Practice policies

Services

Services include psychotherapy, medication management, and medication-assisted treatment for substance use disorders. Therapy and treatment are interventions that have both benefits and risks. Benefits include a decrease in the symptoms for which you are seeking care and an increased feeling of well-being. Risks include potential discomfort in discussing troubling feelings, emotions, and behaviors. Medications may have side effects and risks. Therapy and treatment have been shown to improve feelings of stress, anxiety, depression, and substance use. There are no guarantees that therapy or treatment will work for you.  

You can expect evidence-based, ethical, and safe care. You can expect treatment that is respectful without bias or discrimination. If you are unhappy with your treatment, please discuss your concerns with me. You are free to end your treatment at any time.  

Appointments

You can expect the first appointment to last from 90 minutes to two hours. This will allow us to review your goals, history, determine if therapy or treatment is appropriate, and develop a treatment plan. Subsequent appointments are typically shorter. Psychotherapy appointments last 55 minutes, and follow-up medication management visits are typically 30 minutes. Appointment length and frequency may change based on treatment needs.  

Appointments should be scheduled at the end of the previous appointment. A $50 fee will be assessed for appointments not cancelled within 24 hours of the start time. Please arrive on time. Late arrival will deduct from the appointment time. Chronic lateness or missed appointments will necessitate the formation of a treatment contract. If you cannot abide by the contract to be on time for appointments, your treatment in this practice may be terminated. In this case, I will provide you with a referral to another healthcare provider. 

Fees

Non-insurance payments are due upon receipt of invoice. Payments are accepted in cash or major credit card. If there is an issue with non-payment, a treatment contract may be required. If you cannot abide by this contract, your treatment in this practice may be terminated. In this case, I will provide you with a referral to another healthcare provider. 

Medication

If medication is prescribed as part of your treatment plan, you are asked to take it as prescribed. All prescriptions will be sent to your pharmacy electronically. You are responsible for alerting the office of any pharmacy changes prior to a prescription being sent. Please alert the office at least 48 hours before you run out of medication. 

• Prescriptions for controlled medications cannot be ordered with refills. You must meet with your prescriber when your prescription runs low. Controlled medications can only be ordered for a 30-day supply at a time. If you take your medication every day, it’s wise to schedule your appointments every 28 days to allow time for a new prescription to be sent and for the pharmacy to fill it. 

• Refills for controlled medications will not be sent in early. You are to take your medications as prescribed. If you find that you are taking your medication more frequently than what is prescribed, contact your prescriber. 

• There is a database of controlled medication prescriptions that gets checked before new prescriptions are ordered. This provides information on medication, dose, quantity, prescriber, pharmacy, and date last filled. This allows prescribers, pharmacists, and the DEA to ensure that controlled medication prescriptions are not being prescribed irresponsibly.  

• You must meet with your prescriber in-person at least once per year. If this is not possible, your local healthcare provider must contact the prescriber of your controlled medication to consult whether the medication is still appropriate and medically safe. 

• If your medication is stolen, you must file a police report for a new prescription to be filled early. It is unwise to bring your whole bottle of medication out with you. Likewise, if you have guests, secure your medications somewhere that guests won’t be able to access. 

• It’s your responsibility to store and look after your medications appropriately. 

• It’s illegal to share prescription medications with others. 

• Many medications, controlled and otherwise, are subject to shortages. This is another reason it is wise to schedule your follow up appointments at least two days before you are out of your medication.  

Communication

I am available by phone between 9:00 am and 5:00 pm, Monday through Friday. Please leave a detailed message and your call will be returned as soon as possible. Appointments can be rescheduled via phone or text. Treatment will not be conducted over the phone, text, or email. Any other telephone calls should be limited to urgent matters that cannot wait until the next scheduled appointment. 

If you are experiencing a medical emergency, call 911. The closest emergency department with psychiatric services is Health Alliance Hospital at 105 Mary’s Avenue in Kingston, N.Y. 

Medical Records

Medical records will be kept through a secure electronic medical record system. You will have access to your medical record through a secure patient portal. You will be given an access code after your first appointment that will allow you to establish a username and password.  

