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Hennepin County Medical Center
NOTICE OF PRIVACY PRACTICES
Effective April 14, 2003
THIS NOTICE DECRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE
REVIEW IT CAREFULLY.
In this Notice, the words "HCMC," "we,"
"us," and "our" mean any or all of the following:
- Hennepin County Medical Center, a facility of
Hennepin County, Minnesota
- Medical Staff of the Hennepin County Medical Center
- The following community clinics and their medical staffs:
Family Medical Center, Hennepin Care
South, and Hennepin Care North
- Other independent providers or contractors who
participate in our organized health care arrangement
“You” means anyone who receives health
care services or products from us. “Health information” means
any information that we create or receive relating to your health or health
care payment, whether oral, written, or recorded in any form.
Purpose of this
Notice
This Notice describes our privacy practices
and how we protect the confidentiality of your health information. We
are required by law to maintain the privacy of your health information
and to give you this Notice about our legal duties and privacy practices.
We must follow our Notice that is currently in effect. We reserve the
right to change the terms of this Notice. Any changed Notice will be effective
for health information we already have about you, as well as for new information.
The Notice will contain an effective date on the first page, in the top
right-hand corner. We will post the current Notice on our Web site, www.HCMC.org
and in a prominent place at each of our locations. In addition, we will
make a paper copy of this Notice available at each of our locations.
Uses and Disclosures of Your Health Information
We may use and disclose your health information for the following purposes:
Treatment: We
will use and disclose your health information to provide, coordinate,
or manage your health care and any related services or products. For example,
we may disclose information about you to doctors, nurses, social workers,
chaplains, other clinicians and professionals in training to coordinate
and provide you with things such as prescriptions, lab work, x-rays
or referrals.
Payment: We may use and disclose your health
information to obtain payment for your health care services. For example,
we may tell your health plan or medical insurer about treatment you have
received or are going to receive in order to obtain payment or determine
whether your insurance plan will cover it.
Health Care Operations: We may use and disclose
information about you to support and improve our health care services
to you. These activities may include, but are not limited to, quality
assessment activities, licensing, marketing and fundraising, business
planning and management activities.
Some examples include:
We may contact you to remind you of your appointment
or to reschedule an appointment.
We may use or disclose your information to assess the
care and outcomes of your care and others like it. These results will
then be used to continually improve the quality of care for all the patients
we serve.
We may send you satisfaction surveys to assess your
satisfaction with our services.
We may on occasion disclose information about you to
a business associate to conduct fundraising activities on our behalf. We
do not sell your information to anyone.If we contact you for fundraising
and you do not wish to be contacted in the future, you will be given the
opportunity to have your name removed from the solicitation list.
We may send you information about health-related services
or benefits.
We will disclose your health information to third-party “business associates”
that perform various activities such as billing or accreditation on our
behalf. Our business associates’ access to your health information
will be limited, and we require our business associates to safeguard your
information just as we do.
Research: We will not use or disclose any health
information that identifies you or can be used to identify you for any research
purposes without either obtaining your prior written authorization or following
state law procedures for attempting to notify you of our research request.
You will be asked to sign additional authorizations if you wish to participate
in clinical research trials involving treatment.
Hospital Directory: If you are admitted to a hospital room or the
Emergency Department, we may include certain limited information about you
in the hospital directory. This information may include your name, location
in the hospital, and your general condition (e.g., fair, stable, etc.).
This directory information may be released to people who ask for you by
name. Members of the clergy may request your religious affiliation. If you
do not want your name included in the hospital directory or if you want
the information restricted, you will be given the opportunity to request
this when you register.
Individuals Involved in Your Care: If you agree, we may release certain
health information about you to a friend or family member involved in your
care or payment related to your care. If you are unable to agree due to
your incapacity or emergency circumstances, we may disclose your health
information as necessary if we determine that it is in your best interest,
based on our professional judgment. We may disclose information about you
to an organization assisting in a disaster relief effort so that your family
can be notified about your condition, status and location.
Workers’ Compensation: We may disclose your health information
as authorized to comply with workers’ compensation laws and other similar
legally-established programs.
