THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION UNDER THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA).

Koochiching County provides many types of services, such as health and social services. County staff must collect information about you to provide these services. Koochiching County knows that information we collect about you and your health is private. The County is required to protect this information by Federal and State law. We call this information “protected health information (PHI).”

The Notice of Privacy Practices will tell you how the County may use or disclose information about you in provision of health care plans and as a health care provider. Not all situations will be described. Koochiching County is required to give you a notice of our privacy practices for the information we collect and keep about you under the Health Insurance Portability and Accountability Act. Certain exclusions exist under HIPAA but are governed under other state and federal law.

*Koochiching County May Use and Disclose Information Without Your Authorization:

• For Treatment. The County may use or disclose information with health care providers who are involved in your health care. For example, information may be shared to create and carry out a plan for your treatment.

• For Payment. The County may use or disclose information to get payment or to pay for the health care services you receive. For example, The County may provide PHI to bill your health plan for health care provided to you.

• For Health Care Operations. The County may use or disclose information in order to manage its programs and activities. For example, The County may use PHI to review the quality of services you receive.

• Appointments and Other Health Information. The County may send you reminders for medical care or checkups. The County may send you information about health services that may be of interest to you.

• For Public Health Activities. The County is the public health agency that keeps and updates vital records and tracks some diseases.

• For Health Oversight Activities. The County may use or disclose information to inspect or investigate health care providers.

• As Required by Law and For Law Enforcement. The County will use and disclose information when required or permitted by federal or state law or by a court order.

• For Abuse Reports and Investigations. The County is required by law to receive and investigate reports of abuse.

• For Government Programs. The County may use and disclose information for public benefits under other government programs. For example, The County may disclose information for the determination of Supplemental Security Income (SSI) benefits.

• To Avoid Harm. The County may disclose PHI to law enforcement in order to avoid a serious threat to the health and safety of a person or the public.

• For Research. The County uses information for studies and to develop reports. These reports do not identify specific people.

• Disclosures to Family, Friends, and Others. The County may disclose information to your family or other persons who are involved in your medical care. You have the right to object to the sharing of this information.

• Other Uses and Disclosures Require Your Written Authorization
For other situations, the County will ask for your written authorization before using or disclosing information. You may cancel this authorization at any time in writing. The County cannot take back any uses or disclosures already made with your authorization.

• Other Laws Protect PHI. Many of the County programs have other laws for the use and disclosure of information about you. For example, you must give your written authorization for the County to use and disclose your mental health and chemical dependency treatment records.

Your PHI Privacy Rights
When information is maintained by Koochiching County as a public health agency, the public health records are governed by other State and Federal laws and are not subject to the rights described below.

• Right to See and Get Copies of Your Records. In most cases, you have the right to look at or get copies of your records. You must make the request in writing. You may be charged a fee for the cost of copying your records.

• Right to Request a Correction or Update of Your Records. You may ask the County to change or add missing information to your records if you think there is a mistake. You must make the request in writing, and provide a reason for your request.

• Right to Get a List of Disclosures. You have the right to ask the County for a list of disclosures made after April 14, 2003. You must make the request in writing. This list will not include the times that information was disclosed for treatment, payment, or health care operations. The list will not include information provided directly to you or your family, or information that was sent with your authorization.

• Right to Request Limits on Uses or Disclosures of PHI. You have the right to ask that the County limit how your information is used or disclosed. You must make the request in writing and tell the County what information you want to limit and to whom you want the limits to apply. The County is not required to agree to the restriction. You can request that the restrictions be terminated in writing or verbally.

• Right to Revoke Permission. If you are asked to sign an authorization to use or disclose information, you can cancel that authorization at any time. You must make the request in writing. This will not affect information that has already been shared.

• Right to Choose How We Communicate with you. You have the right to ask that the County share information with you in a certain way or in a certain place. For example, you may ask the County to send information to your work address instead of your home address. You must make this request in writing. You do not have to explain the basis for your request.

• Right to File a Complaint. You have the right to file a complaint if you do not agree with how the County has used or disclosed information about you.

• Right to Get a Paper Copy of this Notice. You have the right to ask for a paper copy of this notice at any time.

How to Contact the County to Review, Correct, or
Limit Your Protected Health Information (PHI)

You may contact the County office you are receiving services from or the County Privacy Officer at the address listed at the end of this notice to:

• Ask to look at or copy your records
• Ask to correct or change your records
• Ask to limit how information about you is used or disclosed
• Ask for a list of the times the County disclosed information about you
• Ask to cancel your authorization

The County may deny your request to look at, copy or change your records. If the County denies your request, the County will send you a letter that tells you why your request is being denied and how you can ask for a review of the denial. You will also receive information about how to file a complaint with the County or with the U.S. Department of Health and Human Services, Office for Civil Rights.

How to File a Complaint or Report a Problem
You may contact any of the people listed below if you want to file a complaint or to report a problem with how the County has used or disclosed information about you. Your benefits will not be affected by any complaints you make. The County cannot retaliate against you for filing a complaint, cooperating in an investigation, or refusing to agree to something that you believe to be unlawful.

U.S. Department of Health and Human Services – Office for Civil Rights:
Region V - IL, IN, MI, MN, OH, WI
Office for Civil Rights
U.S. Department of Health & Human Services
233 N. Michigan Ave. - Suite 240
Chicago, IL 60601
(312) 886-2359; (312) 353-5693 (TDD)
(312) 886-1807 FAX

Koochiching County Privacy/Client Information Officer:
County Coordinator
Koochiching County Courthouse
715 4th Street
International Falls, MN 56649
Phone: 218-283-1152

County Attorney
Koochiching County Courthouse
715 4th Street
International Falls, MN 56649
Phone: 218-283-1130

In the future, the County may change its Notice of Privacy Practices. Any changes will apply to information the County already has, as well as any information the County receives in the future. A copy of the new notice will be posted and provided as required by law. *You may ask for a copy of the current Notice anytime you visit a County facility.

For More Information
If you have any questions about this notice or need more information, please contact the County Office you are receiving services from or the Koochiching County Privacy Officer.
Thank you!