HIPAA Notification of Privacy Practices

In addition to the above information, based on the federal Health Insurance Portability and Accountability Act (HIPAA), as a mental health provider within the state of Indiana, TBH also complies with the following state laws regarding the release of mental health records to the patient and other authorized persons.

Maintenance of Records

• TBH is required to maintain a record for each patient receiving mental health services. The information contained in the mental health record belongs to the patient involved as well as to the provider. TBH shall maintain the original mental health record for at least seven (7) years.

Confidentiality

A patient’s mental health record is confidential and are typically disclosed only with prior consent of the patient. However, information with the health record can be disclosed without prior consent under the following circumstances, in accordance with IC 16-39-3:

• A client’s mental health records may be released in investigations and legal proceedings if a court orders the release of the patient’s mental health record after finding, by a preponderance of the evidence that:
  1. Other reasonable methods of obtaining the information are not available or would not be effective; and
  2. The need for disclosure outweighs the potential harm to the patient.
• Upon the written request of the parent, guardian, or court appointed special guardian who is involved in the planning, provision, and monitoring of the mental health of a child enrolled in a school, the provider shall provide the child’s school principal or school leader with information as described in IC 16-39-2-3, in accordance with those provisions.
• Other disclosures permitted without the client’s consent can be found in IC 16-39-2-6.

Provider’s Use of Records

Except as provided in IC 16-39-4-5, the original health record of the patient is the property of the provider and as such may be used by the provider without specific written authorization for legitimate business purposes, including the following:

• Submission of claims for payment from third parties;
• Collection of accounts;
• Litigation defense;
• Quality assurance;
• Peer review;
• Scientific, statistical, and educational purposes

In the execution of the above legitimate business purposes, the provider shall at all times protect the confidentiality of the health record and may disclose the identity of the patient only when disclosure is essential to the provider’s business use or to quality assurance and peer review.

Patient Access; Restrictions; Appeal

A patient is entitled to inspect and copy the patient’s own mental health record. However, if the provider that is responsible for the patient’s mental health records determines for good medical cause, upon the advice of a physician, that the information requested under this section is detrimental to the physical or mental health of the patient, or is likely to cause the patient to harm the patient or another person, the provider may withhold the information from the patient. The patient may appeal the provider’s refusal to permit the patient to inspect and copy the patient’s own record under IC 4-21.5.

Access to Patient’s Designee or Legal Representative; Written Request

Upon a patient’s written request and reasonable notice, a patient’s mental health record shall be made available for inspection and copying by the provider at any time to an individual or organization designated by the patient or to the patient’s legal representative. A patient’s written request for the release of the patient’s mental health record under this section must include the following:

1. The name of the patient.
2. The name of the person requested to release the patient’s mental health record.
3. The name of the person, provider, or organization to whom the patient’s mental health record is to be released.
4. The purpose of the release.
5. A description of the information to be released from the mental health record.
6. The signature of the patient.
7. The date the request is signed.
8. A statement that the patient’s consent to release of mental health records is subject to revocation at any time, except to the extent that action has been taken in reliance on the patient’s consent.
9. The date, event, or condition on which the patient’s consent to release of mental health records will expire if not previously revoked.

Discovery or Admissibility Without Patient’s Consent; Court Ordered Release

Mental health records are not discoverable or admissible in any legal proceeding without the consent of the patient, except that the court may order the release of the patient’s record without his/her consent upon the showing of good cause following a hearing under IC 16-39-3 or in a proceeding under IC 31-30 through IC 31-40 following a hearing held under the Indiana Rules of Trial Procedure.

Exercise of Patient’s Rights by Others; Equal Access to Records; Fees

The following persons are entitled to exercise the patient’s rights on the patient’s behalf:

1. If the patient is a minor, the parent, guardian, or other court appointed representative;
2. If the provider determines that the patient is incapable of giving or withholding consent, the patient’s guardian, a court appointed representative of the patient, a person possessing a health care power of attorney for the patient, or the patient’s health care representative.

A custodial parent and a noncustodial parent of a child have equal access to the child’s mental health records unless:

1. A court has issued an order that limits the noncustodial parent’s access to the child’s mental health records; and
2. The provider has received a copy of the court order or has actual knowledge of the court order.

If the provider incurs an additional expense by allowing a parent equal access to a child’s mental health records, the provider may require the parent requesting the equal access to pay a fee under IC 16-39-9 to cover the cost of the additional expense.

Decedents’ Records; Consent to Release

Consent to the release of a deceased patient’s record may be given by the personal representative of the patient’s estate. If there is no appointment of a personal representative, consent may be given by:

1. The patient’s spouse; or
2. If there is no spouse, any responsible member of the patient’s family, including a parent, guardian, or custodian of the deceased patient’s minor child.