Privacy Policy
Effective Date: March 1, 2025
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
Your Rights Regarding Your Health Information
You have the following rights regarding your health information:
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your health information, with some exceptions. We will provide a copy of your health information within 30 calendar days of receiving a written request. [Minn. Stat. § 144.292, Subd. 5]
Right to Amend: If you believe your health information is incorrect or incomplete, you have the right to request an amendment. We may deny your request, but we will explain the reasons in writing within 60 calendar days.
Right to an Accounting of Disclosures: You have the right to request a list of disclosures we have made of your health information in the past six (6) years.
Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. For example, you can ask us not to use or share certain information for treatment, payment, or operations (TPO). While we are not required to agree to your request, we will consider it. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for payment or our operational purposes with your health insurer. We will honor this request unless we are required by law to share such information. Minnesota law requires consent for the disclosure of treatment, payment, or operational information. [Minn. Stat. § 144.293, Subd. 2]
Right to Confidential Communications: You have the right to request that we communicate with you in a certain way or at a specific location.
Right to a Copy of this Notice: You have the right to request a paper copy of this Notice, even if you have agreed to receive this Notice electronically.
Right to File a Complaint: If you believe your privacy rights have been violated, you can file a complaint with us, the Minnesota Attorney General’s Office, or the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint. To file a complaint, contact the Minnesota Attorney General’s Office or the U.S. Department of Health and Human Services Office for Civil Rights at:
U.S. Department of Health and Human Services Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
Call: 1-877-696-6775
Visit: www.hhs.gov/ocr/privacy/hipaa/complaints
How We Use and Disclose Your Health Information
We may use and disclose your health information for the following purposes:
Treatment: We may use your health information to provide you with mental health treatment and services. We may share your information with other professionals involved in your care, including providers within our network. Your consent is required for us to share your information outside our network unless it’s an emergency and you cannot provide consent.
Payment: We may use your health information to obtain payment for the services we provide. Your consent is required for us to share your health information with health plans or other entities.
Health Care Operations: We may use your health information for our business activities such as quality assessment, improvement, and practice management. We may use your health information to manage your mental health treatment and services and contact you when necessary. Your consent is required for us to share your health information with other providers for their own health care operations.
Required by Law: We may disclose your health information when required by federal, state, or local law.
Responding to Legal Actions: We can share your health information in response to a court or administrative order, or subpoena (please consult legal counsel if necessary).
Public Health and Safety: We may disclose your health information to prevent or control disease, report adverse reactions to medications, report suspected abuse or neglect, or respond to serious threats to public safety.
Reporting: We may use or disclose your health information for reporting purposes, as necessary.
Research: Under certain conditions, we may use or disclose your health information for health research purposes. [Minn. Stat. § 144.295, Subd. 1]
Your consent is required for us to share your information in the following cases:
Psychotherapy Notes
Marketing
Sale of Your Health Information
Additional protections apply to our use and disclosure of certain of your health information:
Reproductive Health Care Information: We will never use or disclose your health information to conduct a criminal, civil or administrative investigation or impose criminal, civil or administrative liability on any person for the mere act of seeking, obtaining, providing or facilitating reproductive health care, or to identify any person for such purposes. For example, we will not share your information with a law enforcement agency investigating legally provided reproductive health care. An attestation that your information will not be used for any such purpose is required for us to share your reproductive health care information for health oversight activities, judicial and administrative proceedings, law enforcement purposes and to coroners, medical examiners and funeral directors with respect to deceased persons.
Substance Use Disorder Treatment Record: Your consent or a valid court order is required to for us to use or disclose your substance use disorder treatment records or testimony relaying the content of such records for a criminal, civil, administrative or legislative proceeding against you.
Certain persons or entities who receive your health information as permitted under this Notice may redisclose your information, in which case it may no longer be protected by federal health privacy laws.
Your Health Information Privacy
We are committed to protecting the privacy of your health information. We will not use or disclose your health information without your consent, except as outlined in this Notice.
Our Responsibilities
Maintain Privacy and Security: We are required by law to protect the privacy and security of your health information.
Inform of Breach: If a breach occurs that compromises the privacy or security of your information, we will notify you promptly.
Follow Notice Practices: We are required to follow the privacy practices outlined in this Notice. We will not use or share your information other than as described here unless you provide written consent. You may change your mind at any time by notifying us in writing.
For more information, visit: https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html.
Changes to the Terms of this Notice
We may update this Notice, and the changes will apply to all health information we have about you. The updated Notice will be available upon request, in our office, and on our website.
Contact Us
If you have any questions about this Notice or your rights, please contact us at:
Domestic Abuse Project
Director of Programs, 1121 NE Jackson Street, Suite 105, Minneapolis, MN 55413
Phone: 612-874-7063
Email: Dap@mndap.org
For further information regarding your rights, you may contact the U.S. Department of Health and Human Services at 1-877-696-6775.