Privacy

For Treatment: We may use and share information about you to coordinate and manage your care and treatment. For example, a Wilder healthcare or mental health professional may share your information with another Wilder healthcare or mental health professional for consultation or a referral. Under Minnesota law, your approval is required in order for us to share your information with another healthcare provider outside of Wilder, except as described in this Notice.

For Billing and Payment: With your approval, we may use and share your information so that we and others who have provided care to you can bill and collect payment for these services. For example, we may share your information with your health plan, Medicare or Medical Assistance to get approval before providing treatment and to ensure Wilder will get payment for the care you received.

For Business Reasons: We may use and share information about you for business reasons that could include: to follow laws and regulations, to train and educate, to improve care and service, to budget and plan, to audit, to maintain our computer systems, to evaluate staff, to decide if we should offer more services, and to find out how satisfied you are. If we share your information with someone else in order for them to do these tasks on our behalf, they must agree in writing to also protect and restrict the use of your information.

To Inform People Involved in or Paying for Your Care: Wilder will typically get your written approval before giving information to a family member or friend involved in your care. However, if you are not able to give your approval, we will decide what, if any, information to share. We may also share information with a person helping to pay for your care. In each of these cases, you may limit what health information we share. For example, we may provide limited medical information to allow a family member to pick up a prescription for you.

To Contact You about Appointments, Insurance, and Other Matters: Wilder may contact you by mail or phone (including leaving messages on a home answering machine or voice mail) for many reasons including to: remind you about an appointment, discuss your care, to ask about insurance, billing, or payment; follow up on your care, or ask how well we cared for you. If you object to a specific method of contact, please let us know so we may accommodate your request. With your consent, Wilder may be able to send you a text message for appointment reminders only.

For Research: We can use or share your information for health research if you do not object. To Comply with the Law & for Legal Proceedings: We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it want to see that we’re complying with federal privacy laws. We may disclose information about you to report suspected abuse, neglect, or domestic violence; for a legal proceeding in response to a court or protective order. Only in very limited circumstances will Wilder release information about you in response to a subpoena.

For Fundraising: Wilder may contact you for fundraising efforts, but you can tell us not to contact you again.

For Special Situations: These situations include when required by law; for public health activities, for health oversight activities; for law enforcement purposes or with a law enforcement official, as permitted or required by law; to coroners or medical examiners, as permitted by law; to avert a serious threat to health or safety (including Duty to Warn); for certain specialized government functions such as military, national security, and presidential protective services; for workers’ compensation purposes; or to government agencies or private disaster relief or assistance organizations engaged in disaster relief activities.

Other Uses of Your Information: Wilder will not use or share your information for reasons other than those described in this Notice unless you agree in writing. For example, you may want us to give your information to your employer or your child’s school. We will only do this with your written approval. Likewise, we would never sell your information, use it for marketing, or share psychotherapy notes without your written approval.

Right to Receive a Copy of this Notice: You have a right to receive a paper copy of this notice at any time.

Right to Review and Get a Copy of Your Information: You may ask to review or receive a copy of your medical records, unless the law otherwise protects the information you are requesting. If your information is maintained in an electronic format, you have the right to request an electronic copy. We will make every effort to provide your information in the format you request, if it is readily producible. This request should be made in writing using a form that Wilder will provide. If your request to review or receive a copy of your medical record is denied, you have the right to have the denial reviewed by a health care professional. Wilder reserves the right to charge you for copying or producing an electronic copy of your information consistent with limits established by state and federal law.

Right to Ask for a Change in Your Medical Record: If you think that our information about you is incorrect or incomplete, you may make a written request asking us to make the correction. You must indicate why you are asking for the correction. If we agree, we will tell you and correct your record. We cannot take anything out of the record and can only add new information to complete or correct existing information. With your help, we will notify others who have the incorrect or incomplete information. If we deny your request we will inform you why within 60 days. You may indicate in writing that you disagree with the denial and we will include this in your medical record and in future releases of your record.

Right to Ask for Confidential Communication: You have the right to ask us to contact or communicate with you in a certain way or at a certain place. For example, you can ask that we contact you only at work or only using a specific address. Your request must be in writing and must say how or where you wish to be contacted. You must provide an address to send bills for payment. We will accept all reasonable requests. However, if we are unable to contact you using the ways or locations you have requested, we may contact you using any information we have.

