Notice of Privacy Practices

You can ask to see or get an electronic or paper copy of your health record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary within a reasonable time.

If you are asking in order to review your current care, we may not charge you a fee. For copies of past records, or for certain appeals, we may charge specified fees.[Minn. Stat. 144.292 subd. 6]

We will not withhold your records because you are unable to pay.

You can ask us to correct information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.

You can ask us to contact you a specific way — for example, at a particular phone number, or by mail to a different address. We will say yes to all reasonable requests.

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and may say no if it would affect your care.

If you pay for a service out of pocket in full, you can ask us not to share that information with your health plan for payment or operations. We will say yes unless a law requires us to share it.

Minnesota law already requires your consent before we disclose information for treatment, payment, or operations.[Minn. Stat. 144.293 subd. 2]

You can ask for an accounting of the times we shared your health information in the six years before the date you ask, who we shared it with, and why. We will include all disclosures except those for treatment, payment, and operations, and certain others such as any you asked us to make. One accounting a year is free; we may charge a reasonable, cost-based fee for another within 12 months.

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. We will provide one promptly.

If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will confirm that the person has this authority before we act.

You can complain by contacting us using the details at the bottom of this notice.

You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by writing to 200 Independence Avenue SW, Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints.

We will not retaliate against you for filing a complaint.

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference — for example if you are unconscious — we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

Minnesota law also requires your consent for most other sharing.[Minn. Stat. 144.293 subd. 2]

We can use your health information and share it with other professionals treating you only if we have your consent. We can release your records to providers outside our organization without consent only in an emergency where you are unable to consent. We may share your information with a provider within our organization.[Minn. Stat. 144.293 subd. 2 and 5]

We can use and share your information to run our programs, improve your care, and contact you when necessary. We must obtain your consent before we release your records to other providers for their own operations.[Minn. Stat. 144.293 subd. 2 and 5]

We can use and share your health information to bill and get payment from health plans or other payers, with your consent.[Minn. Stat. 144.293 subd. 2]

• Preventing disease
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or exploitation of a vulnerable adult or a child, as our staff are required by law to do
• Preventing or reducing a serious threat to anyone's health or safety

We can use or share your information for health research if you do not object.[Minn. Stat. 144.295 subd. 1]

We will share information about you if state or federal law requires it, including with the U.S. Department of Health and Human Services if it wants to see that we are complying with federal privacy law.[Minn. Stat. 144.293 subd. 2]

We can share health information with a coroner or medical examiner when a person dies. We need consent to share information with a funeral director.[Minn. Stat. 390.11 subd. 7(a)]

• For workers' compensation claims
• For law enforcement purposes, with your consent unless required by law[Minn. Stat. 144.293 subd. 2]
• With health oversight agencies for activities authorized by law
• For special government functions such as military and national security, with your consent unless required by law

We can share health information in response to a court or administrative order, or in response to a subpoena.[Minn. Stat. 144.293 subd. 2]

We will never share substance use disorder treatment records without your written permission, except as those laws allow. These records receive protection beyond ordinary health information.[42 CFR Part 2; Minn. Stat. 254A.09]