Violations
Discussion: In what ways do you think record guidelines are often violated that may at first appear to be harmless.
Leaving a folder out, discussing clients with anyone not involved with treatment, and computers facing clients are all examples.
True or False: Privacy rules only apply to electronic and physical data of an identifiable individual
False: It includes all information within the practice, including oral, written, and typed information
What is the APA's stance on the inclusion of financial information on informed consent?
The APA Ethics Code includes “fees” as essential elements required at the earliest time possible.
Dr. T only keeps online records. They are stored in an encrypted database on a secure server. Patient files are deleted after 5 years of inactivity. Access to patient files are password protected. Is Dr. T's online storage ethical?
No. Records must be maintained for 7 years for adults or 3 years after a minor reaches the age of maturity.
True or False: The HIPAA privacy rule only applies to living patients.
False: While exception may be made both dead and living patients are covered.
You are running a private practice, and a client has just learned that the fees for treatment have increased (15%). He threatens to sue because this was not the agreed upon price. What steps should you have taken to protect yourself?
Include information in the informed consent (prices may change, have a set date for change), have an advance notice. “Psychologists do not misrepresent their fees.”
You discover that a colleague is selling the personal information of one of his clients. When confronted, he says that he is only selling data on clients who cannot pay for treatment and the money helps to cover what they cannot afford. The clients do not know this. Should you do anything?
Companies often sell user data, but health information is protected.
True or False: A Notice of Disclosure (a document detailing what information is disclosed for treatment) does not cover psychotherapy notes.
True: The psychologist must obtain additional authorization for process notes to be released
If despite precautions, a client cannot pay for treatment, what options are available to address this concern?
Paying balance in full, payment plan agreement, increasing the amount of time between treatment sessions, agreeing to a reduced fee, referring the client to another professional or to a facility that offers a sliding fee scale or pro bono services
To ensure the confidentiality of your clients, you decide to write your notes in a shorthand that is easy for you to recognize, but not others. Is this an appropriate way to maintain your records?
Records must be maintained and organized in a way that anyone who should have legitimate access can understand.
A colleague keeps her passwords on sticky notes she has attached to her in her office computer. Is this a risk to patients' privacy. If so, what can be changed?
Passwords should be secured in a safe location or in approved online resources.
If a patient would like a treatment summary sent to another psychologist, can a treating psychologist refuse because of an unpaid bill?
Psychologists may not withhold records because payment has not been received.
You are working in the counseling center. A client mentions a student's name that you recognize as another client for the counseling center. After the session, you decide to access the second student's file to see if you can find something that may help your client. Did a violation occur? What?
The second student is not your client, and you are providing information about one client to another. Both are violations.
Dr. Q is concerned about the information in Mrs. K's record that she had an affair and fears that it could be damaging to her. Should he delete this information?
Never tamper with records.
How do you determine what price to charge for fees?
Ensure that fees are fair, reasonable, and commensurate with the services provided. Consideration should be given to the clients’ ability to pay.