Privacy Policy Statement

 Services

We treat patients for a variety of mental health concerns. Psychiatric Mental Health Nurse Practitioners are licensed to provide both medication management and talk therapy, though some providers may focus more on one or the other. While many PMHNPs enjoy seeing clients for both medication and talk therapy, it is also common for patients to have a counselor in the community. We are happy to work collaboratively with your counselor for the medication piece only.

Patient Participation

Active patient participation is essential to recovery and to the maintenance of lifelong health and wellness. Your treatment plan will be based upon your personal goals. If you are unsure what your goals are then your provider will work with you to help answer these questions. Minimal progress is made if a patient is only using one hour a week of therapy (or less) to explore their feelings or work on changes. Restoring balance and building new habits takes work. Medications can often help with symptoms but do not automatically lead to meaningful change.

Risks Associated with Treatment

Every type of health care carries potential benefits and possible risks and adverse effects. All medications, as well as herbal and natural preparations, have the potential for causing adverse effects in some individuals. On rare occasions, these effects can be serious. Medications may cause adverse effects through allergic reactions, through unwanted actions on your body and brain, through interactions with other medications, or in combination with alcohol, marijuana, or recreational drugs. Adverse effects will often go away within the first few weeks after a medication change. Unfortunately, there is no way to predict in advance who will suffer what effects from which medications and whether they will resolve within the first few weeks. Prior to prescribing a medication, your provider will discuss with you the potential benefits, risks, and the most common adverse effects of the proposed medication. However, since there will not be enough time in your appointment to review every possible side effect, it is important that you review the printed medication that you are given by your pharmacy. It is essential that you keep your provider informed about any medical conditions and any prescribed, over-the-counter medications, herbs, or supplements that you are taking. For safe and effective medication management, it is very important that you inform your provider of any alcohol, marijuana or recreational drug use, which will be kept in confidence in accordance with our privacy practices statement.

Off-Label Use of Medication

Many medications used in psychiatry are prescribed "off-label," meaning that the medication is not formally approved by the Food and Drug Administration (FDA) for the purpose for which it is being prescribed. A lack of FDA approval does not imply a lack of efficacy or safety. FDA approval often results from a decision of a pharmaceutical company to spend the money to seek such approval for marketing purposes. The medication recommendations made by your provider are based on their training, experience, evidence from scientific research, and the practice of experts and colleagues in our community, matched to your unique needs and preferences.

Psychotherapy

We believe strongly in the value of psychotherapy. Most clients do better with a combination of talk therapy and medication than with medications alone. Psychotherapy carries risks of short-term emotional discomfort or anxiety in the process of achieving long-term improvement. For example, your work may at times cause you to experience distressing or painful memories, to expose yourself to situations or sensations that are anxiety provoking, or to practice challenging new ways of thinking or behaving. However, these “side-effects” of therapy should not become intolerable or hazardous to you. If this is the case, it is important to discuss these concerns with your provider.

Initial Appointment

The first meeting will last approximately 60-90 minutes. We will discuss the issues that led you to seek assistance, your past medical, surgical, developmental, social and psychiatric history, current life status, and treatment goals. By the end of this meeting, our goal is to provide you with a sense of how your provider may be able to help you. We may be able to work out an initial plan of treatment by the end of this meeting, but often an additional meeting or two are needed to fully develop a plan. Depending on the evaluation, medications may not be prescribed until the second meeting or later. You are considered to be in active treatment if you fill a medication prescription after the initial visit, or otherwise when you have attended your first follow-up visit.

Ongoing Sessions

The duration and frequency of visits depends upon your preferences and needs. Typically, you will meet more frequently at the beginning of treatment, and less often after your treatment goals start to be reached. Depending on these treatment goals, visits may be as long as 50 minutes, or could be limited to a 15 to 25-minute check in. Except in unusual circumstances, if you are in ongoing treatment then you will need to meet with your provider at minimum once every three months; this is essential for maintaining good contact and oversight of your medications. In some cases, a client who is stable and on a simple medication regimen may have the option of having care transferred to a primary care provider.

Contacting Us

Our office staff is an important part of your care team. They are the front-line for phone call inquiries, as they can address issues that arise for clients. In addition to helping with scheduling, billing, and insurance, they can address issues such as records requests and pharmacy questions. Of course, when the concern is something of a clinical nature or is otherwise not something that is appropriate for our office staff to address, you will be connected with your provider via secure message. Urgent matters involving your provider will be replied to as soon as possible, at least by the end of the business day. Non-urgent matters involving your provider will be responded to within 3 business days. Please review the “Emergencies” section for crises that occur after-hours or on weekends. You can contact our office Monday–Thursday, from 8am to 6pm, by calling 541-382-1395. If you reach the recording, we will get back to you as soon as possible. You are also free to email office staff. Keep in mind that email is not considered a secure way to transmit information, hence privacy cannot be guaranteed. It is also not appropriate for urgent communication. Do not attempt to contact us by text since none of our phones are set up to receive them.

Patient Portal

You will need to set up an account in the patient portal of Valant, the electronic record system used by this office.  This patient portal allows you secure access to update your contact information, view your balance, receive billing statements electronically, view your scheduled appointments, and receive clinical documents pertinent to your care. You will be receiving an email from us asking you to set up your patient portal. Please make sure to set up your account within 7 days of receiving the email.

