This notice describes how health information about you may be used and disclosed and how you can get access to this information. please review this notice carefully.

Rally Point Counseling, PLLC (Rally Point) and Rally Point Counselors are required to give you this Notice of Privacy Practices to comply with the regulations established under federal law (the Health Insurance Portability and Accountability Act – HIPAA). This notice is intended to describe your rights, and to inform you about the ways in which Rally Point and your counselor may disclose your Protected Health Information (PHI) and the obligations we have when using and disclosing your protected health information.

We are required to abide by the terms of this Privacy Practice Notice. We reserve the right to change the terms of our Privacy Practice Notice at any time. Any new Privacy Practice Notice will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Privacy Practice Notice via our online portal and an updated copy of our Privacy Practices is always available on our website.

Your records at Rally Point contain personal information about you. This information about you may identify you, and things which relate to your past, present or future physical or mental health condition and related health care services are referred to as Protected Health Information (PHI). 

Rally Point and Rally Point Counselors respect your confidentiality and are committed to protecting your personal information. We will only disclose information that we are required to under state and federal law, and/or with your signed consent.

How we may use and disclose health information about you:

Following is a list of categories in which Rally Point may use and disclose your PHI. Not every use or disclosure in a category will be listed,  but all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment. In order to provide the best treatment possible, your PHI may be used and disclosed by those involved in your care for the purpose of providing, coordinating, or managing your counseling and related services. . This includes clinical staff consultations and clinical supervision within Rally Point, and utilization review procedures under your insurance plan. Without your written authorization, we may not disclose PHI to any other individual, social agency, governmental agency, treatment professional or lay person except as mandated by law. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care, disclosures for treatment purposes are not limited to the minimum necessary standard. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between healthcare providers and referrals of a patient for healthcare from one health care provider to another.

For Psychotherapy Notes. Rally Point and Rally Point Counselors keep psychotherapy notes, and any use or disclosure of such notes requires your authorization unless the use or disclosure is for our use in treating you, for our use in training or supervising mental health providers within our practice, for our use in legal proceedings between us, for use by the Secretary of Health and Human Services to investigate compliance, required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes, required to help avert a serious threat to the health and saftey of others, or otherwise required by law. 

For Payment. We may use and disclose PHI so that we can receive payment for treatment services provided to you. This will only be done with your authorization. Examples of payment related activities are making a determination of eligibility or coverage for insurance benefits, processing appropriate identifying data for credit card utilization, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services we will only disclose the minimum amount of PHI necessary for purpose of collection, such as dates of services, attempts to secure payment. No personal history data would be shared.

For Health Care Operations. We may use or disclose, as needed, your PHI in order to support the running of our office including, but not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, we may share your PHI with third parties and perform various business activities (e.g. billing or administrative services) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI. For external training or teaching purposes PHI will not be disclosed without your written authorization.

As Required By Law. Illinois law is more protective of certain information than the Privacy Rule. Under HIPAA, the more protective law is the controlling law. Accordingly, Rally Point. and Rally Point Counselors will not disclose your information relating to treatment for mental health, developmental disabilities, alcoholism, drug dependence without in each case obtaining your authorization unless otherwise permitted or required by Illinois or federal law. Where you give authorization, you may revoke it at any time.

The Privacy Rule and Illinois law allow us to use or disclose your protected health information/patient health records without your authorization or informed consent for the limited reasons described below:

• As Required by Law. We are permitted to disclose your PHI when required to do so by federal, state or local law.

• Victims of Abuse, Neglect, or Domestic Violence. The Privacy Rule authorizes us to notify the appropriate government authority if a counselor believes a client has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree, or when required or authorized by law.

• Disputes, Lawsuits, Administrative Proceedings. If you are involved in a lawsuit or dispute, the Privacy Rule allows us to disclose your confidential PHI in response to a court administrative order. We may also disclose your PHI in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested if that is required by law. Illinois law may require a court order for the release of client health care records in these circumstances, and may be considered more protective of your privacy than the Privacy Rule.

• Law Enforcement. The Privacy Rule allows us to disclose protected health information if asked to do so by a law enforcement official in the following circumstances:

  • In response to a court order, subpoena, warrant, summons or similar process. To identify or locate a suspect, fugitive, material witness or missing person.

  • About the victim of a crime if, under certain limited circumstances, Rally Point. is unable to obtain the person’s agreement.

  • About a death Rally Point believes may be the result of criminal conduct. About criminal conduct at Rally Point.

  • In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Illinois law generally requires a court order for the release of client health records in these circumstances, and may be considered more protective of your privacy than the Privacy Rule.

Specialized Government Functions. In certain circumstances, the Privacy Rule authorizes us to use or disclose your PHI to facilitate specified government functions:

• Military and Veterans. Rally Point may disclose the PHI of armed forces personnel as required by military command authorities for the proper execution of a military mission.

• National Security and Intelligence Activities. Rally Point may disclose your PHI to authorized federal officials for intelligence, counter intelligence, and other national security activities authorized by law.

• Protective Services for the President and others. Rally Point may disclose your PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state, or to conduct special investigations.

