Telehealth Program

Firefly is committed to continued health and care for the community. To maintain care during periods of potential physical office closures our providers can offer to conduct individual sessions, family sessions and assessments via telehealth services. “Telehealth” is the delivery of health services when the provider and client are not in the same physical site through the use of technology. Telehealth services includes video sessions through software on a computer or tablet, or phone sessions. This may require, in some cases, for you to download a software interface to enable telehealth services (e.g. Zoom, RingCentral, etc.). Our administrative team can assist anyone having difficulty with this technology over the phone to help connect you with your provider. 

• There is no way to guarantee technological platforms are 100% secure. There is the possibility of a security breach on any technological platform which would affect the privacy and confidentiality of the client’s protected health information.

• Since the client will be engaging in sessions in their own home, Firefly cannot guarantee the same level of privacy that takes place when a session is held in our clinic. 

• Clients and caregivers for child clients are responsible for ensuring their telehealth session is held in a private room with headphones to limit the possibility of others overhearing confidential information.

• Clients and families who engage in expressive therapies or specialty therapies (play therapy, therapeutic art, sandtray therapy, music, movement, EMDR, Animal Assisted Therapies) your therapy sessions may look vastly different from in-person sessions. Your clinician will utilize creativity, their skills and abilities to ensure progress toward therapeutic goals are maintained. This may require clients to make use of expressive supplies that may be already present in the home. Clinicians will work collaboratively with clients and caregivers during sessions to determine if this is necessary, or to shift therapeutic modalities in a manner that is supportive of goal attainment and therapeutic progress. Clients are not expected to purchase supplies for expressive telehealth sessions. 

• Current information from insurance companies indicate coverage for telehealth service delivery in response to COVID-19. Clients are responsible for knowing their benefits and understanding that fees for mental health services provided which an insurance company elects to not cover will be the client’s responsibility. 

• I understand and consent to receiving telehealth services that will contain personal identifying information and protected health information.

• I understand my clinician will be at a different physical location than I am.

• I understand I have the right to withdraw my consent to receiving telehealth services at any time without any affect to my right to future care and treatment.

• I have been informed of and accept the potential risks to receiving telehealth services including the potential for a breach in privacy, confidentiality and protected health information.

• I understand the same laws that govern privacy and confidentiality of medical information also govern telehealth and no information obtained by Firefly or it’s clinicians will be disclosed to any other entity without your written consent or as may be allowed by law.

• I have the right to ask my provider and Firefly management questions relative to your specific telehealth encounters, security practices, technical specifications, and other risks. 

I elect telehealth coverage through the following methods and certify: 

• I have read or had read and/or had this form explained to me.

• I fully understand the contents including risks and benefits of telehealth services 

• I have the right to ask questions about telehealth processes and practices and withdraw consent for telehealth services at any time.