Notice of Karner Psychological Associates Privacy Policy


Privacy is a primary concern of all those who come to Karner Psychological Associates. It can be complicated because of the many federal and state laws and our professional ethics.

This Notice of Privacy Rights will tell you how KPA handles your medical information. It tells how we use this information within this office, how we share it with other professionals and organizations, and how you yourself can gain access to it. We want you to know that these procedures have been established to help you make the best decisions for yourself and your family. Because the state and federal laws are complicated and parts of them may not apply to you, we have removed a few small sections. If you have any questions or want to know more about anything in this Notice just ask.

Each time you visit Karner Psychological Associates or any other healthcare providers; information is collected about you and your physical and/or mental health. It may be information about your past, present or future health or conditions, or the treatment or tests you received from us or from others, or about your payments for healthcare.

The information we collect is called, in the law, Protected Health information or PHI. This information goes into your treatment record or file at our office.

At Karner Psychological Associates PHI is likely to include these kinds of information:

  • Your history. (Your history may include information about your childhood, work, marriage, and personal experiences.)
  • Reasons you came to KPA for treatment. (Your problems, complaints, symptoms or needs.)
  • Diagnoses. (Diagnoses are the medical terms for your problems and symptoms.)
  • Treatment Plan. (A Treatment Plan is a list of the treatments and other services which we think will be best to help you.)
  • Progress Notes. (At each meeting, your therapist writes a note about how you are doing and sets goals that are reachable with you for your next meeting.)
  • Records we get from others who treated you or evaluated you.
  • Psychological test scores, school records and other similar reports.
  • Information about the medications you are taking or took in the past.
  • Legal matters.
  • Billing and insurance information.

This list is just to give you an idea of what your PHI contains. However, there may be other kinds of information that goes into your KPA healthcare record.

We use this information for many purposes. For example, we may use it:

  • To plan your treatment.
  • To decide how well your treatment is working for you.
  • When we talk to other healthcare professionals who are treating you, such as your family doctor or the professional who referred you to us.
  • To document that you actually received the services from us which we billed to you or your health insurance company.
  • For teaching and training of healthcare professionals.
  • For medical or psychological research.
  • For public health officials trying to improve health care in the Capital Region.
  • To improve the way we do our job by measuring the results of our work.

When you understand what is in your record and what it is used for, you can make better decisions about whom, when and why others should have this information.

Although your healthcare record is the physical property of Karner Psychological Associates (or the healthcare practitioner or facility that collected it), the information belongs to you. You can read it, and, if you want a copy, we can make one for you. If you request a copy, there will be a charge for the costs of copying ($0.75 per page), and postage, if you want the records mailed to you.

In some rare situations you will not be able to see all of what is in your records. You may discuss with your therapist any possible limitations to your ability to see all of his/her notes.

If you find anything in your records that you think is incorrect or believe that something important is missing you can ask KPA to amend or add information to your record.

In some rare situations, we do not have to agree to do that but we will inform you in writing of the reasons. If you request, our Privacy Officer, whose name appears at the end of this Notice, can explain more about this.

KPA is required to inform you about your privacy rights in conformity with the privacy regulations issued by the Health Insurance Portability and Accountability Act of 1996, which is also known as HIPPA. HIPPA requires us to keep your Personal Healthcare Information (or PHI) private and to give you notice about our legal duties and our privacy practices in a Notice of Privacy Practices (or NPP).

Karner Psychological Associates is committed to obeying the letter and spirit of HIPPA as evidenced in this Notice of Privacy Practices. We will follow HIPPA rules and these privacy practices as long as they are in effect. If we make any changes in our privacy practices, a new Notice of Privacy Practices will be published and posted at the offices of Karner Psychological Associates. You or anyone else can get a copy of our Notice of Privacy Practices from our Privacy Officer at any time.  The NPP will be posted on our website at:

When your PHI is read by your therapist or others at Karner Psychological Associates that act is called, in the law, “USE.” If the information is shared with or sent to others outside KPA, that is called in the law, “DISCLOSURE.” Except in some circumstances, when we use your PHI here or disclose it to others we share only the minimum necessary PHI needed for those people to do their jobs. The law gives you the right to know about your PHI, how it is used and to have a say in how it is disclosed.

KPA uses and discloses Personal Health Information for several reasons. Mainly we use and disclose PHI for routine purposes described below. For other uses we must tell you about them and receive a written authorization from you, unless the law specifically allows the disclosure without your authorization. These exclusions are also described below.

We need information about you and your condition to provide care to you. Unless you agree to let us collect this information and to use it and share it to care for you properly, we will be unable to treat you. Therefore, we must have your written Agreement (Consent Form) before we begin treatment.

After you have read this notice and had your questions answered you will be asked to sign a separate Consent Form. The Consent Form allows KPA to use and share your PHI with other people or organizations who provide treatment to you, arrange for payment of our services, or some other business functions called healthcare operations. Together these routine functions are called TPO and the Consent Form allows KPA to use and disclose your PHI for TPO.

