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The Counseling Services Staff provide confidential services practicing within professional ethics and laws that protect one’s privacy.  

Health & Wellness Services Counselors follow the ethical guidelines for social workers and professional counselors. This means that what is shared in counseling is not shared anywhere else. We don’t report things like sexual assault or underage drinking. The only time we share information is if the immediate safety is at risk for you or someone else, or if you give written permission for us to share specific things with specific people via a release of information form. 

If you have questions, please contact us at 920-403-3266 or health@snc.edu.

Notice of Privacy Practices 
Health & Wellness Services - Counseling Services records are kept separate from all other files to ensure that individual privacy and confidentiality are maintained. No information is released without the knowledge and written consent of the individual except for those rare instances identified below

Understanding Your Protected Health Information
When you visit Health & Wellness Services - Counseling Services, a record is made which consists of your private health information. Your record is the property of St. Norbert College. The information within belongs to you. Being aware of what is in your record will help you to make more informed decisions when authorizing disclosure to others. In using and disclosing your PHI, it is our objective to follow the Wisconsin state law and the privacy act of the Federal Health Insurance Portability and Accountability Act (HIPAA). Your health record serves as: 
  • A basis for planning your care and treatment. 
  • A means of communication among the health care professionals who may contribute to your care. 
  • A legal document describing the care you received. 
  • A tool with which we can assess and continually work to improve the care given and the outcomes we achieve. 
Responsibilities of Health & Wellness Services - Counseling Services Concerning Your Private Health Information (PHI)
Health & Wellness Services - Counseling Services will: 
  • Maintain the privacy of your PHI as required by law and provide you with the opportunity to review our HIPAA policies. 
  • Abide by the terms of this notice currently in effect. We have the right to change our notice of privacy practices and to make the new provisions effective for all protected health information that we maintain, including that obtained prior to the change. Should our information practices change, we will post new changes and provide you with a copy. 
  • Notify you if we are unable to agree to a requested restriction. 
  • Accommodate reasonable requests to communicate with you about your PHI by alternative means or at alternative locations. 
Your Private Health Information Rights 
You have the right to: 
  • Review and obtain a paper copy of the notice of information practices upon request. You may also be informed about what is contained in your PHI. Your request to review your counseling record needs to be in writing and needs the approval of the director for Health & Wellness Services. PHI will be given in summary form and when possible will include the presence of the treating provider. 
  • Request and provide written authorization and permission to release information (both verbally and/or in writing) for purposes of outside treatment and health care operations. 
  • Revoke your authorization in writing at any time to use, disclose or restrict health information except to the extent that action has already been taken. 
  • Request a restriction on certain uses and disclosures of your PHI in writing to the director for Health & Wellness Services. This request may or may not be granted. 
  • Request that we amend your health information. This request must be submitted in writing and include the reasons supporting the amendment. 
  • Obtain an accounting of disclosures of your health information for purposes other than treatment and care operation and certain other activities for the last six years, but not before April 14, 2003. 
Disclosures for Treatment and Health Operations 
Health & Wellness Services - Counseling Services will use your PHI, with your consent, in the following circumstances: 

Disclosure to others outside of Health & Wellness Services - Counseling Services
With your written authorization, we will discuss (verbally and/or in writing) information that is mutually agreed upon between you and your counselor with an outside party. You may revoke a written authorization permitting a release of your PHI at any time. However, the revocation will not affect any use or disclosures permitted by your authorization while it was in effect. Health & Wellness Services - Counseling Services will not use or disclose your PHI without your authorization except as described below:

For health care operations 
With your permission, members of Health & Wellness Services - Counseling Services may use information in your health record to assess the performance, operations and outcome of services. 

With your permission, the counseling providers may contact you to provide appointment reminders, information about treatment alternatives, other health-related benefits and services that may be of interest to you. You will be asked how you would like our staff to contact you, e.g. phone and/or letter. Health & Wellness Services - Counseling Services does not use email as a form of communication regarding your PHI. 

Use of PHI Without Your Consent 

Health & Wellness Services - Counseling Services will use your PHI, without your consent or authorization, in the following circumstances:

Child abuse 
If the counseling staff has reasonable cause to suspect that a child has been, or is in danger of abuse, neglect or threatened with abuse or neglect, a report must be made to a relevant county department, child welfare agency, police or sheriff's department. 

Adult and domestic abuse 
If the counseling staff has reasonable cause to suspect that an elder person is the victim of abuse, neglect, domestic violence or other crimes, a report may be filed with the relevant county department or state official. 

Serious threat to health or safety 
If the counseling staff has reasonable cause to suspect that you may cause harm to yourself or another person, steps may be taken to notify or assist in notifying a family member, personal representative, college official(s), police and/or anyone else who may help maintain your or another’s physical safety. A plan may be developed which requires an assessment for commitment proceedings. 

Judicial or administrative proceedings 
If you are involved in a court proceeding and a request is made for information about your diagnosis, treatment and/or mental health records, such information is privileged under state law and will not be released without written authorization from you or your personal or legally-appointed representative. The privilege does not apply when a third party is evaluating you or where the evaluation is court ordered. A court order may also require – without your consent – the release of counseling records. 

As required by law for national security and law enforcement 
We may disclose your health information under certain circumstances to military authorities. Health & Wellness Services - Counseling Services may disclose to authorized federal officials, health information required for lawful intelligence, counterintelligence and other national security activities. Health & Wellness Services - Counseling Services may also disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. 

Law/health oversight 
As required by law, we may disclose your health information for investigative purposes. For example, if the Wisconsin Department of Regulation and Licensing requests that we release records to them in order for the Medical or Psychology Examining Board to investigate a complaint against a provider, we must comply with the request. 

As required by law for purposes of public health 
Health & Wellness Services - Counseling Services may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability. 

Consultation/office management
Health care providers and counselors may consult with the our staff to help manage and coordinate your treatment. Administrative staff (e.g. office manager/receptionist) may also have limited access to your PHI. 

For more information or to report a problem, please refer to the following:

If you have questions and would like additional information, please ask your clinician who will provide you with more information or help you schedule an appointment with the director for Health & Wellness Services.
If you are concerned that your privacy rights have been violated; disagree with a decision Health & Wellness Services - Counseling Services has made about access to your health information; or if you would like to make a request to amend or restrict the use or disclosure of your health information, you may discuss these issues with your mental health provider or you may contact the director for Health & Wellness Services.

If you wish to appeal any decision, you may do so to the vice president for Student Affairs. If all other appeals have been exhausted, you may express your concern to the  Secretary of the U.S. Department of Health and Human Services. The  director will provide you with the address for filing a complaint upon request. 

We respect the individual’s right to the privacy of their health information. There will be no retaliation in any way for filing a complaint with the U.S. Department of Health and Human Services or any other appropriate agency, department or person.
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