STILL WATERS COUNSELING SERVICES, PLLC
Phone: (309) 270-3848
Effective Date: 03/23/2026

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This notice describes how your health information may be used and disclosed and how you can access this information. Please review it carefully.

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I. Our Pledge Regarding Your Health Information

We understand that information about your health and the care you receive is personal. We are committed to protecting it. We create records of the care and services you receive to provide quality care and comply with legal requirements. This notice applies to all records of your care created by this practice.

 

We are required by law to:

• Keep your health information private.

• Give you this notice describing our legal duties, privacy practices, and your rights.

• Follow the terms of this notice currently in effect.

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We may update this notice. If we do, the new notice will apply to all information we maintain and will be available in our office and on our website.

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II. How We May Use and Disclose Your Health Information

We may use or disclose your protected health information (PHI) without your written authorization for:

 

1. Treatment, Payment, and Health Care Operations

• Treatment: Sharing information with other healthcare providers involved in your care (e.g., consulting with another therapist, referring you for specialized care).

• Payment: Using or disclosing PHI to bill insurance, process claims, or coordinate payment.

• Operations: Activities like quality improvement, training, supervision, audits, and ensuring proper care.

 

2. Legal and Safety Reasons

• Lawsuits and Disputes: We may disclose PHI in response to a court order or subpoena. Efforts will be made to notify you when permitted.

• Serious Threats: If needed to prevent or reduce a serious threat to your health or safety, or the health and safety of others.

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III. Uses and Disclosures Requiring Your Written Authorization

You must provide written authorization for:

• Psychotherapy Notes: Our separate personal notes analyzing session content. Most disclosures require your written authorization, except as allowed by law (e.g., for your own treatment by us, supervision/training, or certain legal defenses).

• Marketing Purposes: We do not use your PHI for marketing.

• Sale of PHI: We do not sell your PHI.

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IV. Uses and Disclosures That May Not Require Authorization

We may use or disclose PHI without your authorization for:

• Compliance with state or federal laws, including child/elder/dependent adult abuse reporting.

• Public health activities and preventing serious threats.

• Health oversight activities, including audits and investigations.

• Judicial or administrative proceedings, such as responding to court orders.

• Law enforcement purposes, including reporting crimes on our premises.

• Coroners/medical examiners performing authorized duties.

• Research under strict privacy protections.

• Special government functions, including military, intelligence, or correctional facility operations.

• Workers’ compensation claims compliance.

• Appointment reminders or information about treatment alternatives or health-related benefits we offer.

 

V. Uses and Disclosures Where You Can Object

We may share PHI with family members, friends, or others involved in your care or payment unless you object in whole or in part. Your verbal agreement is sufficient for these disclosures; a formal written Release of Information (ROI) is not required.

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In emergency situations, we may share PHI if we reasonably believe it is necessary to prevent harm, and consent may be obtained retroactively.

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Note: Illinois law (Mental Health and Developmental Disabilities Confidentiality Act, 740 ILCS 110/) provides additional protections for mental health records. We will only disclose information as permitted under both HIPAA and Illinois law and will honor any objection you make to sharing PHI with family or friends.

 

VI. Your Rights Regarding Your PHI

You have the right to:

• Request restrictions on certain uses/disclosures of your PHI.

• Request restrictions for services paid out-of-pocket in full.

• Request confidential communications (e.g., email vs. phone).

• Access and obtain copies of your PHI (excluding psychotherapy notes) in paper or electronic form within 30 days. We may charge reasonable, cost-based fees and will provide a fee estimate in advance.

• Request an accounting of disclosures (past 6 years).

• Request corrections to your PHI.

• Receive a paper or electronic copy of this Notice at any time, even if you agreed to electronic delivery.

 

VII. Breach Notification

If your unsecured PHI is breached, we will notify you as required by law.

 

VIII. Privacy Officer / Contact

If you have questions, concerns, or wish to file a complaint about your privacy rights, please contact:
Keilyn French, Owner/Therapist / Privacy Officer
Phone: (309) 270-3848
Email: admin@stillwaterstherapy.org

You may also file a complaint with the U.S. Department of Health & Human Services.

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IX. Minors and Foster Care Clients

Parents or legal guardians generally have rights to PHI for minors. In foster care situations, state law and court orders may affect who can access PHI. We follow these rules while maintaining your privacy to the extent allowed by law.

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X. 2026 HIPAA Updates – Substance Use Disorder (SUD) Records

If we create or maintain substance use disorder (SUD) treatment records protected under 42 CFR Part 2, we follow those stricter rules. Most uses or disclosures of these records, including for treatment, payment, or operations, generally require your written consent, and you have additional rights regarding these records.

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