TPO functions include:

  • Treatment :We use your personal and medical information to provide you with treatment services. These might include individual counseling, family or group therapy, psychological, educational or vocational testing, developing treatment plans, or measuring progress or the benefits of our services.Therefore, we may share or disclose your PHI to others who provide treatment to you, such as your personal physician. If you are being treated by more than one KPA therapist, they can share your PHI so as to better coordinate the services you are receiving.Therapists will enter their findings, the actions they took, and their plans into your record so that they can collectively decide what treatments work best for you and to develop a Treatment Plan for you. We may refer you to other professionals or consultants for services we cannot provide. When we do this we need to tell them some things about you and your conditions. We will receive from them their findings and opinions and those will be entered into your KPA records.If you receive treatment in the future from other professionals we can also share your PHI with them. These are some examples of how we use and disclose your PHI to optimize your treatment.
  • Payment: We may use you information to bill you, your insurance carrier or others so we can be paid for the treatment we provide to you. We may contact your insurance company to check on exactly what your insurance covers. We may have to tell them about your diagnoses, what treatments you have received and the changes we expect in your conditions. We will need to tell them about when we provided services, your progress and other similar things.
  • Healthcare Operations: We may use your PHI to see where we can make improvements in the care and services we provide. We may be required to supply some information to some governmental health agencies so they can study disorders and treatment and to make plans for services that are needed. If we do, your name and personal information will be removed from from the information we provide.


  • Appointment Reminders: We may use and disclose contents of your PHI to reschedule or remind you of appointments for treatments or other services. If you want us to call or write to you only at a specific site or prefer some other way to reach you, you must inform us of the preferred phone number, address, etc. in writing and you can request the appropriate form from your Therapist.
  • Treatment Alternatives: KPA may use and disclose your PHI to inform you or recommend possible treatments or alternatives that may be of help to you.
  • Other Benefits and Services: We may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you.
  • Research: We may share or use your information to do research to improve treatment. For example, we may compare two treatment modalities for the same disorder to see which works better or faster or costs less. In all cases, when such research is conducted, your name, address, and other personal information will be removed from the information given to researchers. If they need to know who you are we will discuss the research project with you and have you sign a special Authorization form before any information is shared.
  • Business Associates: There are some jobs we may hire outside contractors or other businesses to do for us. In the law, these entities are called Business Associates. Business Associates might include a billing service or a medical transcription service. To do their jobs properly, Business Associates need to receive some information from your PHI. To protect your privacy each Business Associate must agree within their contract with us to safeguard all personal information they receive from KPA.

IF KPA wants to use your Personal Health Information for any purpose besides TPO or those other uses described above, we need your written permission on an authorization Form. We do not expect to need this very often.

If you do authorize us to disclose your PHI, you can revoke that permission, in writing, at any time. Once a cancellation of your authorization is received, no further disclosures of your PHI for that purpose will be made. Of course, we cannot take back any information disclosed prior to the receipt of your revocation of Authorization.

In some cases HIPPA allows us to use and disclose some of your PHI without your consent or authorization. The following are some examples:

  • When Required By Law: There are some federal, state or local laws that require us to disclose personal information:
    We are mandated to report suspected child abuse; If you are involved in a lawsuit or legal proceeding and we receive a subpoena, request for discovery or other lawful process we may have to release your PHI. KPA is required to disclose some information to government agencies which are charged with enforcing compliance with privacy laws.
  • For Law Enforcement Purposes: We may release personal information to law enforcement officials on receipt of a subpoena or court order as part of an investigation of a crime or criminals.
  • For Public Health Activities: We might disclose some of your PHI to agencies that investigate diseases or injuries.
  • For Specific Government Functions: KPA may disclose PHI of military personnel and veterans to federal benefit programs relating to eligibility and enrollment. We also may disclose your PHI to New York State Workers Compensation and Disability programs, to correctional facilities if you are an inmate, and for national security reasons.
  • To Prevent A Serious Threat To Health And Safety: If we come to believe that there is a serious threat to your health or safety or that of another person or the public we can disclose some of your PHI. We will only do this to persons who can prevent the danger.

KPA can share some information about you with your family or close others. However, we will only share information with those involved with your care and anyone else you choose such as close friends or clergy. We will ask you about who you want us to tell what information about your condition or treatment. You can tell us what you want and we will honor your request as long it is not against the law.

If it is an emergency, and we are unable to ask you if you disagree, we can share information if we believe it is what you would have wanted and if we believe it will help you if we do share the information. If we do share information in an emergency situation, we will inform you in writing as soon as we can. Should you not approve we will immediately cease the disclosure, as long as it is not against the law.

Whenever we disclose your PHI we will keep a detailed record of the action. You can get an accounting (list) of many of these disclosures. The accounting will include, who we disclosed to, what was disclosed and when the disclosure was made.

If you need more information or have questions about the privacy practices described above, you make speak to your Therapist or to KPA’s Privacy Officer.

If you have a problem with how your PHI has been handled or if you believe your privacy rights have been violated, immediately contact the KPA Privacy Officer. You have a right to file a complaint with us and with the Secretary of the Federal Department Of Health and Human Services in Washington, DC. We promise you that we will not in any way limit your care at KPA or take any actions against you if you complain.

KPA Privacy Officer:
Frank Doberman, Ph.D.
Phone: 456-5056 Ext. 204