Right to Ask for Limits on the Use and Sharing of Your Information: You may request in writing that Wilder not use your information in certain ways or for certain purposes, including treatment, payment, or business reasons. You may also ask us to limit the information we share about you with someone involved in your care or paying for your care. However, Wilder has the right to refuse your request if we believe it would affect your care. If we do agree we will follow your request unless the information is needed to treat you in an emergency.

Right to Limit Sharing of Information with Health Plans: If you pay for a service out-of-pocket and in full, you can ask us not to share that information with your health plan or insurer. We will say “yes” unless a law requires us to share this information. To make this request, you must ask before you receive any services. Let us know you want to limit sharing with your health plan when you schedule your appointment. Any information shared before we receive payment in full, such as information for pre-authorizing your insurance, may be shared. Also, we can limit information only for an episode of care (services provided during a single visit). If you want to limit information beyond an episode of care, you must pay in full for each future visit.

Right to Ask for a List of When Your Medical Information Was Shared: Sometimes Wilder must share your medical information with others, usually because we are required by law to do so. To find out with whom, if anyone, we have shared your information, submit a request in writing, and indicate what period of time you want to know about. This period of time may not be longer than six years from your request. The list will not include information that we are not required to track, such as disclosures for treatment, payment, or business reasons; to you or someone representing you, that you authorized us to make; or made in an instance where the law does not require or permit it.

Right to Notice in Case of a Breach: You have a right to know if your information has been breached. We will follow what the law requires to let you know if your information has been shared in error.

Right to Take Back Your Written Permission: If you have given permission for use or sharing of your health information, you may take back that permission, in writing, at any time. If you take back your permission, Wilder will no longer use or share your health information for the reasons listed on your written authorization. Of course, we cannot take back information already shared with your permission.

If you are applying for or receiving services (including diagnosis, treatment, or referral) for drug or alcohol abuse your privacy rights are additionally protected by the Confidentiality of Alcohol and Drug Abuse Patient Records (42 CFR part 2). Generally if you are applying for or receiving services for drug or alcohol abuse, we may not disclose any information identifying you as receiving these services or as having a substance use disorder, unless:

• We obtain your written authorization;
• The disclosure is made to medical personnel in a medical emergency;
• The disclosure is made to qualified researchers without your written authorization under certain limited circumstances set forth in 42 C.F.R. Part 2. When required by law, we will obtain an agreement from the researcher to protect the privacy and confidentiality of your information;
• The disclosure is made to a qualified service organization that performs certain treatment services (such as lab analyses) or business operations (such as quality assurance) for us. Wilder will obtain the qualified service organization’s agreement in writing to protect the privacy and confidentiality of your information in accordance with Federal and State law;
• The disclosure is made to a government agency or other qualified non-government personnel to perform an audit or evaluation of us. Wilder will obtain an agreement in writing from any non-government personnel to protect the privacy and confidentiality of your information in accordance with Federal and State law;
• The disclosure is allowed by a court order and permitted under Federal and State confidentiality laws and regulations;
• The disclosure is made to report a crime committed by a client either at Wilder or against any person who works for Wilder or about any threat to commit such a crime; or
• The disclosure is made to report child abuse or neglect to appropriate State or local authorities.

If you want more information about your privacy rights, wish to file a complaint because you believe your privacy rights have been violated, or you disagree with a decision that we made about access to or disclosure of your medical information, you may contact Wilder:

Director of Compliance/Privacy Officer
Amherst H. Wilder Foundation
451 Lexington Parkway North
St. Paul, Minnesota 55104
(651) 280-2477 | compliance@wilder.org

Filing a complaint will not affect the quality of the services you receive from Wilder and you will not be retaliated against for filing a complaint.

If you believe your privacy rights have been violated, you may also file a complaint with the:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6755
www.hhs.gov/ocr/privacy/hipaa/complaints/

Violation of federal law and regulations on Confidentiality of Substance Use Disorder Records is a crime and suspected violations of 42 CFR Part 2 may be reported to the United States Attorney – District of Minnesota at 651-848-1950.