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Vail Place
NOTICE OF PRIVACY PRACTICES
and Minnesota Government Data Practices Act
THIS NOTICE DESCRIBES HOW PRIVATE INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Introduction
Protecting the privacy and confidentiality of your private health information is very important at Vail Place. Protecting your information and providing this notice to you is mandated by federal and state laws. In order for Vail Place to provide mental health services to you, we must obtain, maintain, use and disclose specific information about you. This notice will explain how and why we gather information and circumstances when we would disclose or release this information to others. We must give you notice of our legal duties and privacy practices concerning your private information, including: We must protect information that we have created or received about your past, present, or future mental health condition, mental health care we provide to you or payment for your mental health care; We must notify you about how we protect your private information; We must explain how, when and why we use or disclose your private information; and We may only use or disclose your private information as we have described in this Notice; and we must abide by the terms of this Notice.
As a Vail Place participant, you have legal rights about your private information and these rights will be explained in this Notice.
How Vail Place Protects your Personal Information
Vail Place is serious about protecting your private information. We have adopted policies and procedures that require our employees and business associates to treat your personal information as private. We limit access to your personal information to those who need it to do their jobs. All employees are trained on procedures regarding confidential information and we consistently monitor our privacy practices. We protect private information of former and current participants in the same way. Vail Place uses and discloses only the minimum amount of necessary information.
Private information that Vail Place gathers.
Vail Place employees will ask you for personal information such as your name, address, date of birth, gender, telephone numbers, social security number, mental health information to verify that you are eligible to receive our services, etc. Any information that can be used to identify you is considered private information.
How and why Vail Place collects your information.
Staff will ask for private information during our intake process to verify your eligibility for Vail Place services. In addition to gathering information at the time of intake, Vail Place may periodically, and at least every three years, need to gather new or updated information to continue providing you with services. The information obtained from others and documentation based on Vail Place services will be contained in your individual file in a locked cabinet. We have developed safeguards to keep your information private. The information in your file will be accessible to staff who need it to provide services to you and to do their jobs.
Do you have to answer the questions we ask?
Generally, the law does not say that you have to give us information. However, if you do not give us some information, we may not be able to provide you with services.
When Does Vail Place Use and Disclose Private Information?
We use and disclose private information for a variety of reasons. We have a limited right to use and/or disclose your information for the purposes of treatment, payment and Vail Place operations. Beyond that, we must have your written authorization or consent unless the law permits or requires us to do so without your authorization or consent. If we disclose your private information to an outside agency in order for them to perform a function on our behalf, we must have an agreement from that agency that it will provide the same degree of privacy protection to your information. The law provides that we are permitted some uses and disclosures without your consent or authorization. The following offers examples of our potential uses/disclosures of your private information.
Uses and Disclosures of Private Information for Purposes of Treatment, Payment and Health Care Operations: Generally, we may use or disclose your private information as follows:
Mental Health Treatment:
We will use your private information to provide and manage your mental health care within Vail Place. We may disclose and use your private information with our affiliates, also known as related organizations. Vail Place affiliates are Hennepin County and State of Minnesota employees located at Vail Place that are a part of our Mental Health Collaborative Team. These employees are part of our work team and they have access to your private information. We will not share your information with other Hennepin County or State of Minnesota employees, unless required by law.
Appointment Reminders and Contacts:
We may use your private information to contact you about your appointments or other services that may be of interest to you.
Payment:
We may use or disclose your private information to bill and collect payment for the treatment and services provided to you (i.e. Medical Assistance or Hennepin County). The information on, or accompanying the bill, may include information that identifies you, your diagnosis and services you received.
Vail Place Operations:
We may use or disclose private information about you in the course of operating Vail Place. We may use your private information to help us train new staff and evaluate the quality of our services. We may also disclose your information to consultants and other business associates who help us with these functions (i.e. billing, computer support and legal services).
Minnesota Informed Consent
For some of the disclosures of private information described above, we are required by Minnesota law to obtain a written Informed Consent from you, unless the disclosure is authorized by law.
Other Uses and Disclosures:
Allowing You an Opportunity to Object
We will always attempt to get your permission before sharing information with family, friends or other responsible people involved in your care. However, there may be circumstances when we may need to communicate with these individuals without your permission to share a limited amount of information about: Payment, if they are involved in paying for your services, monitoring your Medical Assistance status, etc.;
Your location (hospital, shelter, etc.); or In the event of your death. If you object to our use/disclosure in these circumstances, please contact our Privacy Official.
