Notice of Privacy Practices for Foundation First Services
Your Information. Your Rights. Our Responsibility.
This notice outlines how your health information may be used and shared, and how you can access it. Please read it carefully. You have privacy rights under HIPAA (Health Insurance Portability and Accountability Act), as well as rights under the Minnesota Health Records Act and the Minnesota Government Data Practices Act.
Why We Ask for Your Information
- To distinguish you from others with the same name.
- To ensure you receive the services you’re eligible for.
- To provide services to you.
- To receive payment for services rendered.
Do You Have to Answer Our Questions?
- Generally, the law does not require you to provide this information.
What Happens If You Don’t Answer Our Questions?
- We require certain information to provide you with services. Without this information, we may not be able to assist you.
Your Rights
Regarding your health information, you have several rights, and this section outlines those rights, as well as our responsibilities to you.
Request a Copy of Your Health Record
- You can request a copy of your health record, either electronically or in paper form.
- We will provide a copy or summary of your health information, usually within 30 days of your request.
Request a Copy of This Privacy Notice
- You may ask for a paper copy of this privacy notice at any time, and we will provide it promptly.
Choose Someone to Act for You
- If you’ve granted someone medical power of attorney or if someone is your legal guardian or conservator, they can exercise your rights and make decisions regarding your health information.
File a Complaint if You Believe Your Privacy Rights Have Been Violated
- If you believe your privacy rights have been violated, you can file a complaint by contacting our staff or Foundation First Services President, Abdifitah Mohamed at 651-307-5723 or via email at foundationfirstservices@hotmail.com
- You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by mailing a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201 or by calling 1-877-696-6775.
- We will not retaliate for filing a complaint.
Our Uses and Disclosures
Here’s how we typically use or share your health information, following necessary consents under the Minnesota Health Records Act.
To Treat You
- We use your health information to provide you with services and may share your information with other providers involved in your care.
- Example: A doctor treating you may request your health information for coordinated care.
To Run Our Organization
- We use and share your health information to operate and improve our services, and to contact you when necessary.
- Example: We manage your treatment and services using your health information.
- We may share health information with business associates who help us provide services, under a business associate agreement.
For Billing
- We can use and share your health information to bill health plans or other entities for services provided.
- Example: We provide your health information to your insurance company to ensure payment for your services.
To Comply With the Law
- We will share your information if required by state or federal law, including with the Department of Health and Human Services to verify our compliance with federal privacy laws.
To Address Legal and Government Requests
- We can use or share your health information:
- For workers’ compensation claims.
- For law enforcement purposes or with law enforcement officials.
- With health oversight agencies for authorized activities.
- For special government functions, such as military or national security services.
- For mandatory reporting under the Minnesota Vulnerable Adults Act.
In Response to Legal Actions
- We can share health information in response to a court order, subpoena, or other legal processes.
In Collaboration with Medical Examiners or Funeral Directors
- We can share health information with a coroner or medical examiner when an individual passes away.
Our Responsibilities
We are required by law to protect the privacy and security of your health information.
- We will notify you promptly if a breach occurs that may compromise the security or privacy of your information.
- We must follow the duties and privacy practices outlined in this notice and provide you with a copy.
- We will not use or share your information for any other purpose unless you give us written consent. If you grant us permission, you can change your mind at any time by notifying us in writing.