Hamline University - Counseling & Health Services
INFORMED CONSENT FOR TREATMENT AND PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW PERSONAL AND HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. IT IS YOUR RESPONSIBILITY TO REVIEW IT CAREFULLY.
Confidentiality and Privacy of Your Health Records Counseling and Health Services maintains your health information separately from all other Hamline University records about you. Access to health records is limited to appropriate C&HS staff. Except as permitted by law or described in this policy, we will not disclose information about you or your health care to persons outside of C&HS without your permission. Medical and Counseling services at C&HS share the same administrative oversight, waiting room, and electronic health records. The shared electronic health record allows all medical and counseling staff to share information and coordinate your care. To protect your privacy within the agency, we follow a "need to know" guideline. This means that C&HS providers may review your records if they are providing you with care that requires such access. We operate as an interdisciplinary team, so that you may benefit from a whole-health approach to your care. Your health record is archived for eight (8) years after your graduation.
Limits to Confidentiality In accordance with state and federal law, exceptions to confidentiality require C&HS staff to disclose information or take other action in situations where:
• you state you seriously intend to harm yourself or another person(s);
• you report or describe any physical abuse, neglect, or sexual abuse of children or vulnerable adults within the last three (3) years;
• you report the use of an illegal drug for a non-medical purpose during a pregnancy;
• you report or describe sexual exploitation by counseling or health care professionals;
• the courts subpoena your electronic health records. In such a case, we will work with you and with the court to try to limit the release of information to only that which is absolutely necessary.
Minors and Confidentiality Students under the age of 18 cannot be treated for health related services without parental/guardian consent. Exceptions to this are governed by Minnesota Statutes, Chapter 144, and include treatment of issues related to pregnancy and reproductive health, alcohol and drug abuse, and sexually transmitted infections.
Telephone and Electronic Communication The content of phone calls, voice mail messages, text messages, and e-mail/secure messaging will be incorporated into your electronic health record (EHR). E-mail is not a secure mode of communication, and therefore it should not be used to communicate personal information to your counselor or health clinician.
Training Our facility provides training for doctoral students in counseling & clinical psychology. As part of this training, counseling sessions are video-recorded for review in a confidential setting by clinical supervisors. Recordings of sessions are erased at the end of each semester. If your counselor is a trainee, s/he will provide you with more detailed information about these procedures.
Complaints If you have concerns about the health care services being provided to you, we encourage you to discuss them with your healthcare provider. If you are unable or unwilling to do that, you may share your concerns with the Director of Counseling Services, Hussein Rajput, Phd, LP or the Director of Health Services, Jodi M. Metz, PA-C, or with a member of the Dean Of Students office.
Your Rights Your rights are listed below. If you would like to exercise any of these rights, inquire at the front desk or ask a staff member for the proper form.
• The right to inspect and receive copies: You may request a copy of your records, by submitting a request in writing to Student Health and Counseling.
• The right to request confidential communications: You are assured this by communicating with C&HS via our secure messaging system.
• The right to amend your record: You may request to amend your record if you think it is incorrect or that important information is missing.
• The right to obtain an accounting of disclosures: You may request to receive a list of certain instances when we have disclosed your health information.
If you have questions about your privacy rights or believe they have been violated, you can file a complaint with: US Dept. of Health & Human Services, 200 Independence Ave. SW, Washington, DC 20201. Toll Free: 1-877-696-6775 or 202-601-0257.
Services Counseling & Health Services (C&HS) is an integrated health care clinic offering the following services to enrolled Hamline University students:
• Medical / physical health care
• Counseling / mental health care
• Psychiatric consultation services
Referrals Counseling & Health Services provides a wide array of health care and counseling services for Hamline students but we are not able to meet every need. Based on C&HS resources as well as your individual treatment goals and needs, you may be referred to community providers for continuing care and treatment.
Costs All office visits to C&HS are covered by tuition and fees. Some lab tests, medications, and procedures offered during a visit are provided for a nominal charge. Health Services can submit claims to insurance carriers for some lab tests, if desired. You (or the insurance policy holder) are responsible for these charges & those resulting from health care received off-campus including lab services for specimens obtained at C&HS. You should be prepared to provide your insurance card when obtaining these services.
Appointments Since demand for services is typically high, we ask that you only schedule appointments that you are confident you will keep. If you need to cancel or reschedule, please call 651-523-2204 with as much advance notice as possible so that we may make the time slot available to another student. Missed appointments with a counselor or health clinician will result in a $15 charge to your student account. Missed appointments with the psychiatrist will result in a $50 charge to your student account. Repeated rescheduling and/or canceling of appointments without advance notice may result in termination of care from C&HS.
Treatment Rights When seeking care from C&HS, you are entitled to receive information about the methods and duration of treatment, techniques used, fee structure, and associated risks, if known. Treatment is an active and cooperative effort involving both you and your care providers. If you should have any concerns about your progress or the results of your treatment, we encourage you to discuss them with us at any time. You can seek a second option from another staff member, request a transfer to another provider, or terminate treatment at any time.