• Medical Suitability Determinations. Rally Point may disclose your PHI to the Department of State for use in making medical suitability determinations.

Workers’ Compensation. It is our preference to obtain authorization from you prior to releasing PHI in this manner, but Rally Point maintains the right to release your PHI for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Serious Threats to Health or Safety: If a Rally Point Counselor is engaged in professional duties and you communicate to them a specific and immediate threat to cause serious bodily injury or death, to an identified or to an identifiable person, and they believe you have the intent and ability to carry out that threat immediately or imminently, they are legally required to take steps to protect third parties. These precautions may include warning the potential victim(s), or the parent or guardian of the potential victim(s), if under 18, notifying a law enforcement officer, or seeking your hospitalization. By our own policy, Rally Point and Rally Point Counselors may also use and disclose medical information about you when necessary to prevent an immediate, serious threat to your own health and safety. If you become a party in a civil commitment hearing, Rally Point can be required to provide your records to the magistrate, your attorney or guardian ad litem, a CSB evaluator, or a law enforcement officer, whether you are a minor or an adult.

Child Abuse Reporting: If Rally Point or a Rally Point Counselor has reason to suspect that a child is abused or neglected, they are required by Illinois law to report the matter immediately to DCFS.

Couples Therapy: If you and your partner decide to have individual sessions as a part of couples therapy, what you say in those individual sessions will be considered to be a part of the couples therapy, and can be discussed in joint sessions with a Rally Point Counselor.

Other Uses of Medical Information. Other uses and disclosures of information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose information about you, you may revoke that permission in writing at any time. If you revoke permission, we will no longer use or disclose the medical information about you for the reasons covered in your authorization. You understand that we are unable to take back any disclosure we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

Appointment Reminders. We may call, write or email to remind you of scheduled appointments, to inquire about your interest in continuing counseling or if you haven’t scheduled an appointment or have not notified us of the termination of your counseling. 

Marketing Communication. If you opt-in or subscribe to content produced by Rally Point, you may receive communications from us. Marketing communication of this nature is not made in connection with your status as a current or former client and is not considered professional advice. Your confidentiality is our priority, and we do not store your status as a past or current client in any non-secure systems. You may unsubscribe from all marketing communication from Rally Point at any time.

Sale of PHI. Rally Point will not sell your PHI in the normal course of business. 

Your Rights Regarding your PHI:

You have the following rights regarding PHI that we maintain about you. To exercise any of these rights, please submit your request in writing to Rally Point Counseling, PLLC at 61 S Grove Ave., Elgin IL 60120, or by email at hello@rallypointcounseling.com.

Right to Access to Inspect and Copy. You have the right to inspect and copy a designated set of your Rally Point and/or your specific counselor’s maintained records. This designated set typically includes counseling and billing records, but may not include your counselor's personal psychotherapy notes.

Right to a Reporting of Disclosures. You have the right to request an accounting of certain disclosures that we make of your PHI. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.

Right to Amend: You have the right to request that PHI Rally Point or your individual counselor has on file for you be amended. Your request must be made in writing, and must include reasoning that supports your request. Rally Point may deny your request if you are requesting information be amended that was not created by Rally Point or a Rally Point Counselor, is not part of medical information kept by us, is not part of the information you would be permitted to inspect or copy, or if the information listed is accurate and complete. In these instances, your request will be added to the information record. 

Right to Request Restrictions. You have the right to request a restriction or limitation on the use of disclosure of your PHI for treatment, payment or health care operation. We are not required to agree to your request. A request for restrictions must be in writing, directed to Rally Point Counseling, PLLC. and should include (1) what information you want to limit; (2) whether you want to limit its use, disclosure or both; and (3) to whom you want the limits to apply. You also have the right to request that Rally Point not disclose PHI to health plans related solely to services you have paid for out-of-pocket and in full.

Right to Request Confidential Communication. You have the right to request that we communicate with you in a certain way or at a certain location. For instance, you may ask that we phone you at home or by cell phone, rather then at work

Right to a Copy of this Notice. You have a right to a copy of this notice.

Right to Receive a Notification of PHI Confidentiality Breach. Rally Point is required to notify you if we discover a privacy breach, defined as the acquisition, access, use, or disclosure of your PHI that compromises the security or privacy of your PHI.

Rights Pertaining to Minors. Under Illinois law, minors age 12 through 17 have the right to access and authorize the release of their own mental health records and information, and their parents or legal guardians have such rights only if the minor does not object or a Rally Point Counselor does not feel there are compelling reasons to deny parental or legal guardian access. Parents or legal guardians may always receive information regarding the minor’s physical and mental condition, diagnosis, treatment needs, services provided/needed, and medication. 

Complaints: If you believe Rally Point. or your specific counselor has violated your privacy rights, you have the right to file a complaint in writing to Rally Point’s office or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W. Washington, D.C. 20201.

Acknowledgment

Acknowledging this document means you

• have read, understand, and agree to the above disclosures and policies;

• have had a chance to ask questions about anything in this document that is unclear;

Effective Date Of This Document

This document and the terms within went into effect on March 15th, 2022

For Questions Contact:

Rally Point - hello@rallypointmin.com