Clay County Public Health

Clay County Public Health Notice of Privacy Practice

This notice describes how medical information about you may be used and disclosed please review carefully.

Use and Disclosure of Health Information

Clay county Public Health may use your health information for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. The Agency has established policies to guard against unnecessary disclosure of your health information.

The following is a summary of the circumstances under which, and purposes for which, your health information may be used and disclosed: To Provide Services. The Agency may use your health information to coordinate care within the Agency and with others involved in your care, such as your attending physician and other health care professionals who have agreed to assist the Agency in coordinating care. For example, physicians involved in your care will need information about your health in order to prescribe appropriate medications. The Agency also may disclose your health care information to individuals outside of the Agency involved in your care including pharmacists, suppliers of medical equipment, other health care professionals, or the Minnesota Department of Health Communicable Disease Program.

To Obtain Payment. The Agency may include your health information in invoices to collect payment from third parties for the care you receive from the Agency. For example, the Agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the Agency. The Agency also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for services that will be provided to you.

To Conduct Agency Operations. The Agency may use and disclose health information for its own operations in order to facilitate the function of the Agency and as necessary to provide quality care to all of the Agency clients. Agency operations includes such activities as:

• Quality assurance and improvement activities, job performance and review activities.
• Activities designed for health promotion and disease prevention to improve health.
• Case management and care coordination.
• Outreach, screening and referral activities.
• Arranging with health care providers and clients with information about service and treatment options and other related functions that do not include treatment.
• Training programs including those in which students, trainees or practitioners in health care learn under supervision.
• Review and auditing, including compliance reviews.
• Minnesota Department of Health licensing activities.
• Agency program planning and evaluation.
• Business management and general administrative activities.

For Fundraising activities. Your name will not be released for fundraising activities without your written consent.

 For Appointment Reminders. The Agency may use and disclose your health information to contact you as a reminder for immunizations, well child checkups and reminders that you have an appointment for a home or office visit.

The following is a summary of the circumstances under which, and purposes for which, your health information may also be used and disclosed: When Legally Required. The Agency will disclose your health information when it is required to do so by any Federal, State or local law.

Disease Prevention and Control. The Agency may disclose to the Minnesota Department of Health, if you or your family have any communicable disease.

 To Report Abuse and or Neglect. The Agency is required to notify government authorities if the agency believes a client is the victim of abuse and or neglect. The Agency will make this disclosure only when specifically required or authorized by law or when the client agrees to the disclosure. The Agency is required to release information regarding when child abuse and or neglect is suspected or in a Vulnerable Adult situation to the Common Entry Point (CEP) at 701-235-3620, or the county sheriff's office or to the county social service agency, as appropriate. The Agency is required to release information as requested by the county social service child protection or vulnerable adult workers as part of their investigations.

To Conduct Health Oversight Activities. The Agency may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. The Agency, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.

For Law Enforcement Purposes. As permitted or required by State law, the Agency may disclose your health information to a law enforcement official for certain law enforcement purposes as follows:

• For the purpose of identifying or locating a suspect, fugitive, material witness or missing person.
• Under certain limited circumstances, when you are the victim of a crime.
• To a law enforcement official if the Agency has a suspicion that your death was the result of criminal conduct including criminal conduct at the Agency.
• In an emergency in order to report a crime.

To Coroners And Medical Examiners. The Agency may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

Authorization to Use or Disclose Health Information

Other than is stated above, the Agency will not disclose your health information other than with your written permission (authorization). If you or your representative give permission to the Agency to use or disclose your health information, you may revoke that permission in writing at any time.

Your Rights with Respect to Your Health Information 

You have the following rights regarding your health information that the Agency maintains: Right to request restrictions. You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the Agency's disclosure of your health information to someone who is involved in your care or the payment of your care. However, the Agency is not required to agree to your request. If you wish to make a request for restrictions, please contact Kathy McKay, Administrator, Clay county Public Health, telephone 218-299-5220.

Right to receive confidential communications. You have the right to request that the Agency communicate with you in a certain way. For example, you may ask that the Agency only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact Kathy McKay, Clay county Public Health, telephone 218-299-5220. The Agency will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

 Right to inspect and copy your health information. You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to Kathy McKay, Clay County Public Health, telephone 218-299-5220. If you request a copy of your health information, the Agency may charge a reasonable fee for copying and assembling costs associated with your request.

Right to amend health care information. You or your representative have the right to request that the Agency amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by the Agency. A request for an amendment of records must be made in writing to Kathy McKay, Clay county Public Health, telephone 218-299-5220. The Agency may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by the Agency, if the records you are requesting are not part of the Agency's records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of the Agency, the records containing your health information are accurate and complete.

Right to an accounting. You or your representative have the right to request an accounting of disclosures of your health information made by the Agency for certain reasons, including reasons related to public purposes authorized by law. The request for an accounting must be made in writing to Kathy McKay, Clay county Public Health, telephone 218-299-5220. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of 6 (6) years. The Agency would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

Right to a paper copy of this notice. You or your representative have a right to a separate paper copy of this Notice at any time even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact Kathy McKay, Clay county Public Health, telephone 218-299-5220.

Duties of the Agency

The Agency is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The Agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If the Agency changes its Notice, the Agency will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative have the right to express complaints to the Agency and to the Secretary of Department of Health and Human Services if you or your representative believe that your privacy rights have been violated. Any complaints to the Agency should be made in writing to Kathy McKay, Clay county Public Health, telephone 218-299-5220. The Agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

Contact Person

The Agency has designated Kathy McKay, Administrator, as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at:

Clay County Public Health
715 N. 11th Street
Suite 303
Moorhead, MN 56560
Phone: 218-299-5220.

If you believe that your health information privacy rights have been violated, you may file a complaint at the address below: 

Privacy Official
Minnesota Department of Human Services
444 Lafayette Road N.
St. Paul, MN 55155-3813
Phone: 651-296-5764

Office of Civil Rights
Medical Privacy, Complaint Division
U.S. Department of Health and Human Services
200 Independence Avenue SW.
HHH Building, Room 509H
Washington, D.C. 20201
Phone: 866-627-7748
TTY: 866-788-4989

Effective Date

This Notice is effective April 14, 2003.

If you have any questions regarding this notice, please contact: Kathy McKay, Clay county Public Health, Telephone 218-299-5220.