In an Emergency
We may share private information about you in an emergency.
Authorized by Law
We are authorized by law to use or disclose your private information without obtaining a consent or authorization from you in some situations. Listed below are examples of when we would be required to do so:
Required by law: We will disclose your private information when such disclosure is required by federal, state or local laws.
Necessary for public health activities: When reporting to public health authorities the exposure to certain communicable diseases or risks of contracting or spreading a disease.
Related to victims of abuse and neglect: When reporting suspected victims of abuse or neglect.
For health oversight activities: When disclosing mental health information to a state or federal health oversight agency so that they can appropriately monitor the healthcare system.
For judicial and administrative proceedings: When responding to a request for health information contained in a court order.
For law enforcement purposes: When complying with laws that require the reporting of certain types of wounds or injuries.
To a Coroner or Medical Examiner: To allow them to carry out their duties.
To avert a serious threat to health or safety: When disclosing private information that will help prevent a serious threat to the health or safety of you, another person or the general public.
Related to specialized government functions: We may disclose private information about you if it relates to military and veterans' activities or national security.
Related to Workers' Compensation: When reporting health information to entities that provide benefits for work-related injuries and illness.
Related to correctional institutions: And in other custody situations.
Requiring Your Authorization: Other uses and disclosures of your private information not covered in this Notice will be made only with your written authorization. You may revoke an Authorization (in writing) at any time. Your revocation will not affect any uses or disclosures allowed by your authorization while it was in effect.
Individual Rights
You have the following rights about your private information that Vail Place has on record.
1. To Inspect or Obtain a Copy. You may review your file or request a copy or a summary of your private information held by Vail Place that we use to make decisions about you. To obtain a copy of or inspect your file, please speak to the Program Coordinator who will explain the process to you and get you the appropriate form to fill out. We may charge a reasonable fee for copying. There may be situations when we would deny your request. In these situations, we will respond to you in writing, stating why we cannot grant your request and describing your right to request a review of our denial.
2. To Request an Amendment of your Information. If you believe there is a mistake in your file, you may request, in writing, that Vail Place change your private information that we have on file. You must tell us why you think the information is inaccurate or incomplete. Vail Place is not required to agree with a request of this nature; however, if we agree we will document the change on any future release of that information, and we will change your private information, inform you and tell others that need to know about the change. If we deny your request, we will respond to you in writing stating the reasons for the denial. You may file a statement of disagreement with us. You may ask that any future disclosures of the private information under dispute include your requested amendment and our denial to your request.
3. To Request Restrictions of Disclosures. You may request, in writing, restrictions on certain uses and disclosures of your private information. Vail Place does not have to agree to a restriction if it is not feasible for us to do so, and we will notify you of our decision. If we do agree, we will comply with our agreement, unless you are experiencing an emergency situation or we are otherwise required to disclose the information.
4. To Choose How We Contact You. You have the right to ask that we send you information at an alternative address or by an alternate means. We must agree to your request as long as it is reasonably easy for us to do so.
5. To Find Out What Disclosures Have Been Made. You have the right to get a list of certain disclosures we have made of your health information to non-affiliated third parties. We ask that your request be made in writing. You may ask for disclosures made up to six (6) years before the date of your request (not including disclosures made prior to April 14, 2003). We will provide you with one accounting in any 12-month period free of charge.
6. To Receive a Copy of This Notice. You have the right to request and receive a paper copy of this notice at any time. We will make this Notice available in electronic form and post it on our website.
* Updating and Distributing this Notice: Vail Place may update our privacy practices on occasion. If we do, we will post a revised notice at Vail Place, make copies available to you on request and post the revised Notice on our website. We will make the new notice provisions effective for all private information that we maintain. Vail Place will also, from time to time, advise recipients of our privacy polices and practices. Vail Place will abide by the terms of this notice which is in effect as of April 14, 2003.
Further Information
If you received this Notice electronically (from our web site or by e-mail), you are entitled to a paper copy.
If you have any questions about this notice, please call Shelly Zuzek, Vail Place Privacy Official, at 952-938-9622 ext. 31.
Revised: June 3, 2003
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