.
Uses and Disclosures Without Your Consent: Student Health Services and Counseling Services may use or disclose medical and mental health information about you without your consent in certain situations. We may use or disclose your protected health information without your consent when:
While the Office of Disability Services strives to keep your student and other records confidential, the Office may disclose your student and other records as allowed by exceptions to FERPA and other applicable laws, such as the ADA. This includes disclosures such as those related to health and safety emergencies, reported or suspected abuse and other instances.
Other Uses and Disclosures Based on Your Authorization: Other uses and disclosures of your protected health information not covered by this Notice will only be made upon your written permission. If you provide such written permission, you may revoke it at any time.
Unless otherwise required by law, Counseling Services will obtain written authorization from you before releasing psychotherapy notes and notes of your conversations with professionals during private, group or other counseling sessions, which Counseling Services may keep separate from your medical record.
Your Rights Related to Your Medical and Mental Health Information: You have the following rights in your protected health information:
Those records which are student educational records as defined by FERPA and maintained Office of Disability Services are subject to the rights set forth in the University's FERPA policy. The records maintained by the Office which are subject to the ADA will be handled as so required.
Protected Health Information properly disclosed at your request by Student Health Services and Counseling Services to another health care provider can be disclosed by them without the knowledge of Student Health Services and Counseling Services. Information shared with a third party by the Office of Disability Services may be disclosed by them without the Office's knowledge.
If you are using Counseling Services, the counselor may ask you to see a medical doctor to help determine if there is a medical condition, medication or other physical basis for a condition which needs medical attention. Continued counseling services may depend on cooperation with results of such referral, sharing referral results with my counselor, receiving additional service determined by my counselor, the counselor's ability to confer with other service providers, and establishing a counselor-approved ongoing cooperative team of service providers. You also have the right to discontinue counseling services at any time by notifying your counselor and your counselor may terminate Counseling Services if it is determined that your treatment needs require resources or competencies beyond those available at Counseling Services.
If other applicable law prohibits or limits use or disclosure of your Protected Health Information, Student Health Services, Counseling Services and the Office of Disability Services follow the more stringent law.
Any use or disclosure other than those described above is performed only after you give your consent. You may cancel your consent at any time by notifying Student Health Services, Counseling Services, or the Office of Disability Services in writing.
The Student Health Services, Counseling Services, and the Office of Disability Services reserve the right to change the terms of this Privacy Notice, and will provide clients with a copy of the revised notice.
If you have concerns about any Department of Student Wellness services or wish to file a complaint, you may contact the Director of Student Wellness at 620-341-5222. This Privacy notice is in effect as of Jan 1, 2011.