Minnesota Sex Offender Program 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. Please review it carefully.

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. DHS is required to protect this information by state and federal law.

Why do we ask for this information?

Most of the time we use and release this information for treatment, health care operations, and payment. We also use it:

To tell you apart from other people with the same or similar name
To decide what you are eligible for
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
For court proceedings
To investigate reports of people who may lie about the help they need
To collect money from other agencies, like insurance companies, if they should pay for your care
To collect money from the state or federal government for help we give you
To determine if you are getting any types of public assistance.

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.

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. However, sometimes we will share information as needed and as allowed or required by law. For example, we may share your information with the following types of agencies or persons who need the information to do their jobs:

Employees or volunteers with other state, county, local, federal, collaborative and nonprofit agencies
Researchers, auditors, investigators, and others who do quality of care reviews and studies or commence prosecutions or legal actions related to managing the human services programs
Court officials, county attorney, attorney general, other law enforcement officials, Special Review Board, Supreme Court Appeal Panel, state and federal auditors, , child support officials, and child protection, and fraud investigators
Governmental agencies in other states administering public benefits programs
Social Security Administration
Educational institutions and organizations
Health care providers within our related network, including mental health agencies and drug and alcohol treatment facilities
Health care insurers, health care agencies, managed care organizations and others who pay for your care, guardians, conservators or persons with power of attorney.
Coroners and medical investigators upon death if they investigate your death
Credit bureaus, creditors or collection agencies if you do not pay fees you owe to us for services
Human services offices, including child support enforcement offices
Anyone else the law says we must or can give the information.

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

You may see and copy medical or other private information we may have about you. You may have to pay for the copies.
You may give other people permission to see and have copies of information about you. You may revoke that consent at any time in writing.
You may question if the information we have about you is correct. Send your concerns in writing. Tell us why the information is wrong or not complete. Send your own explanation of the information you do not agree with. We will attach your explanation any time information is shared with another agency. You have the right ask us to share your information with you in a certain way or in a certain place. You must ask us to do this in writing and we will consider your request.
You have the right to ask us to limit or restrict the way that we use or disclose your information, but we are not required to agree to this request.
You have the right to get a record of the people or organizations with whom we have shared your information. You must ask for a copy of this record in writing.
If you do not understand the information, ask your primary therapist or client rights coordinator to explain it to you.
You can ask the Minnesota Department of Human Services for another copy of this notice.

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 on this form 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 complain if you believe your privacy rights have been violated. You cannot be denied service or treated badly because you have made a complaint. If you believe that your medical privacy was violated you may send a written complaint either to the county agency, the organization or to the federal civil rights office at:

U.S. Department of Health and Human Services Office for Civil Rights, Region V
233 N. Michigan Avenue, Suite 240
Chicago, IL 60601
(312) 886-2359 (Voice) or toll free (800) 368-1019 or (866) 282-0659 (312) 353-5693 (TTY/TDD) (312) 886-1807 (Fax)

If you think that the Minnesota Department of Human Services has violated your privacy rights, you may send a written complaint to the U.S. Department of Health and Human Services at the address above or to:

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