Direct Care and Treatment Notice of Privacy Practices

This notice describes how medical and other private information about you may be used and disclosed and how you can get access to this information.

In order to provide proper service to you the Department of Human Services (DHS) collects personal information about you. This information is related to past, present or future physical or mental health services for treatment, healthcare operations, and other services as needed. State and federal law requires DHS to protect this information. DHS has to provide you with this notice of its duty to protect your rights. DHS has to follow this notice, and if the terms of this notice change, you will be notified and given a revised notice if requested.

Why do we ask for this information?

Most of the time we use and release this information for treatment, health care operations, and payment. Treatment is services that DHS provides to you and to make sure the clinical team and others outside DHS provide you the treatment and services you need. Healthcare operations includes audits, making sure we follow the rules of the program, running the program, and reviewing the quality of the services you receive. Payment is billing and collecting for your services.

We also use this information:

To tell you apart from other people with the same or similar name
To help you get medical, mental health, financial or social services
To decide if you can pay for some of your services
To make reports, do research, do audits and evaluate our programs
To investigate you if you give us wrong information on purpose
To collect money from other agencies, like insurance companies and the state or federal government.

Do you have to answer the questions we ask?

You do not have to give us your personal information. We need this information to help you. Without the information, we may not be able to provide appropriate help. If you give us wrong information on purpose, you can be investigated.

With whom may we share information?

Many times we must have written authorization to share your personal information. You may revoke that authorization. However, certain laws require DHS to use or release your information without your authorization. DHS may share your information with the following types of agencies or persons who need the information to do their jobs:

Other human service offices, including child support enforcement offices
Health care providers, including drug and alcohol treatment facilities and mental health centers
Facilities or programs operated by DHS's Direct Care and Treatment Administration
Insurance companies and managed care organizations and others that may pay for your care
Hospitals in a medical emergency and local and state health departments
Internal Revenue Service, Social Security Administration, Minnesota Department of Revenue, Minnesota Department of Veterans Affairs, Minnesota Department of Human Rights, Minnesota Department of Corrections, U.S. Immigration and Customs Enforcement and school districts
State and federal auditors and fraud prevention and control units
Employees and contractors with the Minnesota Department of Human Services, U.S. Department of Health and Human Services, county social services agencies and human services boards
Anybody who inquires about your presence unless directory information is withheld
Local collaborative agencies and agencies that license this program
Law enforcement, attorney general, county attorneys and court officials
Parent, guardian, conservator, legal representative
Various offices of the Ombudsman
The Minnesota Disability Law Center as the state's protection and advocacy organization
American Indian tribes, if your family is in need of human services at a tribal reservation
Child or adult protection investigators and fraud investigators
Coroner or medical examiner
Anyone else to whom the law says we can give the information.

Mental health records

DHS may use or release your information without your authorization for public health activities, health oversight activities, research purposes, health and safety reasons, for certain government functions and when required by law.

Alcohol and drug records

State and federal laws protect the use and release of alcohol and drug records. The federal rule is Title 42, part 2, of the Code of Federal Regulations. Most of the time, DHS must have your written authorization to release your information to an outside agency. This also includes identifying you as a patient in a chemical dependency program. Some examples of when your consent is not required include if there is:

A court order
A medical emergency
Child abuse or neglect.

Breaking the federal privacy rule or state law is a crime. The federal penalty is a fine of not more than $500 for the first offense. For repeat offenses the fine is not more than $5,000. An individual is guilty of a misdemeanor under state law.

Suspected violations of alcohol and drug abuse privacy laws may be reported to the U. S. Attorney, Fourth Judicial District, District of Minnesota, 110 South Fourth St., Room 514, Minneapolis, MN 55401.

What are your rights regarding the information we have about you?

The right to see and get copies of your records. You may ask if DHS has information about you and get copies. You may have to pay for the copies. You may authorize other people to see and get copies of your records.
The right to request restrictions on uses and releases. You can request that DHS restrict use or release of your information. Your request must be in writing. You must tell DHS what information you want to restrict. You must tell for whom you want these restrictions to apply. We will consider your request. We do not have to agree to your request. If DHS agrees to restrict our use or release of your information, the agreement will be put in writing. We cannot agree to limit uses and releases required by law. You can request to end a restriction at any time.
The right to choose how we communicate with you. You have the right to ask us to share information with you in a certain way or in a certain place. For example, you may ask us to send health information to your work address instead of your home address. You must make this request in writing. You do not have to explain why you are making the request. If your request is reasonable, we will grant it.
The right to request amendment. You may question the accuracy of the information we have about you. You may request in writing that DHS correct or add to the record. You must tell us why that information is incorrect or missing. We will either accept or deny your request in writing. If DHS accepts your request, we will correct or add to the record. If DHS denies your request, we will explain why.
The right to find out what releases have been made. You have the right to ask us for a list of releases made after April 14, 2003. This list will not include the releases for treatment, payment or health care operations. This list will not include information provided directly to you. It will not include information released to others with your authorization. You must send a request in writing to our privacy official if you want a copy of this list.
The right to have an explanation of this document. You may ask to have this information explained to you.
Rights of children. If you are under 18, parents may see information about you. Parents may allow others to see information about you. You may ask in writing that information not be shared with your parents. You must tell DHS what information you want withheld and why. If DHS agrees that sharing the information is not in your best interest, the information will not be shared with your parents. If DHS does not agree, the information will be shared with your parents if they ask for it. If your health is put at risk, DHS may share your information. Some treatments do not need your parents’ consent.
Rights of emancipated minors. DHS is permitted or may be required by law to deny a parent’s access to information when a child can legally consent to medical services.

What are our responsibilities?

We must protect the privacy of your medical and private information according to the terms of this notice.
We may not use your information for reasons other than the reasons listed here unless we get special written permission from you. We may not share your information with individuals and agencies other than those listed on this form unless we get special written permission from you.
We must follow the terms of this notice, but we may change our privacy policy in the future. We might do this, for example, because privacy laws change and require us to change our practices. The new notice will be available upon request.

What if you believe your privacy rights have been violated?

You may file a complaint if you believe your privacy rights have been violated. We cannot retaliate against you for filing a complaint. Your complaint must be sent to one of the following:

Minnesota Department of Human Services
Attn: Privacy Official
PO Box 64998
St. Paul, MN 55164-0998

Office of Civil Rights
Medical Privacy, Complaint Division
U.S. Department of Health and Human Services
200 Independence Avenue Southwest, HHH Building Room 509H
Washington, D.C. 20201

You may also contact the Minnesota Department of Human Services if you need more information about this notice.

Direct Care and Treatment
Chief Operating Officer
Minnesota Department of Human Services
PO Box 64979
St. Paul, MN 55164-0979