Other Uses and Disclosures Without Your Authorization
In addition to the above-listed purposes, we may need to use or disclose
your health information without your authorization for the following purposes:
to the government for public health activities as permitted or required
by law to report disease statistics, births and deaths, child or vulnerable
adult abuse or neglect, domestic violence, reactions to medications, problems
with products, and disease exposures;
to a health oversight agency for audits, investigations, inspections,
accreditation and licensure activities;
to prevent a serious and imminent threat to the health or safety or
a person or the public, or to help the police apprehend an individual
involved in a violent crime;
to organ procurement organizations to facilitate organ or tissue donation
and transplantation;
to a law enforcement official in response to a court order to identify
or locate a suspect, witness, or missing person;
to identify a victim of crime if, under certain limited circumstances,
we are unable to obtain the victim’s agreement; or in emergency circumstances
to report the location and perpetrator of a crime;
to a court or party in litigation in response to a valid court or administrative
order;
to a coroner or funeral director as permitted or required by law to
identify a deceased person, determine the cause of death, or otherwise
as necessary to carry out their duties;
if you are an inmate of a correctional institution, to the institution
as necessary for your health and the health and safety of other individuals;
for military, national security or lawful intelligence activities; or
otherwise as permitted or required by law.
Other uses and disclosures of your health information will be made only
with your written authorization. You may revoke that authorization in
writing at any time, but we cannot take back any disclosures we have already
made in reliance on your authorization.
Your Rights Regarding Your Health Information
Access to Your Health Information: With some exceptions, you have
the right to inspect and request a copy of your medical records, billing
records and records used to make decisions about your care or services
if those records include health information about you and are maintained
or used by us. If you wish to access to your health information, please
write to us and we will respond to your request and tell you when and
where you can review your health information in our possession within
our normal business hours. If you would like a copy of your health information,
we may charge a reasonable administrative fee for copying your health
information to the extent permitted by applicable law. If we deny your
request for review or copy of your health information, we will explain
the reason in writing. If your request to review or copy your medical
information is denied, you can request in writing that we ask another
licensed health care professional within our organization to review your
request and the denial. The person conducting the second review will not
be the person who denied your original request.
Right to Amend Your Health Information: You have the right to request
amendments to your health information if you feel that records are incorrect
or incomplete. If you wish to have your health information corrected or
updated, please write to us and tell us what you want changed and why.
We will respond to you in writing, either accepting or denying your request.
If we deny your request, we will explain why.
Right to Receive an Accounting of Disclosures of Your Health Information:
You have the right to request an accounting of certain disclosures that
we make of your health information. You can request an accounting by writing
to us. Certain disclosures, such as those made with your consent and/or
for treatment, payment, or health care operations, will not be included
in the accounting we provide to you. Your request must state a time period,
which may not be longer than six years and may not include dates before
April 14, 2003. The first accounting you request within a 12-month period
will be free. For additional accountings, we may charge you for the costs
of providing the accounting. We will notify you in advance of the cost
involved.
Right to Request Restrictions: You have the right to request restrictions
on how we use and disclose your health information for our treatment,
payment, and health care operations. We are not required 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 a restriction,
you must make your request in writing to:
Information Access Manager
Health Information Management
Mail Code 820
Hennepin County Medical Center
701 Park Avenue
Minneapolis, MN 55415-1676
612-873-3179
In your request, you must tell us (1) what information you want to limit;
(2) whether and how you want to limit our use, disclosure or both; and
(3) to whom you want the limits to apply.
Right to Confidential Communications: You have the right to request
that we provide your health information to you in a confidential manner.
For example, you may request that we send your health information by an
alternate means (e.g., sending by a sealed envelope, rather than a post
card) or to an alternate address (e.g., calling you at a different telephone
number, or sending a letter to you at your office address rather than
your home address). We will attempt to accommodate any reasonable requests,
unless they are administratively too burdensome, or prohibited by law.
Right to Complain: If you have any questions about this Notice,
believe that your privacy rights have been violated, or wish to file a
complaint, please direct your inquiries to:
Patient Representative Office
Hennepin County Medical Center
701 Park Avenue South
Minneapolis, MN 55415-1676
612-873-8585
You may also complete a complaint form while in any of our clinics and
it will be forwarded
to the
Privacy Officer for resolution. You also have the right to directly complain
to the Secretary of the United States Department of Health and Human Service.
If you wish to do so, please write to the Office for Civil rights, U.S.
Department of Health and Human Services, 233 No. Michigan Ave., Suite
240, Chicago, IL 60601. We will not retaliate against you for filing a
complaint against us.
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