Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Our health information responsibilities
- We have a duty to protect the privacy of your health information and to give you this Notice.
- We have a duty to abide by our current Notice of Privacy Practices.
"Health information" means information about your past or present health status, condition, diagnosis, treatment, prognosis, or payment for health care. (There are some exceptions.)
Who will follow this notice
This notice describes our facility’s practices and that of:
- all departments and units of the facility
- all residents, medical students and other trainees affiliated with Allina Hospitals & Clinics
- all volunteers who may assist you while you are in the facility
- all employees, staff and other facility workers
Your health information rights
Restrictions on use or disclosure. This Notice describes some restrictions on how we can use and disclose your health information. You may ask us for additional restrictions on how we use or to whom we disclose the information. You need to make such a request in writing. We are not required to agree to your request. If we do agree, we will follow the restriction except:
- in an emergency where the information is needed for your treatment
- if you give us written permission to use or disclose your information
- if you decide or we decide to end the restriction
- as otherwise required by law
If you restrict us from providing information to your insurer, you also need to explain how you will pay for your treatments.
Alternative communication. Normally, we will communicate with you at the address and phone number you give us. You may ask us to communicate with you in other ways or at another location. We will agree to your request if it is reasonable.
Patient access. You may request to look at or get copies of your health information. You need to make your request in writing. If you ask for copies in a format other than paper copies, we will give you that other format if practical.
If you ask for copies, we may charge photocopying fees and costs of retrieval, the cost of making copies of x-rays or other images, and postage if the copies are mailed. If you ask for another format we can provide, we will charge a reasonable fee based on our costs.
If your request is denied, we will send the denial in writing. This will include the reason and describe any rights you may have to a review of the denial.
Amendment. You may ask us to change certain health information. You need to make such a request in writing. You must explain why the information should be changed. If we accept your change, we will try to inform prior recipients (including people you list in writing) of the change. We will include the changes in future releases of your health information. If your request is denied, we will send the denial in writing. This denial will include the reason and describe any steps you may take in response.
Disclosure list. You may receive a list of disclosures of your health information – with some exceptions – made by us or our business associates. The list does not include:
- disclosures made for treatment, payment or health care operations (this term is defined in the next section)
- disclosures made before April 14, 2003
- other disclosures as allowed by law
You need to make your request in writing. If you ask for a list more than once in a 12-month period, we may charge you a fee for each extra list. You may withdraw or change your request to reduce or eliminate the charge.
Paper copy of notice. You may receive a paper copy of our current Notice of Privacy Practices.
How to exercise these rights. Please contact us at the appropriate site listed on the previous page to use any of these rights or receive more information about any related fees.
Uses and disclosures of health information
To provide you the best quality care, we have certain needs to use and disclose health information. We safeguard your health information whenever it is used or disclosed. We make all uses and disclosures according to our privacy policies and the law. We may use and disclose your health information as follows:
Treatment, payment and health care operations. We may use and disclose your health information for:
- treatment (includes working with another provider)
- payment (such as billing for services provided)
- our health care operations
These are non-treatment and nonpayment activities that let us run our business or provide services. Examples of these disclosures you have authorized include quality assessment and improvement, reviewing the competence or qualifications of health professionals, and conducting training programs.
Medical emergency. We may use or disclose your health information to help you in a medical emergency.
Appointment reminders and treatment alternatives. We may send you appointment reminders, or tell you about treatments and health-related benefits or services that you may find helpful.
Patient information directory. We may disclose the following information to people who ask about you by name:
- location in the facility
- general condition
- religious affiliation (given only to clergy)
You may choose not to have us disclose some or all of this information. For example, if you do not want us to tell people your location, we will agree to your instructions. (In some cases, such as medical emergencies, we may not get your instructions until you can communicate with us.)
People involved in your care. When you allow us to, we may disclose limited health information to people involved in your care (for example, a family member or emergency contact) or to help plan your care. If you tell us you do not want this information given out, it will not be shared. If appropriate, we may allow another person to pick up your prescriptions, medical supplies or X-rays.
Philanthropy. We may contact you or have our foundations contact you about fundraising programs and events to sustain our mission. We will only use or disclose your basic demographic information (such as name and address) and the dates you were treated by us. You may receive letters or other publications asking you to consider making a tax-deductible contribution to Allina to support our foundations and their missions. We do not sell or rent patients' names or addresses to any organization outside of Allina.