Telehealth

You have the option to have appointments via telehealth. You will receive a secure link before the appointment time, so you may join via home computer or mobile device. When using telehealth, you must be in New York State at the time of appointment. 

Privacy and Confidentiality 

Records of your treatment are confidential. There are very limited circumstances when details of your treatment can legally be released and require a court subpoena. In this case, only the basics of your treatment would be revealed; such as diagnosis, dates of appointments, or medications prescribed. The content of discussions remains legally protected. 

If you indicate that someone, including yourself, is in danger, we will work together to find a solution. If no solution can be found, I am mandated by law to ensure your safety and the safety of others. I am a mandated child abuse reporter.  

HIPAA Policies

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a Federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally are kept properly confidential.  HIPAA gives you, the patient, the right to understand and control how your personal health information (PHI) is used.  HIPAA provides penalties for covered entities that misuse personal health information.  

As required by HIPAA, we prepared this explanation of how we are to maintain the privacy of your health information and how we may disclose your personal information.  

We may use and disclose your medical records only for the following purposes: treatment, payment, and health care operation.

•Treatment means providing, coordinating, or managing healthcare and related services by one or more healthcare providers.  An example of this is if you are referred to a primary care doctor or another specialist.

•Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collections activities, and utilization review.  An example of this would include sending your insurance company a bill for your visit.  

•Health Care Operations include the business aspects of running our practice, such as conducting quality assessments and improving activities, auditing functions, cost management analysis, and customer service.  An example of this would be patient survey cards.

•The practice may also be required or permitted to disclose your PHI for law enforcement or other legitimate reasons.  In all situations, we shall do our best to assure its continued confidentiality to the extent possible.  

We may also create and distribute de-identified health information by removing all reference to individually identifiable information.  

We may contact you, by phone or in writing, to provide appointment reminders or information about treatment alternatives or other health-related benefits and services, in addition to other fundraising communications, that may be of interest to you.  You do have the right to "opt out" with respect to receiving fundraising communications from us.

The following use and disclosures of PHI will only be made pursuant to us receiving a written authorization from you:

•Most uses and disclosure of psychotherapy notes (these are not part of your medical record under HIPAA);

•Uses and disclosure of your PHI for marketing purposes, including subsidized treatment and health care operations;

•Disclosures that constitute a sale of PHI under HIPAA; and

•Other uses and disclosures not described in this notice.

You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your prior authorization.

You may have the following rights with respect to your PHI.

•The right to request restrictions on certain uses and disclosures of PHI, including those related to disclosures of family members, other relatives, close personal friends, or any other person identified by you.  We are, however, not required to honor a request restriction except in limited circumstances which we shall explain if you ask.  If we do agree to the restriction, we must abide by it unless you agree in writing to remove it.  

•The right to reasonable requests to receive confidential communications of Protected Health Information by alternative means or at alternative locations.

•The right to inspect and copy your PHI.

•The right to amend your PHI.

•The right to receive an accounting of disclosures of your PHI.

•The right to obtain a paper copy of this notice from us upon request.

•The right to be advised if your unprotected PHI is intentionally or unintentionally disclosed.

If you have paid for services "out of pocket", in full and in advance, and you request that we not disclose PHI related solely to those services to a health plan, we will accommodate your request, except where we are required by law to make a disclosure. 

We are required by law to maintain the privacy of your Protected Health Information and to provide you the notice of our legal duties and our privacy practice with respect to PHI.  

This notice if effective as of September 1, 2023 and it is our intention to abide by the terms of the Notice of Privacy Practices and HIPAA Regulations currently in effect.  We reserve the right to change the terms of our Notice of Privacy Practice and to make the new notice provision effective for all PHI that we maintain.  We will post and you may request a written copy of the revised Notice of Privacy Practice from our office.

You have recourse if you feel that your protections have been violated by our office.  You have the right to file a formal, written complaint with office and with the Department of Health and Human Services, Office of Civil Rights.  We will not retaliate against you for filing a complaint.