Medication Refills

It is our shared responsibility to ensure you do not run out of medication. For your part, you should track your use of medication and plan requests for refills in advance. Major pharmacies often provide reminder services to assist with this. It works best to arrange refills at the time of an appointment. We strive to respond to refill requests as soon as possible, but we cannot guarantee we will respond in time unless you give us at least 7-days’ notice before you run out. If you have not seen your provider for more than 3 months, you will need to schedule a follow-up appointment before a medication refill can be authorized. In that event, your provider may authorize an amount of medication to last until that scheduled appointment.

Stimulant medications (Adderall, Ritalin, Concerta, etc.) and Anti-Anxiety medications (Xanax, Ativan, Valium, etc): These are sensitive controlled substances that require heightened responsibility for both provider and client. We will not replace lost or stolen stimulant prescriptions or medications, or refill any stimulant medications early, regardless of the reason. These medications will not be refilled without clients keeping their appointments. Your provider may make use of a Stimulant or Benzodiazepine Contract.

Court Proceedings or Evaluations for Disability Applications

We do not provide any information or medical records to attorneys or law enforcement officers without your permission except as required by law or court order. If a provider is required to be deposed or testify, hourly rates with travel allowances may be billed to you for their services. We do not perform evaluations or submit paperwork for the purposes of applying for long-term disability, or for a legal proceeding such as a criminal trial or child custody hearing. By entering into treatment, you are agreeing not to involve us in legal/court proceedings. You may request copies of your medical records for use in such applications and proceedings. In appropriate circumstances with established clients, your provider may provide assessments and support for Family Medical Leave Act (FMLA) applications, for school and workplace accommodations. If there is significant time involved in preparing a letter or report for such a purpose, you will be billed for the time involved (see Fee Schedule)

Emergencies

We strive to be available to patients whenever there is an urgent situation and encourage you to contact us whenever a crisis arises. However, if a crisis occurs after business hours or on the weekend you may need to access emergency services since we may not be able to get back to you as soon as you need. In the event of an emergency, call 911, call your county’s crisis line (below), or go to the nearest emergency department. Please know that having strong thoughts or impulses to harm yourself (or others) is a medical emergency; in such a situation, it is completely appropriate to contact 911 or seek help at an emergency room.

Central Oregon EMERGENCY Resources:

-National Suicide Prevention Lifeline: 1-800-273-TALK (8255) | www.suicidepreventionlifeline.org

-Lifeline crisis chat available online on the website | Available 24/7 

-Crisis Text Line: Text 741741 from anywhere in the USA |www.crisistextline.org | Available 24/7 

-David Romprey Oregon Warmline: 1-800-698-2392 (available 9 am - 11 pm) 

-Deschutes County Crisis Line: 541-322-7500 ext. 9 or 1-800-875-7364 (available 24/7) 

-If you are hospitalized, please attempt to call us within 12 hours or have the hospital physician call us at 541-382-1395 so we can coordinate your care.

Central Oregon Mental Health Resources:

-Deschutes County Behavioral Health: 541-322-7500

-Crook County Behavioral Health: 541-504-9577 or 541-323-5330

-Jefferson County: 541-475-6575

Confidentiality

Information about your treatment and anything discussed between us will be kept confidential and will not be shared without your written consent. A release of information must be signed before any information can be provided to or requested from other individuals or agencies. The following outlines the few exceptions to this policy:

1. If there is a threat of harm to you or another person,

2. If there is a suspicion of child and/or elder abuse,

3. If we receive a court subpoena to testify or relinquish records,

4. During an emergency when you are unable to give written or verbal consent, but clinical information is needed to make a decision,

5. When required for billing by insurance companies (in this case only the minimum information that is required will be provided and if more is requested, we will inform you first).

For more information regarding confidentiality and disclosure of information, please refer to the Privacy Practices section of your paperwork or visit the "For Patients" section on our website.

Confidentiality and Treatment of Children and Adolescents

If you are age 14 or older, by Oregon law you do not need the permission of your parent/guardian to receive mental health care. However, the spirit of the law is that your parent/guardian be involved as much as possible. In our practice we require the agreement of both you and your parent/guardian consent for all treatment. Either of you have the right to withdraw that consent at any time. You do not have to take medications or accept mental health treatment even if your parent/guardian wants you to. Your privacy is important and will be treated seriously. In general, information will not be disclosed to parents without your permission unless there is good reason to believe you may be in danger of hurting yourself or another person. However, it is important to know that for those under 18, there are exceptions to privacy laws. Parents/guardians do have the right to access your medical records, which may contain sensitive information discussed in sessions with your provider. They will also need to be notified about missed appointments.

Termination of Treatment

As a patient, you are free to terminate care at any time. However, we hope that you will let your provider know if you are considering discontinuing treatment so that we have an opportunity to address any concerns, or so that we may make a plan with you to stop your medications and/or transfer care if you prefer. It is our policy to terminate treatment after a client’s third late cancel or no-show within the span of 12 months. It is very challenging for people to access specialty care. Therefore, if you are not showing up for your appointments (whether late cancels or no shows) or are otherwise not engaged in your treatment, then we feel it is important to free up your provider’s time to help others who are in need. Additionally, if we have not heard from you in six months then we will assume that you have transferred or terminated care and you will be administratively discharged. If treatment is terminated for whatever reason and you wish to reengage at a later date, you can call the office to see what options are available.

Grievance Procedures

If you are dissatisfied for any reason, we encourage you to discuss your concerns with your provider directly to try and resolve the issue. We value your feedback and find that both patient and provider can benefit from discussions of problems. If your concern is unable to be resolved in this manner, you may wish to contact your insurance company, the Oregon State Board of Nursing (OSBN), or the Oregon Medical Board (OMB).  OSBN and OMB oversees the care provided by Nurse Practitioners and Physicians in Oregon.