Research. We may use or share your health information for research purposes as allowed by law or if you have given permission.
Death; organ donation. We may disclose certain health information about a deceased person to the next of kin. We may also disclose this information to a funeral director, coroner, medical examiner, law enforcement official or organ donation agency.
Health care workplace medical surveillance/injury/illness. If your employer is a health care provider, we may share health information required by state or federal law:
- for workplace medical surveillance activities, or
- about work-related illness or injury
Law enforcement. We may disclose certain health information to law enforcement. This could be:
- about a missing child
- when there may have been a crime at the facility, or
- when there is a serious threat to the health or safety of another person or people
Correctional facility. We may disclose the health information of an inmate or other person in custody to law enforcement or a correctional institution.
Abuse, neglect or threat. We may disclose health information to the proper authorities about possible abuse or neglect of a child or a vulnerable adult. If there is a serious threat to a person's health or safety, we may disclose information to the person who is threatened or to law enforcement.
Food and Drug Administration (FDA) regulation. We may disclose health information to entities regulated by the FDA to measure the quality, safety and effectiveness of their products.
Military authorities/national security. We may disclose health information to authorized people from the U.S. military, foreign military and U.S. national security or protective services.
Public health risks. We may disclose health information about you for public health purposes, such as:
- reporting and controlling disease (such as cancer or tuberculosis), injury or disability
- reporting vital events such as births and deaths
- reporting adverse events or surveillance related to food, medications or problems with health products
- notifying persons of recalls, repairs or replacements of products they may be using, or
- notifying a person who may have been exposed to a disease or may be at risk for catching or spreading a disease or condition
Health oversight activities. We may disclose health information to government, licensing, auditing and accrediting agencies for actions allowed or required by law.
Required by other laws. We may use or disclose health information as required by other laws. For example:
- We may disclose health information to the U.S. Department of Health and Human Services during an investigation.
- We may disclose health information under workers’ compensation or similar laws.
- We may disclose health information:
- to social services and other agencies or people allowed to receive information about certain injuries or health conditions for social service, health or law enforcement reasons
- about an unemancipated minor or a person who has a legal guardian or conservator regarding a pending abortion
- about an emancipated minor or a minor receiving confidential services to prevent a serious threat to the health of the minor
Legal process. We may disclose health information in response to a state or federal court order, legal orders, subpoenas or other legal documents.
Health records under state law. Release of health records (such as medical charts or X-rays) by licensed Minnesota providers usually requires the signed permission of a patient or the patient's legal representative. Exceptions include: medical emergencies, visits to a related provider for treatment, or other releases required or allowed by law.
With your authorization
Your authorization. We may use or disclose health information only with your written permission, except as described above. If you give written permission, you may withdraw it at any time by notifying us in writing. A form to revoke your permission is available from the Allina facility where you received services, or from the contact listed on this page. Your permission will end when we receive the signed form or when we have acted on your request.
Questions and complaints
If you have questions about our privacy practices, please contact us at the appropriate office listed on the previous page. If you think your privacy rights have been violated, or if you disagree with a decision about any of your rights, you may file a complaint with us at the appropriate contact office.
You also may send a written complaint to the U.S. Department of Health and Human Services – Office of Civil Rights (OCR). We will give you the address to file a complaint upon request. Please know you will not be penalized for filing a complaint.
Organizations covered by this notice
This Notice applies to the privacy practices of the Allina Hospitals & Clinics listed below, their related sites and health professionals who provide care to you at these sites. These businesses are part of an organized health care system. We may share health information within our system for treatment, payment or health care operations.
Allina Home Care, Hospice & Palliative Care
Allina Home Oxygen & Medical Equipment
Minneapolis Cardiology Associates
Crosby Cardiovascular Services
Midwest Internal Medicine
St. Francis Regional Medical Center
Southwest Surgical Center
United Neurosurgery Association
River Falls Area Hospital, also part of the organized health care system, uses a different Notice because it is located in Wisconsin.
This Notice takes effect April 14, 2003 and applies to all health information we have. It will remain in effect until we replace it. We may change the terms of this Notice and make the new terms applicable for all health information we have. This includes health information we created or received before we made the changes to our Notice. We will make any revised Notice available in hard copy and display it in our facilities and on our web site. Also, you can request the revised Notice in person or by mail.
Source: Allina Hospitals & Clinics
First published: 04/13/2003
Last updated: 05/02/2005
Reviewed by: Allina Privacy and Security Compliance