Ramsey County Notice of Privacy Practices

Effective September 23, 2013

THIS NOTICE DESCRIBES HOW PRIVATE INFORMATION, INCLUDING HEALTH INFORMATION, ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

YOUR PRIVACY RIGHTS

You have privacy rights under the Minnesota Government Data Practices Act, the federal Health Insurance Portability and Accountability Act (HIPAA) and other state and federal laws, rules and regulations. These laws protect your privacy but also allow us to give information about you to others if the law requires or permits it. We may tell you before we release your information. These laws require us to keep your information private and to give you notice of our legal duties and practices to protect private information. We must follow the terms we have agreed to in this notice. We reserve the right to change the terms of this notice and apply any changes to all present and future information that we collect about you, except as prohibited by the Minnesota Government Data Practices Act.

This Notice of Privacy Practices describes how we may use or disclose your protected information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected information. You have the right to approve or refuse the release of specific information except when the release is required or authorized by law or regulation.

ACKNOWLEDGMENT OF RECEIPT OF THIS NOTICE

You will be asked to provide a signed acknowledgment of receipt of this notice. Our intent is to make you aware of the possible uses and disclosures of your protected information and your privacy rights. The delivery of services will in no way be conditioned upon your signed acknowledgment. If you decline to provide a signed acknowledgment, we will continue to provide you services, and will use and disclose your protected information for treatment, payment, and operations when necessary.

RAMSEY COUNTY POLICY STATEMENT

This notice describes Ramsey County practices regarding your protected information. Ramsey County provides a number of health and human services programs for residents of Ramsey County. The County requests information about you to help us provide services. We know that information about you is private and the County will protect the privacy of the information. If we collect private information about you we may use it only for the purposes that we have listed in this notice unless you give us permission to share it for other purposes.

WHY DO WE ASK FOR PRIVATE INFORMATION?

We may ask you for information so we can:

  • tell you from other persons by the same name or similar name,
  • decide if you can receive services from us,
  • decide on what type or how much of the services you can get,
  • help you get medical, mental health, financial or social services,
  • decide if you can pay for any help you get,
  • make reports, do research, audit, and evaluate our programs,
  • investigate reports of people who may lie about the help they need,
  • decide about out-of-home care and in-home care for you or your children,
  • collect money from other agencies if they should pay for your care, such as insurance companies,
  • decide if you or your family needs protective services, and/or
  • collect money from the state or federal government for help we give you.

Do You Have To Answer The Questions We Ask?

Generally, the law does not say you have to give us this information. Federal Law requires that you give us your Social Security Number if you want financial help or help with child support enforcement.

Immigration Information

Immigration information given as part of an application for services is private. Immigrant information will only be used for eligibility determinations and program administration. If you are applying only for emergency services, you do not need to give us information about your immigration status. Non-immigrant or undocumented people who are pregnant, under age 18, age 65 and older, or people with disabilities, may also be eligible without providing immigration information.

What Will Happen If You Do Not Answer The Questions We Ask?

We need information about you to tell if you can get help from any program. Without some information, we may not be able to help you. It may be that we can help you but the help may be late or not enough. Purposely giving us wrong information may result in an investigation and charging you with fraud.

OUR DUTIES TO YOU REGARDING PROTECTED INFORMATION

“Protected information” is individually identifiable information. This information includes demographics: for example, age, address, e-mail address, and relates to your past, present, or future physical health, mental health, or condition and related health or human service care. The County is required by law to do the following:

  • make sure that your protected information is kept private,
  • give you this notice of our legal duties and privacy practices related to the use and disclosure of your protected information,
  • notify you if you are affected by a breach, as defined by HIPAA, of unsecured protected health information,
  • follow the terms of the notice currently in effect, and
  • communicate any changes in the notice to you.

HOW WE MAY USE OR DISCLOSE YOUR PROTECTED INFORMATION

Following are examples of permitted uses and disclosures of your protected information. These examples are not exhaustive.

Required Uses and Disclosures

By law, we must disclose your information to you unless it has been determined by a competent medical authority that it would be harmful to you. We must also disclose information to the Minnesota Department of Health and Human Services and the Secretary of the Department of Health and Human Services (DHHS) for investigations or determinations of our compliance with laws on the protection of your information.

Treatment/Services

We may use and disclose your protected information to provide, coordinate, or manage your care and related services provided by Ramsey County. This includes the coordination or management of your care with a third party. We may disclose your protected information from time-to-time to another county employee who, at the request of your physician, social worker, nurse, therapist, probation officer, or financial worker, becomes involved in your care by providing assistance with your diagnosis or treatment.

In emergencies, we will use and disclose your protected information to provide the treatment you require.

Payment

Your protected information will be used, as needed, to obtain payment for your services. This may include certain activities the County might undertake before it approves or pays for the services recommended for you such as determining eligibility or coverage for benefits, and undertaking utilization review activities.

Health Care/ Human Services Operations (see addendum if applicable)

We may use or disclose, as needed, your protected information to support the daily activities related to health and human services care. These activities include, but are not limited to:

  • eligibility determination,
  • providing you with information about treatment alternatives or other related benefits and services that might interest you,
  • quality assessment activities,
  • investigations,
  • oversight or staff performance reviews,
  • training of students,
  • licensing,
  • financial management of the organization,
  • conducting or arranging for other care related activities, and
  • to remind you of your appointment.

We will share your protected information with third-party "business associates" who perform various activities (for example; billing, transcription services) for the county. The business associates are also required to protect your information.

Required By Law

We may use or disclose your protected information if law or regulation requires the use or disclosure.

