NOTICE OF PRIVACY PRACTICES
MinnesotaHelp.info^TM Long-term Care Choices

This information is available in other forms to people with disabilities by contacting 651-431-2500 or 1-800-882-6262. TDD users can call 711 or 1-800-627-3529. Speech to Speech Relay users can call 1-877-627-3848.

This notice describes how medical information and other private information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

You have privacy rights under the Minnesota Data Practices Act and the federal Health Insurance Portability and Accountability Act (HIPAA). These laws protect your privacy, but also let us give information about you to others if a law requires it. We may tell you before we give the information to another organization.

Why do we ask you for this information?
The Minnesota Board on Aging uses the information to create an account that you can access at a later date. You do not need to use the name of a real person to Register on this site. Usage of the tool is not dependent on any personal information.

Do you have to answer the questions we ask?
You can refuse to put any personal information in this tool. Usage of the tool is not dependent on any personal information.

With whom may we share the information about you?
Your name and other identifying information will not be made public and will remain private. We will not share private information about you with anyone other than the Minnesota Board on Aging or its designated vendors who maintain the Web site, unless required by law.

Why do I need to be notified of this when I use MinnesotaHelp.info^TM Long-term Care Choices?
We want you to be aware of what we do with the information we collect from you when assisting you. Even though you are actively seeking help from us and are voluntarily providing this information, we want you to know how the information we collect is used.

You have rights regarding your information.

• You may ask if we have any information about you and get copies. You will have to pay for the copies.
• If you do not understand the information, you may ask to have it explained to you.
• You may give other people permission to see and have copies of private data about you, including protected health information (referred to below, collectively, as "protected information").
• If we have collected protected information about you, we may use it only for the purposes that we have listed in this notice.
• You may question the accuracy of any information we have about you.
• You have the right to ask us to share your protected health information with you in a certain way or in a certain place. For example, you may ask us to send health information to your work address instead of your home address. You must make this request in writing. If we find that your request is reasonable, we will grant it.
• You can ask us to restrict uses or disclosures of your protected health information. Your request must be in writing. You must explain what information you want to restrict from being disclosed and to whom you want these restrictions to apply. You can request to end these restrictions at any time by calling or writing to us.
• You have the right to receive a record of certain types of disclosures of your health information. We must keep a record of certain disclosures of your health information for six years from the date it was shared. If you want a copy of this record, you must send a request in writing to the Privacy Official listed below.

What if you believe the information we have about you is wrong?
Send your concerns in writing, telling us why the information is not accurate or complete. You may send your own explanation which will be attached any time that information is shared with another agency.

What if you believe your privacy rights have been violated?
You may complain if you believe your privacy rights have been violated. You cannot be denied service or treated badly because you have made a complaint. If you believe that your medical privacy was violated by using MinnesotaHelp Long-Term Care Choices, you may send a written complaint to the federal Office of Civil Rights at:

U.S. Department of Health and Human Services
Office for Civil Rights - Region V
233 N. Michigan Avenue, Suite 240
Chicago, IL 60601
(312) 886-2359 (Voice)
(312) 353-5693 (TTY/TDD)
(312) 886-1807 (Fax)

If you think the Minnesota Board on Aging has violated your privacy rights, you may send a written complaint to the U.S. Department of Health and Human Services at the address above, or to:

Attn: Privacy Official
Minnesota Board on Aging
P.O. Box 64976
St. Paul, MN 55164-0976
phone (651) 431-2500

May 11, 2006