THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

 As part of providing services to you, we will collect information about your health care. We need this information to provide you with quality services and to comply with certain legal requirements.  This notice applies to all of the records of your care generated at Crow Wing County.  The law requires us to:

How We May Use and Disclose Information About You.  Listed below is a number of reasons or ways in which information about you might be disclosed.  In each category we will explain what we mean and give an example.  NOT EVERY USE OR DISCLOSURE IN A CATEGORY WILL BE LISTED.  The ways we might disclose information include:

For Treatment.  We may disclose information about you to any personnel at Crow Wing County or outside of Crow Wing County who are involved in your care.  For example, your nurse may need to share information about your medications with your psychiatrist or physician.

For Payment.  We may use and disclose information about you so that services may be billed and payment may be collected from you, an insurance company, or a government health program.  We may also tell your health plan about a service you may receive to obtain prior approval or to determine whether your Plan will cover the treatment.

For Health Care Operations.  We may use information about you for quality assessment & improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating practitioner and provider performance, conducting training programs, certification, licensing or credentialing activities.

To provide appointment reminders:  We may disclose limited health information to provide you with appointment reminders such as voicemail/answering machine messages, postcards, or letters.

As Required by Law.  We will disclose information about you when required by federal, state, or local law. 

For Public Health Activities:  We may use and disclose medical information about you for public health activities which may include:  prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions and to notify appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or other crimes. 

 To Avoid a Serious Threat to Health or Safety.  We may use or disclose information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Military and Veterans.  If you are a member of the armed forces, we may release information about you as required by military command authorities.

Workers' Compensation.  We may release information about you for workers' compensation or similar programs.

Health Oversight Activities.  We may disclose information to a health oversight agency for activities authorized by law.  Examples are government audits, investigations, inspections and licensure.

Lawsuits and Disputes.  If you are involved in a lawsuit or dispute, or if there is a lawsuit or dispute concerning your services, we may disclose information about you in response to a court or administrative order.  We may also disclose information about you in response to a subpoena, discovery request, or other lawful process from someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement.  In certain situations, we may release information about you to law enforcement officials.  For example, we might release information about you to identify or locate a missing person; about a death that may be the result of criminal conduct; or in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description of location of the person believed to have committed the crime.

Coroners, Medical Examiners and Funeral Directors.  We may release information to a coroner or medical examiner to identify a deceased person or determinate a cause of death.  We may release information to funeral directors as necessary to help them carry out their duties. 

National Security and Intelligence, Protective Services for the President and Others.  We may release information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

Correctional Programs.  If you are an inmate or in the custody of a law enforcement officer, we may release information about you to the correctional institution or law enforcement official, for example, to provide you with health care, to protect your health and safety or the health and safety of others.

YOUR RIGHTS REGARDING INFORMATION ABOUT YOU

You have the following rights:

To Inspect and Copy Your Crow Wing County Medical Records  Usually, this includes medical and billing records, but may exclude psychotherapy notes.  To inspect and copy information in your record, you must submit your request in writing to your nurse or State Director or HIPAA Privacy Officer.  We may charge a fee for the costs of copying, mailing or other costs related to your request.

In very limited circumstances, we may deny your request.  If we deny your request, you may ask that the denial be reviewed.  Another licensed health care professional of Crow Wing County's choice will review your request for review.

To Amend Your Records.  If the information we have about you is incorrect or incomplete, you may make a written request to the HIPAA Privacy Officer to amend the information.  You must include a reason that supports your request.

We may deny your request if it is not in writing or does not include a reason to support the request.  We may also deny your request if you ask us to amend information that:

If you disagree with the denial, you may submit a statement of disagreement.  If you request an amendment to your record, we will include your request in the record, whether the amendment is accepted or not.

To Receive an Accounting of Disclosures.  We will keep a log of disclosures made on or after April 14, 2003, other than disclosures for treatment, billing or health care operations.  You have the right to request the list of disclosures.  You must submit a written request to the HIPAA Privacy Officer.  The request may not cover more than a six-year period.

To Request Restrictions.  You may request a restriction on the disclosure of information about you for treatment, payment or health care operations.  Your request must be in writing and made to the HIPAA Privacy Officer.  Your request must tell us 1) what information you want to limit; 2) whether you want to limit our use, our disclosure or both; and 3) to whom you want the limit to apply.  For example, you could ask that we not use or disclose information to a certain person about services you've received.

We do not have to agree to your request.  If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

To Request Alternative Ways to Communicate.  You may request that we communicate with you about your services in a certain way or at a certain location.  For example you can ask that we contact you only at work, or only by mail.  Your request must be in writing, must tell us how you would like us to communicate with you, and it must be and sent to the HIPAA Privacy Officer.  We will accommodate all reasonable requests.

To Receive a Paper Copy or Electronic Copy of this Notice.  You have the right to receive a paper copy or an electronic copy of this notice.  You may request either a paper or an electronic notice from the HIPAA Privacy Officer.

ADDITIONAL RIGHTS UNDER STATE LAW.  State privacy laws may provide additional privacy protections.  Any such protections will be listed in our Tennessen Notice.

CHANGES TO THIS NOTICE.  We may change this notice in the future.  We can make the revised or changed notice effect for information we already have about you as well as any information we have in the future.

COMPLAINTS.  If you believe your privacy rights have been violated, you may file a complaint.  Write to Crow Wing County or the U.S. Department of Health and Human Services, at the address below.  All complaints must be in writing.

We will not retaliate against you for filing a complaint.

Privacy Officer
Crow Wing County
County Administrator's Office
326 Laurel Street
Brainerd, MN  56401
Phone:  218-824-1055

Office of Civil Rights
Medical Privacy, Complaint Division
U.S. Department of Health and Human Services
200 Independence Avenue, SW, HHH building, Room 509H
Washington, D.C  20201
Phone:  866-627-7748