Public Health

We may disclose your protected information to a public health authority who is permitted by law to collect or receive the information. The disclosure may be necessary to do the following:

  • prevent or control disease, injury, or disability,
  • report births and deaths,
  • report child abuse or neglect,
  • report reactions to medications or problems with products,
  • notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition, or
  • notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

Communicable Diseases

We may disclose your protected information, if authorized by law, to a person who might have been exposed to a communicable disease or might otherwise be at risk of contracting or spreading the disease or condition.

Oversight

We may disclose protected information to an oversight agency for activities authorized by law, such as audits, investigations, and inspections. These oversight agencies might include government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.

Legal Proceedings

We may disclose protected information during any judicial or administrative proceeding, in response to a court order or administrative tribunal (if such a disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request, or other lawful process.

Law Enforcement

We may disclose protected information for law enforcement purposes, including the following:

  • responses to legal proceedings,
  • information requests for identification and location,
  • circumstances pertaining to victims of a crime,
  • deaths suspected from criminal conduct,
  • crimes occurring at a Ramsey County site, and
  • medical emergencies believed to result from criminal conduct.

Coroners, Funeral Directors, and Organ Donations

We may disclose protected information to coroners or medical examiners for identification to determine the cause of death or for the performance of other duties authorized by law.

We may also disclose protected information to funeral directors as authorized by law. Protected information may be used and disclosed for cadaver organs, eye, or tissue donations.

Research

We may disclose your protected information to researchers/evaluators when authorized by law.

Criminal Activity

Under applicable federal and state laws, we may disclose your protected information if we believe that its use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Workers’ Compensation

We may disclose your protected information to comply with workers’ compensation laws and other similar legally established programs.

Inmates

We may use or disclose your protected information if you are an inmate of a correctional facility and Ramsey County created or received your protected information while providing care to you. This disclosure would be necessary (1) for the institution to provide you with health care, (2) for your health and safety or the health and safety of others, or (3) for the safety and security of the correctional institution.

USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

Unless a legal exception applies, we need your written authorization to use or disclose your protected health information for:

most uses and disclosures of psychotherapy notes;
uses and disclosures of protected health information for marketing; and
the sale of protected health information

For marketing and the sale of protected information, the authorization must state that the disclosure will result in remuneration (payment) to Ramsey County. For all other uses and disclosures of protected health information that are not described or referenced somewhere else in this notice, we also need your written authorization. You may cancel your authorization at any time in writing. However, Ramsey County cannot take back any information already used or disclosed before you cancel.

PARENTAL ACCESS

If you are under 18, parents may see information about you and allow others to see this information, unless you have asked that this information not be shared with your parents or the information involved medical treatment for which parental consent was not required. You must make this request in writing and say what information you want withheld and why. If the agency agrees that sharing the information is not in your best interest, the information will not be shared with your parents. If the agency does not agree, the information will be shared with your parents if they ask for it. When parental consent for medical treatment is not required, information will not be shown to parents unless the health care provider believes failing to share the information would jeopardize your health.

YOUR RIGHTS REGARDING YOUR PRIVATE INFORMATION

You may exercise the following rights by submitting a written request to Ramsey County. Please be aware that Ramsey County might deny your request; however, you may seek a review of the denial.

Right To Inspect And Copy

You may inspect and obtain a copy of your protected information that is contained in a "designated record set" for as long as we maintain the protected information. A designated record set contains health care, mental health, social services or payment records and any other records that Ramsey County uses for making decisions about you.

This right does not include inspection and copying of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected information that is subject to law that prohibits access to protected information.

Right To Request Restrictions

You may ask us not to use or disclose any part of your protected health information for treatment, payment, or health care operations. In your written request, you must tell us:

  • what health information you want restricted,
  • whether you want to restrict our use, disclosure, or both,
  • to whom you want the restriction to apply, for example, disclosures to your spouse, and
  • an expiration date.

If Ramsey County believes that the restriction is not in the best interest of either party, or that Ramsey County cannot reasonably accommodate the request, the county is not required to agree. If the restriction is mutually agreed upon, we will not use or disclose your protected health information in violation of that restriction, unless it is needed to provide emergency treatment. You may revoke a previously agreed upon restriction, at any time, in writing.

Right To Request Alternate Communications

You may request that we communicate with you using alternative means or at an alternative location. We will not ask you the reason for your request. We will accommodate reasonable requests, when possible.

Right To Request Amendment

If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your protected information as long as we maintain this information. While we will accept requests for amendment, we are not required to agree to the amendment. You have additional rights to appeal if the county does not agree to your amendment.

Right To An Accounting Of Disclosures

You may request that we provide you with an accounting of the disclosures we have made of your protected health information. This right applies to disclosures made for purposes other than services, treatment, payment or operations as described in this Notice of Privacy Practices. The disclosure must have been made after April 14, 2003, and no more than 6 years prior to the date of request. This right excludes disclosures made to you or others you authorized to receive information regarding your care.

RIGHT TO OBTAIN A COPY OF THIS NOTICE

You may obtain a paper copy of this notice from Ramsey County or by requesting a copy from your Social Worker/Case Manager, Financial Worker, Health Care Professional or Probation Officer.

COMPLAINTS

If you believe that your privacy rights have been violated, you may file a complaint. Please send your complaint in writing, to Ramsey County or the U.S. Department of Health and Human Services at this link or the address below. We cannot deny you service or treat you badly because you filed a complaint against us.

Contact Information

Ramsey County
County Courthouse and City Hall
15 W. Kellogg Blvd., Room 250
Saint Paul, MN 55102
651-266-8008

Region V, Office for Civil Rights
US Department of Health and Human Services
233 N. Michigan Ave., Suite 240
Chicago, IL 60601
312-886-2359
FAX 312-886-1807
TDD 312-353-569