Notice Of Privacy Practices

Iris M. Hogan, MSW, LICSW
1126 NW 64th Street
Seattle, WA 98107
(206) 696-8111
irishogan@reasontohope.net

Effective Date: September 8, 2026

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

Your privacy matters. This Notice of Privacy Practices explains how I may use or disclose information about your health and mental health, how I protect that information, and the rights you have regarding it.

For purposes of this Notice, “Protected Health Information” or “PHI” means individually identifiable information about your past, present, or future physical or mental health; health care services; or payment for health care services.

If you have questions about this Notice or would like to exercise any of your privacy rights, you are welcome to contact me.

My Responsibilities

I am required by law to:

  • Maintain the privacy and security of your Protected Health Information.
  • Provide you with this Notice explaining my legal duties and privacy practices regarding your information.
  • Follow the terms of the Notice currently in effect.
  • Notify you following a breach of unsecured Protected Health Information when notification is required by law.
  • Comply with applicable federal and Washington State laws governing the confidentiality, use, and disclosure of health and mental health information.

I may change the terms of this Notice from time to time. Any revised Notice may apply to all of the information I maintain. The current Notice will be available on my website, through my client materials, and upon request.

How I May Use and Disclose Your Information

I may use or disclose your PHI without your written authorization for the following purposes, when permitted or required by federal and Washington State law.

For Treatment and Coordination of Care

I may use your health information to provide, coordinate, or manage your treatment.

Consistent with HIPAA and Washington law, I may also disclose information and records related to mental health services to a health care provider who is providing care to you or to a health care provider to whom you have been referred for evaluation or treatment. This may include, for example, communicating with a referring or treating physician, psychiatrist, nurse practitioner, therapist, or other health care provider when the communication is for your treatment or coordination of care.

Washington law also permits certain disclosures to people working in authorized care-coordination roles when the legal requirements for those disclosures are met.

I will take appropriate steps to protect mental health information shared for treatment or care coordination.

Psychotherapy notes receive additional protection and will not be released under this treatment and care-coordination provision without your authorization.

For Payment

I may use or disclose information as necessary to bill for and receive payment for services provided.

For example, this may include providing information to a health plan, billing service, payment processor, or collection service, when applicable and permitted by law. If information is disclosed for billing or collection purposes, I will limit the disclosure to information appropriate for that purpose.

For Health Care Operations

I may use or disclose your information as permitted by law to operate my practice and support the quality, safety, and administration of services.

For example, this may include scheduling, recordkeeping, billing, auditing, quality assurance, legal or professional consultation, practice administration, and business planning. Information will be protected and disclosed only as permitted or required by applicable law.

Use of Electronic Systems and Technology

I use electronic health record, telehealth, communication, billing, scheduling, and other technology systems to support care and practice operations.

When a service provider handles Protected Health Information on my behalf, I use providers and safeguards appropriate to the service and applicable law. These providers may include electronic health record, telehealth, billing, scheduling, secure communication, information-technology, or administrative-support providers.

I may use technology tools to assist with administrative or documentation-related tasks. These tools do not replace my independent clinical judgment. I take reasonable steps to protect the privacy and security of your information, including limiting access to information as appropriate.

Uses and Disclosures Without Your Authorization

In certain situations, I may be required or permitted by law to use or disclose your information without your written authorization. These situations may include:

  • When required by law. I may disclose information when federal, Washington State, or other applicable law requires it.
  • Public health and safety. I may disclose information when permitted or required by law to prevent or lessen a serious threat to health or safety.
  • Abuse, neglect, or exploitation reporting. I may report suspected abuse, neglect, abandonment, or exploitation of a child, vulnerable adult, or other protected person when required or permitted by law.
  • Health oversight activities. I may disclose information to legally authorized health oversight agencies for activities such as audits, inspections, investigations, licensure, or disciplinary actions.
  • Judicial and administrative proceedings. I may disclose information in response to legal process when disclosure is permitted or required by applicable federal and Washington law. Mental health information may receive protections beyond those applicable to other health information.
  • Law enforcement. I may disclose information to law enforcement officials in limited circumstances when permitted or required by law.
  • Workers’ compensation. I may disclose information as authorized by law for workers’ compensation or similar programs.
  • Government functions. I may disclose information for certain specialized government functions when permitted or required by law.
  • Coroners, medical examiners, and funeral directors. I may disclose limited information to these parties when authorized by law.
  • Organ and tissue donation. I may disclose information to organizations involved in organ or tissue donation and transplantation when permitted by law.

When the minimum-necessary standard applies, I will make reasonable efforts to limit the information used or disclosed to what is reasonably necessary for the purpose.

Washington Mental Health Confidentiality

Information and records related to mental health services receive additional confidentiality protections under Washington State law.

I protect your mental health information in accordance with applicable federal and Washington State law. When Washington law provides greater privacy protection than federal law, I follow the applicable Washington requirements.

Washington law generally protects information acquired in the course of providing professional services and information and records related to mental health services. However, Washington law also identifies circumstances in which disclosure is permitted or required without a separate written authorization.

These circumstances include certain disclosures for treatment and coordination of care. As described above, information related to mental health services may be shared, consistent with HIPAA and Washington law, with a health care provider who is providing care to you or to whom you have been referred for evaluation or treatment, and with certain authorized care coordinators.

This does not mean that your mental health information may be freely shared with other people or providers. Disclosure must be permitted by applicable law, and appropriate steps must be taken to protect the information.

Psychotherapy notes receive additional protection and will not be released under Washington's treatment and care-coordination provision without your authorization.

Uses and Disclosures With Your Authorization

Uses and disclosures of your information that are not described in this Notice will be made only with your written authorization unless otherwise permitted or required by law.

You may revoke a written authorization at any time by submitting a written request to me. Your revocation will not affect any use or disclosure that I already made in reliance on your authorization before I received your written revocation.

Most uses and disclosures of psychotherapy notes, if I maintain them separately from your clinical record, require your written authorization except as otherwise permitted or required by law.

Written authorization is also generally required before I use or disclose your information for marketing purposes or sell your health information. I do not sell your health information.

Special Protections for Substance Use Disorder Records

Certain substance use disorder patient records are subject to additional federal confidentiality protections under 42 CFR Part 2.

To the extent that I receive or maintain substance use disorder patient records that are subject to 42 CFR Part 2, I will protect those records as required by federal law.

Part 2 records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent or the use or disclosure is authorized by a court order accompanied by a subpoena or other legal requirement, as required by applicable law.

If I maintain Part 2 records, additional restrictions may apply to their use, disclosure, and redisclosure.

Your Rights Regarding Your Information

You have the following rights with respect to the health and mental health information I maintain about you.

Right to Inspect and Obtain a Copy

You have the right to inspect or obtain an electronic or paper copy of your health information maintained in your designated record set, subject to certain legal exceptions.

To request access, submit your request in writing to me using the contact information below.

Under Washington law, I will respond to a written request to examine or copy your health care information as promptly as required by the circumstances and generally no later than 15 working days after receiving your request. If unusual circumstances delay the request, I will notify you in writing as required by law.

I may charge a reasonable fee permitted by applicable law for copies or other allowable costs.

Right to Request an Amendment

If you believe information in your record is inaccurate or incomplete, you have the right to request that I amend it.

Your request must be made in writing and should explain why you believe the amendment is needed. I may deny your request in certain circumstances permitted by law. If I deny your request, I will provide a written explanation and explain your rights regarding the denial.

Right to Request Restrictions

You have the right to request restrictions on how I use or disclose your information for treatment, payment, or health care operations, or to request limits on disclosures to family members or others involved in your care or payment for your care.

I am not generally required to agree to a requested restriction. However, if you pay for a health care service in full out of pocket and request that I not disclose information about that service to your health plan for payment or health care operations, I will honor that request unless disclosure is otherwise required by law.

Right to Request Confidential Communications

You have the right to request that I communicate with you in a particular way or at a particular location.

For example, you may ask me to contact you only by email, only by phone, not to leave voicemail messages, not to mail information to your home, or to send mail to a different address. I will accommodate reasonable requests.

Right to Receive an Accounting of Disclosures

You have the right to request a list of certain disclosures of your health information made by me during the six years before your request.

This accounting does not include every disclosure. For example, it generally does not include disclosures made for treatment, payment, or health care operations; disclosures you authorized; and certain other disclosures excluded by law.

Right to Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.

You may request a copy by contacting me using the information below.

Right to Choose Someone to Act for You

If you have given another person legal authority to act on your behalf-such as through a health care power of attorney, legal guardianship, or another legally valid appointment-that person may exercise your privacy rights and make choices about your information as permitted by law.

I will verify that person's authority before taking action.

Right to Be Notified of a Breach

You have the right to receive notice if a breach occurs that may have compromised the privacy or security of your unsecured Protected Health Information, when notification is required by law.

Privacy Contact

If you have questions about this Notice, want to exercise your privacy rights, or believe your privacy rights have been violated, please contact:

Iris M. Hogan, MSW, LICSW
Privacy Contact
1126 NW 64th Street
Seattle, WA 98107
(206) 696-8111
irishogan@reasontohope.net

Complaints

If you believe your privacy rights have been violated, you may file a complaint with me using the contact information above.

You may also file a complaint with:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201

You may submit a complaint through the U.S. Department of Health and Human Services Office for Civil Rights Complaint Portal or by mail, email, or fax.

You may also contact the Washington State Department of Health regarding concerns within its jurisdiction.

I will not retaliate against you for filing a complaint. Filing a complaint will not affect your care or services.

Acknowledgment of Receipt

You may be asked to sign an acknowledgment confirming that you received or were offered a copy of this Notice of Privacy Practices. Your decision not to sign an acknowledgment does not affect your right to receive services or a copy of this Notice.